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Sample records for causing spastic compressive

  1. Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Dewan Udita

    2010-01-01

    Full Text Available Extramedullary hemopoiesis (EMH is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

  2. Hereditary spastic paraplegia-causing mutations in atlastin-1 interfere with BMPRII trafficking

    OpenAIRE

    Zhao, Jiali; Hedera, Peter

    2012-01-01

    Disruption of the bone morphogenic protein (BMP)-linked signaling pathway has been suggested as an important factor in the development of hereditary spastic paraplegia (HSP). HSP-causing proteins spastin, spartin and NIPA1 were reported to inhibit the BMP pathway. We have previously shown a strong interaction of NIPA1 and atlastin-1 proteins. Hence, we investigated the role of another HSP-associated protein atlastin-1 in this signaling cascade. Endogenous and expressed atlastin-1 showed a str...

  3. Hereditary spastic paraplegia caused by the PLP1 'rumpshaker mutation'

    DEFF Research Database (Denmark)

    Svenstrup, Kirsten; Giraud, Geneviève; Boespflug-Tanguy, Odile;

    2010-01-01

    'rumpshaker mutation.' PATIENTS: A family with HSP caused by the 'rumpshaker mutation.' RESULTS: The patients showed nystagmus during infancy and had early onset of HSP. They had normal cognition, and cerebral MRI showed relatively unspecific white matter abnormalities on T2 sequences without clear...

  4. Congenital irreducible atlantoaxial dislocation associated with cervical intramedullary astrocytoma causing progressive spastic quadriparesis

    Directory of Open Access Journals (Sweden)

    Chatley Anooj

    2008-01-01

    Full Text Available Simultaneous presence of congenital irreducible atlantoaxial dislocation (AAD and cervical intramedullary astrocytoma has not been previously described and may cause disabling myelopathy. This 55-year-old lady presented with suboccipital pain, spastic quadriparesis, Lhermitte′s phenomenon and sphincteric disturbances. Lateral radiographs and magnetic resonance imaging showed irreducible AAD, occipitalized atlas, C2-3 fusion, and,an intramedullary tumor from C2-5 level iso-to-hypointense, non-enhancing, except in a small segment in the dorsal C2 level. A suboccipital craniectomy with C2-5 laminectomy revealed a greyish-white tenacious tumor. The tumor was decompressed using a C2-5 midline myelotomy and duroplasty. An occipitocervical lateral mass fixation was performed. Histopathology revealed a low-grade astrocytoma. At three-month follow-up, her spasticity had decreased and quadriparesis and sphincteric disturbances were persisting. Postoperative lateral radiographs and intrathecal contrast CT scan showed a stable occipitocervical construct. Thus, the suboccipital craniectomy and laminectomy with midline myelotomy and duroplasty facilitated space for progressively expanding intramedullary astrocytoma with irreducible AAD; the lateral mass fixation provided stability at the craniovertebral junction.

  5. The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

    OpenAIRE

    Ashkan Irani; Azadeh Imani; Seyyed Ali Hosseini

    2012-01-01

    Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divi...

  6. Extramedullary haematopoeisis causing spinal cord compression

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    F Ismail

    2010-08-01

    Full Text Available Extramedullary haematopoeisis (EMH is a rare cause of spinal cord compression. However, in a patient with a haematological disorder and in particular thalassaemia, EMH with paraspinal masses should be considered and imaging planned appropriately.

  7. Mutations in DARS Cause Hypomyelination with Brain Stem and Spinal Cord Involvement and Leg Spasticity

    Science.gov (United States)

    Taft, Ryan J.; Vanderver, Adeline; Leventer, Richard J.; Damiani, Stephen A.; Simons, Cas; Grimmond, Sean M.; Miller, David; Schmidt, Johanna; Lockhart, Paul J.; Pope, Kate; Ru, Kelin; Crawford, Joanna; Rosser, Tena; de Coo, Irenaeus F.M.; Juneja, Monica; Verma, Ishwar C.; Prabhakar, Prab; Blaser, Susan; Raiman, Julian; Pouwels, Petra J.W.; Bevova, Marianna R.; Abbink, Truus E.M.; van der Knaap, Marjo S.; Wolf, Nicole I.

    2013-01-01

    Inherited white-matter disorders are a broad class of diseases for which treatment and classification are both challenging. Indeed, nearly half of the children presenting with a leukoencephalopathy remain without a specific diagnosis. Here, we report on the application of high-throughput genome and exome sequencing to a cohort of ten individuals with a leukoencephalopathy of unknown etiology and clinically characterized by hypomyelination with brain stem and spinal cord involvement and leg spasticity (HBSL), as well as the identification of compound-heterozygous and homozygous mutations in cytoplasmic aspartyl-tRNA synthetase (DARS). These mutations cause nonsynonymous changes to seven highly conserved amino acids, five of which are unchanged between yeast and man, in the DARS C-terminal lobe adjacent to, or within, the active-site pocket. Intriguingly, HBSL bears a striking resemblance to leukoencephalopathy with brain stem and spinal cord involvement and elevated lactate (LBSL), which is caused by mutations in the mitochondria-specific DARS2, suggesting that these two diseases might share a common underlying molecular pathology. These findings add to the growing body of evidence that mutations in tRNA synthetases can cause a broad range of neurologic disorders. PMID:23643384

  8. Medullar compression caused by vertebral hemangioma

    International Nuclear Information System (INIS)

    This is case of a 41 years old feminine patient in whom a unique primary bone tumor injury was demonstrated, diagnosed as a bone hemangioma, located at T-7, with grew and compressed the spinal cord. These bone vascular and frequently observed in the radiological studies and autopsies, in a sporadic form are only symptomatic, growing and affecting the nervous roots and the spinal cord. The clinical history of the patient is described with the preoperative studies and magnetic resonance 6 years after the surgery: The medical literature of these primary bony injuries is reviewed and as they are treated. Objectives: to present the clinical history of a patient who consults having medullar compression syndrome caused by an unusual extra-medullar tumor injury, of bony origin, primary and benign, with clinical controls 8 years after the operation and without evidence of tumor recurrences. The medical literature of this bone pathology is reviewed. Methodology: the clinical history of the patient is described, who was treated surgically successfully, because spinal cord was decompressed without neurological sequels. Vertebral instability was not observed and nor diagnosed. The patient was periodically taken care of with last control of magnetic resonance 6 years after the surgery and last medical control 8 years later. Medical publications are extensively reviewed

  9. The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

    Directory of Open Access Journals (Sweden)

    Ashkan Irani

    2012-10-01

    Full Text Available Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divided into two groups. The first lower limb spasticity was assessed by a neurologist, and then by an experienced occupational therapist whitout being aware of research process before the intervention, The experimental group went under treatment using positioning therapeutic intervention and neurodevelopmental treatment, while the control group was treated and only with NDT. The research Instrument used was the Modified Ashworth scale (MAS and the H-Reflex and, H/M ratio in the lower limb spasticity was assessed, Utilizing Experimental pretest - post test with control group design. The data of this study was analyzed using t Test k square test and the findings showed meaningful differences between the two groups.Result: The findings of this study reveraled meaningful differences between the two groups, scores of mean spasticity in interference group was significantly less than control group (p=0/003 Conclusion: Application of Anti spastic Orthosis before rehabilitation exercises is recommended for diplegic spastic children.

  10. Thoracic cord compression caused by contiguous multilevel ossification of ligamentum flavum in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    WANG Kai; CHEN Xin

    2007-01-01

    Objective:To explore the epidemiology, clinical presentation, radiology and surgical treatment outcome in Chinese patients with myelopathy caused by contiguous multilevel ossification of ligamentum flavum.Methods: Medical notes and imaging data of 18 Chinese patients (14 males and 4 females, aged 43-72 years, mean: 57 years ) with myelopathy caused by contiguous multilevel ossification of ligamentum flavum were studied retrospectively in this article. The diagnosis was based on clinical examination, X-ray films, computerized tomography ( CT) and magnetic resonance imaging (MRI) scanning results and pathological results. Sixteen patients were treated by laminectomy and two by laminoplasty. The average follow-up duration was 34 months ( range, 28-49 months ). The outcome was evaluated by Japanese Orthopaedics Association (JOA) score.Results: The average time for occurring clinical symptoms was 7.5 months (range, 2 days-16 months). All the 18 cases presented with clinical evidences of chronic and progressive thoracic spinal cord compression, which included bilateral leg weakness, spastic gait, numbness in lower limbs, paresthesia in terminal and perineum, and urinary incontinence. Neurological examination revealed severe spastic paraparesis, absence of abdominal reflexes, and reduction of the sensory function below the compression level. The mean JOA score before operation was 3. 6 (range, 0-6). MRI and CT scans of the thoracic spine confirmed the presence of contiguous multilevel ossification of the ligamentum flavum. The mean recovery rate after surgery in terms of JOA score was 66.3% (range, 33.3%-100%), with a mean final JOA score of 8. 3. Thoracic decompression laminectomy or laminoplasty could result in a good postoperative outcome.Conclusions: Contiguous multilevel ossification of the ligamentum flavum is not a common cause of myelopathy in Chinese population and should be treated as early as possible. MRI and CT scan examinations may diagnose the presence of

  11. Late-onset dysphagia caused by severe spastic peristalsis of a free jejunal graft in a case of hypopharyngeal cancer.

