1/95. Effects of altering cycling technique on gluteus medius syndrome.OBJECTIVE: We discuss how altering the cycling technique of a cyclist receiving periodic chiropractic care helped in the management of gluteus medius syndrome. CLINICAL FEATURES: A 24-year-old male amateur cyclist had numbness and tingling localized to a small region on the superior portion of the right buttock. The area involved demonstrated paresthesia to light touch sensory evaluation. The cyclist had received chiropractic adjustments 2 days before the onset of the symptoms. One week earlier, the patient began riding a new bicycle with different gearing than his previous one. Manual-resisted muscle testing created soreness in the lumbosacral area and buttocks. trigger points were identified in the right gluteus medius. Standing lumbar spine flexion was 70 degrees, limited by tight hamstrings. INTERVENTION AND OUTCOME: Because the patient was already receiving periodic chiropractic care, no passive therapy was used. Patient education regarding the difference in gear selection in bicycles of a higher quality was provided. He was instructed to train in lower gears than he had previously used and to maintain a cadence of 70 to 90 revolutions of the pedals per minute. After 2 days, the paresthesia on the right buttock resolved. The trigger points were only mildly tender with minimal residual soreness of the involved muscles. CONCLUSION: Management of gluteus medius syndrome by altering the cadence and gear development for a bicyclist is discussed. Either frank or cumulative injury to the gluteus medius muscle is the typical etiologic factor for this syndrome. Repetitive strain of the patient's gluteus medius muscle as a result of poor cycling technique appeared to be the cause here. knowledge of bicycle fitting, training techniques, and bicycle mechanics appeared necessary to resolve the problem.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
2/95. Surgical treatment of vascular lesions of the spinal cord.Paravertebral block and resection of upper thoracic sympathetic ganglions were performed on cases in which vascular disturbance of the spinal cord was considered partly responsible. Block was performed in 14 cases and clinical improvement was seen in 10 cases out of them while resection was considered effective in 2 out of 3 cases. The evoked EMG of patients was assumed recovery of a part of synaptic function in the ischemic cord after the block. On the other hand, the skin temperature of the lower extremity did not show considerable change and this supports the view that the restoration of clinical picture was not due to the improvement of the periphral circulation of extremities. From these observations, it would be well presumed that favorable effect of sympathectomy consists partly in the improvement of vascular disturbance of the spinal cord.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
3/95. L4-5 disk lesion resulting in back pain with bowel, bladder and sexual dysfunction without paraparesis.This is a case report of a patient with bowel, bladder and sexual dysfunction associated with low back pain. This patient had an essentially normal neurological examination. There was radiological evidence of a disk lesion, and urodynamic findings consistent with lower motor neuron bladder dysfunction. His symptoms are attributed to a L4-5 disk herniation resulting in a partial cauda equina syndrome. The relevant anatomy is reviewed, and the differential diagnosis is discussed.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
4/95. Burkitt's lymphoma presenting as lower lip paraesthesia in a 24 year old Nigerian. Case report.An unusual case of stage D Burkitt's lymphoma in a 24 year old Nigerian female undergraduate is reported. There was a four month history of left lower lip paraesthesia followed three months later by a slowly progressive 'pimple-sized' nodular mandibular swelling arising from the mental foramen region. A full-blown, rapidly developing abdominal mass manifested only three weeks after a biopsy of the mandibular swelling. Aspiration of the latter and a histologic report of the mandibular mass confirmed Burkitt's lymphoma. The patient responded very well to appropriate chemotherapy. Clinicians should not overlook insidious jaw swellings in any adult residing in the endemic zone of Burkitt's lymphoma, in view of the fact that successful therapy is dependent on early diagnosis. Mental nerve paraesthesia is very rarely seen in Burkitt's lymphoma.- - - - - - - - - - ranking = 5.431440334507keywords = lower, jaw (Clic here for more details about this article) |
