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https://www.readbyqxmd.com/read/27861224/neuralgic-amyotrophy-associated-with-hepatitis-e-virus-infection-first-case-in-the-united-states
#1
Jose D Avila, David Lacomis, Erek M Lam
Hepatitis E is an emerging viral infection in developed countries. It can present with multiple extra-hepatic manifestations, including neuralgic amyotrophy. We report a 52-year-old man who presented with neck and shoulder pain followed by orthopnea and left arm weakness. Electrodiagnostic testing showed left phrenic neuropathy and denervation in bilateral C5 and C6 myotomes. He also had elevated liver enzymes, which led to the diagnosis of acute hepatitis E. This is the first case of neuralgic amyotrophy associated with hepatitis E in the United States...
December 2016: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/27709072/hirayama-s-disease-an-italian-single-center-experience-and-review-of-the-literature
#2
Valerio Vitale, Ferdinando Caranci, Chiara Pisciotta, Fiore Manganelli, Francesco Briganti, Lucio Santoro, Arturo Brunetti
BACKGROUND: Hirayama's disease (HD), is a benign, self-limited, motor neuron disease, characterized by asymmetric weakness and atrophy of one or both distal upper extremities. In the present study we report the clinical, electrophysiological and MRI features of a group of Italian patients, with review of the literature. Moreover we propose an optimized MRI protocol for patients with suspected or diagnosed HD in order to make an early diagnosis and a standardized follow up. METHODS: Eight patients with clinical suspicion of Hirayama disease underwent evaluation between January 2007 and November 2013...
August 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/27468275/distinguishing-radiculopathies-from-mononeuropathies
#3
Jennifer Robblee, Hans Katzberg
Identifying "where is the lesion" is particularly important in the approach to the patient with focal dysfunction where a peripheral localization is suspected. This article outlines a methodical approach to the neuromuscular patient in distinguishing focal neuropathies versus radiculopathies, both of which are common presentations to the neurology clinic. This approach begins with evaluation of the sensory examination to determine whether there are irritative or negative sensory signs in a peripheral nerve or dermatomal distribution...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27430450/imaging-of-progressive-weakness-or-numbness-of-central-or-peripheral-origin
#4
Joshua P Klein
Weakness and numbness occur in a variety of patterns that reflect injury to different parts of the central and peripheral nervous system. Progressive symptoms most often signify an underlying structural or degenerative problem. Familiarity with the major descending motor and ascending sensory tracts of the central nervous system, as well as radicular (dermatome and myotome) and peripheral nerve anatomy, is essential. Damage to these tracts and nerve fibers produces characteristic clinical symptoms and signs...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/26983673/monomelic-amyotrophy-with-proximal-upper-limb-involvement-a-case-report
#5
Eman Al-Ghawi, Talal Al-Harbi, Adnan Al-Sarawi, Mohamed Binfalah
BACKGROUND: Monomelic amyotrophy is an uncommon, benign, unilateral disorder of the lower motor neurons, affecting predominantly the hand and forearm muscles. Proximal involvement of the arm and shoulder muscles is an unusual presentation that has been rarely reported in the literature. CASE PRESENTATION: A 28-year-old white man presented with insidious-onset, slowly progressive, unilateral weakness and atrophy of his left shoulder girdle and deltoid muscles. A neurological examination revealed weakness and atrophy in his left deltoid, infraspinatus and supraspinatus muscles...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/26409623/refinement-of-myotome-values-in-the-upper-limb-evidence-from-brachial-plexus-injuries
#6
S W Bell, M J C Brown, T J Hems
PURPOSE: We reviewed patients with partial supraclavicular brachial plexus injuries in order to refine the myotome values of the upper limb. METHODS: Forty-two patients with defined partial injuries to the supraclavicular brachial plexus were reviewed from a prospective database. The injuries patterns covered C5, C5-6, C5-7, C5-8, C7-T1 and C8-T1 roots. Upper plexus injuries were classified on the basis of surgical exploration and intraoperative stimulation and lower plexus injuries from MRI...
September 22, 2015: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26363965/myotonia-like-symptoms-in-a-patient-with-spinal-and-bulbar-muscular-atrophy
#7
Kunihiko Araki, Hirotaka Nakanishi, Tomohiko Nakamura, Naoki Atsuta, Shinichiro Yamada, Yasuhiro Hijikata, Atsushi Hashizume, Keisuke Suzuki, Masahisa Katsuno, Gen Sobue
We describe the case of a 33-year-old man with a 4-year history of worsening muscle stiffness and weakness in his right hand. He showed elevated serum creatine kinase levels at the onset of muscle stiffness that was characterized by delayed muscle relaxation after voluntary contraction. This symptom often occurred during cold exposure, and was partially attenuated by sodium channel blockade. Electrodiagnostic findings in repetitive nerve stimulation, short-exercise, and cooling tests were normal. Electromyography showed chronic denervation potentials in his cranial, cervical, thoracic, and lumbosacral myotomes without myotonic discharge...