    Science.gov (United States)

    Imai, Takayuki; Goto, Takahiro; Matsumoto, Ko; Kurosawa, Koreyuki; Asada, Yukinori; Saijo, Shigeru; Matsuura, Kazuto

    2016-12-01

    Free jejunal transfer is the main technique used for reconstructing a circumferential defect caused by total pharyngo-laryngo-cervical-esophagectomy in certain cancer cases. We report a rare case of severe late-onset dysphagia caused by autonomous spastic peristalsis, which led to complete obstruction of the free jejunal route. A 70-year-old man underwent treatment for hypopharyngeal cancer involving total pharyngolaryngectomy with free jejunal transfer. After uneventful peri- and postoperative recovery, he developed sudden-onset severe dysphagia 22 months later. Gastrografin fluoroscopy revealed abnormal peristalsis and contraction of the transferred jejunum, leading to complete obstruction. Nutritional treatment, application of depressants of peristalsis, and xylocaine injection into the outer space of the jejunal mucosa all failed to alleviate the dysphagia. Surgical treatment involving a longitudinal incision of the jejunal graft, and interposing a cutaneous flap, as a fixed wall, between the incised jejunal margins to prevent obstruction was performed. After further reconstructive surgery involving using a pectoralis major musculocutaneous flap and a split-thickness skin graft to close a refractory jejunum-skin fistula, the dysphagia was permanently alleviated. To our knowledge, this is the first report of severe dysphagia caused by peristalsis of a free jejunal graft. PMID:27068782

  12. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke

    OpenAIRE

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-01-01

    Abstract Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases. This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapeziu...

  13. Management of Spasticity in Children with Cerebral Palsy

    OpenAIRE

    Shamsoddini, Alireza; AMIRSALARI, Susan; Hollisaz, Mohammad-Taghi; Rahimnia, Alireza; Khatibi-Aghda, Amideddin

    2014-01-01

    Cerebral palsy is the most common cause of spasticity and physical disability in children and spasticity is one of the commonest problems in those with neurological disease. The management of spasticity in children with cerebral palsy requires a multidisciplinary effort and should be started as early as possible. There are a number of treatments available for the management of spasticity. This article reviews the variety of options available for the clinical management of spasticity.

  14. Qualitative development of the ‘Questionnaire on Pain caused by Spasticity (QPS),’ a pediatric patient‐reported outcome for spasticity‐related pain in cerebral palsy

    OpenAIRE

    Geister, Thorin L.; Quintanar-Solares, Manjari; Martin, Mona; Aufhammer, Stephan, Walter; Asmus, Friedrich

    2013-01-01

    Purpose To develop a patient-reported outcome measure for spasticity-related pain in children/adolescents (age 2–17 years) with cerebral palsy (CP), the ‘Questionnaire on Pain caused by Spasticity (QPS).’ Methods Using a semi-structured interview guide, concept elicitation interviews on spasticity-related pain in upper and lower limbs were conducted in 21 children and caregiver pairs. Data were used to modify initial QPS modules and develop six draft modules, which were subsequently refined a...

  15. Placebo effects in a multiple sclerosis spasticity enriched clinical trial with the oromucosal cannabinoid spray (THC/CBD): dimension and possible causes.

    Science.gov (United States)

    Di Marzo, Vincenzo; Centonze, Diego

    2015-03-01

    Regulatory authorities admit clinical studies with an initial enrichment phase to select patients that respond to treatment before randomization (Enriched Design Studies; EDSs). The trial period aims to prevent long-term drug exposure risks in patients with limited chances of improvement while optimizing costs. In EDSs for symptom control therapies providing early improvements and without a wash-out period, it is difficult to show further improvements and thus large therapeutic gains versus placebo. Moreover, in trials with cannabinoids, the therapeutic gains can be further biased in the postenrichment randomized phase because of carryover and other effects. The aims of the present review article are to examine the placebo effects in the enrichment and postenrichment phases of an EDS with Δ(9) -tetrahydrocannabinol and cannabidiol (THC/CBD) oromucosal spray in patients with multiple sclerosis (MS) spasticity and to discuss the possible causes of maintained efficacy after randomization in the placebo-allocated patients. The overall mean therapeutic gain of THC/CBD spray over placebo in resistant MS spasticity after 16 weeks can be estimated as a ~1.27-point improvement on the spasticity 0-10 Numerical Rating Scale (NRS; ~-20.1% of the baseline NRS score). We conclude that careful interpretation of the results of EDSs is required, especially when cannabinoid-based medications are being investigated. PMID:25475413

  16. Adaptor Protein Complex 4 Deficiency Causes Severe Autosomal-Recessive Intellectual Disability, Progressive Spastic Paraplegia, Shy Character, and Short Stature

    OpenAIRE

    Abou Jamra, Rami; Philippe, Orianne; Raas-Rothschild, Annick; Eck, Sebastian H.; Graf, Elisabeth; Buchert, Rebecca; Borck, Guntram; Ekici, Arif; Brockschmidt, Felix F.; Nöthen, Markus M.; Munnich, Arnold; Strom, Tim M.; Reis, Andre; Colleaux, Laurence

    2011-01-01

    Intellectual disability inherited in an autosomal-recessive fashion represents an important fraction of severe cognitive-dysfunction disorders. Yet, the extreme heterogeneity of these conditions markedly hampers gene identification. Here, we report on eight affected individuals who were from three consanguineous families and presented with severe intellectual disability, absent speech, shy character, stereotypic laughter, muscular hypotonia that progressed to spastic paraplegia, microcephaly,...

  17. Botulinum toxin in poststroke spasticity.

    Science.gov (United States)

    Ozcakir, Suheda; Sivrioglu, Koncuy

    2007-06-01

    Poststroke hemiparesis, together with abnormal muscle tone, is a major cause of morbidity and disability. Although most hemiparetic patients are able to reach different ambulatory levels with rehabilitation efforts, upper and lower limb spasticity can impede activities of daily living, personal hygiene, ambulation and, in some cases, functional improvement. The goals of spasticity management include increasing mobility and range of motion, attaining better hygiene, improving splint wear and other functional activities. Conservative measures, such as positioning, stretching and exercise are essential in spasticity management, but alone often are inadequate to effectively control it. Oral antispastic medications often provide limited effects with short duration and frequent unwanted systemic side effects, such as weakness, sedation and dry mouth. Therefore, neuromuscular blockade by local injections have become the first choice for the treatment of focal spasticity, particularly in stroke patients. Botulinum toxin (BTX), being one of the most potent biological toxins, acts by blocking neuromuscular transmission via inhibiting acetylcholine release. Currently, focal spasticity is being treated successfully with BTX via injecting in the spastic muscles. Two antigenically distinct serotypes of BTX are available on the market as type A and B. Clinical studies of BTX used for spastic hemiplegic patients are reviewed in this article in two major categories, upper and lower limb applications. This review addresses efficacy in terms of outcome measures, such as muscle tone reduction and functional outcome, as well as safety issues. Application modifications of dose, dilutions, site of injections and combination therapies with BTX injections are also discussed. PMID:17607049

  18. Hereditary Spastic Paraplegia

    Science.gov (United States)

    ... there any treatment? What is the prognosis? What research is being done? Clinical Trials Organizations What is Hereditary Spastic Paraplegia? Hereditary spastic paraplegia (HSP), also called familial spastic paraparesis (FSP), refers to a group of inherited disorders that ...

  19. Hydrokinezotherapy as the cause of physical rehabilitation of children of preschool age with cerebral paralysis of spastic form.

    Directory of Open Access Journals (Sweden)

    Baybuza I.V.

    2011-06-01

    Full Text Available In this work is considered effective influences of physical exercises in water. The dynamics of development of functional indexes is shown by the kardio-respirator and kinesthesia systems. In an experiment took part 15 children of preschool age with the cerebral paralysis of spastic form. It is well-proven that the most substantial changes happened at the estimation of indexes of dynamic force of muscles and goniometry of lower limbs. Leaning against the got results, it is possible to recommend a hydrokinezotherapy in treatment of patients with this pathology.

  20. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke

    Science.gov (United States)

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-01-01

    Abstract Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases. This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapezius was diagnosed by physical examination and needle electromyographic study. Botulinum toxin was injected into the spastic periscapular muscles under ultrasound imaging guidance. During the 3-week follow-up visit after injection, both patients showed increased shoulder active ROM, without any sign of scapular destabilization. The results suggest that botulinum toxin injection to spastic periscapular muscles can increase shoulder active ROM without causing scapular destabilization in patients with poststroke spastic scapular dyskinesia. PMID:26266368

  1. Eagle Syndrome Causing Vascular Compression with Cervical Rotation: Case Report

    Science.gov (United States)

    Demirtaş, Hakan; Kayan, Mustafa; Koyuncuoğlu, Hasan Rıfat; Çelik, Ahmet Orhan; Kara, Mustafa; Şengeze, Nihat

    2016-01-01

    Summary Background Eagle syndrome is a condition caused by an elongated styloid process. Unilateral face, neck and ear pain, stinging pain, foreign body sensation and dysphagia can be observed with this syndrome. Rarely, the elongated styloid process may cause pain by compressing the cervical segment of the internal carotid and the surrounding sympathetic plexus, and that pain spreading along the artery can cause neurological symptoms such as vertigo and syncope. Case Report In this case report we presented a very rare eagle syndrome with neurological symptoms that occurred suddenly with cervical rotation. The symptoms disappeared as suddenly as they occurred, with the release of pressure in neutral position. We also discussed CT angiographic findings of this case. Conclusions Radiological diagnosis of the Eagle syndrome that is manifested with a wide variety of symptoms and causes diagnostic difficulties when it is not considered in the differential diagnosis is easy in patients with specific findings. CT angiography is a fast and effective examination in terms of showing compression in patients with the Eagle syndrome that is considered to be atypical and causes vascular compression. PMID:27354882

  2. Post-surgical thoracic pseudomeningocele causing spinal cord compression.

    Science.gov (United States)