5/95. occupational exposure to methyl methacrylate monomer induces generalised neuropathy in a dental technician.A 36-year-old dental technician for 14 years developed paraesthesia and numbness in her legs. Neurophysiological studies revealed absent sensory nerve action potentials (SNAPs) from her lower limbs and normal upper limb SNAPs on presentation. Motor nerve studies were normal. Repeat studies 2 months after leaving her job showed some improvement in the lower limb SNAPs. It is suggested that her symptoms were caused by occupational exposure to methyl methacrylate monomer.- - - - - - - - - - ranking = 2keywords = lower (Clic here for more details about this article) |
6/95. paresthesia and the traumatic bone cyst. Abbreviated case report.A case of a traumatic bone cyst is reported because of the unusual nature of the chief complaint. The initial symptom of the disease was mandibular nerve neuropathy with numbness of the left side of the lower lip and chin.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
7/95. carbofuran-induced delayed neuropathy.BACKGROUND: Although carbamates have been widely used in the world for many years, carbamate-induced delayed neuropathy is rare. We report what appears to be delayed neuropathy caused by poisoning with carbofuran, a cholinesterase-inhibiting carbamate, although the certainty of diagnosis is somewhat limited by the lack of a sural nerve biopsy and spinal fluid examination. CASE REPORT: A 23-year-old man attempted suicide by ingesting 100 mL of carbofuran (2,3-dihydro-2,2-dimethyl-7-benzofuranyl methylcarbamate). After recovering from acute cholinergic toxicity, he had notable paresthesia in his lower limbs and difficulty walking. Electrophysiologic findings revealed sensorimotor neuropathy. Recovery began at 1 week and continued for 4 months. A similar delayed neuropathy has been described with carbamate, 1-naphthyl N-methylcarbamate, and m-tolyl methylcarbamate, but not with carbofuran insecticides.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
8/95. Revision of a spinal column stimulator lead without lead replacement.OBJECTIVE: The objective of this case report is to describe a technique for percutaneous spinal column stimulator (SCS) revision without lead replacement. CASE REPORT: A 35-year-old woman with a single-lead SCS implanted for control for left lower extremity pain underwent revision of her SCS lead because of loss of stimulation paresthesia in the area of pain. Using the method described, the lead was revised without lead replacement. CONCLUSION: SCS leads can be revised without placement of a new lead.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
9/95. Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft.A case report of saphenous neuralgia following arthroscopically assisted anterior cruciate ligament reconstruction with hamstring tendons is presented. The patient complained of paresthesia in the anteromedial region of the lower leg and tenderness at the medial side of the knee without motor or reflex abnormalities. Because saphenous neuralgia can mimic disorders of the knee, peripheral vascular disease, and lumbar nerve root compression, diagnosis can be confirmed by anesthetic blockade. The patient underwent saphenous neurolysis. Six months after surgery, the patient had normal cutaneous sensation at the medial aspect of the lower leg and ankle and she no longer complained of any painful dysesthesia. To minimize the risk of damaging the saphenous nerve when harvesting hamstring tendons, the knee should be flexed and the hip external rotated.- - - - - - - - - - ranking = 2keywords = lower (Clic here for more details about this article) |
10/95. Acute thoracoabdominal aortic dissection presenting as painless, transient paralysis of the lower extremities: a case report.Acute dissection of the aorta can be one of the most dramatic of cardiovascular emergencies. Its symptoms can occur abruptly and progress rapidly. Prompt recognition and appropriate intervention is crucial. However, not all aortic dissections present with classic symptoms of abrupt chest, back, or abdominal pain, and the diagnosis may be missed. A 63-year-old woman presented with transient loss of lower extremity motor and sensory function as the only symptom of an acute thoracoabdominal aortic dissection. Aortic dissection presenting as a transient neurologic syndrome is quite unusual. The sudden onset of weakness and parasthesia can result from the interruption of blood flow to the spinal cord. These symptoms of acute spinal cord ischemia, suggestive of a serious cardiovascular event, must be recognized and thoroughly investigated.- - - - - - - - - - ranking = 5keywords = lower (Clic here for more details about this article) |
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