Cases reported "Muscle Rigidity"

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1/11. Primary brainstem injury: benign course and improved survival.

    Primary brainstem injury following head injury is a rare event. The victims often have features of supratentorial injury, and a primary isolated injury to the brainstem occurring due to shearing stresses or to injury from the tentorial edge is extremely rare. In the presence of supratentorial injury, these patients may have altered sensorium. Isolated brainstem injury may manifest itself as internuclear ophthalmoplegia, anisocoria, rigidity and cerebellar tremor. Such injuries are now being diagnosed more often due to improved imaging techniques. We treated nine such cases who had sustained primary brainstem injury in road traffic accidents, all but one of whom were subsequently independent. Primary brainstem injuries need not be associated with poor prognosis and mortality and may run a benign course with good quality of survival.
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ranking = 1
keywords = ophthalmoplegia
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2/11. amyotrophic lateral sclerosis with supranuclear ophthalmoplegia and rigidity.

    ophthalmoplegia is rarely reported in patients with amyotrophic lateral sclerosis (ALS). We describe a patient with sporadic ALS, who had developed progressive external ophthalmoplegia of supranuclear origin and rigidity in the neck. autopsy findings showed histopathological abnormalities consistent with ALS. In addition to these findings, there was neuronal loss and gliosis in the putamina and globi pallidi, and gliosis in the periaqueductal gray matter. Our case appears to raise the possibility that ALS comprises a heterogenous group of disorders.
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ranking = 2006.186869148
keywords = supranuclear ophthalmoplegia, supranuclear, ophthalmoplegia
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3/11. Bilateral substantia nigra changes on MRI in a patient with encephalitis lethargica.

    A 33-year-old woman admitted for meningoencephalitis had features of encephalitis lethargica develop on her third day of illness. She had ophthalmoplegia, akinetic mutism, and prominent extrapyramidal signs consisting of lip and hand tremors, cogwheel rigidity, and facial bradykinesia.
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ranking = 1
keywords = ophthalmoplegia
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4/11. Corticobasal degeneration. A unique pattern of regional cortical oxygen hypometabolism and striatal fluorodopa uptake demonstrated by positron emission tomography.

    Corticobasal degeneration presents with an asymmetric akinetic-rigid syndrome, apraxia and combinations of supranuclear gaze palsy, myoclonus, and an alien limb. Six patients aged 59-77 yrs, diagnosed on clinical criteria as having corticobasal degeneration, have been studied with positron emission tomography using tracers of dopamine storage capacity and oxygen metabolism. Striatal 18F-6-fluorodopa uptake was reduced in an asymmetric pattern, caudate and putamen being involved in all cases. Uptake into medial frontal cortex was also impaired. Regional cortical oxygen metabolism was most significantly depressed in the superior and posterior temporal, inferior parietal, and occipital associated cortices. Within the frontal lobe, the hypometabolism was chiefly posterior. This unique combination of regional hypometabolism and disruption of the nigrostriatal system is discussed in relation to the clinical features of the disease and is compared with reported findings in other disorders of cognition and movement.
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ranking = 88.012617273223
keywords = supranuclear, palsy
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5/11. Cerebral sarcoidosis presenting as supranuclear gaze palsy with hypokinetic rigid syndrome.

    A 31-year-old man with histologically documented pulmonary sarcoidosis developed a severe hypokinetic rigid syndrome with a supranuclear gaze palsy following recurrent lymphocytic meningitis and occlusive hydrocephalus. Magnetic resonance imaging (MRI) showed multiple hyperintense foci in the CNS, not detectable by computed tomography (CT). Long-term steroid therapy led to clinical complete remission.
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ranking = 440.06308636612
keywords = supranuclear, palsy
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6/11. Cerebellar stimulation in man. Quantitative changes in spasticity.