    Macki, Mohamed; Lo, Sheng-fu L; Bydon, Mohamad; Kaloostian, Paul; Bydon, Ali

    2014-03-01

    Pseudomeningoceles are extradural cerebrospinal fluid collections categorized into three groups: traumatic, congenital, and iatrogenic. Iatrogenic pseudomeningoceles occur after durotomy, usually after cervical or lumbar spine surgery. Although many remain asymptomatic, pseudomeningoceles can compress or herniate the spinal cord and nerve roots. We present a 57-year-old woman who had a thoracic laminectomy and discectomy. Two weeks after surgery, she presented with lower extremity weakness and gait difficulty. Physical examination revealed hyperreflexia and a T11 sensory level. MRI revealed a pseudomeningocele compressing the thoracic spinal cord. The patient underwent surgical drainage of the cyst. On follow-up, she had complete resolution of her symptoms, and MRI did not show a residual lesion. To our knowledge, this is the second documented post-operative pseudomeningocele causing symptomatic spinal cord compression of the thoracic spine. In this article, a review of the literature is presented, including four reported patients with post-traumatic pseudomeningocele causing myelopathic symptoms and 20 patients with iatrogenic pseudomeningocele that resulted in neurological decline due to herniation or compression of neural tissue. Treatment options for these lesions include conservative management, epidural blood patch, lumbar subarachnoid drainage, and lumbo-peritoneal shunt placement. Surgical repair, usually by primary dural closure, remains the definitive treatment modality for iatrogenic symptomatic pseudomeningoceles. PMID:24210805

  3. Central Nervous System Aspergillosis causing Spinal Cord Compression

    Directory of Open Access Journals (Sweden)

    Faraz Ahmed

    2010-07-01

    Full Text Available Central nervous system (CNS aspergillosis is a rare and uniformly fatal complication of disseminated disease, involving the cerebral hemispheres and cerebellum in the majority of cases. It is a ubiquitous mold and refers to a group of diseases caused by monomorphic mycelial fungi of the genus Aspergillosis fumigatus. Outbreaks of invasive aspergillosis are a problem in immunocompromized persons after they are exposed to air-borne spores.1 Aspergillosis causing spinal cord compression due to epidural abscess formation and hypertrophic pachymeningitis is a rare entity, thus such a case is presented herewith.

  4. Splicing Defect in Mitochondrial Seryl-tRNA Synthetase Gene Causes Progressive Spastic Paresis Instead of HUPRA Syndrome.

    Science.gov (United States)

    Linnankivi, Tarja; Neupane, Nirajan; Richter, Uwe; Isohanni, Pirjo; Tyynismaa, Henna

    2016-09-01

    Mitochondrial aminoacyl-tRNA synthetases are an important group of disease genes typically underlying either a disorder affecting an isolated tissue or a distinct syndrome. Missense mutations in the mitochondrial seryl-tRNA synthetase gene, SARS2, have been identified in HUPRA syndrome (hyperuricemia, pulmonary hypertension, renal failure in infancy, and alkalosis). We report here a homozygous splicing mutation in SARS2 in a patient with progressive spastic paresis. We show that the mutation leads to diminished levels of the synthetase in patient's fibroblasts. This has a destabilizing effect on the tRNASer(AGY) isoacceptor, but to a lesser degree than in HUPRA syndrome patients. tRNASer(UCN) is largely unaffected in both phenotypes. In conclusion, the level of tRNASer(AGY) instability may be a factor in determining tissue manifestation in patients with SARS2 mutations. This finding exemplifies the sensitivity of the nervous system to partially reduced aminoacylation, which is sufficient in other tissues to maintain respiratory chain function. PMID:27279129

  5. Autosomal recessive spastic tetraplegia caused by AP4M1 and AP4B1 gene mutation: expansion of the facial and neuroimaging features.

    Science.gov (United States)

    Tüysüz, Beyhan; Bilguvar, Kaya; Koçer, Naci; Yalçınkaya, Cengiz; Çağlayan, Okay; Gül, Ece; Sahin, Sezgin; Çomu, Sinan; Günel, Murat

    2014-07-01

    Adaptor protein complex-4 (AP4) is a component of intracellular transportation of proteins, which is thought to have a unique role in neurons. Recently, mutations affecting all four subunits of AP4 (AP4M1, AP4E1, AP4S1, and AP4B1) have been found to cause similar autosomal recessive phenotype consisting of tetraplegic cerebral palsy and intellectual disability. The aim of this study was analyzing AP4 genes in three new families with this phenotype, and discussing their clinical findings with an emphasis on neuroimaging and facial features. Using homozygosity mapping followed by whole-exome sequencing, we identified two novel homozygous mutations in AP4M1 and a homozygous deletion in AP4B1 in three pairs of siblings. Spastic tetraplegia, microcephaly, severe intellectual disability, limited speech, and stereotypic laughter were common findings in our patients. All patients also had similar facial features consisting of coarse and hypotonic face, bitemporal narrowing, bulbous nose with broad nasal ridge, and short philtrum which were not described in patients with AP4M1 and AP4B1 mutations previously. The patients presented here and previously with AP4M1, AP4B1, and AP4E1 mutations shared brain abnormalities including asymmetrical ventriculomegaly, thin splenium of the corpus callosum, and reduced white matter volume. The patients also had hippocampal globoid formation and thin hippocampus. In conclusion, disorders due to mutations in AP4 complex have similar neurological, facial, and cranial imaging findings. Thus, these four genes encoding AP4 subunits should be screened in patients with autosomal recessive spastic tetraplegic cerebral palsy, severe intellectual disability, and stereotypic laughter, especially with the described facial and cranial MRI features. PMID:24700674

  6. Rupture of sigmoid colon caused by compressed air.

    Science.gov (United States)

    Yin, Wan-Bin; Hu, Ji-Lin; Gao, Yuan; Zhang, Xian-Xiang; Zhang, Mao-Shen; Liu, Guang-Wei; Zheng, Xue-Feng; Lu, Yun

    2016-03-14

    Compressed air has been generally used since the beginning of the 20(th) century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mmHg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review. PMID:26973403

  7. Enlarged spinoglenoid notch veins causing suprascapular nerve compression

    International Nuclear Information System (INIS)

    To report the magnetic resonance (MR) imaging findings of enlarged veins in the spinoglenoid notch as a cause of suprascapular nerve compression.Design and patients Six patients presented to MR imaging for evaluation of chronic shoulder pain. Clinical information and MR imaging studies were reviewed. The spinoglenoid notch vascular structures were compared with measurements made in 10 age-matched controls. Spinoglenoid notch vascular structures measured in 10 asymptomatic age-matched control patients ranged from 1 to 4 mm in diameter with an average of 2.2 mm. The six study patients had vascular structures that ranged from 6 to 10 mm in diameter with an average of 8.4 mm. Atrophy and fatty infiltration of the infraspinatus muscle was noted as an associated finding at MR imaging in all six patients. Surgery was performed in three of the six patients, at which time a venous varix was identified in the spinoglenoid notch in all three patients. We describe distended veins in the spinoglenoid notch. These may be readily apparent at MR imaging and should be distinguished from paralabral ganglion cysts compressing the suprascapular nerve in the absence of labral tears, especially if percutaneous aspiration of a ganglion cyst is entertained. (orig.)

  8. Enlarged spinoglenoid notch veins causing suprascapular nerve compression

    Energy Technology Data Exchange (ETDEWEB)

    Carroll, Kevin W. [Radiology Regional Center, 700 Goodlette Road, Naples, FL 34102 (United States); Helms, Clyde A. [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Otte, Michael T. [Invision Medical Imaging and Radiology, 8200 East Belleview Avenue, Suite 124, Greenwood Village, CO 80111 (United States); Moellken, S.M.C. [San Francisco Magnetic Resonance Center, 3333 California Street, Suite 105, San Francisco, CA 94118 (United States); Fritz, R. [National Orthopedic Associates, 1260 South Eliseo Drive, Greenbrae, CA 94904 (United States)

    2003-02-01

    To report the magnetic resonance (MR) imaging findings of enlarged veins in the spinoglenoid notch as a cause of suprascapular nerve compression.Design and patients Six patients presented to MR imaging for evaluation of chronic shoulder pain. Clinical information and MR imaging studies were reviewed. The spinoglenoid notch vascular structures were compared with measurements made in 10 age-matched controls. Spinoglenoid notch vascular structures measured in 10 asymptomatic age-matched control patients ranged from 1 to 4 mm in diameter with an average of 2.2 mm. The six study patients had vascular structures that ranged from 6 to 10 mm in diameter with an average of 8.4 mm. Atrophy and fatty infiltration of the infraspinatus muscle was noted as an associated finding at MR imaging in all six patients. Surgery was performed in three of the six patients, at which time a venous varix was identified in the spinoglenoid notch in all three patients. We describe distended veins in the spinoglenoid notch. These may be readily apparent at MR imaging and should be distinguished from paralabral ganglion cysts compressing the suprascapular nerve in the absence of labral tears, especially if percutaneous aspiration of a ganglion cyst is entertained. (orig.)

