1/324. Acute sensorimotor polyneuropathy with tonic pupils and an abduction deficit: an unusual presentation of polyarteritis nodosa.A tonic pupil may occur in isolation or as part of a systemic disorder. We report a patient who developed tonic pupils and an abduction deficit in the setting of polyarteritis nodosa. The combination of a tonic pupil and an abduction deficit should suggest the possibility of a vasculopathic disorder, because the ciliary ganglion and lateral rectus muscle are both supplied by the lateral muscular artery. Widespread small artery and arteriolar narrowing and occlusion are the hallmarks of polyarteritis nodosa. Unusual ischemic syndromes may occur, such as this rare combination of neuro-ophthalmic signs, by involvement of both the nutrient artery and its collaterals. We are unaware of other reports of neuropathic tonic pupils in association with polyarteritis nodosa.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/324. peroneal nerve palsy caused by intraneural ganglion.A case of peroneal nerve palsy caused by an intraneural ganglion is presented. The cystic mass was located posterolateral to the lateral femoral condyle and extended along the common peroneal nerve distal to the origin of the peroneus longus muscle. The nerve was compressed in the narrow fibro-osseous tunnel against the fibula neck and the tight origin of the peroneus longus muscle. The nerve was decompressed by complete tumor excision and transection of the origin of the peroneus longus muscle. Full recovery of nerve function was obtained in 6 months.- - - - - - - - - - ranking = 3keywords = muscle (Clic here for more details about this article) |
3/324. Interruption of the radial nerve at proximal level: reconstruction following anterior transposition.The authors describe two cases of radial paralysis due to interruption in the proximal level, treated by autologous nerve grafting, following anterior transposition. At long-term follow-up, in one case after 12 years, there was good functional recovery, while in the second case there was still no recovery after 2 years. The surgical technique involving anterior transposition of the nerve is described, which in this type of lesion facilitates neurorrhaphy.- - - - - - - - - - ranking = 15.116111335399keywords = paralysis (Clic here for more details about this article) |
4/324. Pulmonary manifestations of poems syndrome: case report and literature review.phrenic nerve paresis is an unusual complication of POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein spike and skin changes) syndrome. In this report, we describe a case of poems syndrome in which a 56-year-old woman presented with dyspnea and ventilatory failure due to bilateral phrenic nerve paralysis. To our knowledge, only one other case of phrenic neuropathy in poems syndrome has been reported.- - - - - - - - - - ranking = 15.116111335399keywords = paralysis (Clic here for more details about this article) |
5/324. hypertrophy and pseudohypertrophy of the lower leg following chronic radiculopathy and neuropathy: imaging findings in two patients.Enlargement of the ipsilateral muscle compartment is an exceptional finding in patients with chronic radiculopathy, peripheral nerve injury, anterior horn cell diseases, or acquired peripheral neuropathy. We report radiographic, ultrasonographic, CT and MRI findings in a patient with chronic S1 radiculopathy and another with chronic neuropathy of the common fibular nerve (L4-S2), both presenting with painless enlargement of the calf muscles.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
6/324. Congenital muscular dystrophy with central and peripheral nervous system involvement in a Belgian patient.We report a patient with congenital muscular dystrophy (CMD), developmental brain defects, and peripheral neuropathy. Marked hypotonia and plagiocephaly were noted at birth. failure to thrive, generalized muscle weakness and wasting, absent deep tendon reflexes, partial seizures, and secondary microcephaly developed. brain MRI showed a large area of cortical dysplasia, a thin but complete corpus callosum, and diffuse ventriculomegaly. Nerve conduction velocities were slow and creatine kinase levels only mildly elevated. Muscle biopsy showed dystrophic features with normal merosin, sarcoglycan, and dystrophin immunostaining. The Japanese Fukuyama CMD founder mutation was not detected. This is the first report of a patient with merosin-positive CMD, cobblestone lissencephaly, and demyelinating peripheral neuropathy.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
