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Spasticity management

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https://www.readbyqxmd.com/read/28512616/surgical-management-of-syringomyelia-associated-with-spinal-adhesive-arachnoiditis-a-late-complication-of-tuberculous-meningitis-a-case-report
#1
Jun Seok Lee, Geun Sung Song, Dong Wuk Son
Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28509356/assessments-of-pain-in-children-and-adolescents-with-cerebral-palsy-a-retrospective-population-based-registry-study
#2
Lena Westbom, Amanda Rimstedt, Eva Nordmark
AIM: To explore pain screening in CPUP, a follow-up surveillance programme for people with cerebral palsy (CP), specifically to describe reported pain prevalence, localizations, patterns of distribution; to compare with studies using psychometrically sound assessment instruments; and to assess agreement between pain documented in CPUP and medical records. METHOD: Registry study of a population with CP, born 1993 to 2008, living in Skåne, Sweden in 2013. Descriptive data, cross-tabulations, and chi-square tests to characterize and compare the study groups...
May 16, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28497442/-myths-and-evidence-on-the-use-of-botulinum-toxin-spasticity-in-adults-and-in-children-with-cerebral-palsy
#3
J C Martinez-Castrillo, J L Pena-Segura, P Sanz-Cartagena, X Alonso-Curco, J M Arbelo-Gonzalez, G Arriola-Pereda, M D Coll-Bosch, J A Conejero-Casares, A Garcia-Ribes, S Jauma-Classen, J Pagonabarraga, J Vidal-Valls, P J Garcia-Ruiz
INTRODUCTION: Spasticity is a medical problem with a high incidence that significantly impact on the quality of life of patients and their families. AIM: To analyze and to answer different questions about the use of botulinum toxin type A (BTA) in our clinical practice. DEVELOPMENT: A group of experts in neurology develop a list of topics related with the use of BTA. Two big groups were considered: spasticity in adults and in children with cerebral palsy...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28484733/per-oral-endoscopic-myotomy-for-achalasia-cardia-outcomes-in-over-400-consecutive-patients
#4
Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Rakesh Kalapala, Santosh Darisetty, Guduru Venkat Rao, Nageshwar Reddy
Background and study aims Per-oral endoscopic myotomy (POEM) has emerged as an efficacious treatment modality for the management of achalasia cardia (AC) and non-achalasia spastic esophageal motility disorders. Initial results are encouraging. We analyzed the safety and efficacy of POEM in a large cohort of patients with AC. Patients and methods The data from patients who underwent POEM (from January 2013 to June 2016) was prospectively collected and analyzed. Clinical success was defined as Eckardt score ≤ 3 after POEM procedure...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28480944/interdisciplinary-spasticity-management-clinic-outcomes-using-the-goal-attainment-scale-a-retrospective-chart-review
#5
Amy Hanlan, Patricia Mills, Rachel Lipson, Heather Finlayson
OBJECTIVE: To generate practice-based evidence of outcomes in an interdisciplinary spasticity management clinic using practical application of the Goal Attainment Scale (GAS). DESIGN: Retrospective chart review. PATIENTS: A total of 225 adult patients who were referred for spasticity management at a tertiary rehabilitation hospital and returned for follow-up between 2010 and 2013. METHODS: GAS scores were determined for all patients...
May 16, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28478825/do-flexible-inter-injection-intervals-improve-the-effects-of-botulinum-toxin-a-treatment-in-reducing-impairment-and-disability-in-patients-with-spasticity
#6
Carlo Trompetto, Lucio Marinelli, Laura Mori, Luca Puce, Elisa Pelosin, Carlo Serrati, Francesco Fattapposta, Steno Rinalduzzi, Giovanni Abbruzzese, Antonio Currà
In patients treated with botulinum toxin-A (BoNT-A), toxin-directed antibody formation was related to the dosage and frequency of injections, leading to the empirical adoption of minimum time intervals between injections of 3months or longer. However, recent data suggest that low immunogenicity of current BoNT-A preparations could allow more frequent injections. Our hypothesis is that a short time interval between injections may be safe and effective in reducing upper limb spasticity and related disability...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28471471/pathophysiology-diagnostic-work-up-and-management-of-balance-impairments-and-falls-in-patients-with-hereditary-spastic-paraplegia
#7
Jorik Nonnekes, Bas van Lith, Bart P van de Warrenburg, Vivian Weerdesteyn, Alexander C H Geurts
INTRODUCTION: Balance impairments are common in patients with hereditary spastic paraplegia and are among the most debilitating symptoms, as they frequently result in falls and fall-related injuries. Several features of hereditary spastic paraplegia contribute to balance impairments and multiple treatment options exist. However, an overview of these underlying mechanisms and their treatment is currently lacking. METHODS: This paper reviews the pathophysiology, diagnostic workup, and management of balance impairments in hereditary spastic paraplegia...