  9. Orthopaedic Management of Spasticity.

    Science.gov (United States)

    Pidgeon, Tyler S; Ramirez, Jose M; Schiller, Jonathan R

    2015-12-01

    Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications. Orthopaedic surgeons manage numerous sequelae of spasticity, including joint contractures, hip dislocations, scoliosis, and deformed extremities. When combined with the efforts of rehabilitation specialists, neurologists, and physical/occupational therapists, the orthopaedic management of spasticity can help patients maintain and regain function and independence as well as reduce the risk of long-tem complications. PMID:26623452

  10. Primary hyperparathyroidism. A rare cause of spinal cord compression.

    Science.gov (United States)

    Haddad, Fares H; Malkawi, Omar M; Sharbaji, Amer A; Jbara, Ibrahim F; Rihani, Hanan R

    2007-05-01

    We report a case of a 62-year-old postmenopausal hypertensive lady who was treated for osteoporosis with calcium and Vitamin D. She presented with progressive lower limb weakness and paresthesia with sensory level at T4. Investigations revealed high parathyroid hormone 1152 ng/dl, calcium 10.9 mg/dl, and low phosphorus of 2.4 mg/dl after stopping calcium supplement. Chest x-ray showed an expansile mass lesion of the right 6th rib confirmed by chest CT. Thoracic MRI showed a mass lesion extending from the T3 vertebral body and compressing the spinal cord. There were multiple lytic lesions of the scalp, ribs, femur, and pelvis suggesting metastatic lesions. A neck ultrasound and SESTA MIBI parathyroid scan confirmed a right lower parathyroid adenoma. Excision biopsy of the rib lesion confirmed a vascular lesion with features of brown tumor BT. Decompression surgery of the thoracic spine was performed, and the histopathology confirmed BT. Two weeks later the patient underwent right parathyroidectomy that proved to be a parathyroid adenoma. She showed a remarkable improvement in her clinical condition and there were some regression of the bony lesions observed 12 months post parathyroidectomy. This case should alert physicians to the association of multiple brown tumors in PHPT and that the presentation may be an aggressive one mimicking metastasis, patients with osteoporosis warrant at least calcium profile to rule out a secondary cause. PMID:17457452

  11. Primary hyperparathyroidism: A rare cause of spinal cord compression

    International Nuclear Information System (INIS)

    We report a case of a 62-year-old postmenopausal hypertensive lady who was treated for osteoporosis with calcium and Vitamin D. She presented with progressive lower limb weakness and paresthesia with sensory level at T4. Investigations revealed high parathyroid hormone 1152 ng/dl, calcium 10.9 mg/dl, and low phosphorus of 2.4 mg/dl after stopping calcium supplement. Chest x-ray showed an expansile mass lesion of the right 6th rib confirmed by chest CT. Thoracic MRI showed a mass lesion extending from the T3 vertebral body and compressing the spinal cord. There were multiple lytic lesions of the scalp, ribs, femur, and pelvis suggesting metastatic lesions. A neck ultrasound and SESTA MIBI parathyroid scan confirmed a right lower parathyroid adenoma. Excision biopsy of the rib lesion confirmed a vascular lesion with features of brown tumor BT. Decompression surgery of the thoracic spine was performed, and the histopathology confirmed BT. Two weeks later the patient underwent right parathyroidectomy that proved to be a parathyroid adenoma. She showed a remarkable improvement in her clinical condition and there were some regression of the bony lesions observed 12 months post parathyroidectomy. This case should alert physicians to the association of multiple brown tumors in PHPT and that the presentation may be an aggressive one mimicking metastasis, patients with osteoporosis warrant at least calcium profile to rule out a secondary cause. (author)

  12. Repetitive Transcranial Magnetic Stimulation in Patients with Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Mehmet Ağırman

    2011-06-01

    Full Text Available Hereditary spastic paraplegia (HSPP is a heterogeneous genetic disease characterized by progressive spasticity of lower extremities. Spasticity is a major cause of long-term disability in HSPP and significantly affects the functional life of patients. Repetitive transcranial magnetic stimulation (rTMS is widely used in diagnosis and treatment of many neurological and psychiatric diseases. Although the positive impacts of rTMS for spasticity have been reported, no study has been found on HSPP. We present two HSPP patients treated with low frequency rTMS (20 minutes at a frequency of 1 Hz (1200 pulses, for a period of 10 treatment sessions.

  13. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke: Case Series.

    Science.gov (United States)

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-08-01

    Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases.This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapezius was diagnosed by physical examination and needle electromyographic study. Botulinum toxin was injected into the spastic periscapular muscles under ultrasound imaging guidance.During the 3-week follow-up visit after injection, both patients showed increased shoulder active ROM, without any sign of scapular destabilization.The results suggest that botulinum toxin injection to spastic periscapular muscles can increase shoulder active ROM without causing scapular destabilization in patients with poststroke spastic scapular dyskinesia. PMID:26266368

  14. Tropical Spastic Paraparesis

    Science.gov (United States)

    ... NINDS NINDS Tropical Spastic Paraparesis Information Page Synonym(s): Retrovirus-Associated Myelopathy, HTLV-1 Associated Myelopathy Table of ... an important association was established between the human retrovirus — human T-cell lymphotrophic virus type 1 (also ...

  15. Arterial compression of nerve is the primary cause of trigeminal neuralgia

    OpenAIRE

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-ping

    2013-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of...

  16. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  17. Spasticity mechanisms - for the clinician

    Directory of Open Access Journals (Sweden)

    AmbarChakravarty

    2010-12-01

    Full Text Available Spasticity, a classical clinical manifestation of an upper motor neuron lesion, has been traditionally and physiologically defined as a velocity dependent increase in muscle tone caused by the increased excitability of the muscle stretch reflex. Clinically spasticity manifests as an increased resistance offered by muscles to passive stretching (lengthening and is often associated with other commonly observed phenomenon like clasp-knife phenomenon, increased tendon reflexes, clonus and flexor and extensor spasms. The key to the increased excitability of the muscle stretch reflex (muscle tone is the abnormal activity of muscle spindles which have an intricate relation with the innervations of the extrafusal muscle fibers at the spinal level (feed-back and feed-forward circuits which are under influence of the supraspinal pathways (inhibitory and facilitatory. The reflex hyperexcitability develops over variable period of time following the primary lesion (brain or spinal cord and involves adaptation in spinal neuronal circuitries caudal to the lesion. It is highly likely that in humans, reduction of spinal inhibitory mechanisms (in particular that of disynaptic reciprocal inhibition is involved. While simply speaking the increased muscle stretch reflex may be assumed to be due to an altered balance between the innervations of intra and extrafusal fibers in a muscle caused by loss of inhibitory supraspinal control, the delayed onset after lesion and the frequent reduction in reflex excitability over time, suggest plastic changes in the central nervous system following brain or spinal lesion. It seems highly likely that multiple mechanisms are operative in causation of human spasticity, many of which still remain to be fully elucidated.

  18. Prolactinoma during pregnancy causing compression symptoms responding to bromocriptine therapy.

    OpenAIRE

    Saunders, N. J.

    1985-01-01

    A woman with pituitary macroadenoma causing pressure symptoms and a partial right third cranial nerve palsy during pregnancy is described. Complete resolution occurred using oral bromocriptine therapy alone and the remainder of the pregnancy was uneventful.

  19. CDC WONDER: Compressed Mortality - Underlying Cause of Death

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CDC WONDER Mortality - Underlying Cause of Death online database is a county-level national mortality and population database spanning the years since 1979...

  20. Tropical spastic paraparesis in Northeastern Brazil

    Directory of Open Access Journals (Sweden)

    C. M. de Castro Costa

    1989-06-01

    Full Text Available Ten possible cases of tropical spastic paraparesis (TSP in Northeastern Brazil (Ceará are presented. They show the typical symptoms and signs of TSP consisting of weakness of the lower limbs, spastic gait, hiperreflexia, bladder dysfunction and variable signs of posterior columns impairment. The laboratory examinations excluded other compressive, infective, degenerative or demyelinating lesions of their spinal cord. Our patients age ranged from 21 to 59 years, all were of black origin and all were of lower social class. There was a slight preponderance of females. An etiological implication of a retrovirus (HTLV-I has been shown for TSP, but for lack of technical conditions we could not determine it in our patients, and that stands as our subsequent step in those and further cases.

  1. Nerve compression as an essential factor in causing ischaemic and post-ischaemic paraesthesiae

    Directory of Open Access Journals (Sweden)

    Eros Abrantes Erhart

    1950-03-01

    Full Text Available In order to explain why ischaemia produced by compression at the proximal part of the forearm or at the wrist, does not cause sensory disturbances identical to those observed in compression at the upper arm, several experiments were made on ourselves and other subjects. The method used was essentially that of Lewis and Pochin. Circulation was blocked at different levels of the limb by applying the pressure of 200 mm/Hg with a sphygmomanometer cuff; compression of the median, ulnar and tibial nerve trunks was made with the aid of a small cushion under the cuff. We observed always that the nerve compression is an essential factor in causing ischaemic and post-ischaemic paraesthesiae.

  2. Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi

    Directory of Open Access Journals (Sweden)

    Akiko Ikegami

    2015-01-01

    Full Text Available We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the right renal pelvis and ureter, and compression of the bilateral common iliac veins by the distended bladder. Iliac vein compression syndrome was diagnosed. Bilateral iliac vein compression due to bladder distention (secondary to neurogenic bladder, benign prostatic hyperplasia, or urethral calculus as in this case is an infrequent cause of acute bilateral leg edema. Detecting distention of the superficial epigastric veins provides a clue for diagnosis of this syndrome.

  3. Ganglion Cyst Associated with Triangular Fibrocartilage Complex Tear That Caused Ulnar Nerve Compression

    OpenAIRE

    Ugur Anil Bingol, MD; Can Cinar, MD; Neslihan Tasdelen, MD

    2015-01-01

    Summary: Ganglions are the most frequently seen soft-tissue tumors in the hand. Nerve compression due to ganglion cysts at the wrist is rare. We report 2 ganglion cysts arising from triangular fibrocartilage complex, one of which caused ulnar nerve compression proximal to the Guyonʼs canal, leading to ulnar neuropathy. Ganglion cysts seem unimportant, and many surgeons refrain from performing a general hand examination.

  4. Ganglion Cyst Associated with Triangular Fibrocartilage Complex Tear That Caused Ulnar Nerve Compression

    Directory of Open Access Journals (Sweden)

    Ugur Anil Bingol, MD

    2015-03-01

    Full Text Available Summary: Ganglions are the most frequently seen soft-tissue tumors in the hand. Nerve compression due to ganglion cysts at the wrist is rare. We report 2 ganglion cysts arising from triangular fibrocartilage complex, one of which caused ulnar nerve compression proximal to the Guyonʼs canal, leading to ulnar neuropathy. Ganglion cysts seem unimportant, and many surgeons refrain from performing a general hand examination.

