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https://www.readbyqxmd.com/read/29232836/spasticity-management-in-disorders-of-consciousness
#1
REVIEW
Géraldine Martens, Steven Laureys, Aurore Thibaut
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage...
December 9, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29231593/-impacts-on-urodynamic-parameters-and-the-protein-expressions-of-m2-and-m3-receptors-of-detrusor-in-the-rats-of-detrusor-hyperreflexia-treated-with-ginger-salt-isolated-moxibustion-at-shenque-cv-8
#2
Yi Liu, Xuerui Wang, Tianran Li, Liting Lin, Guangxia Shi, Yuanbo Fu, Cunzhi Liu
OBJECTIVE: To discuss the effects on detrusor hyperreflexia treated with ginger-salt-isolated moxibustion at "Shenque" (CV 8) and its mechanism. METHODS: Thirty female adult SD rats were selected. The model of detrusor hyperreflexia was prepared with complete spinal transection at T9, of which, 20 rats were randomized into a model group (10 rats) and a moxibustion group (10 rats). A sham-operation group (10 rats) was set up for sham-spinal transection. In the moxibustion group, when urine incontinence occurred (about in 2 weeks of modeling), the ginger-salt-isolated moxibustion at "Shenque" (CV 8) was given, 3 moxa cones each time, once a day, continuously for 7 days...
April 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29164027/a-clinical-practice-guideline-for-the-management-of-degenerative-cervical-myelopathy-introduction-rationale-and-scope
#3
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Jeffrey C Wang
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. Patients with DCM may present with common signs and symptoms of neurological dysfunction, such as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased tone, and sensory dysfunction. Clinicians across several specialties encounter patients with DCM, including primary care physicians, rehabilitation specialists, therapists, rheumatologists, neurologists, and spinal surgeons...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29133002/clinical-characteristics-of-lumbosacral-spinal-dural-arteriovenous-fistula-davf-comparison-to-thoracic-davf
#4
Toshiki Endo, Takumi Kajitani, Tomoo Inoue, Kenichi Sato, Kuniyasu Niizuma, Hidenori Endo, Yasushi Matsumoto, Teiji Tominaga
OBJECTIVE: Spinal dural arteriovenous fistula (DAVF) occurs at any spinal level but the clinical characteristics of lumbosacral DAVF have not been well documented. Purpose of this study was to evaluate clinical characteristics of lumbosacral DAVF and compare these features to those in thoracic DAVF. METHODS: Twenty-five consecutive patients with 16 thoracic and 9 lumbosacral DAVF were included (mean age, 63.9 years; twenty men). All patients presented with progressive myelopathy...
November 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29101071/subarachnoid-to-subarachnoid-shunt-for-correction-of-nonfunctioning-baclofen-pump-in-a-severe-case-of-chronic-debilitating-post-spinal-cord-injury-spasticity
#5
Adewale A Bakare, Jonathan Weyhenmeyer, Albert Lee
BACKGROUND AND IMPORTANCE: Perhaps the most disabling condition seen in patients with spinal cord injury is spasticity. Spasticity is characterized as hyperreflexia and hypertonicity as a result of damage to the supraspinal tracts in the aftermath of SCI. Intrathecal baclofen (ITB) is the mainstay therapy for spasticity unresponsive to oral baclofen. One of the problems associated with post-SCI spasticity unresponsive to ITB is development of scar tissue that prevents the diffusion of baclofen in the desired spinal cord area...
October 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29097135/apparent-c8-t1-radiculopathy-with-hand-weakness-due-to-mid-cervical-spondylosis
#6
Menachem Sadeh, Ron Dabby
Hand weakness and wasting in the setting of mid-cervical spondylosis and disc herniation without radiological evidence for compression of the C8 or T1 roots has been rarely reported. We retrospectively studied the data of patients with hand weakness and mid-cervical spondylosis. The clinical and radiological findings were compared to a control group of patients with weakness of the arm or forearm muscles and similar mid-cervical spondylosis. We found 19 patients with weakness and atrophy of the intrinsic hand muscles, and 13 patients with weakness proximal to the hand muscles to serve as a control group...