7/324. Laryngeal electromyographic findings in charcot-marie-tooth disease type II.charcot-marie-tooth disease is a hereditary motor and sensory neuropathy that exhibits progressive muscular atrophy in the limbs, beginning with the lower extremities. It is now understood to be a heterogeneous group of disorders that can be differentiated both clinically and genetically. In charcot-marie-tooth disease type II C, axonal neuropathy, diaphragm weakness, and vocal cord paralysis are described within kindreds. We used laryngeal electromyography to study a patient with this disorder. This technique has potential in the diagnosis of charcot-marie-tooth disease type II.- - - - - - - - - - ranking = 15.116111335399keywords = paralysis (Clic here for more details about this article) |
8/324. Bilateral lumbosacral plexopathy after mesenteric thrombosis.OBJECTIVE: A case of lumbosacral plexopathy (LSP) following operation for mesenteric thrombosis. DESIGN: Case report of a 64-year-old man who developed weakness and numbness of the distal legs after an operation for mesenteric thrombosis. SETTING: Department of Physical medicine and rehabilitation, University Hospital La Fe, Valencia, spain. SUBJECT: Single patient case report. MAIN OUTCOME MEASURE: Clinical and electromyography follow-up of the patient between October 1996 and August 1997. RESULTS: physical examination revealed marked lower extremity weakness, hypotonia, hyporreflexia and normal bowel and bladder function. electromyography demonstrated marked denervation of all major muscle groups, and sensory nerve conduction showed absence of responses in all peripheral nerves, in both legs. CONCLUSION: To our knowledge, bilateral LSP following an intervention of mesenteric thrombosis, has never been reported in the literature. diagnosis of LSP might be based on electromyography and nerve conduction studies that demonstrate electrodiagnostic criteria for LSP, including denervation in muscles innervated by at least two lumbosacral segmental levels and involving at least two different peripheral nerves, without paraspinal involvement.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
9/324. Restoring hand function in patients with severe polyneuropathy: the role of electromyography before tendon transfer surgery.electromyography (EMG) was evaluated as a supplement to clinical examination and biomechanical considerations to optimize forearm donor muscle selection before tendon transfers to 4 functionless hands in 3 patients with slowly progressive polyneuropathies. Two patients had unusually severe charcot-marie-tooth disease; the third patient had idiopathic mononeuropathy multiplex. Standard EMG parameters were used to devise an intuitive muscle grading system, including most importantly interference patterns and motor control, plus motor unit morphology and stability. Given our objective of restoring survivable function despite ongoing polyneuropathy, we found that EMG reveals prognostically important differences among partially denervated candidate muscles that cannot be detected by experienced clinical examiners. Opposition transfer was performed on one hand of each patient. After 39-, 39-, and 51-month follow-up durations, restored opposition was graded as good in these 3 hands. We conclude that EMG provides meaningful guidance in selecting optimal forearm muscles for tendon transfers to hands in the setting of slowly progressive polyneuropathies.- - - - - - - - - - ranking = 4keywords = muscle (Clic here for more details about this article) |
10/324. Organophosphate neuropathy due to methamidophos: biochemical and neurophysiological markers.Neuropathy target esterase (NTE), the putative target enzyme for organophosphate induced delayed polyneuropathy (OPIDP), can be measured in lymphocytes but has rarely been assessed in acute human poisoning. serum autoantibodies to nervous system proteins develop in hens poisoned with neuropathic insecticides and also have not been studied after human poisoning. Serial lymphocyte NTE (LNTE) was measured in a 16-year-old boy after acute poisoning with methamidophos for evaluation as a predictor of subsequent neuropathy. The profiles of serum autoantibodies to neurofilament triplet proteins, myelin basic protein, and glial fibrillary acidic protein were measured in order to characterize changes occurring as a result of OPIDP. Clinical neuropathy characterized by steppage gate and profound lower extremity weakness, decreased grip and pinch strength, and decreased ulnar and absent tibial compound muscle action potentials developed 2 weeks following poisoning. Sensory examination and nerve conduction studies were normal. On day 3 following poisoning LNTE was depressed (77% compared with subsequent baseline enzyme activity). Marked increases in serum immunoglobulin g (IgG) autoantibodies to glial fibrillary acidic protein and to neurofilament 200 were observed after the development of OPIDP. We conclude that inhibition of lymphocyte NTE is predictive of subsequent OPIDP. serum autoantibody titers to nervous system proteins may be useful markers of neuropathy.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
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