  5. Ganglion cyst associated with triangular fibrocartilage complex tear that caused ulnar nerve compression.

    Science.gov (United States)

    Bingol, Ugur Anil; Cinar, Can; Tasdelen, Neslihan

    2015-03-01

    Ganglions are the most frequently seen soft-tissue tumors in the hand. Nerve compression due to ganglion cysts at the wrist is rare. We report 2 ganglion cysts arising from triangular fibrocartilage complex, one of which caused ulnar nerve compression proximal to the Guyon's canal, leading to ulnar neuropathy. Ganglion cysts seem unimportant, and many surgeons refrain from performing a general hand examination. PMID:25878929

  6. Intractable vomiting caused by vertebral artery compressing the medulla: A case report

    Directory of Open Access Journals (Sweden)

    Lauren Gorton

    2015-01-01

    Full Text Available Vertebral artery compressing the medulla and causing intractable vomiting has only been reported once previously. We report a case of a 69-year-old woman with intractable nausea and vomiting causing a 50 pound weight loss and who failed medical management and whose symptoms were completely reversed following microvascular decompression (MVD.

  7. Os odontoideum with "free-floating" atlantal arch causing C1-2 anterolisthesis and retrolisthesis with cervicomedullary compression

    Directory of Open Access Journals (Sweden)

    Behari Sanjay

    2010-01-01

    Full Text Available Background: Os odontoideum (OO with C1-2 anterolisthesis and retrolisthesis may cause cervicomedullary injury both from anterior and posterior aspects. We analyzed fourteen such patients for biomechanical issues, radiological features and management of OO with free-floating atlantal arch and review pertinent literature. Materials and Methods: Fourteen patients having nonsyndromic, reducible atlantoaxial dislocation (AAD with orthotopic OO were analyzed. During neck flexion, their C1 anterior arch-os complex displaced anteriorly relative to remnant odontoid-C2 body. The posteriorly directed hypoplastic remnant odontoid sliding below the atlas and forward translation of the C1 posterior arch caused concomitant cervicomedullary compression. During neck extension, there was retrolisthesis of the "free-floating" C1 arch-os complex into spinal canal. Spinal stenosis and lateral C1-2 facet dislocation; Klippel-Feil anomaly; and posterior circulation infarcts were also present in one patient each, respectively. Posterior C1-2 (n=10 or occipitocervical fusion (n=3 was performed in neutral position to stabilize atlantoaxial movements. Results: Follow-up (mean, 3.9 years assessment revealed improvement in spasticity and weakness in 13 patients. One patient had neurological deterioration following C1-2 posterior sublaminar fusion, requiring its conversion to occipitocervical contoured rod fusion. One patient with posterior circulation stroke died prior to any operative intervention. Follow-up lateral view radiographs showed a bony union or a stable construct in these 13 patients. Conclusions: OO with free-floating atlantal arch may precipitate cord injury both during neck flexion and extension. This condition may be overlooked unless lateral radiographs of craniovertebral junction are undertaken in neck extension, along with the usual ones in neutral and flexed positions. Etiological factors include C1 ring-OO unrestrained movements above the hypoplastic

  8. Robotic pilot study for analysing spasticity: clinical data versus healthy controls

    OpenAIRE

    Seth, Nitin; Johnson, Denise; Taylor, Graham W.; Allen, O. Brian; Abdullah, Hussein A

    2015-01-01

    Background Spasticity is a motor disorder that causes significant disability and impairs function. There are no definitive parameters that assess spasticity and there is no universally accepted definition. Spasticity evaluation is important in determining stages of recovery. It can determine treatment effectiveness as well as how treatment should proceed. This paper presents a novel cross sectional robotic pilot study for the primary purpose of assessment. The system collects force and positi...

  9. MRI of vertebral compression fractures: differentiation between benign and malignant causes

    International Nuclear Information System (INIS)

    To evaluate the MR image in the differentiation of benign and malignant lesion in compression fracture of the vertebral body. MR images of 47 benign(acute traumatic within one month : 19, chronic traumatic longer than one month or nontraumatic : 28) and 21 metastatic compression fractures were respectively reviewed in terms of margin of lesions, signal intensity, paraspinal mass formation, soft tissue change, and involvement of posterior element of vertebra. MR images of T1-(T1WI) and T2-weighted gradient echo (GE T2WI) sequence were obtained on 0.5T unit in sagittal and axial orientation with 5 mm section thickness. The margin of benign compression fracture was usually indistinct (acute fracture: 90% (17/19), chronic fracture: 68% (19/28)), whereas it was sharply delineated in metastatic compression fracture (92%, 12/13) (ρ < 0.001). Paraspinal mass was seen in both acute fraumatic and metastatic compression fractures (acute fracture: 26% (5/19), metastatic fracture:52% (11/21). Soft tissue change was seen only in acute compression fractures (58%, 11/19). Involvement of posterior element of vertebra was noted in metastatic fracture (71%, 15/21), acute fracture (32%, 6/19) and chronic fracture (7%, 2/28). On MR imaging, involvement of entire portion of a given vertebral body, sharp margin between normal and abnormal areas in partially involved cases, paraspinal mass formation, and posterior element involvement are more frequently seen in metastatic compression fractures, which are considered to be useful in differentiation between benign and malignant causes of compression fracture

  10. Unusual facial pain secondary to inferior alveolar nerve compression caused by impacted mandibular second molar

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2014-01-01

    Full Text Available Symptoms of inferior alveolar nerve (IAN compression are reported during endodontic procedures, placement of implants, third molar surgeries, inferior alveolar nerve block injections, trauma, orthognathic injuries, ablative surgeries or use of medicaments. Presented is a rare case of a 15-year-old girl who reported severe pain in relation to an impacted permanent mandibular left second molar, the roots of which had entrapped the mandibular canal causing compression of IAN. Timely surgical intervention and sectional removal of the impacted molar is indicated to relieve the symptoms and avoid permanent damage to the nerve.

  11. Computed tomography in spastic cerebral palsy

    International Nuclear Information System (INIS)

    Eigthy-three children with spastic cerebral plays (CP) were examined with cranial CT. In 56 cases the CT findings were abnormal. The most frequent abnormality was atrophy, present in 44 patients. The frequency of pathologic CT increased with severity of the CP. Patients with CP of postnatal aetiology more often had abnormal CT than patients with other known causes. Pathologic CT findings were seen more often in patients with seizures than in patients without. Infarctions and hemiatrophy were much more frequent in patients with hemiplegia than in patients with other types of spastic CP. A special kind of central atrophy, called isolated atrophy around the cella media, is described. This condition was seen in 20% of cases, most often in hemi- and paraplegic patients. Early infarctions in the border areas between the vasular territories of the internal carotid and the posterior cerebral artery may be the reason for this kind of atrophy. (orig.)

  12. Computed tomography in spastic cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, H.; Taudorf, K.; Melchior, J.C.

    1982-09-01

    Eighty-three children with spastic cerebral palsy (CP) were examined with cranial CT. In 56 cases the CT findings were abnormal. The most frequent abnormality was atrophy, present in 44 patients. The frequency of pathologic CT increased with severity of the CP. Patients with CP of postnatal aetiology more often had abnormal CT than patients with other known causes. Pathologic CT findings were seen more often in patients with seizures than in patients without. Infarctions and hemiatrophy were much more frequent in patients with hemiplegia than in patients with other types of spastic CP. A special kind of central atrophy, called isolated atrophy around the cella media, is described. This condition was seen in 20% of cases, most often in hemi- and paraplegic patients. Early infarctions in the border areas between the vascular territories of the internal carotid and the posterior cerebral artery may be the reason for this kind of atrophy.

  13. Myeloid Sarcoma: An Unusual Presentation of Acute Promyelocytic Leukemia Causing Spinal Cord Compression

    OpenAIRE

    Tay Za Kyaw; Jayaranee A.s. Maniam; Ping Chong Bee; Edmund Fui Min Chin; Veera Sekaran Nadarajan; Hemalatha Shanmugam; Khairul Azmi Abd Kadir

    2012-01-01

    Acute promyelocytic leukemia with concurrent myeloid sarcoma is a rare clinical event. Herein we describe a patient that presented with back pain and bilateral leg weakness caused by spinal cord compression due to extramedullary deposition of leukemic cells. Acute promyelocytic leukemia was suspected based on immunophenotypic findings of malignant cells in bone marrow aspirate. The diagnosis was confirmed by the presence of PML-RARα fusion copies. MRI showed multiple hyperintense changes on t...

  14. Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi

    OpenAIRE

    Akiko Ikegami; Takeshi Kondo; Tomoko Tsukamoto; Yoshiyuki Ohira; Masatomi Ikusaka

    2015-01-01

    We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the rig...

  15. Elastic stresses and plastic deformations in 'Santa Clara' tomato fruits caused by package dependent compression

    Directory of Open Access Journals (Sweden)

    PEREIRA ADRIANA VARGAS

    2000-01-01

    Full Text Available The objective of this work was to study the fruit compression behavior aiming to develop new tomato packages. Deformations caused by compression forces were observed inside packages and in individual 'Santa Clara' tomato fruit. The forces applied by a transparent acrylic lever to the fruit surface caused pericarp deformation and the flattened area was proportional to the force magnitude. The deformation was associated to the reduction in the gas volume (Vg, caused by expulsion of the air from the loculus cavity and reduction in the intercellular air volume of the pericarp. As ripening advanced, smaller fractions of the Vg reduced by the compressive force were restored after the stress was relieved. The lack of complete Vg restoration was an indication of permanent plastic deformations of the stressed cells. Vg regeneration (elastic recovery was larger in green fruits than in the red ones. The ratio between the applied force and the flattened area (flattening pressure, which depends on cell turgidity, decreased during ripening. Fruit movements associated with its depth in the container were observed during storage in a transparent glass container (495 x 355 x 220 mm. The downward movement of the fruits was larger in the top layers because these movements seem to be driven by a summation of the deformation of many fruits in all layers.

