Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 2.022
Filter
1.
Fisioter. Bras ; 22(3): 486-499, Jul 15, 2021.
Article in Portuguese | LILACS | ID: biblio-1290557

ABSTRACT

Uma das principais causas de morte e limitação funcional em todo o mundo é o Acidente Vascular Encefálico (AVE), causando alterações significativas sobre as atividades de vida diária do indivíduo. O AVE ocorre a partir de comprometimentos vasculares, ocasionando danos cognitivos e musculares, sendo necessário o tratamento fisioterapêutico para a recuperação da função. A realidade virtual se tornou uma aliada da fisioterapia para a recuperação de pacientes pós-AVE, como forma de tornar o tratamento mais interativo e atraente para o paciente. O presente estudo teve como objetivo verificar a eficácia do uso da realidade virtual na recuperação funcional dos membros superiores em pacientes com sequelas de AVE, por meio de uma revisão sistemática. Os estudos utilizados foram buscados em duas bases de dados, onde aqueles selecionados deveriam obedecer aos critérios de inclusão e exclusão pré-determinados. Os resultados obtidos mostraram que a realidade virtual em conjunto com a fisioterapia pode proporcionar resultados significantes para a melhora funcional do membro superior afetado, o que acarreta melhora e bem estar geral do paciente. (AU)


One of the main causes of death and functional limitation worldwide is the stroke, causing significant changes in the individual's daily activities. Stroke occurs from vascular impairments, causing cognitive and muscle damage, requiring physiotherapeutic treatment to recover function. Virtual reality has become a complement of physiotherapy for the recovery of post-stroke patients, with a way of making treatment more interactive and attractive to the patient. The present study aimed to verify the effectiveness of the use of virtual reality in the functional recovery of the upper limbs in patients with stroke sequelae, through a systematic review. The studies used were searched on two scientific bases, where those selected should obey the predetermined inclusion and exclusion criteria. The results obtained showed that virtual reality in conjunction with physical therapy can provide significant results for the functional improvement of the upper limb affected, which leads to improvement and general well-being of the patient. (AU)


Subject(s)
Humans , Paralysis , Stroke , Virtual Reality , Quality of Life , Physical Therapy Modalities , Upper Extremity
4.
Rev. chil. neuro-psiquiatr ; 58(3): 286-293, set. 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1138583

ABSTRACT

Resumen Introducción: La Hipertensión Intracraneal Idiopática (HICI) es un síndrome neurológico caracterizado por un aumento de la presión intracraneal en ausencia de lesión estructural o hidrocefalia. Los síntomas incluyen cefalea, tinnitus pulsátil, oscurecimientos visuales transitorios y pérdida visual. Dentro de los signos destacan diplopía por parálisis del VI par, edema de papila y disminución de la agudeza visual. Los pacientes no tienen compromiso de conciencia ni signos neurológicos focales. La principal complicación es la pérdida visual que puede ser irreversible. La asociación entre HICI y nitrofurantoína (NTF) se reportó en 1974. Caso clínico: Mujer de 42 años, con sobrepeso, que desarrolló una HICI aproximadamente 18 meses posterior al inicio de nitrofurantoína profiláctica. Consultó por cefalea frontal, opresiva que aumentaba con la maniobra de Valsalva, asociada a disminución fluctuante de la agudeza visual y episodios de oscurecimiento. Al examen destacó edema de papila bilateral, sin déficit neurológico focal. La presión del líquido cefalorraquídeo (LCR) fue de 25,5 cm de agua. La resonancia magnética mostró signos de aumento de la presión del LCR, sin lesiones estructurales ni hidrocefalia. El cuadro se recuperó concomitantemente a la suspensión de la NTF y el uso de topiramato. No se constató daño visual permanente. Conclusiones: Se debe sospechar la HICI en mujeres en edad fértil con sobrepeso. Dentro de los gatillantes del síndrome destacan varios fármacos, entre ellos la NTF. El principal objetivo del tratamiento de la HICI es preservar la función visual.


