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Pinar Akpinar, Arzu Atici, Feyza U Ozkan, Ilknur Aktas, Duygu G Kulcu, Kubra Neslihan Kurt
OBJECTIVE: To assess the reliability of the Spinal Cord Assessment Tool for Spastic Reflexes (SCATS). DESIGN: Observational reliability study of the SCATS . SETTING: Inpatient rehabilitation unit at an education and research hospital. PARTICIPANTS: This study included 47 subjects between the ages of 18 and 88 years with spinal cord injury, American Spinal Injury Association (ASIA) impairment scale grades from A to D with spasticity, and at least 6 months post injury...
October 12, 2016: Archives of Physical Medicine and Rehabilitation
Petra Marsico, Victoria Frontzek-Weps, Julia Balzer, Hubertus J A van Hedel
The Hypertonia Assessment Tool is a 7-item instrument that discriminates spasticity, dystonia, and rigidity on 3 levels: item scores, subtype, and hypertonia diagnosis for each extremity. We quantified the inter- and intrarater reliability using Kappa statistics, Gwet's first-order agreement coefficient (both with 95% confidence interval), and percentage agreement for all levels. For validity, we compared the Hypertonia Assessment Tool subtype with the clinical diagnosis provided by the physicians. Two physiotherapists tested 45 children with neuromotor disorders...
October 14, 2016: Journal of Child Neurology
Christian Fontaine, Xavier Lannes, Aurélien Aumar, Michel-Yves Grauwin, Nadine Nachef, Étienne Allart
OBJECTIVE: The spastic hemiplegic patient often presents dystonia of extensor hallucis longus (EHL) and, more rarely, extensor digitorum longus (EDL). This dystonia is difficult to treat by tendon lengthening, because its primum movens is purely neurological without retraction musculo-tendinous. A hyponeurotisation by partial section of the branches of the common and deep fibular nerve(s) could be a therapeutic alternative to botulinum toxin injections. Its technique has never been described...
September 2016: Annals of Physical and Rehabilitation Medicine
Charlotte Pineau, Brice Lavrard, François Boyer, Laëtitia Percebois-Macadré
OBJECTIVE: MRI has highly changed the assessment of post-traumatic syringomyelia (PTS), roughly estimated at 30% nowadays. Times to onset (TTO) symptoms are random. This case report describes how hyperhidrosis appeared and revealed PTS diagnosis. OBSERVATIONS: Mr M., 43-year-old, is rehabilitation inpatient after T10 AIS A spinal cord injury (SCI). Three months after this event, Mr M complains of acute hyperhidrosis crisis always located below the injury, which can occur at any time of the day, particularly when he moves...
September 2016: Annals of Physical and Rehabilitation Medicine
Aude Paquet, Bertrand Olliac, Manuel-Pierre Bouvard, Bernard Golse, Laurence Vaivre-Douret
BACKGROUND: Altered motor performance has been described in Autism Spectrum Disorders (ASD) with disturbances in walking; posture, coordination, or arm movements, but some individuals with ASD show no impairment of motor skills. The neuro-developmental processes that underpin the performance of neuro-psychomotor functions have not been widely explored, nor is it clear whether there are neuro-psychomotor functions specifically affected in ASD. Our objective was to focus on the semiology of motor disorders among children with ASD using a neuro-developmental assessment tool...
2016: Frontiers in Psychology
E Gedda, A Robbins, M Hentzien, A Giltat, V Pinel-Petit, J Souille, Y N'Guyen
INTRODUCTION: We assessed (i) the frequency of consultations for faintness in the Emergency department (ED) of a University hospital centre (UHC), (ii) clinical epidemiology and (iii) cost of faintness, taking a particular interest into the determining risk factors for hospitalization. METHODS: This epidemiological study has been conducted retrospectively, from data obtained for every patient having consulted for faintness in ED of Reims UHC (01/01/12-03/31/12)...
September 9, 2016: La Revue de Médecine Interne
Charles P Gabel, Natalie Rando, Markus Melloh
To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting...