November 2015: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/25085761/dynamic-mri-testing-of-the-cervical-spine-has-prognostic-significance-in-patients-with-progressive-upper-limb-distal-weakness-and-atrophy
#8
Marc Gotkine, Alon Abraham, Vivian E Drory, Zohar Argov, John Moshe Gomori, Sergiu C Blumen
BACKGROUND: The syndrome of isolated progressive upper-limb distal weakness and atrophy results from disease processes affecting lower motor neurons originating in the cervical anterior horn gray matter. Lower motor neuron dysfunction restricted to the C7-T1 myotomes in the absence of neuropathy, upper motor neuron signs, sphincter disturbances or abnormality on conventional MR imaging is suggestive of either Hirayama disease (HD), or the initial manifestation of a progressive motor neuron disease such as amyotrophic lateral sclerosis (ALS)...
October 15, 2014: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/24165502/a-portuguese-case-of-hirayama-disease
#9
REVIEW
Mário Correia de Sá, Henrique Costa, Sérgio Castro, Marta Vila Real
Hirayama disease, also known as monomelic amyotrophy or juvenile spinal muscular atrophy of the distal upper extremity features the impairment of the anterior horn cells of the distal cervical spinal cord secondary to dural sac anterior displacement during cervical flexion. We describe a case of a 17-year-old boy with a history of scoliosis, evaluated in the emergency department for decreased muscle strength and atrophy of the left upper limb with progressive worsening for about 6 months. We performed electrophysiological studies that showed severe neurogenic atrophy involving the C7-T1 left myotomes...
2013: BMJ Case Reports
https://www.readbyqxmd.com/read/24094906/clinical-findings-and-electrodiagnostic-testing-in-108%C3%A2-consecutive-cases-of-lumbosacral-radiculopathy-due-to-herniated-disc
#10
M Mondelli, A Aretini, U Arrigucci, F Ginanneschi, G Greco, F Sicurelli
STUDY AIM: This prospective study aim to examine whether clinical findings and electrodiagnostic testing (EDX) in patients with lumbosacral monoradiculopathy due to herniated disc (HD) differ as a function of root involvement level (L5 vs. S1) and HD zone (paramedian vs. intraforaminal). PATIENTS AND METHODS: All patients with L4, L5 or S1 monoradiculopathy were prospectively enrolled at four electromyography (EMG) labs over a 2-year period. The diagnosis was based on a congruence between patient history and MRI evidence of HD...
October 2013: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/23962698/effect-of-neck-flexion-on-somatosensory-and-motor-evoked-potentials-in-hirayama-disease
#11
A Abraham, M Gotkine, V E Drory, S C Blumen
UNLABELLED: Hirayama disease (HD) is a rare motor disorder mainly affecting young men, characterized by atrophy and weakness of forearm and hand muscles corresponding to a C7-T1 myotome distribution. The weakness is usually unilateral or asymmetric and progression usually stops within several years. The etiology of HD is not well understood. One hypothesis, mainly based on MRI findings, is that the weakness is a consequence of cervical flexion myelopathy. The aim of this study was to explore the function of corticospinal and ascending somatosensory pathways during neck flexion using evoked responses...
November 15, 2013: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/23622355/main-steps-of-skeletal-muscle-development-in-the-human-morphological-analysis-and-ultrastructural-characteristics-of-developing-human-muscle
#12
REVIEW
Norma Beatriz Romero, Monica Mezmezian, Anna Fidziańska
During embryogenesis, paraxial mesoderm undergoes segmentation into somites, progressing from head to tail. Somites differentiate into dermomyotomes, then into dermatomes and myotomes. Some head muscles derive from the anterior paraxial and precordal mesoderm. Between 10 and 13 weeks of gestation, the fusion of myoblasts generates primary myotubes with central nuclei, and the latter form the second generation of myotubes which requires active innervation. Nicotinamide adenine dinucleotide dehydrogenase-tetrazolium reductase appears before succinate dehydrogenase, and ATPase shows an intermediary activity...
2013: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/23464852/perineural-hematoma-following-lumbar-transforaminal-steroid-injection-causing-acute-on-chronic-lumbar-radiculopathy-a-case-report
#13
Mehul J Desai, Shivani Dua
INTRODUCTION: Transforaminal epidural steroid injections (TFESI) are commonly performed for the treatment of lumbar herniated nucleus pulposus and lumbosacral radiculopathy. Although rare, documented complications including spinal cord infarction, paraparesis, epidural abscess, paraplegia, and epidural hematoma have been reported. Here, we present a case of perineural hematoma affecting the L4 nerve root resulting in progressive acute-on-chronic lumbar radiculopathy following TFESI. CASE REPORT: A 72-year-old female presented with 3 months of low back and right anterior thigh pain...