Abstract Introduction: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure without a space occupying lesion or hydrocephalus. The symptoms are headache, pulsatile tinnitus, transient visual obscurations, and visual loss. Signs are diplopia caused by sixth cranial nerve paresis and papilledema with its associated loss of sensory visual function. The patient maintains an alert and oriented mental state, but has no localizing neurologic findings. The only major morbidity with IIH is visual loss. The association between IIH and nitrofurantoin was reported in 1974. Case: A 42 years old female, overweighed, who developed IIH 18 months after the start of prophylactic nitrofurantoin. She had frontal oppressive headache that increased with the Valsalva maneuver, fluctuant visual loss and transient visual obscurations. She had bilateral papilledema without localizing neurologic findings. The cerebrospinal fluid (CSF) pressure was 25.5 cm H2O. Magnetic resonance imaging showed signs of increased CSF pressure without structural lesions or hydrocephalus. IIH recovered with the withdrawal of nitrofurantoin and the use of topiramate. There was not permanent visual loss. Conclusions: It is recommendable to suspect IIH in obese women in the childbearing years. There are several drugs associated with IIH including nitrofurantoin. The main objective of treatment is to prevent visual loss.


Subject(s)
Humans , Female , Adult , Paralysis , Pseudotumor Cerebri , Intracranial Pressure , Headache , Nitrofurantoin
5.
Rev. argent. dermatol ; 101(1): 71-80, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1125808

ABSTRACT

Resumen: El síndrome de Melkersson-Rosenthal (SMR) es una entidad clínica rara, de patogénesis desconocida. Se manifiesta característicamente por edema orofacial recidivante, lengua fisurada y parálisis recurrente del nervio facial. Representando así undesafío diagnóstico y terapéutico, además de generar importante compromiso social al individuo acometido. El presente artículo tiene como objetivo describir el caso de un paciente de 15años de edad que presentó: edema labial, lengua fisurada y queilitis granulomatosa al examen histopatológico, llevándose a consideración la hipótesis del síndrome citado, con resultados satisfactorios al tratamiento establecido.


Abstract: Melkersson-Rosenthal syndrome (MRS) is a rare clinical entity with an unknown pathogenesis. It clinically manifests in orofacial edema, plicated tongue and recurrent paralysis of the facial nerve. It represents a diagnostic and therapeutic challenge, and has an important psycosocial impact on the affected individual. This study describes the case of a 15-year-old patient who presented with labial edema, plicated tongue and granulomatous cheilitis on histopathological examination, for which a diagnosis of MRS was proposed. The patient showed a good response to treatment.


Subject(s)
Humans , Male , Adolescent , Tongue, Fissured/etiology , Edema/etiology , Facial Nerve/physiopathology , Melkersson-Rosenthal Syndrome/physiopathology , Paralysis/etiology , Melkersson-Rosenthal Syndrome/diagnosis
7.
Chinese Journal of Traumatology ; (6): 211-215, 2020.
Article in English | WPRIM | ID: wpr-827832

ABSTRACT

Since December 2019, COVID-19, an acute infectious disease, has gradually become a global threat. We report a case of thoracolumbar fractures (T and L) and incomplete lower limb paralysis in a patient with COVID-19. After a series of conservative treatment which did not work at all, posterior open reduction and pedicle screw internal fixation of the thoracolumbar fracture were performed in Wuhan Union Hospital. Three weeks later, the patient could stand up and the pneumonia is almost cured. We successfully performed a surgery in a COVID-19 patient, and to our knowledge it is the first operation for a COVID-19 patient ever reported.


Subject(s)
Betacoronavirus , Coronavirus Infections , Fracture Fixation, Internal , Humans , Lumbar Vertebrae , Wounds and Injuries , General Surgery , Male , Middle Aged , Pandemics , Paralysis , General Surgery , Pedicle Screws , Pneumonia, Viral , Spinal Fractures , General Surgery , Thoracic Vertebrae , Wounds and Injuries , General Surgery
8.
Arch. argent. pediatr ; 117(6): 664-669, dic. 2019. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1046726

ABSTRACT

Desde la eliminación de la circulación del virus polio salvaje, disminuyeron los casos de parálisis fláccida aguda. Sin embargo, continúan ocurriendo casos asociados a otros enterovirus no polio y virus neurotropos. Se presenta el caso de una paciente de 9 años con diagnóstico de meningitis y mielitis con compromiso motor en los miembros inferiores y vejiga neurogénica asociado a enterovirus, con resolución completa del cuadro neurológico posterior a la administración de gammaglobulina hiperinmune.