August 18, 2016: World Journal of Orthopedics
Charles C Anunobi, Olufemi Bankole, Nzechukwu Z Ikeri, Nurudeen A Adeleke
Clear cell meningiomas are an uncommon subtype of meningioma rarely seen in infancy. We report a case of clear cell meningioma in an 8-month-old male infant. He presented at the Lagos University Teaching Hospital, Lagos, Nigeria, in 2015 with persistent vomiting, poor feeding and failure to thrive over a four month period. Generalised hypertonia and hyperreflexia were noted on examination. Computed tomography of the brain revealed a huge largely isodense suprasellar mass with a hypodense core. The tumour, which measured 6 × 5 × 4 cm, enhanced non-uniformly with contrast injection and extended to occlude the third ventricle...
August 2016: Sultan Qaboos University Medical Journal
Jun Matsumoto-Miyazaki, Yoshitaka Asano, Yuka Ikegame, Tomohiro Kawasaki, Yuichi Nomura, Jun Shinoda
BACKGROUND AND OBJECTIVE: Spastic hypertonia usually occurs in patients with chronic disorders of consciousness (DOC) following severe traumatic brain injury (TBI). Spinal motor neuron excitability has been reported to increase in patients with brain damage. The aim of this study was to evaluate the immediate effects of acupuncture on spinal motor neuron excitability in patients with DOC following TBI by using evoked electromyography. SETTING AND PARTICIPANTS: Eleven male patients (mean age, 33 ± 14 years) with refractory muscle spasticity of the upper extremity accompanying chronic DOC following TBI and admitted to Chubu Medical Center for Prolonged Traumatic Brain Dysfunction were included...
August 30, 2016: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Rafid Al-Mahfoudh, Paul S Mitchell, Martin Wilby, Daniel Crooks, Chris Barrett, Robin Pillay, Tim Pigott
STUDY DESIGN: Case series and review of the literature. OBJECTIVE: To review the management of giant calcified disks in our large cohort and compare with the existing literature. We discuss our surgical technique. METHODS: Twenty-nine cases of herniated thoracic disk between 2000 and 2013 were reviewed. Eighteen patients were identified as having giant calcified thoracic disks, defined as diffusely calcified disks occupying at least 40% of the spinal canal...
September 2016: Global Spine Journal
Federico Raviglione, Giorgio Conte, Daniele Ghezzi, Cecilia Parazzini, Andrea Righini, Raffaella Vergaro, Andrea Legati, Luigina Spaccini, Serena Gasperini, Barbara Garavaglia, Massimo Mastrangelo
The FARS2 gene encodes the mitochondrial phenylalanyl-tRNA synthetase and is implicated in autosomal recessive combined oxidative phosphorylation deficiency 14, a clinical condition characterized by infantile onset epilepsy and encephalopathy. Mutations in FARS2 have been reported in only few patients, but a detailed description of seizures, electroencephalographic patterns, magnetic resonance imaging findings, and long-term follow-up is still needed. We provide a clinical report of a child with FARS2-related disease manifesting drug-resistant infantile spasms associated with focal seizures...
November 2016: American Journal of Medical Genetics. Part A
Yvette N Lamb, Lesley J Scott
Intramuscular incobotulinumtoxinA (Xeomin(®)) is indicated for the treatment or improvement of adult patients with upper limb spasticity (featured indication), cervical dystonia, blepharospasm and glabellar lines. It is a highly purified formulation of botulinum toxin type A that inhibits acetylcholine signalling at neuromuscular junctions, reducing muscle hypertonia. This narrative review discusses the clinical use of incobotulinumtoxinA in adults with upper limb spasticity and summarizes its pharmacological properties...
September 2016: Drugs
Gianina Ravenscroft, Mark R Davis, Phillipa Lamont, Alistair Forrest, Nigel G Laing
Early-onset muscle disease includes three major entities that present generally at or before birth: congenital myopathies, congenital muscular dystrophies and congenital myasthenic syndromes. Almost exclusively there is weakness and hypotonia, although cases manifesting hypertonia are increasingly being recognised. These diseases display a wide phenotypic and genetic heterogeneity, with the uptake of next generation sequencing resulting in an unparalleled extension of the phenotype-genotype correlations and "diagnosis by sequencing" due to unbiased sequencing...
August 9, 2016: Seminars in Cell & Developmental Biology
Maxime M van Meegdenburg, Monika Trzpis, Erik Heineman, Paul M A Broens
Chronic anal fissure is a painful disorder caused by linear ulcers in the distal anal mucosa. Even though it counts as one of the most common benign anorectal disorders, its precise etiology and pathophysiology remains unclear. Current thinking is that anal fissures are caused by anal trauma and pain, which leads to internal anal sphincter hypertonia. Increased anal basal pressure leads to diminished anodermal blood flow and local ischemia, which delays healing and leads to chronic anal fissure. The current treatment of choice for chronic anal fissure is either lateral internal sphincterotomy or botulinum toxin injections...