April 27, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28463855/noncardiac-chest-pain-diagnosis-and-management
#8
Takahisa Yamasaki, Ronnie Fass
PURPOSE OF REVIEW: Noncardiac chest pain (NCCP) has been defined as recurrent chest pain that is indistinguishable from ischemic heart pain after excluding a cardiac cause. NCCP is a common and highly challenging clinical problem in Gastrointestinal practice that requires targeted diagnostic assessment to identify the underlying cause of the symptoms. Treatment is tailored according to the cause of NCCP: gastroesophageal reflux disease (GERD), esophageal dysmotility or functional chest pain...
May 1, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28458952/intrathecal-baclofen-pump-infection-treated-by-adjunct-intrareservoir-teicoplanin-instillation
#9
Rovlias Aristedis, Papoutsakis Dimitrios, Paidakakos Nikolaos, Blionas Alexandros
BACKGROUND: The delivery of intrathecal baclofen via pumps is gaining increasing use in the management of intractable spasticity. One of the rare but devastating complications of this method is infection. In the majority of cases, removal of the device is required, despite appropriate intravenous antibiotic therapy. We report a case that highlights the use of intrareservoir teicoplanin to achieve sterilization of the infected pump system in a patient in whom removal of the pump was not an easy option...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28451697/assessment-and-treatment-of-spastic-equinovarus-foot-after-stroke-guidance-from-the-mont-godinne-interdisciplinary-group
#10
Thierry Deltombe, Delphine Wautier, Philippe De Cloedt, Michèle Fostier, Thierry Gustin
OBJECTIVE: To present interdisciplinary practical guidance for the assessment and treatment of spastic equinovarus foot after stroke. RESULTS: Clinical examination and diagnostic nerve block with anaesthetics determine the relative role of the factors leading to spastic equinovarus foot after stroke: calf spasticity, triceps surae - Achilles tendon complex shortening and dorsiflexor muscles weakness and/or imbalance. Diagnostic nerve block is a mandatory step in determining the cause(s) of, and the most appropriate treatment(s) for, spastic equinovarus foot...
April 26, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28435924/treatment-of-chronic-traumatic-c7-t1-grade-iii-spondylolisthesis-with-mild-neurological-deficit-case-report
#11
Jacinto Mata-Gómez, Marta Ortega-Martínez, Julio Valencia-Anguita, Ignacio Gilete-Tejero, Manuel Royano-Sánchez
Traumatic cervical severe spondylolisthesis is a rare and severe lesion which is typically associated with a spinal cord injury. Nevertheless, it occasionally has a pauci-symptomatic course which may delay its diagnosis. The authors report an exceptional case of a 33-year-old woman who had mild spasticity in her lower limbs and neck pain 9 months after a traffic accident. The computed tomographic scan and magnetic resonance image revealed C7-T1 grade III spondylolisthesis and spinal cord signal change. The initial cervical traction did not obtain a spinal realignment...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28433830/spasticity-management-the-current-state-of-transcranial-neuromodulation
#12
REVIEW
Antonino Leo, Antonino Naro, Francesco Molonia, Provvidenza Tomasello, Ileana Saccà, Alessia Bramanti, Margherita Russo, Placido Bramanti, Angelo Quartarone, Rocco Salvatore Calabrò
This narrative review aims to provide an objective view of the noninvasive neuromodulation (NINM) protocols available for treating spasticity, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). On the basis of the relevant randomized controlled trials, we infer that NINM is more effective in reducing spasticity when combined with the conventional therapies than used as a stand-alone treatment. However, the magnitude of NINM after-effects depends significantly on the applied hemisphere and the underlying pathology...