Since the wild poliovirus no longer circulates, the number of cases of acute flaccid paralysis decreased. However, cases related to non-polio enteroviruses and neurotrope viruses continue to occur. We present a nine-year-old patient with meningitis and myelitis with motor involvement in the lower limbs and neurogenic bladder associated with enterovirus, with complete resolution of the neurological symptoms following the administration of hyperimmune gammaglobulin.


Subject(s)
Humans , Female , Child , gamma-Globulins/therapeutic use , Enterovirus , Myelitis/diagnostic imaging , Paralysis
9.
Rev. cuba. med. trop ; 71(2): e335, mayo.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093568

ABSTRACT

El linfoma no Hodgkin es la segunda neoplasia más frecuente en pacientes con sida. Sus formas clínicas sistémicas asociadas con el virus de inmunodeficiencia humana casi siempre tienen un alto grado una malignidad. La participación del sistema nervioso central es un hecho frecuente en pacientes con este tipo de linfoma. El objetivo es describir una forma atípica de presentación del linfoma no Hodgkin en un paciente con sida. Se informa acerca de un paciente de 28 años, VIH positivo, con linfoma no Hodgkin de células grandes B difuso que se presentó con parálisis aislada del III par craneal como principal manifestación inicial, la enfermedad progresó rápidamente y en pocos días tuvo un desenlace fatal. Se concluye que es necesario considerar el diagnóstico de linfoma no Hodgkin en pacientes con sida y parálisis del III par craneal, para de esta forma realizar un diagnóstico temprano e iniciar tratamiento oportuno debido a la rápida evolución y mal pronóstico de la enfermedad(AU)


Non-Hodgkin's lymphoma is the second most common neoplasm in patients with AIDS. Its systemic clinical forms associated with the human immunodeficiency virus almost always have a high degree of malignancy. Involvement of the central nervous system is a frequent occurrence in patients with this type of lymphoma. The purpose of the study is to describe an atypical presentation of non-Hodgkin's lymphoma in a patient with AIDS. A case is reported of a male 28-year-old HIV-positive patient with diffuse large B-cell non-Hodgkin's lymphoma who presented with isolated cranial nerve III palsy as the main initial manifestation. The disease progressed rapidly and had a fatal outcome some days later. It is concluded that it is necessary to consider the diagnosis of non-Hodgkin's lymphoma in patients with AIDS and cranial nerve III palsy, in order to make an early diagnosis and initiate timely treatment, in view of the rapid evolution and poor prognosis of the disease.(AU)


Subject(s)
Humans , Male , Adult , Lymphoma, Non-Hodgkin/complications , HIV Infections/complications , Fatal Outcome , Early Diagnosis , Paralysis , HIV Infections/mortality
10.
Acta neurol. colomb ; 35(1): 36-39, ene.-mar. 2019. graf
Article in Spanish | LILACS | ID: biblio-989196

ABSTRACT

RESUMEN La parálisis pseudoperiférica es una presentación infrecuente del ataque cerebrovascular (ACV) isquémico, que suele llevar a un diagnóstico erróneo de patología de nervio periférico. Se caracteriza por una presentación clínica consistente en paresia de la mano o de un grupo de dedos y alteración de la sensibilidad que puede simular el compromiso de un nervio periférico. Se reporta el caso clínico de un paciente que cursó con parálisis pseudoperiférica, con compromiso motor predominantemente cubital asociado a hipoestesia multimodal en la región hipotenar, lo cual ilustrando la dificultad de la localización topográfica para explicar el compromiso motor y sensitivo por un síndrome mononeuropático, troncular, radicular o medular. Se resalta la importancia de una adecuada evaluación semiológica, que permita hacer aproximaciones diagnósticas acertadas para dar un manejo adecuado de acuerdo con el estudio topográfico en las patologías neurológicas.