March 2014: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/23419571/clinical-predictors-of-emg-confirmed-cervical-and-lumbosacral-radiculopathy
#14
Ali Hassan, Bilal Hameed, Muhammad Islam, Bhojo Khealani, Mustafa Khan, Saad Shafqat
BACKGROUND: Electromyography (EMG) for suspected cervical or lumbosacral root compression is often negative, producing expense and physical discomfort that could have been avoided. To improve patient selection for testing, we sought to identify clinical features that would accurately predict presence of radiculopathy on EMG. METHODS: Adult patients consecutively evaluated for suspected cervical or lumbosacral root compression at an academic clinical neurophysiology laboratory were prospectively enrolled...
March 2013: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/23246211/l5-s1-extraforaminal-intraneural-disc-herniation-mimicking-a-malignant-peripheral-nerve-sheath-tumor
#15
Manish S Sharma, Jonathan M Morris, Mark A Pichelmann, Robert J Spinner
BACKGROUND CONTEXT: An extraforaminal disc herniation may present as a retroperitoneal mass and is thus a differential diagnosis for a malignant lesion. PURPOSE: To highlight the difficulty in the accurate preoperative differentiation between an extraforaminal disc herniation and a malignant retroperitoneal mass despite the use of advanced anatomical and metabolic imaging. STUDY DESIGN: Case report. METHODS: The authors present a case of a 55-year-old man, with a family history of neurofibromatosis, who presented to us 2 months after the insidious occurrence of severe, unrelenting, right-sided, L5 dermatomal pain...
December 2012: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/23237996/hirayama-disease-in-austria
#16
Josef Finsterer, Wolfgang Löscher, Julia Wanschitz, Matthias Baumann, Stefan Quasthoff, Wolfgang Grisold
OBJECTIVES: Hirayama disease (HD) is a segmental cervical myelopathy which affects the C7-D1 myotomes and presents with unilateral or asymmetric upper limb weakness/wasting. The study aimed at systematically collecting cases of HD in Austria and at describing and discussing their presentation on clinical and instrumental investigations and at comparing them with cases reported from other countries. METHODS: Neurological Departments of secondary and tertiary centers and colleagues in outpatient units involved in the management of neuromuscular disorders in Austria were contacted and asked to provide standardised data about their HD cases...
October 2013: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/23220833/hirayama-disease-a-frequently-undiagnosed-condition-with-simple-inexpensive-treatment
#17
Rajesh Verma, Rakesh Lalla, Tushar B Patil, Arvind Gupta
Hirayama disease is a non-progressive asymmetric juvenile muscular atrophy involving C7-T1 myotomes leading to weakness and atrophy of intrinsic muscles of hand and forearm with relative sparing of the brachioradialis muscle. This benign focal cervical poliopathy is believed to be caused by forward displacement of the posterior cervical dural sac. In this case report we highlight the importance of dynamic MRI of cervical spine for diagnosis of the above condition and the use of hard cervical collar to prevent further flexion injury...
2012: BMJ Case Reports
https://www.readbyqxmd.com/read/23177027/electrodiagnosis-of-cervical-radiculopathy
#18
REVIEW
Kevin Hakimi, David Spanier
Cervical radiculopathy is a common diagnosis with a peak onset in the fifth decade. The most commonly affected nerve root is C7, C6, and C8. The etiology is often compressive, but may arise from noncompressive sources. Patients commonly complain of pain, weakness, numbness, and/or tingling. Examination may reveal sensory or motor disturbance in a dermatomal/myotomal distribution. Neural compression and tension signs may be positive. Diagnostic tests include imaging and electrodiagnostic study. Electrodiagnostic study serves as an extension of the neurologic examination...
February 2013: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/23172387/acute-bilateral-painless-radiculitis-with-abnormal-borrelia-burgdorferi-immunoblot
#19
Jorge L Almodovar, Michael K Hehir, Katharine A Nicholson, Elijah W Stommel
A 57-year-old woman with a history of hypertension and hypothyroidism presented with painless left arm weakness and numbness 2 weeks before evaluation. Nerve conduction studies of the left arm revealed normal motor and sensory responses. Needle examination revealed acute denervation changes in all myotomes of the affected extremity, including cervical paraspinals on the left, and several myotomes on the contralateral side. The laboratory evaluation revealed normal anti-GM1 antibodies and 3 IgM/5 IgG bands on Lyme Western Blot...
December 2012: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/22855446/-phylogenetic-analysis-and-expression-patterns-of-tropomyosin-in-amphioxus
#20
Xin-Yi Li, Yu-Shuang Lin, Hong-Wei Zhang
In amphioxus, we found a mesoderm related gene, tropomyosin, which encodes a protein comprising 284 amino acid residues, sharing high identities with other known Tropomyosin proteins both in vertebrates and invertebrates. Phylogenetically, amphioxus Tropomyosin fell outside the invertebrate clade and was at the base of the vertebrate protein family clade, indicating that it may represent an independent branch. From the early neurula to the larva stage, whole-mount in situ hybridization and histological sections found transcripts of amphioxus tropomyosin gene...
August 2012: Dong Wu Xue Yan Jiu, Zoological Research
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