    The effects of chronic anterior lobe cerebellar stimulation on patients with cerebral palsy have been investigated using a new method of quanitfying muscle rigidity and stretch reflexes. The ankle is oscillated sinusoidally, compliance is measured at several frequencies, and electromyographic activity of the extensor and flexor muscles is recorded. In some patients stimulation can reduce rigidity and coactivation of muscles immediately or slowly over days or months. In others no change is found.
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ranking = 0.0087549214037161
keywords = palsy
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7/11. Bilateral intracerebral haemorrhage presenting with supranuclear ophthalmoplegia, bradykinesia and rigidity.

    A 70 year old man recovered from a left putamenal haemorrhage in 1984 with a residual mild right hemiparesis. In 1985 he presented following the sudden onset of inability to stand. The clinical findings of supranuclear ophthalmoplegia, bradykinesia and rigidity resembled those of progressive supranuclear palsy. CT scan revealed a recent haemorrhage deep in the right hemisphere white matter in addition to a low density change in the left basal ganglia reflecting the site of previous haemorrhage. The patient's course was uncomplicated and the ophthalmoplegia resolved. Bradykinesia and rigidity persist. This case illustrates an unusual clinical presentation of bilateral intracerebral haemorrhage with supranuclear ophthalmoplegia, bradykinesia and rigidity.
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ranking = 3093.2796238487
keywords = supranuclear ophthalmoplegia, progressive supranuclear, supranuclear, supranuclear palsy, ophthalmoplegia, palsy
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8/11. Rigidity and dorsiflexion of the neck in progressive supranuclear palsy and the interstitial nucleus of Cajal.

    Rigidity and dorsiflexion of the neck are typical signs in progressive supranuclear palsy, but the responsible areas in the brain are unknown. To examine whether bilateral lesions of the interstitial nucleus of Cajal (INC) in the midbrain tegmentum contribute to the signs of patients with progressive supranuclear palsy, we have made bilateral INC lesions in cats and tried to correlate these studies with clinical and pathological data, including our case of progressive supranuclear palsy. Bilateral INC lesioned cats showed dorsiflexion of the neck and impairment of vertical eye movement, similar to progressive supranuclear palsy patients. Analysis of the previous clinical-pathological studies and our case have shown that dorsiflexion of the neck in progressive supranuclear palsy patients was correlated more with INC lesions than lesions of the basal ganglia.
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ranking = 1948.5460228891
keywords = progressive supranuclear, supranuclear, supranuclear palsy, palsy
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9/11. rehabilitation in progressive supranuclear palsy: case report.

    Progressive supranuclear palsy (PSP) is a distinct clinicopathologic entity characterized by supranuclear ophthalmoplegia, pseudobulbar palsy, axial dystonia in extension, and subcortical dementia. Although relatively rare, PSP is disabling, thus rehabilitation techniques and management are indicated in nearly every case. This report describes the neurologic presentation, rehabilitation management, and outcome of treatment of a patient with PSP during a 12-month period. The patient required thorough neuromuscular, neuropsychological, speech, swallowing, vision, and social service evaluations prior to the implementation of a rehabilitation program. Therapeutic rehabilitation techniques focused on limb coordination activities, tilt board balancing, ambulation activities, and activities to improve route finding and visual scanning ability. Prism lenses were introduced to compensate for deficits in vertical eye movements. Treatment improved the patient's functional status. Later, as the patient's neurologic status deteriorated, it became necessary to educate the family and caretakers in the ongoing rehabilitation management of the patient.
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ranking = 1449.7732238841
keywords = supranuclear ophthalmoplegia, progressive supranuclear, supranuclear, supranuclear palsy, ophthalmoplegia, palsy
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10/11. Botulinum toxin-A improves the rigidity of progressive supranuclear palsy.

    Botulinum toxin-A (botox) can improve spasticity and decrease painful spasms in the affected limbs of patients with multiple sclerosis. We report significant improvement of muscle rigidity in the upper limbs after focal administration of botulinum toxin A to 2 patients with progressive supranuclear palsy.
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ranking = 1082.5255682717
keywords = progressive supranuclear, supranuclear, supranuclear palsy, palsy
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