April 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#13
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
April 19, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28421032/spasticity-motor-recovery-and-neural-plasticity-after-stroke
#14
REVIEW
Sheng Li
Spasticity and weakness (spastic paresis) are the primary motor impairments after stroke and impose significant challenges for treatment and patient care. Spasticity emerges and disappears in the course of complete motor recovery. Spasticity and motor recovery are both related to neural plasticity after stroke. However, the relation between the two remains poorly understood among clinicians and researchers. Recovery of strength and motor function is mainly attributed to cortical plastic reorganization in the early recovery phase, while reticulospinal (RS) hyperexcitability as a result of maladaptive plasticity, is the most plausible mechanism for poststroke spasticity...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28420314/book-review-spasticity-diagnosis-and-management-brashear-a-spasticity-diagnosis-and-management-2nd-edition-new-york-ny-demos-medical-2016-512-pp-135-isbn-9781620700723
#15
https://www.readbyqxmd.com/read/28403842/outcomes-of-autologous-bone-marrow-mononuclear-cells-for-cerebral-palsy-an-open-label-uncontrolled-clinical-trial
#16
Liem Thanh Nguyen, Anh Tuan Nguyen, Chinh Duy Vu, Doan V Ngo, Anh V Bui
BACKGROUND: Stem cell therapy has emerged as a promising method for improving motor function of patients with cerebral palsy. The aim of this study is to assess the safety and effectiveness of autologous bone marrow mononuclear stem cell transplantation in patients with cerebral palsy related to oxygen deprivation. METHODS: An open label uncontrolled clinical trial was carried out at Vinmec International Hospital. The intervention consisted of two administrations of stem cells, the first at baseline and the second 3 months later...
April 12, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28390512/management-of-medical-complications-during-the-rehabilitation-of-moderate-severe-traumatic-brain-injury
#17
REVIEW
Billie A Schultz, Erica Bellamkonda
Brain injury specialists are experienced providers able to identify and treat the unique medical complications after moderate-severe traumatic brain injury, including posttraumatic seizures, paroxysmal sympathetic hyperactivity, spasticity, hydrocephalus, agitation, neuroendocrine dysfunction, heterotopic ossification, venous thromboembolism, and cranial nerve dysfunction. Owing to the potential negative impact on outcome if left untreated, identification and appropriate treatment is essential. An additional role of the brain injury specialist is to educate family about potential medical complications and anticipated outcomes after brain injury...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28384788/neurologic-evaluation-in-children-with-laryngeal-cleft
#18
Ryan D Walker, Alexandria L Irace, Margaret A Kenna, David K Urion, Reza Rahbar
Importance: Referral to a neurologist and imaging play important roles in the management of laryngeal cleft. Swallowing involves a complex series of neuromuscular interactions, and aspiration can result from anatomical causes (eg, laryngeal cleft), neuromuscular disorders, or some combination thereof. To date, no protocols or guidelines exist to identify which patients with laryngeal cleft should undergo neuroimaging studies and/or consultation with a neurologist. Objective: To establish guidelines for neurologic evaluation and imaging techniques to identify or rule out neuromuscular dysfunction in children with laryngeal cleft...
April 6, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28371499/rod-migration-to-the-thoracic-subarachnoid-space-after-c1-2-instrumentation-a-case-report-and-literature-review
#19
Seref Dogan, Elif Basaran Gundogdu, Mevlüt Özgür Taşkapılıoğlu, Ahmet Karaoglu
Posterior instrumented fusion of the cervical spine is a common surgical procedure in the treatment of cervical subluxation, fractures, and stenosis. Although malpositions are commonly seen, it is rare to observe the malposition of the rod or interconnection because of hardware failure. A 62-year-old woman with spastic tetraparesis as a sequel to pediatric meningitis with C1 -C2 cervical subluxation and myelomalacia had undergone laminectomy of C1 and C1 lateral mass and C2 bilateral pedicular screw fixation...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28370802/spinal-cord-stimulation-for-spasticity-historical-approaches-current-status-and-future-directions
#20
REVIEW
Sean J Nagel, Saul Wilson, Michael D Johnson, Andre Machado, Leonardo Frizon, Matthieu K Chardon, Chandan G Reddy, George T Gillies, Matthew A Howard
INTRODUCTION: Millions of people worldwide suffer with spasticity related to irreversible damage to the brain or spinal cord. Typical antecedent events include stroke, traumatic brain injury, and spinal cord injury, although insidious onset is also common. Regardless of the cause, the resulting spasticity leads to years of disability and reduced quality of life. Many treatments are available to manage spasticity; yet each is fraught with drawbacks including incomplete response, high cost, limited duration, dose-limiting side effects, and periodic maintenance...
April 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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