SUMMARY Pseudo-peripheral palsy is an infrequent presentation of ischemic stroke, which often leads to a misdiagnosis of peripheral nerve pathology. It is characterized by palsy of the hand or a group of fingers and altered sensitivity which can simulate peripheral nerve damage. We report a case of a patient who had pseudo-peripheral palsy with predominantly ulnar motor involvement, associated with multimodal hypoesthesia in the hypothenar region; illustrating the difficulty of topographic localization to explain motor and sensory involvement by a mononeuropathic, radicular or spinal syndrome. We highlight the importance of an adequate semiological evaluation to accurately diagnose and manage these pathologies.


Subject(s)
Paralysis , Stroke , Diagnosis, Differential , Motor Cortex
12.
Article in English | WPRIM | ID: wpr-719560

ABSTRACT

This paper reports a case of a female patient aged 48 years diagnosed with a right lateral medullary infarction and dysphagia after the onset period. In a video fluoroscopic swallowing study (VFSS), significant manifestations were not observed in the oral phase, but during swallowing aspiration, a larger amount of post-swallowing residue were observed on the test of swallowing of semisolid and liquid. After the VFSS, a laryngoscopy was performed, which indicated paralysis and para-median fixation in the right vocal fold. In this case, swallowing with rightward head rotation was adopted as a compensation technique to reduce the aspiration caused by the para-median fixation of the right vocal fold, but it was not enough to improve the dysphagia in this case. To medialize the right vocal fold, hyaluronic acid was injected with laryngoscopic guidance. In a VFSS conducted after the injection, aspiration was not observed on the test of swallowing a semisolid and liquid. The injection of hyaluronic acid is less invasive than surgical operations, does not require general anesthesia, and makes the recovery time shorter. Therefore, it is expected to be an alternative to the treatment of unilateral vocal fold paralysis (UVFP) accompanied with dysphagia.


Subject(s)
Anesthesia, General , Compensation and Redress , Deglutition , Deglutition Disorders , Female , Fluoroscopy , Head , Humans , Hyaluronic Acid , Infarction , Laryngoscopy , Paralysis , Vocal Cords
13.
Article in English | WPRIM | ID: wpr-719398

ABSTRACT

A 65-year-old male patient underwent C-arm fluoroscopy-guided bilateral celiac plexus neurolysis to relieve peritoneal seeding-related pain associated with pancreatic cancer. Following confirmation of spreading, and no intravascular injection of contrast media, 7.5 ml of 0.25% chirocaine was injected in each side. The pain subsided after the block, with no motor or sensory deficits. Subsequently, celiac plexus neurolysis with 99.8% alcohol was performed using a posterolateral approach under fluoroscopic guidance. The patient was instructed to maintain a prone position for 2 hours while the procedure was performed. Approximately 4 hours later, the patient experienced paralysis of both lower extremities and hypoesthesia. Emergent magnetic resonance imaging of the thoracic and lumbar spine revealed gray matter signal change in the cord and conus medullaris at the T10-L1 level, and decreased perfusion at the T11-T12 vertebral bodies, suggesting spinal cord infarction. The patient remained paraplegic until his death 24 days later.


Subject(s)
Aged , Celiac Plexus , Contrast Media , Gray Matter , Humans , Hypesthesia , Infarction , Lower Extremity , Magnetic Resonance Imaging , Male , Pancreatic Neoplasms , Paralysis , Paraplegia , Perfusion , Prone Position , Spinal Cord , Spine
14.
Clinical Pain ; (2): 111-114, 2019.
Article in Korean | WPRIM | ID: wpr-811484

ABSTRACT

Guillain-Barre syndrome (GBS) is usually characterized by acute areflexic ascending paralysis with minimal sensory involvement. Only a few cases of GBS associated with scrub typhus have been reported. Previous case reports focused on the laboratory findings, pathogenesis, and clinical manifestation. Unlike the previous case, neuropathic pain was a prominent symptom of GBS in our case. We report scrub-typhus-related GBS with a detailed description of the clinical manifestations, especially neuropathic pain, along with results of serial follow-up electrodiagnostic studies.


