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Neuromuscular weakness

Jean K Mah, Jia Feng, Marni B Jacobs, Tina Duong, Kate Carroll, Katy de Valle, Cara L Carty, Lauren P Morgenroth, Michela Guglieri, Monique M Ryan, Paula R Clemens, Mathula Thangarajh, Richard Webster, Edward Smith, Anne M Connolly, Craig M McDonald, Peter Karachunski, Mar Tulinius, Amy Harper, Avital Cnaan, Yi-Wen Chen
OBJECTIVES: To investigate motor function associations with age, sex, and D4Z4 repeats among participants with early-onset facioscapulohumeral muscular dystrophy (FSHD) type 1 as defined by weakness onset before 10 years of age. METHODS: We collected standardized motor assessments, including manual muscle testing (MMT), quantitative muscle testing, functional motor evaluations, and clinical severity scores (CSSs), at 12 Cooperative International Neuromuscular Research Group centers...
March 14, 2018: Neurology
Jonathan P Wiens, Gary R Goldstein, Mark Andrawis, Mijin Choi, Jennifer W Priebe
STATEMENT OF PROBLEM: Multiple definitions of centric relation (CR) have evolved over time that may have created confusion or impeded understanding. A recent attempt to achieve a singular definition by surveying the members of the Academy of Prosthodontics (AP) did not achieve majority consensus. PURPOSE: The purpose of this study was to identify those aspects or attributes within the existing definitions of CR in which there was agreement or disagreement among the members of the AP...
March 8, 2018: Journal of Prosthetic Dentistry
Ryo Ueta, Yuji Yamanashi
The neuromuscular junction(NMJ)is the synapse between a motor neuron and the skeletal muscle that is essential for muscle contraction. Impairments at the NMJ lead to neuromuscular-transmission pathologies characterized by fatigable muscle weakness. Muscle-specific receptor tyrosine kinase MuSK plays key roles in NMJ formation. Over the past decade, studies examining the NMJ formation signals have identified molecules involved in the signaling pathways and have promoted a better understanding of characteristic molecular mechanisms for MuSK activation...
2018: Clinical Calcium
Priyanka Tater, Sanjay Pandey
Botulinum toxin has gained immense popularity since its introduction for therapeutic use. It is used in a variety of movement disorders like hemi-facial spasm, focal dystonias like blepharospasm, cervical dystonia, oromandibular dystonia, limb dystonias. It is also being used in patients with tremors, tics and for a variety of indications in Parkinson's disease as well. There are eight subtypes of toxins available, but type A and B are the ones used in movement disorder clinics. The toxin mainly acts by inhibiting the release of acetylcholine at the neuromuscular junction and causing weakness...
March 2018: Neurology India
Tae Chung, Yanli Tian, Jeremy Walston, Ahmet Hoke
OBJECTIVE: Age-associated skeletal muscle weakness is a major contributing factor to an increased late life mortality and morbidity, but its neurobiology is poorly understood. Previously, we provided histological evidence of dying-back axonal degeneration of motor neurons and denervation of neuromuscular junctions (NMJ) in age-associated muscle weakness. Given this, we aim to evaluate the relation between impaired neuromuscular transmission and various aspects of age-associated muscle weakness...
March 1, 2018: American Journal of Physical Medicine & Rehabilitation
Masoud Parish, Haleh Farzin
Muscular dystrophies are considered to be a series of neuromuscular diseases with genetic causes and are characterized by progressive muscle weakness and degeneration of the skeletal muscle. The case of an adult man with Becker dystrophy referred for repair of the patella tendon tearing and patella fracture is described. He underwent successful surgery using total intravenous anesthesia without any complications.
2018: International Medical Case Reports Journal
Ying Si, Xianqin Cui, David K Crossman, Jiaying Hao, Mohamed Kazamel, Yuri Kwon, Peter H King
ALS is a fatal neurodegenerative disorder of motor neurons leading to progressive atrophy and weakness of muscles. Some of the earliest pathophysiological changes occur at the level of skeletal muscle and the neuromuscular junction. We previously identified distinct mRNA patterns, including members of the Smad and TGF-β family, that emerge in muscle tissue at the earliest (pre-clinical) stages. These patterns track disease progression in the mutant SOD1 mouse and are present in human ALS muscle. Because miRNAs play a direct regulatory role in mRNA expression, we hypothesized in this study that there would be distinct miRNA patterns in ALS muscle appearing in early stages that could track disease progression...
