1/108. Suxamethonium, masseter spasm and later malignant hyperthermia.A 25-year-old man admitted with severe upper torso trauma displayed masseter muscle spasm after suxamethonium given during resuscitation. Anaesthesia was initially maintained with intravenous agents during transfer and X-ray angiography. However, during surgery to correct a brachial artery injury, malignant hyperthermia was triggered when isoflurane was given, 2.5 h after the suxamethonium. He responded to treatment, including dantrolene administration. Peak serum and urine myoglobin were 12,947 micrograms.l-1 and 54,571 micrograms.l-1, respectively, while maximum serum creatinine kinase was 17,300 IU. The patient made an uneventful recovery and later proved positive for malignant hyperthermia susceptibility on muscle contracture tests.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/108. Painful pectoralis major myospasm as a result of sternal wound reconstruction: complete resolution with bilateral pectoral neurectomies.We report a patient with a highly unusual and previously unreported complication with the use of the pectoralis major muscle to treat the infected median sternotomy. The diagnosis of painful myospasm was made by a combination of physical findings and exclusion of other conditions such as recurrent infection. Treatment by pectoral denervation was relatively simple and highly successful. patients with chest-wall pain after sternal wound reconstruction should have myospasm entertained as a possible cause.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
3/108. Some manoeuvres for releasing the hypertonus of spastic and shortened muscles.We describe some physiotherapeutic techniques and manoeuvres releasing the increased tone of spastic and shortened muscles. The techniques can be generally characterised and summed up into three groups as follows: I. First types of manoeuvres consists in setting up the extremity or segment into the position usually opposed or antagonistic to the limited direction. This position is held for several tens of seconds. After this, partial of the originally limited range of motion could be observed. A modification of this approach is effective for persistent extensor spasticity of the lower extremities. Extremity is taken up into the internal rotation and flexion of the hip joint, into the maximal flexion of knee joint and into dorsiflexion of ankle joint, and this position is held at least for 30 seconds. After this, the extensor spasticity is usually diminished and also the voluntary movements and gait pattern improved. II. Short active jerk (not exceeding 1/2 sec) in the free direction, alternatively against mild resistance, followed by 3-4 second release and slow stretch into the restricted range. It is essentially important that the initial jerk is as brisk as possible but performed with no special effort. In case the resistance is applied, it should be only slight. Then the therapist must grasp a "melting" of the hypertonus and cautiously guide the segment into the slow and gentle stretch. III. pressure stimulation of the particular active zones. The application of these manoeuvres and its combinations are demonstrated in case reports.- - - - - - - - - - ranking = 2.5keywords = muscle (Clic here for more details about this article) |
4/108. Neonatal cricopharyngeal achalasia--a case report.Primary neonatal cricopharyngeal achalasia due to a spastic cricopharyngeus muscle manifests itself with intractable feeding difficulties, nasal reflux, recurrent aspiration pneumonia and failure to thrive. There are very few reports of this condition in the literature. In the absence of anatomically demonstrable cause, these children are likely to be labelled as having an impairment of the central-nervous system. This in turn may result in long-term misery with ng-tube feeding, and eventually, the creation of a feeding gastrostomy. A minor operation-- cricopharyngeal myotomy-- has been shown to be safe and curative. It can be performed even if only limited preoperative diagnostic tools are available.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
5/108. Motor evoked potentials in a case of stiff-man syndrome: a longitudinal study.The clinical and neurophysiological findings in a patient with a typical stiff-man syndrome and their three-year evolution are described. The patient had high titers of anti-glutamic acid decarboxylase antibodies in both serum and cerebrospinal fluid. magnetic resonance imaging (MRI) of brain and spinal cord was normal. transcranial magnetic stimulation (TMS) revealed a distinctive motor evoked potential (MEP) pattern in proximal lower limb muscles consisting of markedly increased MEP amplitudes and MEP/M ratios, reduced excitability thresholds, and absent silent period. However, MEP latencies, central and peripheral conduction times and amplitudes obtained by magnetic spinal root stimulation were normal. Treatment with benzodiazepine and baclofen normalized both the clinical picture and the MEP values. TMS may be useful both as a diagnostic tool and to monitor the response to drug treatment.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