October 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29068880/quantitative-magnetization-transfer-mri-measurements-of-the-anterior-spinal-cord-region-are-associated-with-clinical-outcomes-in-cervical-spondylotic-myelopathy
#7
Michael Brendan Cloney, Zachary A Smith, Kenneth A Weber, Todd B Parrish
STUDY DESIGN: case-control. OBJECTIVE: To understand the role of magnetization transfer ratio in identifying patients with clinically significant myelopathy and disability. SUMMARY OF BACKGROUND DATA: Magnetization transfer ratio (MTR) is a quantitative measure that correlates with myelin loss and neural tissue destruction in a variety of neurological diseases. However, the usefulness of MTR in patients with cervical spondylotic myelopathy (CSM) has not been examined...
October 24, 2017: Spine
https://www.readbyqxmd.com/read/29049915/adult-primary-cervical-extra-osseous-ewing-s-sarcoma-a-case-report-and-short-literature-review
#8
Haytham Eloqayli
INTRODUCTION: Primary spinal epidural extraskeletal Ewing's sarcoma (EES) is extremely rare, with a peak incidence in the second decade of life. EES in old people is challenging to treat due to the lack of specific guidelines. In this paper, I present a unique case of adult primary cervical epidural EES with a 13-month follow-up. A short literature review of the therapeutic approaches and prognosis is also presented. PRESENTATION OF CASE: I present a case of a 49-year old male patient who presented with right upper limb pain, numbness, hand grip weakness, and hyperreflexia of 3 months duration...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29047014/a-callosal-catastrophe-toxic-leukoencephalopathy-associated-with-thermogenic-weight-loss-supplement-use
#9
Zakraus K Mahdavi, Ram Narayan, Shraddha Mainali, Benjamin M Greenberg, Venkatesh Aiyagari, David L McDonagh
BACKGROUND: The use of weight loss drugs and dietary supplements is common, but safety profiles for these drugs are largely unknown. Reports of toxicity have been published, and the use of these agents should be considered in clinical differential diagnoses. METHODS: We report the case of a patient with toxic leukoencephalopathy and hyponatremia associated with oral consumption of a thermogenic dietary supplement and essential oils. RESULTS: A 30-year-old woman presented after 2 days of headache, blurred vision, photophobia, vomiting, and hand spasms...
October 18, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29031141/analysis-of-spastic-gait-in-cervical-myelopathy-linking-compression-ratio-to-spatiotemporal-and-pedobarographic-parameters
#10
Taro Nagai, Yasuhito Takahashi, Kenji Endo, Ryo Ikegami, Ryuichi Ueno, Kengo Yamamoto
BACKGROUND: Gait dysfunction associated with spasticity and hyperreflexia is a primary symptom in patients with compression of cervical spinal cord. The objective of this study was to link maximum compression ratio (CR) to spatiotemporal/pedobarographic parameters. METHODS: Quantitative gait analysis was performed by using a pedobarograph in 75 elderly males with a wide range of cervical compression severity. CR values were characterized on T1-weighted magnetic resonance imaging (MRI)...
October 10, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28990565/-calpain-as-a-new-therapeutic-target-for-treating-spasticity-after-a-spinal-cord-injury
#11
Vanessa Plantier, Frédéric Brocard
After a spinal cord injury (SCI), patients develop spasticity, a motor disorder characterized by hyperreflexia and stiffness of muscles. Spasticity results from alterations in motoneurons with an upregulation of their persistent sodium current (I NaP), simultaneously with a disinhibition caused by a reduction of expression of chloride (Cl(-)) co-transporters KCC2. Until recently the origin of alterations was unknown. After reviewing pathophysiology of spasticity, the manuscript relates our recent work showing a tight relationship between the calpain-dependent proteolysis of voltage-gated sodium channels, the upregulation of I NaP and spasticity following SCI...