February 24, 2018: Neurobiology of Disease
Syeda Saba Zaidi, Tahira Siddiqui, Sarwar Jamil Siddiqui
Acute onset of quadriplegia is a rare phenomenon seen with hypocalcemia due to hypoparathyroidism. We describe a 33-year gentleman who presented with weakness of all four limbs and areflexia. ECG showed QT abnormality. Nerve conduction study revealed normal sensory and significantly low motor CMAP amplitudes in both the upper and lower extremities. This nerve conduction study can be seen in acute motor neuropathy of various etiologies, among which GBS is the most worrisome. Our patient found to have low calcium and parathyroid hormone level...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Brandon M Roberts, Kaleen M Lavin, Gina M Many, Anna Thalacker-Mercer, Edward K Merritt, C Scott Bickel, David L Mayhew, S Craig Tuggle, James M Cross, David J Kosek, John K Petrella, Cynthia J Brown, Gary R Hunter, Samuel T Windham, Richard M Allman, Marcas M Bamman
Age-related muscle loss (sarcopenia) is a major clinical problem affecting both men and women - accompanied by muscle weakness, dysfunction, disability, and impaired quality of life. Current definitions of sarcopenia do not fully encompass the age-related changes in skeletal muscle. We therefore examined the influence of aging and sex on elements of skeletal muscle health using a thorough histopathological analysis of myocellular aging and assessments of neuromuscular performance. Two-hundred and twenty-one untrained males and females were separated into four age cohorts [mean age 25 y (n = 47), 37 y (n = 79), 61 y (n = 51), and 72 y (n = 44)]...
February 23, 2018: Experimental Gerontology
George J Francis, Amy E Cook, Donald W Morrish, K Ming Chan, Hernish J Acharya
Many neuromuscular diseases (NMD) result in muscle weakness, immobility and greater fracture risk. The objective of this study is to determine the fracture risk of adult patients at a multidisciplinary NMD clinic. Fracture risk was calculated using the Fracture Risk Assessment Tool, the presence of osteoporosis was quantified using bone densitometry and contributing co-morbidities were screened through serum markers. Of the 36 patients studied, 47% were found to be of moderate and high fracture risk. Two thirds of these patients had not been previously screened or treated for osteoporosis...
2018: Journal of Neuromuscular Diseases
Andrew P Lieberman
Spinal and bulbar muscular atrophy (SBMA) is an adult-onset degenerative disorder of the neuromuscular system resulting in slowly progressive weakness and atrophy of the proximal limb and bulbar muscles. The disease is caused by the expansion of a CAG/glutamine tract in the amino-terminus of the androgen receptor. That SBMA exclusively affects males reflects the fact that critical pathogenic events are hormone-dependent. These include translocation of the polyglutamine androgen receptor from the cytoplasm to the nucleus and unfolding of the mutant protein...
2018: Handbook of Clinical Neurology
Esther R van de Wal-Visscher, Jeroen P Kooman, Frank M van der Sande
BACKGROUND: Magnesium (Mg) is an essential cation for multiple processes in the body. The kidney plays a major role in regulating the Mg balance. In a healthy individual, total-body Mg content is kept constant by interactions among intestine, bones and the kidneys. SUMMARY: In case of chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal Mg absorption. Usually Mg remains normal; however, when glomerular filtration rate declines, changes in serum Mg are observed...
January 26, 2018: Blood Purification
Shu Zhang, Qian-Qian Mei, Jing Xin, Hong-Ying Zhang, Shi-Wen Wu, Chun-Feng Liu
OBJECTIVE: Progressive weakness of respiratory muscles remains one of the leading causes of death among patients with Duchenne muscular dystrophy (DMD). Currently, there are few pulmonary function data among Chinese DMD patients. This study was carried out to evaluate the sniff nasal inspiratory pressure (SNIP) change among a group of Chinese DMD patients, and compare it with the SNIP value of patients with neuromuscular disorders in other countries. METHODS: SNIP data were collected in three research groups that consists of 581 subjects: 125 DMD boys who have taken steroid (Age 5...
February 21, 2018: Brain & Development
Abhirami K Iyer, Kathryn J Jones, Virginia M Sanders, Chandler L Walker
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by progressive loss of lower and upper motor neurons (MN) leading to muscle weakness, paralysis and eventually death. Although a highly varied etiology results in ALS, it broadly manifests itself as sporadic and familial forms that have evident similarities in clinical symptoms and disease progression. There is a tremendous amount of knowledge on molecular mechanisms leading to loss of MNs and neuromuscular junctions (NMJ) as major determinants of disease onset, severity and progression in ALS...