6/108. Division of C8 nerve root for treatment of spastic cerebral palsy in the upper limbs: a preliminary report.OBJECTIVE: To investigate the effect of C8 nerve root division on the treatment of spastic cerebral palsy in the upper limbs. methods: Two patients were treated with division of the C8 never root. Supraclavicular incision was made to expose the C5-T1 nerve roots. The intraoperative electromyographic recording technique was used to monitor the responses from the flexor digitorum and flexor carpi ulnaris muscle groups simultaneously. The C5-T1 nerve roots were stimulated and the evoked muscle amplitude potentials (EMAP) were recorded from the muscle groups. The EMAP of the muscle groups obtained during electrical stimulation of the C8 nerve root was the largest, which was used as the basis for C8 nerve root division. RESULTS: Division of the C8 nerve root slightly affected the function of the upper limb, and reduced the muscle tone of the flexor wrist and digitorum. CONCLUSION: Division of the C8 nerve root can reduce the muscle tone of the flexor wrist and digitorum in a short time. The long-term effects need to be followed up further.- - - - - - - - - - ranking = 3keywords = muscle (Clic here for more details about this article) |
7/108. tetanus-like syndrome secondary to metoclopramide administration.A case of metoclopramide-induced pseudotetanus in a 24-year-old woman is described. Symptoms included flexor spasms of the neck muscles, neck pain, left deviation of the lower jaw and tongue protrusion. tetanus was initially suspected. mydriasis, hyperhydrosis and clinical observation indicated that this syndrome could be caused by metoclopramide taken for gastrointestinal symptoms. orphenadrine hydrochloride, diazepam and ketoprofen completely resolved the symptoms. Pseudotetanus presents in many different ways, and it is sometimes very hard to distinguish it from infective tetanus, which is very difficult to diagnose. physicians using metoclopramide should be aware of its adverse effects and how to treat them.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
8/108. The use of intravenous nitroglycerin in a case of spasm of the sphincter of oddi during laparoscopic cholecystectomy.spasm of the sphincter of oddi still occurs during cholecystectomy. Some reports indicate that the spasm, induced by morphine, can be reversed by injection of naloxone, nalbuphine, and glucagon. Others maintain that nitroglycerin or nifedipine can relax the sphincter of oddi muscle. We recently encountered spasm of the sphincter of oddi during a laparoscopic cholecystectomy and treated it successfully with intravenous nitroglycerin.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
9/108. stiff-person syndrome associated with invasive thymoma: a case report.We report a case of a 40-year-old female with continuous muscle stiffness and painful muscle spasms. The symptoms worsened over a two-week period after onset. Electrophysiological examinations revealed continuous muscle discharge, which was markedly reduced by intravenous administration of diazepam. High levels of anti-glutamic acid decarboxylase (GAD) antibodies were detected in both serum and cerebrospinal fluid, suggesting that the patient suffered from stiff-person syndrome. Steroid pulse therapy and immunoadsorption therapy alleviated the clinical symptoms and decreased the anti-GAD antibody titer. A chest CT revealed the presence of an invasive thymoma. Neither anti-acetylcholine receptor (AChR) antibodies nor symptoms of myasthenia gravis (MG) were observed. The patient underwent a thymectomy and postoperative radiotherapy. These treatments further alleviated the clinical symptoms. The present case is the first that associates stiff-person syndrome with invasive thymoma, and not accompanied by MG. The autoimmune mechanism, in this case, may be triggered by the invasive thymoma.- - - - - - - - - - ranking = 1.5keywords = muscle (Clic here for more details about this article) |
10/108. A unilateral presentation of 'Satoyoshi syndrome'.Satoyoshi syndrome is a rare, slowly progressive disorder of unknown etiology with a poor long-term prognosis. The syndrome consists of the following clinical features: (1) painful, intermittent muscle spasms; (2) alopecia; (3) diarrhea; and (4) skeletal abnormalities in cases of juvenile onset. The age of onset is typically less than 20 years of age, although three adult onset cases had been reported. There had been no case report of Satoyoshi syndrome with strict unilateral presentation. We present a 25-year-old man with progressive unilateral hair loss and muscle spasms. Although previous literature had postulated malabsorption and autoimmune mechanism as pathogenic for Satoyoshi syndrome, the presence of a strictly unilateral presentation argues against those hypotheses. However, these hypotheses should still be considered, as our patient did not fit a typical Satoyoshi syndrome. Therefore, more research is needed to understand the pathophysiology and develop an effective treatment to prevent the progression of the disease.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
| | Next -> |