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Spasticity management

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https://www.readbyqxmd.com/read/28435924/treatment-of-chronic-traumatic-c7-t1-grade-iii-spondylolisthesis-with-mild-neurological-deficit-case-report
#1
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
#2
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 non-invasive 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 aftereffects depends significantly on the applied hemisphere and the underlying pathology...
April 19, 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
#3
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
#4
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
#5
https://www.readbyqxmd.com/read/28403842/outcomes-of-autologous-bone-marrow-mononuclear-cells-for-cerebral-palsy-an-open-label-uncontrolled-clinical-trial
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28365157/feasibility-of-a-shorter-goal-attainment-scaling-method-for-a-pediatric-spasticity-clinic%C3%A2-%C3%A2-the-3-milestones-gas
#11
A Krasny-Pacini, F Pauly, J Hiebel, S Godon, M-E Isner-Horobeti, M Chevignard
BACKGROUND: Goal Attainment Scaling (GAS) is a method for writing personalized evaluation scales to quantify progress toward defined goals. It is useful in rehabilitation but is hampered by the experience required to adequately "predict" the possible outcomes relating to a particular goal before treatment and the time needed to describe all 5 levels of the scale. Here we aimed to investigate the feasibility of using GAS in a clinical setting of a pediatric spasticity clinic with a shorter method, the "3-milestones" GAS (goal setting with 3 levels and goal rating with the classical 5 levels)...
March 29, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28358718/imaging-three-dimensional-innervation-zone-distribution-in-muscles-from-m-wave-recordings
#12
Chuan Zhang, Yun Peng, Yang Liu, Sheng Li, Ping Zhou, William Zev Rymer, Yingchun Zhang
OBJECTIVE: To localize neuromuscular junctions in skeletal muscles in vivo which is of great importance in understanding, diagnosing and managing of neuromuscular disorders. APPROACH: A three-dimensional global innervation zone imaging technique was developed to characterize the global distribution of innervation zones, as an indication of the location and features of neuromuscular junctions, using electrically evoked high-density surface electromyogram recordings...
March 30, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28353527/baclofen-pumps-uses-and-complications
#13
Seth M Woolf, Carl R Baum
Intrathecal baclofen therapy, given via an implanted pump in the abdominal wall either as a continuous infusion or bolus dosing, has been used for more than 25 years to treat the spasticity and dystonia associated with various brain and spinal cord conditions. Pediatric clinicians occasionally encounter baclofen pumps, and in the pediatric setting, significant morbidity can arise from their use. This article presents the background, mechanism of action, uses, and complications of intrathecal baclofen therapy and discusses various management strategies should complications occur...
April 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28324754/effects-of-sit-to-stand-training-combined-with-transcutaneous-electrical-stimulation-on-spasticity-muscle-strength-and-balance-ability-in-patients-with-stroke-a-randomized-controlled-study
#14
Kyoung-Sim Jung, Tae-Sung In, Hwi-Young Cho
Sit-to-stand is a fundamental movement of human being for performing mobility and independent activity. However, Stroke people symptoms experience difficulty in conducting the sit-to-stand due to paralysis and especially ankle spasticity. Recently, transcutaneouselectrical- stimulation (TENS) is used to reduce pain but also to manage spasticity. The purpose of this study was to determine (1) whether TENS would lead to ankle spasticity reduction and (2) whether sit-to-stand training combined with TENS would improve spasticity, muscle strength and balance ability in stroke patients...
March 10, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#15
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28302242/vanishing-white-matter-vwm-disease-presenting-as-neuro-ovarian-failure
#16
Abidullah Khan, Mohammad Humayun, Maimoona Ayub, Iqbal Haider, Fahad Ajmal, Syed Saad Shah
A 19-year girl was admitted with a one-month history of worsening spastic paraparesis, cerbellar ataxia, visual decline and worsening headaches on a background of walking difficulty, progressive quadriparesis and migraine since the age of 10 years. She had no sensory loss, and cranial nerves examination was notable for optic atrophy with crescent formation only. She had primary amenorrhea and underdeveloped secondary sexual characteristics. Ultrasonograhic studies of the pelvis confirmed small ovaries, and uterus...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28283107/sexual-dysfunction-levels-in-iranian-women-suffering-from-multiple-sclerosis
#17
Nahid Dehghan-Nayeri, Zohreh Khakbazan, Faezeh Ghafoori, Seyed Massood Nabavi
OBJECTIVE: Sexual dysfunction (SD) is a common complaint in women who suffer from Multiple Sclerosis (MS), which has been categorized in three levels (primary, secondary, and tertiary) in previous studies. This study was conducted to assess the prevalence of sexual dysfunction (SD) at each level, and to identify associated factors and their impacts on SD in married women who suffer from Multiple Sclerosis. This study was conducted in Iran where the cultural barriers are recognized as important challenges in sexual function...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28276775/cannabinoids-therapeutic-use-what-is-our-current-understanding-following-the-introduction-of-thc-thc-cbd-oromucosal-spray-and-others
#18
REVIEW
Mauro Maccarrone, Rafael Maldonado, Miguel Casas, Thomas Henze, Diego Centonze
The complexity of the endocannabinoid (eCB) system is becoming better understood and new drivers of eCB signaling are emerging. Modulation of the activities of the eCB system can be therapeutic in a number of diseases. Research into the eCB system has been paralleled by the development of agents that interact with cannabinoid receptors. In this regard it should be remembered that herbal cannabis contains a myriad of active ingredients, and the individual cannabinoids have quite distinct biological activities requiring independent studies...
April 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28275351/botulinum-toxin-is-effective-in-the-management-of-neurogenic-dysphagia-clinical-electrophysiological-findings-and-tips-on-safety-in-different-neurological-disorders
#19
Enrico Alfonsi, Domenico A Restivo, Giuseppe Cosentino, Roberto De Icco, Giulia Bertino, Antonio Schindler, Massimiliano Todisco, Mauro Fresia, Andrea Cortese, Paolo Prunetti, Matteo C Ramusino, Arrigo Moglia, Giorgio Sandrini, Cristina Tassorelli
Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28264545/innervation-zone-targeted-botulinum-toxin-injections
#20
Bayram Kaymak, Murat Kara, Arzu Yağiz-On, Abdullah R Soylu, Levent Özçakar
Muscle overactivity (spasticity, dystonia or spasm) seen in certain neuromuscular disorders has been effectively treated with intramuscular injection of botulinum neurotoxins (BoTXs). Since they act in the nerve terminals, the toxin must be transported to the neuromuscular junctions which are generally clustered in one or more restricted areas (innervations zone(s)) in a skeletal muscle. The innervation zone targeted BoTX injections using guidance is highly recommended to achieve an optimal therapeutic goal with lower doses and fewer side effects...
March 6, 2017: European Journal of Physical and Rehabilitation Medicine
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