June 2017: Médecine Sciences: M/S
https://www.readbyqxmd.com/read/28985544/spasticity-and-spastic-dystonia-the-two-faces-of-velocity-dependent-hypertonia
#12
Lucio Marinelli, Antonio Currà, Carlo Trompetto, Elisabetta Capello, Carlo Serrati, Francesco Fattapposta, Elisa Pelosin, Chetan Phadke, Claire Aymard, Luca Puce, Franco Molteni, Giovanni Abbruzzese, Fabio Bandini
BACKGROUND: Spasticity and spastic dystonia are two separate phenomena of the upper motor neuron syndrome. Spasticity is clinically defined by velocity-dependent hypertonia and tendon jerk hyperreflexia due to the hyper-excitability of the stretch reflex. Spastic dystonia is the inability to relax a muscle leading to a spontaneous tonic contraction. Both spasticity and spastic dystonia are present in patients who are at rest; however, only patients with spasticity are actually able to kept their muscles relaxed prior to muscle stretch...
September 27, 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/28974243/reduction-of-vertebral-height-with-fragility-vertebral-fractures-can-induce-variety-of-neurological-deterioration
#13
Kazuhiro Fujimoto, Tsukasa Kanchiku, Yasuaki Imajo, Hidenori Suzuki, Norihiro Nishida, Masahiro Funaba, Toshihiko Taguchi
BACKGROUND: The presence of vertebral fractures affect variations in the termination level of conus medullaris (TLCM) and alter neurological findings. However, few studies have examined association between vertebral fractures, TLCM, and neurological findings. Thus, we herein studied the number and severity of vertebral fractures, TLCM, and neurological findings to clarify the mechanism of neurological deterioration in patients with vertebral fractures. METHODS: A total of 411 patients who underwent computed tomographic myelography were classified into those with (group F, n = 73) and those without vertebral fractures (group C, n = 338)...
October 3, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28955431/challenges-of-stroke-management-in-resource-limited-settings-a-case-based-reflection
#14
Yohane G Gadama, Gloria Mwangalika, Louis B Kinley, Beth Jackson, Henry C Mwandumba, Jane Mallewa, Tom Solomon, Rob Simister, Laura A Benjamin, Maria I Vargas, Joseph Kamtchum-Tatuene, Tamara Phiri
A 19-year-old man presented with a 1-year history of headache, generalised body weakness, progressive memory loss, and disorientation. One month prior to admission, there was aggravation of the weakness of the right upper limb, with new-onset difficulty with mastication, speech impairment, apathy, and urinary incontinence. On clinical examination, the patient had a motor aphasia and a right-sided hemiparesis with increased muscle tone and hyperreflexia. A noncontrast computed tomography (CT) scan of the brain revealed large ischaemic strokes extending beyond the classical vascular territories...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28922314/temporal-indices-of-ankle-clonus-and-relationship-to-electrophysiologic-and-clinical-measures-in-persons-with-spinal-cord-injury
#15
Kathleen J Manella, Kathryn E Roach, Edelle C Field-Fote
BACKGROUND AND PURPOSE: Clonus arising from plantar flexor hyperreflexia is a phenomenon that is commonly observed in persons with spastic hypertonia. We assessed the temporal components of a biomechanical measure to quantify ankle clonus, and validated these in persons with spasticity due to spinal cord injury. METHODS: In 40 individuals with chronic (>1 year) spinal cord injury, we elicited ankle clonus using a standardized mechanical perturbation (drop test)...