  16. L2 Radicular Compression Caused by a Foraminal Extradural Gas Pseudocyst

    OpenAIRE

    Lee, Dong Yeob; Lee, Sang-Ho

    2010-01-01

    Gas pseudocysts are a rare cause of lumbar radiculopathy and most symptomatic gas pseudocysts are found within the confines of the spinal canal. A gas pseudocyst in the foramen causing lumbar radiculopathy is very rare. We present a case of a 67-year-old woman suffering from severe pain in the right leg. Computed tomography and magnetic resonance imaging revealed a gas pseudocyst compressing the L2 root at the right L2-3 foramen. The patient underwent cyst excision using the lateral transmusc...

  17. Baclofen in Spastic Cerebral Palsy

    OpenAIRE

    J Akhundian

    2002-01-01

    To evaluate the effect of oral baclofen in spastic cerebral palsy (cp), we studied 40 children with different clinical types of spastic cp. Half of these children served as control group and the others received oral baclofen. All of them were treated with physiotherapy under equal conditions for 6 weeks. We used two methods, modified Ashworth scale and range of motion for evaluation. At the end of therapy we found a significant improvement in the baclofen group compared to control group. As a...

  18. Genetic and phenotypic characterization of complex hereditary spastic paraplegia.

    Science.gov (United States)

    Kara, Eleanna; Tucci, Arianna; Manzoni, Claudia; Lynch, David S; Elpidorou, Marilena; Bettencourt, Conceicao; Chelban, Viorica; Manole, Andreea; Hamed, Sherifa A; Haridy, Nourelhoda A; Federoff, Monica; Preza, Elisavet; Hughes, Deborah; Pittman, Alan; Jaunmuktane, Zane; Brandner, Sebastian; Xiromerisiou, Georgia; Wiethoff, Sarah; Schottlaender, Lucia; Proukakis, Christos; Morris, Huw; Warner, Tom; Bhatia, Kailash P; Korlipara, L V Prasad; Singleton, Andrew B; Hardy, John; Wood, Nicholas W; Lewis, Patrick A; Houlden, Henry

    2016-07-01

    The hereditary spastic paraplegias are a heterogeneous group of degenerative disorders that are clinically classified as either pure with predominant lower limb spasticity, or complex where spastic paraplegia is complicated with additional neurological features, and are inherited in autosomal dominant, autosomal recessive or X-linked patterns. Genetic defects have been identified in over 40 different genes, with more than 70 loci in total. Complex recessive spastic paraplegias have in the past been frequently associated with mutations in SPG11 (spatacsin), ZFYVE26/SPG15, SPG7 (paraplegin) and a handful of other rare genes, but many cases remain genetically undefined. The overlap with other neurodegenerative disorders has been implied in a small number of reports, but not in larger disease series. This deficiency has been largely due to the lack of suitable high throughput techniques to investigate the genetic basis of disease, but the recent availability of next generation sequencing can facilitate the identification of disease-causing mutations even in extremely heterogeneous disorders. We investigated a series of 97 index cases with complex spastic paraplegia referred to a tertiary referral neurology centre in London for diagnosis or management. The mean age of onset was 16 years (range 3 to 39). The SPG11 gene was first analysed, revealing homozygous or compound heterozygous mutations in 30/97 (30.9%) of probands, the largest SPG11 series reported to date, and by far the most common cause of complex spastic paraplegia in the UK, with severe and progressive clinical features and other neurological manifestations, linked with magnetic resonance imaging defects. Given the high frequency of SPG11 mutations, we studied the autophagic response to starvation in eight affected SPG11 cases and control fibroblast cell lines, but in our restricted study we did not observe correlations between disease status and autophagic or lysosomal markers. In the remaining cases, next

  19. Compressive Optic Neuropathy Caused by Cholesterol Gran-uloma in the Posterior Ethmoid Sinus

    Institute of Scientific and Technical Information of China (English)

    Chun-Chih Lin; Ting-Kuang Chao; Tsu-Hua Chen; Jia-Kang Wang

    2015-01-01

    Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature. Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demon-strated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus. Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mu-cociliary clearance of the sinus was reestablished..The patho-logic pictures confirmed the diagnosis of cholesterol granulo-ma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visu-al function fully recovered without recurrent lesions after a three-year follow-up. Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid si-nus. The visual prognosis may be good after transnasal endo-scopic decompression in such patients.

  20. An epidural neuroblastoma causing spinal cord compression in a 67-year-old woman

    Directory of Open Access Journals (Sweden)

    Ethan Taub

    2010-04-01

    Full Text Available We report a case of disseminated neuroblastoma (NB causing epidural spinal cord compression in a 67-year-old woman. Because NB is primarily a tumor of infancy and childhood, less is known about its clinical course and optimal treatment in adults. This patient was treated with a thoracic laminectomy and tumor resection; polychemotherapy with one cycle of vindesine, cisplatin, and etoposide; one cycle of vincristine, dacarbazine, ifosfamide, and doxorubicin; and radiotherapy to the spine. She remained able to walk but died 8.5 months later of diffuse systemic tumor progression.

  1. DISTRACTION EXTERNAL FIXATIONS OF PELVIC FRACTURES CAUSED BY A LATERAL COMPRESSION.

    Directory of Open Access Journals (Sweden)

    Pavlin Apostolov

    2011-11-01

    Full Text Available The authors represent a distraction external pelvic fixation technique, which they use in pelvic fractures caused by a lateral compression. They consider the indications and mounting techniques. The authors recommend the early movement activities (on the 3rd - 5th day after the external fixator placement. This method had been used in 8 patients and 3 cases are analyzed in details. The priority of this technique over open reduction and internal fixation (ORIF mainly are: (1 the implementation of good reduction of the fracture preventing the risk of ORIF; (2 the possibility for early movement activities for the patient.

  2. Spastic Diplegic and Tetraplegic Cerebral Palsy Compared

    OpenAIRE

    J Gordon Millichap

    2005-01-01

    Risk factors of cerebral palsy (CP), seizures, CP severity, EEG, and MRI findings were compared in 38 children with spastic diplegic (DCP) and 48 with spastic tetraplegic (TCP), in a report from Medical University of Bialystok, Poland.

  3. NIPA1 mutation in complex hereditary spastic paraplegia with epilepsy

    DEFF Research Database (Denmark)

    Svenstrup, Kirsten; Møller, R S; Christensen, Jacob;

    2011-01-01

    or signs are found. Mutations in the NIPA1 gene have been reported to cause spastic paraplegia type 6 (SPG6) in 10 families. SPG6 is a rare form of autosomal dominantly inherited HSP associated with a pure phenotype; however, in one complex SPG6 family, idiopathic generalized epilepsy (IGE) has been...... reported missense mutation c.316G>A, p.Gly106Arg, was identified in a complex HSP patient with spastic dysarthria, facial dystonia, atrophy of the small hand muscles, upper limb spasticity, and presumably IGE. The epilepsy co-segregated with HSP in the family. Conclusion: NIPA1 mutations were rare in our...... population of patients with HSP, but can be found in patients with complex HSP. Epilepsy might be more common in SPG6 than in other forms of HSP because of a genetic risk factor closely linked to NIPA1....

  4. Recessive loss-of-function mutations in AP4S1 cause mild fever-sensitive seizures, developmental delay and spastic paraplegia through loss of AP-4 complex assembly

    DEFF Research Database (Denmark)

    Hardies, Katia; May, Patrick; Djémié, Tania;

    2015-01-01

    We report two siblings with infantile onset seizures, severe developmental delay and spastic paraplegia, in whom whole-genome sequencing revealed compound heterozygous mutations in the AP4S1 gene, encoding the σ subunit of the adaptor protein complex 4 (AP-4). The effect of the predicted loss-of-...... reported patients, highlighting that seizures are part of the clinical manifestation of the AP-4 deficiency syndrome. We also hypothesize that endosomal trafficking is a common theme between heritable spastic paraplegia and some inherited epilepsies....

  5. Radiation dermatitis caused by a bolus effect from an abdominal compression device.

    Science.gov (United States)

    Connor, Michael; Wei, Randy L; Yu, Suhong; Sehgal, Varun; Klempner, Samuel J; Daroui, Parima

    2016-01-01

    American Association of Physicists in Medicine (AAPM) Task Group 176 evaluated the dosimetric effects caused by couch tops and immobilization devices. The report analyzed the extensive physics-based literature on couch tops, stereotactic body radiation therapy (SBRT) frames, and body immobilization bags, while noting the scarcity of clinical reports of skin toxicity because of external devices. Here, we present a clinical case report of grade 1 abdominal skin toxicity owing to an abdominal compression device. We discuss the dosimetric implications of the utilized treatment plan as well as post hoc alternative plans and quantify differences in attenuation and skin dose/build-up between the device, a lower-density alternative device, and an open field. The description of the case includes a 66-year-old male with HER2 amplified poorly differentiated distal esophageal adenocarcinoma treated with neoadjuvant chemo-radiation and the use of an abdominal compression device. Radiation was delivered using volumetric modulated arc therapy (VMAT) with 2 arcs using abdominal compression and image guidance. The total dose was 50.4Gy delivered over 40 elapsed days. With 2 fractions remaining, the patient developed dermatitis in the area of the compression device. The original treatment plan did not include a contour of the device. Alternative post hoc treatment plans were generated, one to contour the device and a second with anterior avoidance. In conclusion, replanning with the device contoured revealed the bolus effect. The skin dose increased from 27 to 36Gy. planned target volume (PTV) coverage at 45Gy was reduced to 76.5% from 95.8%. The second VMAT treatment plan with an anterior avoidance sector and more oblique beam angles maintained PTV coverage and spared the anterior wall, however at the expense of substantially increased dose to lung. This case report provides an important reminder of the bolus effect from external devices such as abdominal compression. Special

  6. Spasticity-assessment: a review

    DEFF Research Database (Denmark)

    Biering-Sørensen, F.; Nielsen, Jens Bo; Klinge, Klaus Peter

    2006-01-01

    Study design:Review of the literature on the validity and reliability of assessment of spasticity and spasms.Objectives:Evaluate the most frequently used methods for assessment of spasticity and spasms, with particular focus on individuals with spinal cord lesions.Setting:Clinic for Spinal Cord...... Injuries, Rigshospitalet, University Hospital of Copenhagen, and Department of Medical Physiology, University of Copenhagen, Denmark.Methods:The assessment methods are grouped into clinical, biomechanical and electrophysiological, and the correlation between these is evaluated.Results:Clinical methods: For...... assessment of spasticity, the Ashworth and the modified Ashworth scales are commonly used. They provide a semiquantitative measure of the resistance to passive movement, but have limited interrater reliability. Guidelines for the testing procedures should be adhered to. Spasm frequency scales seem not to...

