1/122. 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) |
2/122. Atypical and typical cranial dystonia following dental procedures.It is generally recognized that focal dystonia of the limbs or cervical region and blepharospasm sometimes follow, and in these cases may be caused or triggered by, peripheral injury. However, the association between peripheral injury and lower cranial dystonia is rare. We report eight cases who developed cranial dystonia within hours to months following a dental procedure. One group of five cases, all women, developed atypical dystonia associated with painful paresthesias at the site of dystonia. Two of these five cases had fixed jaw-deviating dystonia, whereas the remaining three had additional tremor and spread of their dystonia to involve the tongue in all three, and the lips and neck in two cases. These five patients are reminiscent of cases of limb causalgia-dystonia syndrome, which occurs after minor peripheral trauma and can spread. The remaining three cases developed more typical cranial dystonia following the dental procedure. There was no family history of dystonia or prior use of neuroleptics in any of the patients. The close association in time and location of the procedure and onset of symptoms suggests that the onset of the dystonia may have been caused by the dental intervention, but whether there is a causal relationship between the dental intervention and the development of the dyskinesias requires further epidemiologic studies.- - - - - - - - - - ranking = 0.026867540079312keywords = limb (Clic here for more details about this article) |
3/122. 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) |
4/122. Painful tonic/dystonic spasms in sjogren's syndrome.Three patients with sjogren's syndrome are presented in whom frequent tonic/dystonic spasms of the limbs developed during the course of the illness. These patients' clinical findings suggested spinal cord involvement, a localization that was confirmed by magnetic resonance imaging in two patients. In one patient the painful movements responded to treatment with phenytoin and in one other to baclofen. sjogren's syndrome should be considered in the differential diagnosis of conditions that produce tonic/dystonic limb spasms.- - - - - - - - - - ranking = 0.026867540079312keywords = limb (Clic here for more details about this article) |
5/122. Unilateral painful vasospasm in the lower limbs of young women.The cases of five young women who presented with severe pain and associated vascular changes in one foot are described. The pain was spontaneous in onset and lasted for days, and its severity was such that none of the patients were able to walk without disability. Arteriography in three patients revealed arterial spasm. All had a good response from lumbar sympathectomy on the affected side.- - - - - - - - - - ranking = 0.053735080158623keywords = limb (Clic here for more details about this article) |
6/122. 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) |
7/122. Diaphragmatic cramp as a possible cause of noncardiac chest pain and referred mandibular pain.The initial assumption that sudden acute chest pain may be of cardiac origin is justifiable, but when this proves not to be the case the patient is left with little explanation of the cause. It is suggested here that diaphragmatic cramp may be a cause of some undiagnosed noncardiac chest pains associated with mandibular referred pain. The phrenic nerve provides both motor and sensory innervation to the diaphragm, while the trigeminal nerve carries sensation from the mandibular teeth. Both nerves originate in separate nuclei close together in the lower medulla. Interconnections between these nuclei and others higher up in the brain may provide one explanation for this problem.- - - - - - - - - - ranking = 189.10745069394keywords = cramp (Clic here for more details about this article) |
8/122. 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) |
9/122. Acute arterial spasm in an extremity caused by inadvertent intra-arterial injection successfully treated in the emergency department.We present a case of limb ischemia in a young man. For acute alcohol withdrawal, this patient was given chlordiazepoxide (Librium) through an angiocatheter inadvertently placed into a brachial arterial line. This caused severe spasm of the brachial artery and its branches. These findings were confirmed by angiography. Successful treatment occurred with intra-arterial papaverin.- - - - - - - - - - ranking = 0.013433770039656keywords = limb (Clic here for more details about this article) |
10/122. 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 = 0.51343377003966keywords = muscle, limb (Clic here for more details about this article) |
| | Next -> |