October 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28861038/alleviation-of-motor-impairments-in-patients-with-cerebral-palsy-acute-effects-of-whole-body-vibration-on-stretch-reflex-response-voluntary-muscle-activation-and-mobility
#16
Anne Krause, Eckhard Schönau, Albert Gollhofer, Ibrahim Duran, Anja Ferrari-Malik, Kathrin Freyler, Ramona Ritzmann
INTRODUCTION: Individuals suffering from cerebral palsy (CP) often have involuntary, reflex-evoked muscle activity resulting in spastic hyperreflexia. Whole-body vibration (WBV) has been demonstrated to reduce reflex activity in healthy subjects, but evidence in CP patients is still limited. Therefore, this study aimed to establish the acute neuromuscular and kinematic effects of WBV in subjects with spastic CP. METHODS: 44 children with spastic CP were tested on neuromuscular activation and kinematics before and immediately after a 1-min bout of WBV (16-25 Hz, 1...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28856174/a-rare-syndrome-of-grid2-deletion-in-2-siblings
#17
Aravindhan Veerapandiyan, Stephanie Enner, Venkatraman Thulasi, Xue Ming
The Glutamate receptor, ionotropic, delta 2 gene codes for an ionotropic glutamate delta-2 receptor, which is selectively expressed in cerebellar Purkinje cells, and facilitates cerebellar synapse organization and transmission. The phenotype associated with the deletion of Glutamate receptor, ionotropic, delta 2 gene in humans was initially defined in 2013. In this case report, the authors describe 2 brothers who presented with developmental delay, tonic upward gaze, nystagmus, oculomotor apraxia, hypotonia, hyperreflexia, and ataxia...
January 2017: Child Neurology Open
https://www.readbyqxmd.com/read/28852709/ataxia-pancytopenia-syndrome-with-samd9l-mutations
#18
Sorina Gorcenco, Jonna Komulainen-Ebrahim, Karin Nordborg, Maria Suo-Palosaari, Sten Andréasson, Johanna Krüger, Christer Nilsson, Ulrika Kjellström, Elisa Rahikkala, Dominik Turkiewicz, Mikael Karlberg, Lars Nilsson, Jörg Cammenga, Ulf Tedgård, Josef Davidsson, Johanna Uusimaa, Andreas Puschmann
OBJECTIVE: We describe the neurologic, neuroradiologic, and ophthalmologic phenotype of 1 Swedish and 1 Finnish family with autosomal dominant ataxia-pancytopenia (ATXPC) syndrome and SAMD9L mutations. METHODS: Members of these families with germline SAMD9L c.2956C>T, p.Arg986Cys, or c.2672T>C, p.Ile891Thr mutations underwent structured interviews and neurologic and ophthalmologic examinations. Neuroimaging was performed, and medical records were reviewed...
October 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28840068/a-case-of-symptomatic-spinal-dural-arteriovenous-fistula-after-high-volume-lumbar-puncture
#19
Thomas Noh, Rahul Chandra, Jimmy Kim, Ian Lee
BACKGROUND: Spinal dural arteriovenous fistulas (DAVFs) are rare lesions that lead to venous congestion and ischemic injury resulting in neurologic deterioration. Here we present a patient diagnosed with glioblastoma multiforme (GBM) who became symptomatic from a spinal DAVF after a diagnostic high-volume lumbar puncture (LP). CASE DESCRIPTION: When a 72-year-old female developed partial seizures in her left upper extremity without other focal neurological deficits, she underwent a magnetic resonance imaging (MRI) scan of the brain...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28828227/a-novel-p-t139m-mutation-in-hspb1-highlighting-the-phenotypic-spectrum-in-a-family
#20
Jakkrit Amornvit, Mehmet E Yalvac, Lei Chen, Zarife Sahenk
INTRODUCTION: Mutations in the HSPB1 gene encoding the small heat shock protein B1 are associated with an autosomal dominant, axonal form of Charcot-Marie-Tooth disease 2F (CMT2F) and distal hereditary motor neuropathy. Recently, distal myopathy had been described in a patient carrying HSPB1 mutation adding to the complexity of phenotypes resulting from HSPB1 mutations. METHODS: Five patients in a family with concerns of hereditary neuropathy were included. Detailed clinical examinations, including assessments of motor and sensory function, and electrophysiological data were obtained...
August 2017: Brain and Behavior
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