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Periodic paralysis

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https://www.readbyqxmd.com/read/28817551/progress-toward-poliomyelitis-eradication-afghanistan-january-2016-june-2017
#1
Maureen Martinez, Hemant Shukla, Joanna Nikulin, Mufti Zubair Wadood, Stephen Hadler, Chukwuma Mbaeyi, Rudolph Tangermann, Jaume Jorba, Derek Ehrhardt
Afghanistan, Pakistan, and Nigeria remain the only countries where the transmission of endemic wild poliovirus type 1 (WPV1) continues (1). This report describes polio eradication activities, progress, and challenges in Afghanistan during January 2016-June 2017 and updates previous reports (2,3). Thirteen WPV1 cases were confirmed in Afghanistan in 2016, a decrease of seven from the 20 cases reported in 2015. From January to June 2017, five WPV1 cases were reported, compared with six during the same period in 2016...
August 18, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28816829/treatment-outcome-of-metastatic-spine-tumor-in-lung-cancer-patients-did-the-treatments-improve-their-outcomes
#2
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda
STUDY DESIGN: A retrospective, single-center study. OBJECTIVE: Investigation of the changes in the treatment outcomes of patients with lung cancer-derived metastatic spine tumors SUMMARY OF BACKGROUND DATA.: Metastatic spine tumors derived from lung cancer had been progressive, and their prognosis is poor. It has recently been reported that the use of molecularly targeted drugs and bone-modifying agents (BMA) improved the treatment outcomes of patients with lung cancer, but no detailed information about the treatment of metastatic spine tumors has been reported...
August 14, 2017: Spine
https://www.readbyqxmd.com/read/28798241/persisting-fatigue-and-myalgia-as-the-presenting-features-in-a-case-of-hypokalaemic-periodic-paralysis
#3
Matthew Thomas Neame, David Wright, Surendran Chandrasekaran
We report a case of a 9-year-old boy who developed hypokalaemic periodic paralysis (HypoPP) following a prodrome of persistent fatigue and muscle aches associated with mildly elevated creatine kinase (CK) levels.HypoPP is usually associated with a sudden onset of weakness and hypokalaemia at presentation. A review of published cases failed to identify any other reports of individuals with a similar onset of symptoms and elevated CK levels prior to the development of frank HypoPP.In the case described above, the association of these symptoms with elevated levels of CK may have been related to the underlying mutation in the skeletal muscle calcium channels that was subsequently identified...
August 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28797646/spinal-epidural-abscess-a-series-of-101-cases
#4
Martin Vakili, Nancy F Crum-Cianflone
BACKGROUND: Spinal epidural abscesses are uncommon but potentially devastating infections that often elude early diagnosis. An increasing incidence has been suggested; however, few contemporary data are available regarding risk factors and epidemiologic trends over time. METHODS: A retrospective study of spinal epidural abscesses from 2004 to 2014 at a large academic hospital was conducted. Cases were identified using ICD-9 code 324.1, and a review of medical and radiographic records was performed to confirm each case...
August 7, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28783808/recrudescence-of-deficits-after-stroke-clinical-and-imaging-phenotype-triggers-and-risk-factors
#5
Mehmet A Topcuoglu, Esen Saka, Scott B Silverman, Lee H Schwamm, Aneesh B Singhal
Importance: Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon. Objective: To investigate the clinical features, triggers, and risk factors for PSR. Design, Setting, and Participants: This retrospective study incorporated a crossover cohort study to identify triggers and a case-control study to identify risk factors. The study used the Massachusetts General Hospital Research Patient Data Repository to identify patients for the period January 1, 2000, to November 30, 2015, who had a primary or secondary diagnosis of cerebrovascular disease, who underwent magnetic resonance imaging of the brain at least once, and whose inpatient or outpatient clinician note or discharge summary stated the term recrudescence...
August 7, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28776900/pathological-findings-of-japanese-black-cattle-living-in-the-restricted-area-of-the-fukushima-daiichi-nuclear-power-plant-accident-2013-2016
#6
Jun Sasaki, Kayoko Hiratani, Itaru Sato, Hiroshi Satoh, Yoshitaka Deguchi, Hiroyuki Chida, Masahiro Natsuhori, Takahisa Murata, Kenji Ochiai, Kumiko Otani, Keiji Okada, Nobuhiko Ito
Fifty-one Japanese black cattle from four farms in the evacuation zone of the Fukushima nuclear accident were examined pathologically during the period, 2013-2016. We found no evidence of a radiation effect on pathological findings in any of these autopsy cases, although nine cases (3.7%) of enzootic bovine leukosis (EBL) and three cases (1.2%) of goiter were diagnosed. Estimated integrating dose of external exposure in EBL cases ranged from a maximum of 1200 mSv to a minimum of 72 mSv. Clinically, five cases showed wobble, dysstasia or paralysis...
