ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Lateral ankle or foot pain may have various etiologies including entrapment of or injury to the distal sural nerve or early peripheral neuropathy. Antidromic distal sural conduction studies have not been used in clinical neurophysiologic evaluation, however, for technical reasons. The purpose of this study was to determine if by modifying recording parameters and using electronic averaging adequate responses could be obtained to permit standardization of distal sural conduction. Standard surface recording electrodes with an interelectrode separation of 37 mm were used. The distal sural nerve conduction of 40 healthy adult subjects (mean age = 33 ± 9 yr, range = 23 to 52) was measured. The latency to the onset was 3.2 ± 0.4 ms (range = 2.5 to 4.0 ms) and to the negative peak was 3.9 ± 0.5 ms (range = 3.0 to 4.9 ms). The conduction velocity was 38 ± 5 m/s (range = 30 to 48 m/s). The amplitude measured from baseline to negative peak was 5.8 ± 2.1 μV (range = 3.0 to 11.0 μV). The results indicated that electrodiagnostic evaluation of the distal sural nerve could be readily achieved and that this might be useful in differential diagnosis.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Continuous intrathecal infusion of the well known antispastic medication baclofen was evaluated in ten consecutive patients. One year after pump implantation the average Ashworth scale for muscle tone decreased, compared with before treatment, 2.32 points(P< 0.0001), reflexes decreased 2.22 points (P< 0.0001) and the spasm score decreased 1.65 points (P< 0.0001). The average dose increased from 92.22 to 290.95 fig (P< 0.0001) between the 1st month of treatment and 1 yr of treatment. The dosage for all patients more than doubled (P< 0.0022) between 3 months and 1 yr postimplantation. There was no significant difference for muscle tone, reflexes or spasms at 3 months v 1 yr. Complications were not unusual and included temporary atelectasis, orthostatic hypotension with escalation of baclofen dose, loss of penile erections, postsurgical pseudomeningoceles, catheter disruptions and exhausted pump reservoirs. One patient suffered a seizure apparently related to a rapid withdrawal from intrathecal baclofen as a result of catheter sequestration. All patients required a period of intensive inpatient rehabilitation to benefit functionally from the decreased motor tone and/or increased voluntary motor control. The procedure is expensive and close follow-up is necessary for assessing efficacy and refilling the pump. Intrathecal baclofen infusion by subcutaneous pump is useful in treating the effects of spinal spasticity resistant to oral medications. However, there appears to be accommodation to intrathecal baclofen necessitating escalating doses to maintain clinical effects.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The steady state profiles of 63 men with traumatic spinal cord injuries (24 quadriplegics and 39 paraplegics; average age of 31.2 ± 6.8 yr; 18-44 yr) were studied. The average length of post-traumatic period was 6.2 ± 5.0 yr, ranging from 8 months to 20 yr. It was found that all the subjects had normal serum thyroxine, thyrotropin, cortisol, growth hormone and plasma adrenocorticotropic hormone. Seven cases (11.1%) had low serum triiodothyronine and eight cases (12.7%) had low serum testosterone. On the other hand, 17 cases (27.0%) had hyperprolactinemia; 9 cases (14.3%) had elevated serum testosterone level; 6 cases (9.5%) had elevated serum follicle-stimulating hormone; and 4 cases (6.3%) had elevated serum luteinizing hormone. The level of spinal cord injury, injury period and patient age had no correlation with other serum hormone changes except that quadriplegic subjects had lower serum triiodothyronine than the paraplegic, with a mean of 1.42 ± 0.30 v 1.70 ± 0.36 nmol/liter (P< 0.005). Of the eight subjects who had low serum testosterone, none had elevated gonadotropin. There were also eight subjects with elevated follicle-stimulating hormone and/or luteinizing hormone, six of them had normal serum testosterone and two had elevated serum testosterone. This suggested their hypogonadism did not result primarily from classic primary gonadal failure. It could be speculated that other testicular paracrine factors and/or alteration of hypothalamus-pituitarytesticular axis are involved in the pathogenesis of hypogonadism. Further studies in this field will provide information regarding male reproductive physiology and may have impact on fertility enhancement options for men with spinal cord injuries.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The purpose of this study was to determine whether a moderate to high intensity strengthening and aerobic exercise program can improve the strength, exercise capacity, gait and balance of deconditioned male nursing home residents. Ambulatory subjects who scored 30 or less on the modified Tinetti gait and balance assessment scale, who demonstrated less than 80% of age-matched lower extremity strength on isokinetic muscle testing and who gave informed consent were enrolled. Subjects were randomized to either an exercise (n= 8) or a control (n= 6) group. All participants underwent an exercise test to determine maximal oxygen uptake (Vo2max) and received quantitative gait and balance measurements. The subjects assigned to the exercise group then completed a 12-wk program of weight training for the lower extremities and stationary cycling. Both the exercise and control groups were then retested. Ten outcome variables were assessed: Tinetti mobility scores, Vo2max, isokinetic-tested lower extremity strength and endurance, stride length, gait velocity, stance time, gait duration, cadence and balance. The exercise group, after completion of the program, demonstrated significant improvements in Tinetti mobility scores (P< 0.05), combined right and left quadricep muscle strength (P< 0.01), right and left lower extremity muscular endurance (P< 0.01), left stride length and gait velocity (P< 0.05), although other outcome variables changed insignificantly. The control group revealed no changes of significance with the exception of improvement of the combined right and left hamstring muscle strength (P< 0.05). Nevertheless, for those outcome variables that had improved significantly in the exercise group, the changes amounted to only a 5 to 10% increase over the baseline measurements. These findings showed that an appropriately designed high intensity exercise program can result in significant although limited improvements for clinical mobility scores, strength, muscular endurance and certain gait parameters.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, tempromandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found stastically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Spinal cord arteriovenous malformations have been described in association with a variety of congenital diseases affecting the vasculature, including Klippel- Trenaunay-Weber syndrome, Rendu-Osler-Weber syndrome and others, but rarely in association with lymphatic abnormalities. We report the case of a young man with congenital lymphedema and arteriovenous malformations of one lower extremity and a spinal cord arteriovenous malformation. Awareness of the possible presence of a central nervous system arteriovenous malformation in individuals with pre-existing arteriovenous and lymphatic abnormalities may be helpful in their diagnosis and management.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Dural tears with leakage of cerebral spinal fluid into surrounding soft tissues can occur after traumatic spinal cord injury. An unusual case presented in a patient with traumatic paraplegia where the onset was delayed and clinical features were suggestive of autonomic dysfunction. The clinical features, pathophysiology and treatment of this interesting complication following traumatic spinal cord injury are discussed.

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1992

数据来源: OVID