1/121. Antidepressant exacerbation of spasticity.patients with spinal cord injury (SCI) may develop depression. This may be related to adjustment to living with an SCI in addition to dealing with complications of the injury, such as spasticity. Pharmacologic treatment of depression can be difficult because of neurochemical and receptor changes that are associated with SCI. Newer antidepressant agents are purported to have selective activity by alteration of serotonergic neurotransmission. A case report is presented that illustrates exacerbation of spasticity by this family of antidepressant medications. Mechanisms possibly explaining this exacerbation of spasticity are the effects of serotonin on motor neuron and reflex activity, denervation supersensitivity, and the serotonin syndrome. Understanding the relationship between serotonergic systems and spasticity can be important in treating depression in patients with spasticity.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/121. Apneustic breathing in children with brainstem damage due to hypoxic-ischemic encephalopathy.To confirm the presence of apneusis in patients with hypoxic-ischemic encephalopathy and to clarify which factors influence their respiratory patterns, polygraphic studies were performed on two patients. Apneusis was clinically suspected in both patients who had severe brainstem damage. In one subject, inputs of vagal afferents from the gastrointestinal tract and the urinary bladder often resulted in extreme tachypnea instead of apneusis. lung inflation facilitated expiration during inspiratory arrest. Expiration preceded a periodic inhibition of rigospastic discharge in the right biceps muscle. In the other subject, prolonged inspiratory pauses with cyanosis occurred with or without preceding epileptic seizure. Both phenytoin dose reduction and treatment with tandospirone, a serotonin-1A agonist, were effective in improving the respiratory distress in this subject.- - - - - - - - - - ranking = 2.5301405170368keywords = brain (Clic here for more details about this article) |
3/121. Ziconotide for the treatment of severe spasticity after spinal cord injury.Spasticity is a major clinical manifestation of spinal cord injury and upper motor neuron syndrome.- - - - - - - - - - ranking = 2.5keywords = injury (Clic here for more details about this article) |
4/121. High-intensity cycling exercise after a stroke: a single case study.Aerobic exercise training has demonstrated positive effects after brain injury. However, therapists express concern regarding the use of effortful exercise in individuals presenting with spasticity or involuntary muscle activity. This study aimed to address this concern and to evaluate whether an intervention of maximal intensity cycling exercise impaired an individual's ability to actively extend his hemiparetic elbow. Using a single case design, it was shown that active elbow extension improved during the period of this investigation, and was not impaired immediately following maximal cycling exercise.- - - - - - - - - - ranking = 14.976042853124keywords = brain injury, brain, injury (Clic here for more details about this article) |
5/121. An autopsy case of classical Pelizaeus-Merzbacher's disease.A girl aged 8 years and 10 months at death had shown signs of a slowly progressive neurological disease with onset in early infancy. The main clinical features were nystagmus, spastic paraplegia, amd mental deterioration. Pathological examination of the brain showed severe demyelination with perivascular preservation of mylein islands, presenting a tigroid pattern. The patient is the second case of classical Pelizaeus-Merzbacher's disease in japan proven by autopsy.- - - - - - - - - - ranking = 0.50602810340736keywords = brain (Clic here for more details about this article) |
6/121. Episodic coma in a new leukodystrophy.Among the leukodystrophies of a hypomyelinating nature, childhood ataxia with diffuse central nervous system hypomyelination exhibits the unique feature of rapid decrease in mental status after relatively minor head injuries or otherwise noncomplicated febrile illnesses. This article reports the case of a child with progressive spastic quadriparesis in whom unconsciousness developed repeatedly as a result of minor head trauma and required prolonged critical-care nursing. Although cognition is believed to be relatively preserved in this disorder, this child developed progressive cognitive decline. A detailed review of the literature is presented along with discussion of the potential mechanisms of neurologic deterioration.- - - - - - - - - - ranking = 0.00091515050291652keywords = trauma (Clic here for more details about this article) |