  7. Cyclic impulsive compression loading along the radial and tangential wood directions causes localized fatigue

    Science.gov (United States)

    Salmi, Ari; Montonen, Risto; Salminen, Lauri I.; Suuronen, Jussi-Petteri; Serimaa, Ritva; Hæggström, Edward

    2012-12-01

    We report for the first time on the existence of a localized reduction in elasticity caused by repeated compression impaction applied along the tangential wood direction. Previous research indicates that localized strain profiles are generated by such cyclic impacting on wood along its radial direction. This finding is significant for the paper/board-making industry where wood is exposed to cyclic unipolar compression during grinding. However, the effect of the impacting direction, with respect to the orientation of the annual rings, on the localization phenomenon is unknown. In addition, the shape of the developing fatigue layer is unclear. We revisit the localization phenomenon with a focus on tangential impacting. We employed ultrasonics and x-ray tomography to quantify the induced fatigue. An interlacing technique increased the precision of the ultrasonic stiffness depth profiling technique. We studied both radial and tangential wood annual ring geometries. We used ultrasound to quantify the drop in shear modulus resulting from impacting. Both radial and tangential geometries featured strain localization, but the shape of the fatigued layer was different in the radial and tangential wood geometries (steeper profile in the radial geometry). The fatiguing reduced the shear modulus. These results tell us about the ratio of the number of hits that need to be delivered along the radial and tangential direction of the ground wood, respectively. This insight may translate into a design pattern for an energy saving grind stone surface.

  8. Four mutations of the spastin gene in Japanese families with spastic paraplegia

    OpenAIRE

    Basri, Rehana; Yabe, Ichiro; Soma, Hiroyuki; Takei, Asako; Nishimura, Hiroyuki; Machino, Yuka; Kokubo, Yasumasa; Kosugi, Masafumi; Okada, Ryuichirou; Yukitake, Motohiro; Tachibana, Hisao; Kuroda, Yasuo; Kuzuhara, Shigeki; Sasaki, Hidenao

    2006-01-01

    Hereditary spastic paraplegia (HSP) is a group of genetically heterogeneous neurodegenerative disorders characterized by slowly progressive spasticity and weakness of the lower limbs. HSP is caused by failure of development or selective degeneration of the corticospinal tracts, which contain the longest axons in humans. The most common form of HSP is caused by mutations of the spastin gene (SPAST), located on chromosome 2p21-p22, which encodes spastin, one of the ATPases associated with diver...

  9. Concomitant Lipoma and Ganglion Causing Ulnar Nerve Compression at the Wrist: A Case Report and Review of Literature.

    Science.gov (United States)

    Gan, Lee Ping; Tan, Jacqueline Siau Woon

    2016-04-01

    We present a rare case of ulnar nerve compression caused by concurrent lumps-a lipoma and a ganglion at the wrist, with no prior report cited in the English literature. This case illustrates the possibility of dual concurrent pathologies causing ulnar neuropathy and the importance of not missing one. PMID:25536205

  10. Cerebellar Cognitive Affective Syndrome and Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay : A Report of Two Male Sibs

    NARCIS (Netherlands)

    Verhoeven, Willem M. A.; Egger, Jos I. M.; Ahmed, Amir I. M.; Kremer, Berry P. H.; Vermeer, Sascha; van de Warrenburg, Bart P. C.

    2012-01-01

    Background: Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare neurodegenerative disorder caused by mutations in the SACS gene (13q12) encoding the protein sacsin. It is characterized by early-onset cerebellar ataxia, lower limb spasticity, sensorimotor axonal polyneuropath

  11. Leg Spasticity and Ambulation in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Sosnoff, Jacob J.; Pula, John H.; Brian M. Sandroff; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW)...

  12. MR imaging of spastic diplegia

    International Nuclear Information System (INIS)

    Eighteen children (eleven preterm birth and seven term birth) with clinical evidence of spastic diplegia (SD) were studied to clarify the differences of the lesions between preterm and term SD on MR imaging. All with preterm birth showed similar abnormalities of the periventricular white matter represented by high intensity in T2-weighted imaging and low intensity in T1 imaging. It seemed that the lesions were periventricular leukomalacia (PVL) and dysmyelination pathologically and correlated well clinically with spastic diplegia. SD with term birth group showed various lesions, two brain anomalies (schizencephaly and corpocephaly) on PVL: Four showed no lesions. We suggested that SD with preterm birth is not only a clinical but also a pathological entity. (orig.)

  13. The Efficacy of Botulinum Toxin A Intramuscular Injections in After-Stroke Spasticity

    Directory of Open Access Journals (Sweden)

    Melek Karaçam

    2010-09-01

    Full Text Available OBJECTIVE: Spasticity is a common dysfunction in stroke patients. It hinders the performance of everyday living activities and lowers the quality of life. In this study, it was aimed to investigate the effects of botulinum toxin A therapy on various aspects, such as muscle tone, pain, daily living activities and disability. METHODS: Fifteen patients with stroke presenting with focal spasticity in the botulinum toxin outpatient unit were evaluated. Results before and after treatment were evaluated by applying different scales. Modified Ashworth Scale was applied for the severity of spasticity. The Medical Council Research Scale was used to test muscle power, and the disability scoring scale, Visual Analogue Pain Scale and Barthel index were the other measures tested. RESULTS: It was found that therapy with botulinum toxin A was effective in spasticity. The increased muscle tone and the disability scores decreased prominently after the treatment (p< 0.05. Lower values in pain scores (p< 0.05 also contributed to better functional outcome (p< 0.01. Along with the significantly good outcome according to the scales, the higher scores in quality of life, feeling of well-being, good performance during the physiotherapy sessions, and less medications needed for spasticity were also indications in commencing the therapy of botulinum toxin A in spasticity. CONCLUSION: Spasticity is a complicated condition causing serious disability. Botulinum toxin A is a preferred therapy when there is an increased motor activity. The effects of the agent are reversible and reliable. The duration of the treatment is long-lasting. Since botulinum toxin A is easily applied and the outcome in focal spasticity is favorable, it is recommended as the first-line choice in the treatment of focal spasticity.

  14. Diagnosis, investigation and management of hereditary spastic paraplegias in the era of next-generation sequencing

    OpenAIRE

    Hensiek, Anke; Kirker, Stephen; Reid, Evan

    2014-01-01

    The hereditary spastic paraplegias (HSPs) are a group of genetic conditions in which spastic paralysis of the legs is the principal clinical feature. This is caused by a relatively selective distal axonal degeneration involving the longest axons of the corticospinal tracts. Consequently, these conditions provide an opportunity to identify genes, proteins and cellular pathways that are critical for axonal health. In this review, we will provide a brief overview of the classification, clinical ...

  15. Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients.

    OpenAIRE

    Hesse, S; Lücke, D; Malezic, M; Bertelt, C; Friedrich, H. (Hergen); Gregoric, M; Mauritz, K H

    1994-01-01

    Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including...

  16. A ganglion cyst at the elbow causing superficial radial nerve compression: a case report

    Directory of Open Access Journals (Sweden)

    McFarlane John

    2008-04-01

    Full Text Available Abstract Introduction We report a rare case of a ganglion cyst at the elbow causing neurological symptoms by stretching the superficial radial nerve alone. Ganglia associated with radial nerve palsy at the elbow have been reported previously involving the deep branch of the posterior interosseous nerve and the superficial radial nerve, but not the superficial radial nerve alone. Case presentation A 45-year-old woman presented with a 4-month history of a painful lump in the anterior aspect of her left elbow associated with altered sensation in the dorsoradial aspect of her left hand. There was no history of trauma or any exacerbating factors. On examination the altered sensation was in the superficial radial nerve distribution and she had a positive Tinel's sign over the site of the swelling which was located over the anterior aspect of the radiocapitellar joint. Conclusion The unique clinical symptoms and signs of our diagnosis of superficial radial nerve compression were confirmed by magnetic resonance imaging and then operative findings.

  17. Upper limb impairments associated with spasticity in neurological disorders

    Directory of Open Access Journals (Sweden)

    Mirbagheri Mehdi M

    2007-11-01

    Full Text Available Abstract Background While upper-extremity movement in individuals with neurological disorders such as stroke and spinal cord injury (SCI has been studied for many years, the effects of spasticity on arm movement have been poorly quantified. The present study is designed to characterize the nature of impaired arm movements associated with spasticity in these two clinical populations. By comparing impaired voluntary movements between these two groups, we will gain a greater understanding of the effects of the type of spasticity on these movements and, potentially a better understanding of the underlying impairment mechanisms. Methods We characterized the kinematics and kinetics of rapid arm movement in SCI and neurologically intact subjects and in both the paretic and non-paretic limbs in stroke subjects. The kinematics of rapid elbow extension over the entire range of motion were quantified by measuring movement trajectory and its derivatives; i.e. movement velocity and acceleration. The kinetics were quantified by measuring maximum isometric voluntary contractions of elbow flexors and extensors. The movement smoothness was estimated using two different computational techniques. Results Most kinematic and kinetic and movement smoothness parameters changed significantly in paretic as compared to normal arms in stroke subjects (p Conclusion The findings suggest that although the cause and location of injury are different in spastic stroke and SCI subjects, the impairments in arm voluntary movement were similar in the two spastic groups. Our results also suggest that the non-paretic arm in stroke subjects was not distinguishable from the normal, and might therefore be used as an appropriate control for studying movement of the paretic arm.