February 23, 2018: International Journal of Molecular Sciences
Ajai Kumar Singh, Pradeep Kumar Maurya, Dinkar Kulshreshtha, Mayur Deepak Thakkar, Anup Kumar Thacker
OBJECTIVE: Acute neuromuscular weakness related to hypokalemia is a readily treatable disorder associated with diverse aetiologies. In this study we aim to report clinical pattern and biochemical features to identify the different aetiologies of the hypokalemic neuromuscular weakness. METHODS: Retrospective reviews of the medical record were analysed. Evaluation included demography, clinical features, investigations performed to ascertain the aetiologies. All the patients were categorised in to 3 groups; Idiopathic hypokalemic paralysis (IHP), dengue associated hypokalemic paralysis (DHP) and secondary group (SG) which included renal tubular acidosis (RTA- 1 and 2), thyrotoxic periodic paralysis (TPP) and Gitelman's syndrome (GS)...
September 15, 2017: Acta Neurologica Taiwanica
Angela Rosenbohm, Susanne Hirsch, Alexander E Volk, Torsten Grehl, Julian Grosskreutz, Frank Hanisch, Andreas Herrmann, Katja Kollewe, Wolfram Kress, Thomas Meyer, Susanne Petri, Johannes Prudlo, Carsten Wessig, Hans-Peter Müller, Jens Dreyhaupt, Jochen Weishaupt, Christian Kubisch, Jan Kassubek, Patrick Weydt, Albert C Ludolph
OBJECTIVE: Spinal and bulbar muscular atrophy (SBMA) is caused by an abnormal expansion of the CAG repeat in the androgen receptor gene. This study aimed to systematically phenotype a German SBMA cohort (n = 80) based on laboratory markers for neuromuscular, metabolic, and endocrine status, and thus provide a basis for the selection of biomarkers for future therapeutic trials. METHODS: We assessed a panel of 28 laboratory parameters. The clinical course and blood biomarkers were correlated with disease duration and CAG repeat length...
February 20, 2018: Journal of Neurology
Emily O'Connor, Vietxuan Phan, Isabell Cordts, George Cairns, Stefan Hettwer, Daniel Cox, Hanns Lochmüller, Andreas Roos
Congenital myasthenic syndromes (CMS) are a group of rare, inherited disorders characterised by compromised function of the neuromuscular junction, manifesting with fatigable muscle weakness. Mutations in MYO9A were previously identified as causative for CMS but the precise pathomechanism remained to be characterised. Based on the role of MYO9A as an actin-based molecular motor and as a negative regulator of RhoA, we hypothesised that loss of MYO9A may affect the neuronal cytoskeleton, leading to impaired intracellular transport...
February 16, 2018: Human Molecular Genetics
Eddie Garcia, Abdul H Zaid, Diane P Calello, Lisa McHugh, Grant Arzumanov, Najaf Asrar, Ari Sapin, Kristin G Fless
BACKGROUND: Botulism is a paralytic disease caused by the neurotoxin produced by Clostridium botulinum. The majority of cases are due to ingestion or injection drug use. Wound botulism from traumatic injury is exceedingly rare, with only one to two cases reported each year in the United States. CASE REPORT: A 27-year-old man presented to the Emergency Department with diplopia, dysphagia, and progressive weakness 10 days after sustaining a gunshot wound to his right lower leg...
February 12, 2018: Journal of Emergency Medicine
Marije Goudriaan, Benjamin R Shuman, Katherine M Steele, Marleen Van den Hauwe, Nathalie Goemans, Guy Molenaers, Kaat Desloovere
Cerebral palsy (CP) and Duchenne muscular dystrophy (DMD) are neuromuscular disorders characterized by muscle weakness. Weakness in CP has neural and non-neural components, whereas in DMD, weakness can be considered as a predominantly non-neural problem. Despite the different underlying causes, weakness is a constraint for the central nervous system when controlling gait. CP demonstrates decreased complexity of motor control during gait from muscle synergy analysis, which is reflected by a higher total variance accounted for by one synergy (tVAF1 )...
2018: Frontiers in Human Neuroscience
Sung Ho Jang, Seong Ho Kim, Jeong Pyo Seo
RATIONALE: We report on a patient with traumatic brain injury who showed motor recovery concurrent with recovery of injured corticofugal tracts (CFTs), diagnosed by diffusion tensor tractography (DTT). PATIENT CONCERNS: Four weeks after onset, when the patient started rehabilitation, he showed severe weakness of both upper and lower extremities [Motricity Index (MI, full score: 100/100): 9/30]. DIAGNOSES: A 29-year-old male patient underwent conservative management for traumatic hemorrhages in both frontal lobes and right thalamus resulting from a car accident...
February 2018: Medicine (Baltimore)
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