7/121. spinal cord injury medicine. 2. Medical complications after spinal cord injury: Identification and management.This is a self-directed learning module that reviews medical complications associated with spinal cord injury (SCI). It is part of a chapter on SCI medicine in the Self-Directed Physiatric Educational Program for practitioners and trainees in physical medicine and rehabilitation. This article includes discussion of common medical complications that impact rehabilitation and long-term follow-up for individuals with SCI. Issues addressed include the rehabilitation approach to SCI individuals with pressure ulcers, unilateral lower-extremity swelling (deep venous thrombosis, heterotopic ossification, fractures), along with the pathophysiology, assessment, and treatment of spasticity, autonomic dysreflexia, orthostatic hypotension, and pain. overall ARTICLE OBJECTIVE: To describe diagnostic and treatment approaches for medical complications common to individuals with SCI.- - - - - - - - - - ranking = 4.5keywords = injury (Clic here for more details about this article) |
8/121. Chronic meningoencephalomyelitis with spastic spinal paralysis: a case report.A case of chronic meningoencephalomyelitis in a 48-year-old housewife is presented. The onset was characterized by spastic paralysis of the lower extremities. The course was progressive with repeated remissions and exacerbations, and the patient died approximately seven years after the onset of disease. Laboratory tests showed slightly increased cell count in the spinal fluid, accelerated sedimentation rate, positive CRP and RA, and increased ASLO and gamma globulin levels. Neuropathologic examination revealed such changes as perivascular cellular infiltration, glial nodules, poorly demarcated demyelination and recent necrosis in the spinal cord and basal ganglia. Only mild inflammatory findings were noted in the telencephalon and brain stem. The clinico-pathologic findings in this case supported a diagnosis of chronic meningoencephalomyelitis which could not be classified as any known type of encephalomyelitis.- - - - - - - - - - ranking = 0.50602810340736keywords = brain (Clic here for more details about this article) |
9/121. Non-drug induced spasticity reduction achieved by coordination dynamic therapy in CNS injury.In two patients with severe central nervous system (CNS) lesions it could be demonstrated that spasticity reduction can be achieved by the coordination dynamic therapy method without administration of spasmolytic drugs. The reduction of spasticity in the short- and long-term memory was measured with the coordination dynamic recording method. When performing rhythmic coordinated movements, the mainly extensor spasticity reduced in the first case in the short-term memory within 35 min of assisted exercising by approximately 68% (easy treatable case). In the second case spasticity reduced in the short-term memory within 58 min of exercising by 15 up to 28% and in the long-term memory within 6 months by 16% (difficult treatable case) as judged by the improvement of the coordination dynamics when exercising on the special coordination dynamic therapy device. Reduction of spasticity without administration of drugs could be achieved in all of the more than 100 patients undergoing coordination dynamic therapy.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
10/121. Constant involvement of the Betz cells and pyramidal tract in amyotrophic lateral sclerosis with dementia: a clinicopathological study of eight autopsy cases.We investigated clinicopathologically pyramidal signs, including hyperreflexia, Babinski sign, and spasticity, and the involvement of the primary motor cortex and pyramidal tract, in eight Japanese autopsy cases of amyotrophic lateral sclerosis (ALS) with dementia. Pyramidal signs were observed in seven (88%) of the eight autopsy cases. Hyperreflexia and Babinski sign were evident in seven (88%) and three (38%) patients, respectively, but spasticity was not observed in any of the eight patients. Loss of Betz cells in the primary motor cortex was evident in the seven cases in which this structure was examined. Astrocytosis in the fifth layer of the primary motor cortex was noticed in three cases. In all eight cases, involvement of the pyramidal tract was obvious in the medulla oblongata, but no involvement of the pyramidal tract was found in the midbrain. Involvement of the pyramidal tract in the spinal cord, particularly of large myelinated fibers, was observed in all six cases in which the spinal cord was examined. In ALS with dementia, pyramidal signs were shown to be present more frequently than previously believed, and the clinicopathological correlation between pyramidal signs and involvement of the pyramidal tract was obvious. Constant involvement of Betz cells and the pyramidal tract in ALS with dementia has not been reported. Our clinicopathological findings may make a contribution to the understanding of the clinicopathological hallmarks of this disorder. Furthermore, we believe that this study will also contribute to the elucidation of the nosological status of ALS with dementia.- - - - - - - - - - ranking = 0.50602810340736keywords = brain (Clic here for more details about this article) |
| | Next -> |