August 4, 2017: Animal Science Journal, Nihon Chikusan Gakkaihō
https://www.readbyqxmd.com/read/28770389/long-term-stability-of-reconstituted-incobotulinumtoxina-how-can-we-reduce-costs-of-botulinum-toxin-therapy
#7
Dirk Dressler, Hans Bigalke
Botulinum neurotoxin (BNT), the biologically active component of botulinum toxin (BT), is a large double-stranded protein susceptible to various physical and chemical influences. All BT type A (BT-A) drugs are stored as powders allowing shelf lives from 24 to 36 months. After reconstitution, the specified shelf life is reduced to 8-24 h. Some studies, however, suggest longer shelf life. We wanted to test the long-term stability of reconstituted BT-A drugs in the hemidiaphragm assay (HDA), a high quality BT potency test...
August 2, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28768980/thyrotoxicosis-presenting-as-unilateral-drop-foot
#8
Kenju Hara, Hajime Miyata, Takahide Motegi, Ken Shibano, Hideaki Ishiguro
Neuromuscular disorders associated with hyperthyroidism have several variations in their clinical phenotype, such as ophthalmopathy, periodic paralysis, and thyrotoxic myopathy. We herein report an unusual case of thyrotoxic myopathy presenting as unilateral drop foot. Histopathological examinations of the left tibialis anterior muscle showed marked variation in the fiber size, mild inflammatory cell infiltration, and necrotic and regenerated muscle fibers with predominantly type 1 fiber atrophy. Medical treatment with propylthiouracil resulted in complete improvement of the left drop foot...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28766156/a-primer-on-nerve-agents-what-the-emergency-responder-anesthesiologist-and-intensivist-needs-to-know
#9
Keith Candiotti
PURPOSE: The purpose of this review article is to familiarize first responders, anesthesiologists, and intensivists with the medical management of patients exposed to nerve agents. SOURCE: This review is based on the current medical literature available to the general medical community. PRINCIPAL FINDINGS: Nerve agents are some of the deadliest substances known to humanity. Though they kill primarily via muscle paralysis, which leads to respiratory arrest, these agents affect virtually every organ system in the body...
August 1, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28756061/assessment-of-acute-motor-deficit-in-the-pediatric-emergency-room
#10
REVIEW
Marcio Moacyr Vasconcelos, Luciana G A Vasconcelos, Adriana Rocha Brito
OBJECTIVES: This review article aimed to present a clinical approach, emphasizing the diagnostic investigation, to children and adolescents who present in the emergency room with acute-onset muscle weakness. SOURCES: A systematic search was performed in PubMed database during April and May 2017, using the following search terms in various combinations: "acute," "weakness," "motor deficit," "flaccid paralysis," "child," "pediatric," and "emergency". The articles chosen for this review were published over the past ten years, from 1997 through 2017...
July 27, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28742635/long-exercise-test-in-the-interattack-period-of-periodic-paralysis-a-useful-and-sensitive-diagnostic-tool
#11
Jiaoting Jin, Fangfang Hu, Min Li, Suhang Shang, Xing Qin, Hongmei Cao, Jingxia Dang
PURPOSE: The reference values of long exercise test are inconsistent in previous studies. Our research aims to determine the reference values and improve diagnostic efficiency of long exercise test in periodic paralysis. METHODS: In this study, 100 healthy controls, 35 non-periodic paralysis patients, and 47 patients with periodic paralysis were recruited. The procedures of long exercise test were conducted following McMannis(1986) method. RESULTS: The decrease rate in compound muscle action potential amplitudes was correlated with gender, and it was not influenced by age, height, weight, and exercise...
July 24, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28736846/time-course-of-recovery-of-idiopathic-vocal-fold-paralysis
#12
Solomon Husain, Babak Sadoughi, Niv Mor, Ariana M Levin, Lucian Sulica
OBJECTIVES/HYPOTHESIS: To clarify the time course of recovery in patients with idiopathic vocal fold paralysis. STUDY DESIGN: Retrospective chart review. METHODS: Medical records for all patients with idiopathic vocal fold paralysis over a 10-year period were reviewed to obtain demographic and clinical information, including onset of disease and recovery of vocal function. Stroboscopic exams of patients who recovered voice were reviewed blindly to assess return of vocal fold motion...
July 24, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#13
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28722232/rapidly-growing-cystic-vestibular-schwannoma-with-sudden-onset-facial-palsy-ten-years-after-subtotal-excision
#14
Manjunath Dandinarasaiah, Golda Grinblat, Sampath Chandra Prasad, Abdelkader Taibah, Mario Sanna
An elderly male patient diagnosed with a right-sided cystic vestibular schwannoma (CVS) at our center underwent a translabyrinthine approach with a subtotal excision to preserve the facial nerve (FN). The tumor grew slowly for the first 9 years but in the subsequent 2 years grew rapidly, with the patient developing a FN paralysis. Using the previous approach, a second surgery was done and the tumor was excised, leaving behind a sheath of tumor on the facial and lower cranial nerves. This case demonstrates that CVSs show unpredictable growth patterns and need to be followed up for a longer period of time...
