Spontaneous non-traumatic hip dislocation in patients with stroke.

This is a unique clinical case of a spontaneous non-traumatic hip dislocation in a patient with stroke with a hip and knee flexion pattern. This case highlights the role of spasticity as a cause of hip dislocation and the need to combine focal spasticity treatment and surgery to restore ambulation.

Serotonin Syndrome Mimicking Intrathecal Baclofen Withdrawal in a Patient with Hereditary Spastic Paraparesis.

CONTEXT: Serotonin syndrome is a drug-induced condition related to an increased level of serotonin in the brain, which may induce neuromuscular, autonomic and mental symptoms. CASE REPORT: A 40-year-old woman with hereditary spastic paraparesis (Strumpell-Lorrain disease) with an implanted intrathecal baclofen pump for severe spasticity. Two days after starting a medication known to inhibit serotonin re-uptake (paroxetine), she developed a sudden increase in lower limb spasticity with continuous spasms, fever, tachycardia and hypertension. Intrathecal baclofen withdrawal was excluded, confirming serotonin syndrome. CONCLUSION: Medications that inhibit serotonin reuptake may induce serotonin syndrome, resulting in increased spasticity in patients with spinal cord lesions, and should be prescribed with caution.

Does human gait exhibit comparable and reproducible long-range autocorrelations on level ground and on treadmill?

Stride duration of young healthy subjects walking at spontaneous speed fluctuates over the long-term in a very complex way. The presence of long-range autocorrelations among these fluctuations has already been highly suggested for subjects walking on level ground, but the mathematical methods used among studies are variable. Moreover, despite the frequent use of a treadmill in research and in rehabilitation, the presence of such autocorrelations was nearly exclusively assessed during level-ground walking. The first aim of this study was to confirm the presence of long-range autocorrelations among stride duration variability on level ground with a good level of confidence. The stride duration fluctuations of 10 young healthy subjects were assessed on a 37-meter-long track using an integrated approach that combines the results of rescaled range analysis and power spectral analysis. Secondly, the results obtained from treadmill tests were compared with the outcomes of the level-ground walking tests in order to challenge the persistence of the long-range autocorrelations during treadmill walking. Finally, the third aim of this study was to test the reproducibility of the outcomes by comparing the results obtained on the treadmill during two different trials. The outcomes of this study provide significant evidence to confirm the hypothesis that long-range autocorrelations are present among stride duration variability, not only on level ground but also on the treadmill. The reproducibility of the results obtained during treadmill walking further validates the use of a treadmill to assess the long-term fluctuations of gait.