September 2016: Medical Hypotheses
Alexander Drobyshevsky
PURPOSE: To examine the extent of gray and white matter (WM) injury following global antenatal hypoxia-ischemia (H-I) and resulting in muscle hypertonia in newborns in a rabbit cerebral palsy model. MATERIALS AND METHODS: Rabbit dams (n = 15) underwent uterine ischemia procedure resulting in a global fetal H-I at embryonic day 22 (embryonic 22 days gestation). Newborn's brains underwent high resolution diffusion tensor imaging on a 14 Tesla magnet ex vivo. Fractional anisotropy (FA) in brains of hypertonic (n = 9), nonhypertonic (n = 6), and sham control (n = 5) kits were compared voxel-wise using Tract-Based Spatial Statistics (TBSS) approach...
August 9, 2016: Journal of Magnetic Resonance Imaging: JMRI
Mohammad Reza Alaei, Saeed Talebi, Mohammad Ghofrani, Mohsen Taghizadeh, Mohammad Keramatipour
BACKGROUND: Progressive encephalopathy with or without lipodystrophy is a rare autosomal recessive childhood-onset seipin-associated neurodegenerative syndrome, leading to developmental regression of motor and cognitive skills. In this study, we introduce a patient with developmental regression and autism. The causative mutation was found by exome sequencing. METHODS: The proband showed a generalized hypertonia and regression of all developmental milestones. Based on the advantages of next-generation sequencing (NGS), whole exome sequencing (WES) was requested...
November 2016: Iranian Biomedical Journal
Michael Saulino, David J Anderson, Jennifer Doble, Reza Farid, Fatma Gul, Peter Konrad, Aaron L Boster
INTRODUCTION: Troubleshooting helps optimize intrathecal baclofen (ITB) therapy in cases of underdose, overdose, and infection. METHODS: An expert panel of 21 multidisciplinary physicians currently managing >3200 ITB patients was convened, and using standard methodologies for guideline development, created an organized approach to troubleshooting ITB. They conducted a structured literature search that identified 263 peer-reviewed papers, and used results from an online survey of 42 physicians currently managing at least 25 ITB patients each...
August 2016: Neuromodulation: Journal of the International Neuromodulation Society
Aaron L Boster, Susan E Bennett, Gerald S Bilsky, Mark Gudesblatt, Stephen F Koelbel, Maura McManus, Michael Saulino
INTRODUCTION: Intrathecal baclofen (ITB) screening assesses response to a test dose of ITB on spasticity and function and identifies adverse reactions. METHOD: An expert panel consulted on best practices after conducting an extensive literature search and conducting an online survey. RESULTS: A successful trial may confirm predetermined goals, which may include improved mobility/positioning, decreased time/improved independence for activities, less home exercise, better wheelchair tolerance, decreased caregiver time, improved sleep, and reduced pain, or may modify goals and expectations...
August 2016: Neuromodulation: Journal of the International Neuromodulation Society
A Castro, J C Romeu, R Geraldes, J A Pereira da Silva
Systemic lupus erythematosus (SLE) may involve the nervous system but there are no specific biomarkers of neuroSLE. Limbic encephalitis has been rarely associated with SLE. We present a case of a 22-year-old black woman where typical SLE psychosis evolved to an encephalopathy with atypical features, normal MRI, electroencephalogram slowing and frontal and occipito-temporal hypometabolism on fluorodeoxyglucose positron emission tomography (FDG PET).Memory deficits, bizarre behaviour, psychosis, neuromyotonia and movement disorders have been described in autoimmune central nervous system disorders and associated with specific antibodies...
July 17, 2016: Lupus
A V Dharmesh Kumar Raja, T Jones, N Venkadasalapathi, K G Srinivasan
Congenital trismus is quite rare especially when its etiology is not the usual. In our case report an 8 year old female patient with no history of forcep delivery, no history of trauma or infection and a non syndromic presents with trismus since birth. After thorough examination we could conclude that the cause is due to hypertonia of the temporalis muscle and its etiology is discussed.
July 2016: Journal of Maxillofacial and Oral Surgery
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