July 19, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28688160/unilateral-vocal-cord-paralysis-after-surgical-closure-of-a-patent-ductus-arteriosus-in-extremely-preterm-infants
#15
Pramod Pharande, Sathiyapriya Karthigeyan, Karen Walker, Daphne D'Cruz, Nadia Badawi, Melissa Luig, David Winlaw, Himanshu Popat
AIM: Left vocal cord paralysis (LVCP) is variably reported post ligation of patent ductus arteriosus (PDA). Our objective was to determine the incidence of LVCP and identify predictive factors and associated morbidities in preterm infants post PDA ligation. METHODS: This is a retrospective cohort study of infants less than 29 weeks gestational age from 2006 to 2014 who underwent PDA ligation. Infants with laryngeal symptoms underwent flexible fibreoptic nasopharyngolaryngoscopy to evaluate vocal cord function...
July 8, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28684786/autologous-thyroid-cartilage-graft-implantation-in-medialization-laryngoplasty-a-modified-approach-for-treating-unilateral-vocal-fold-paralysis
#16
Ming-Shao Tsai, Ming-Yu Yang, Geng-He Chang, Yao-Te Tsai, Meng-Hung Lin, Cheng-Ming Hsu
Medialization laryngoplasty is the standard surgical treatment for unilateral vocal fold paralysis. This study presents a modified approach in which a thyroid cartilage graft is implanted in medialization laryngoplasty. 22 patients who underwent this approach were included in the study. The results revealed that glottal incompetence and vocal performance were markedly improved following surgery, and the follow-up period ranged from 6 to 74 months (mean, 21.4 months). Acoustic analysis revealed significant improvements in the maximum phonation time (from 3...
July 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28662944/skeletal-muscle-channelopathies-rare-disorders-with-common-pediatric-symptoms
#17
Emma Matthews, Arpana Silwal, Richa Sud, Michael G Hanna, Adnan Y Manzur, Francesco Muntoni, Pinki Munot
OBJECTIVE: To ascertain the presenting symptoms of children with skeletal muscle channelopathies to promote early diagnosis and treatment. STUDY DESIGN: Retrospective case review of 38 children with a skeletal muscle channelopathy attending the specialist pediatric neuromuscular service at Great Ormond Street Hospital over a 15-year period. RESULTS: Gait disorder and leg cramps are a frequent presentation of myotonic disorders (19 of 29). Strabismus or extraocular myotonia (9 of 19) and respiratory and/or bulbar symptoms (11 of 19) are common among those with sodium channelopathy...
June 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28661556/synopsis-of-transoral-endoscopic-laryngopharyngeal-surgery-for-superficial-pharyngeal-cancers
#18
Akihito Watanabe, Masanobu Taniguchi, Yuki Kimura, Masao Hosokawa, Suguru Ito, Shinji Tsukamoto, Shigeyuki Sasaki
BACKGROUND: Endoscopic laryngopharyngeal surgery (ELPS) was developed for superficial pharyngeal cancers in Japan. In this study, we present our results of ELPS for superficial pharyngeal cancers. METHODS: From November 2009 to December 2015, 258 patients with superficial pharyngeal cancers underwent ELPS. Results, including survival rates, postoperative complications, and vocal function, are reviewed. RESULTS: The median follow-up period of 258 patients was 31 months...
June 29, 2017: Head & Neck
https://www.readbyqxmd.com/read/28644255/periodic-paralysis-and-encephalopathy-as-initial-manifestations-of-graves-disease-case-report-and-review-of-the-literature
#19
Theocharis Tsironis, Athanasios Tychalas, Dimitrios Kiourtidis, Jannis Kountouras, Georgia Xiromerisiou, Jobst Rudolf, Georgia Deretzi
BACKGROUND: Thyrotoxic periodic paralysis (TPP) is an uncommon complication of Graves' disease, characterized by the triad of acute hypokalemia without total body potassium deficit, episodic muscle paralysis, and thyrotoxicosis. Graves' encephalopathy is an extremely rare form of encephalopathy associated with autoimmune thyroid disease (EAATD), characterized by neuropsychiatric symptoms, increased antithyroid antibodies and cerebrospinal fluid protein concentration, nonspecific electroencephalogram abnormalities, and cortico-responsiveness...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28638574/thyrotoxic-periodic-paralysis-a-case-study-and-review-of-the-literature
#20
Marcelle Meseeha, Behnaz Parsamehr, Kerri Kissell, Maximos Attia
Acute hypokalemic paralysis is a rare cause of acute weakness. Morbidity and mortality associated with unrecognized disease can occur and include respiratory failure and possibly death. Common causes of hypokalemic paralysis include thyrotoxic periodic paralysis (TPP) which is a disorder most frequently seen in Asian males. TPP is characterized by sudden onset of hypokalemia and paralysis that primarily affects the lower extremities. Treatment of TPP includes replacing potassium rapidly, using nonselective beta-blockade and correcting the underlying hyperthyroidism as soon as possible...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
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