Subject(s)
Follow-Up Studies , Guillain-Barre Syndrome , Neuralgia , Paralysis , Scrub Typhus
15.
Article in English | WPRIM | ID: wpr-740002

ABSTRACT

This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.


Subject(s)
Anesthesia , Arthrocentesis , Facial Nerve , Facial Paralysis , Follow-Up Studies , Humans , Joint Capsule , Middle Aged , Paralysis , Temporomandibular Joint
17.
Article in English | WPRIM | ID: wpr-741305

ABSTRACT

PURPOSE: To understand the ophthalmic clinical features and outcomes of facial nerve palsy patients who were referred to an ophthalmic clinic for various conditions like Bell's palsy, trauma, and brain tumor. METHODS: A retrospective study was conducted of 34 eyes from 31 facial nerve palsy patients who visited a clinic between August 2007 and July 2017. The clinical signs, management, and prognosis were analyzed. RESULTS: The average disease period was 51.1 ± 20.6 months, and the average follow-up duration was 24.0 ± 37.5 months. The causes of facial palsy were as follows: Bell's palsy, 13 cases; trauma, six cases; brain tumor, five cases; and cerebrovascular disease, four cases. The clinical signs were as follows: lagophthalmos, 24 eyes; corneal epithelial defect, 20 eyes; conjunctival injection, 19 eyes; ptosis, 15 eyes; and tearing, 12 eyes. Paralytic strabismus was found in seven eyes of patients with another cranial nerve palsy (including the third, fifth, or sixth cranial nerve). Conservative treatments (like ophthalmic ointment or eyelid taping) were conducted along with invasive procedures (like levator resection, tarsorrhaphy, or botulinum neurotoxin type A injection) in 17 eyes (50.0%). Over 60% of the patients with symptomatic improvement were treated using invasive treatment. At the time of last following, signs had improved in 70.8% of patients with lagophthalmos, 90% with corneal epithelium defect, 58.3% with tearing, and 72.7% with ptosis. The rate of improvement for all signs was high in patients suffering from facial nerve palsy without combined cranial nerve palsy. CONCLUSIONS: The ophthalmic clinical features of facial nerve palsy were mainly corneal lesion and eyelid malposition, and their clinical course improved after invasive procedures. When palsy of the third, fifth, or sixty cranial nerve was involved, the prognosis and ophthalmic signs were worse than in cases of simple facial palsy. Understanding these differences will help the ophthalmologist take care of patients with facial nerve palsy.


Subject(s)
Bell Palsy , Brain Neoplasms , Cerebrovascular Disorders , Cranial Nerve Diseases , Cranial Nerves , Epithelium, Corneal , Eyelids , Facial Nerve , Facial Paralysis , Follow-Up Studies , Humans , Paralysis , Prognosis , Retrospective Studies , Strabismus , Tears
18.
Article in English | WPRIM | ID: wpr-786051

ABSTRACT

PURPOSE: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment.METHODS: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system.RESULTS: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05).CONCLUSION: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.


Subject(s)
Cool-Down Exercise , Humans , Lower Extremity , Muscle Spasticity , Muscle Weakness , Muscles , Paralysis , Rehabilitation , Stroke , Warm-Up Exercise
19.
Article in English | WPRIM | ID: wpr-788819

ABSTRACT

OBJECTIVE: We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL).METHODS: Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom’s criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months.RESULTS: In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom’s criteria or between the single-level and two-level corpectomy groups.CONCLUSION: The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.


Subject(s)
Cervical Vertebrae , Female , Follow-Up Studies , Humans , Longitudinal Ligaments , Methods , Ossification of Posterior Longitudinal Ligament , Paralysis , Retrospective Studies , Spinal Cord Diseases , Spondylosis , Titanium , Transplants
20.
Article in English | WPRIM | ID: wpr-764330

ABSTRACT

No abstract available.


Subject(s)
Lymphoma , Orbit , Paralysis
SELECTION OF CITATIONS
SEARCH DETAIL