  18. Pitfalls with the "chest compression-only" approach: the challenge of an unusual cause

    Directory of Open Access Journals (Sweden)

    Reid Bjørn

    2010-08-01

    Full Text Available Abstract Chest compression-only (CC-only is now incorporated in the Norwegian protocol for dispatch guided CPR (cardiopulmonary resuscitation in cardiac arrest of presumed cardiac aetiology. We present a case that is unique and instructive as well as unusual. It reminds us of the challenges that face bystanders, dispatch centres and ambulance services when faced with possible cardiac arrest. This case report describes a 50 year old man in a rural community. He had suffered a heart attack 8 months previously, and was found unconscious with respiratory arrest in his garden one morning. Due to the proximity to the ambulance station, the paramedics were on the scene within three minutes. A chain-saw was lying beside him, but no external injuries were seen. The patient had no radial pulse, central cyanosis and respiratory gasps approximately every 30 seconds. Ventilation with bag and mask was given, and soon a femoral pulse could be palpated. Blood sugar was elevated and ECG (electrocardiogram was normal. GCS (Glasgow Coma Scale was 3. Upon arrival of the physician staffed air ambulance, further examination revealed bilateral miosis of the pupils and continuing bradypnoea. Naloxone was given with an immediate effect and the patient woke up. The patient denied intake of narcotics, but additional information from the dispatch centre revealed that he was hepatitis C positive. After a few hours, the patient admitted to have obtained a fentanyl transdermal patch from an acquaintance, having chewed it before falling unconscious. This case report shows the importance as well as the challenges of identifying a non-cardiac cause of possible cardiac arrest, and the value of providing causal therapy.

  19. Strumpellin and Spartin, Hereditary Spastic Paraplegia Proteins, are Binding Partners

    OpenAIRE

    Jiali Zhao; Peter Hedera

    2015-01-01

    Hereditary spastic paraplegia (HSP) is one of the most heterogeneous neurodegenerative diseases with more than 50 identified genes causing a relatively stereotypical phenotypic presentation. Recent studies of HSP pathogenesis have suggested the existence of shared biochemical pathways that are crucial for axonal maintenance and degeneration. We explored possible interactions of several proteins associated with this condition. Here we report interactions of endogenous and overexpressed strumpe...

  20. Solitary vertebral plasmacytoma causing compression fracture in a patient with multiple vertebral hemangiomas: a diagnosis easily missed!

    Directory of Open Access Journals (Sweden)

    Shagufta Wahab

    2011-12-01

    Full Text Available The imaging mimics, acute osteoporotic compression fractures, metastasis and malignant melanoma or plasmacytoma pathological fractures are the important clinical problems in geriatric age group that need to be differentiated due to their grossly differing prognostic and therapeutic implications. There are few suggestive features on magnetic resonance imaging (MRI that help differentiate between these entities. Hemangiomas are very common benign spinal tumors that have characteristic features on MRI. In the setting of multiple vertebral hemangiomas causing cord compression in elderly patients, the scenario is even more complex with four different entities with different prognostic profiles. We report such a diagnostic dilemma we encountered in a middle aged female patient with multiple vertebral hemangiomas and compression fracture in D10 vertebra.

  1. Syntelencephaly presenting with spastic diplegia.

    Science.gov (United States)

    Coleman, L T; McCubbin, J P; Smith, L J; Reddihough, D S; Gardner, R J

    2000-08-01

    Two children with syntelencephaly presented with the predominant clinical picture of spastic diplegia. Brain scanning showed deficient formation of the interhemispheric fissure with fusion of occipital and parietal lobes, and an infolding and protrusion of occipital cortex into the telencephalic ventricle. The fusion extended further posteriorly than the cases of "middle interhemispheric fusion" thus far reported. One 7-year old has poor language development, while the other is regarded, at her present age of 3 years, as being cognitively within the normal range. PMID:11071147

  2. Interventional Spasticity Management for Enhancing Patient – Physician Communications

    Directory of Open Access Journals (Sweden)

    Chiyuri NAGAYAMA

    2014-01-01

    Full Text Available Stroke is the third most common cause of death in the Western world, behind heart disease and cancer, and accounts for over half of all neurologic admissions to community hospitals. Spasticity is commonly defined as excessive motor activity characterized by a velocity-dependent increase in tonic stretch reflexes. It is often associated with exaggerated tendon jerks, and is often accompanied by abnormal cutaneous and autonomic reflexes, muscle weakness, lack of dexterity, fatigability, and co-contraction of agonist and antagonist muscles. It is a common complication of central nervous system disorders, including stroke, traumatic brain injury, cerebral palsy, multiple sclerosis, anoxic brain injury, spinal cord injury, primary lateral sclerosis, and hereditary spastic hemiparesis. Leg muscle activation during locomotion is produced by spinal neuronal circuits within the spinal cord, the spinal pattern generator [central pattern generator (CPG]. For the control of human locomotion, afferent information from a variety of sources within the visual, vestibular, and proprioceptive systems is utilized by the CPGs. Findings of this research can be applied to older adults in longitudinal home care who suffer spasticity caused by stroke.

  3. HEREDITARY SPASTIC PARAPLEGIA: FROM GENE TO CLINIC

    Directory of Open Access Journals (Sweden)

    Seyyed Hasan TONEKABONI

    2010-04-01

    Full Text Available ObjectiveHereditary Spastic Paraplegia (HSP is a degenerative disease of genetic origin affecting the corticospinal tracts in the spinal cord. There are three forms of inheritance: Autosomal dominant HSP, Autosomal rececive HSP and X-linked HSP.This disease is characterized by progressive spasticity of leg muscles with varying degrees of stiffness and weakness of other muscle groups. In this review, we will discuss the latest findings on  the pathophysiology of axonal degeneration and all the responsible genetic defects in HSP.Keyword: Hereditary spastic paraplegia, degenerative disease, inheritance

  4. Endovascular treatment of external iliac vein stenosis caused by graft compression after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Willamax Oliveira de Sousa

    2013-06-01

    Full Text Available A 57-year old patient presented with approximately 80% stenosis of the left external iliac vein due to compression by the renal graft after kidney transplantation. The initial clinical manifestation of this vascular complication was progressive edema of the left lower limb, starting in the foot during the immediate postoperative period and reaching the thigh. Renal function also deteriorated during the first four months after transplantation. Venous Doppler ultrasound findings were suggestive of a diagnosis of extrinsic compression by the kidney graft and so phlebography was ordered, confirming stenosis of the left external iliac vein. The patient was initially treated with balloon angioplasty, but there was still residual stenosis so a stent was inserted, eliminating the stenosis. The edema reduced over time and the patient's renal function improved. While vascular complications are rare, and potentially severe, events, success rates are good if treatment is started early.

  5. Management of A Patient with Kommerrell's Aneurysm Causing Tracheal and Esophageal Compression

    OpenAIRE

    Ranjith B Karthekeyan; Syama Sundar; Suresh Rao; Mahesh Vakamudi

    2009-01-01

    Summary Tracheal and esophageal compression is a well-recognized complication of aneurysms of the aortic arch. Most of the patients present with dysphagia and/or respiratory insufficiency. In the adult population a right-sided aortic arch is often asymptomatic unless aneurysmal disease develops. This usually occurs at the level of the take-off of an aberrant left subclavian artery and is known as a Kommerell's aneurysm. In spite of its rarity, this condition is clinically relevant because of ...

  6. Synovial cyst--an unusual cause of nerve root compression. A case report.

    Science.gov (United States)

    Hammer, A J

    1988-01-01

    An elderly woman presented with a tense, synovia-lined ganglion, associated with the left L3/L4 apophyseal joint, which protruded posteriorly and caudally through the joint capsule and extended anteriorly and cephally into the neural canal. The intraspinal extension produced a compression radiculopathy of the L3 nerve root. Removal of the cyst produced acute and dramatic alleviation of the symptoms. PMID:3340901

  7. Spasticity

    Science.gov (United States)

    Dobkin BH. Principles and practices of neurological rehabilitation. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012: ...

  8. Genetics Home Reference: spastic paraplegia type 11

    Science.gov (United States)

    ... with mental impairment and thin corpus callosum HSP-TCC SPG11-related hereditary spastic paraplegia with thin corpus ... A, Stevanin G, Santorelli FM. Screening of ARHSP-TCC patients expands the spectrum of SPG11 mutations and ...

  9. Efficiency of work production by spastic muscles

    OpenAIRE

    Stoquart, Gaëtan; Detrembleur, Christine; Nielens, Henri; Lejeune, Thierry

    2005-01-01

    The present study compared the muscular efficiency in spastic and healthy lower limbs producing the same mechanical work. Sixteen chronic post-stroke hemiparetic and spastic patients and 14 age-matched healthy subjects were submitted to a submaximal stepwise exercise testing on a bicycle ergometer, pedalling with only one lower limb. Net energetic expenditure was computed from oxygen consumption above resting values. Electrical activity of antagonistic muscles in the thigh and in the shank wa...

  10. Mechanical Chest Compressions in Prolonged Cardiac Arrest due to ST Elevation Myocardial Infarction Can Cause Myocardial Contusion.

    Science.gov (United States)

    Stechovsky, Cyril; Hajek, Petr; Cipro, Simon; Veselka, Josef

    2016-09-01

    Acute coronary syndrome is a common cause of sudden cardiac death. We present a case report of a 60-year-old man without a history of coronary artery disease who presented with ST-elevation myocardial infarction. During transportation to the hospital, he developed ventricular fibrillation (VF) and later pulseless electrical activity. Chest compressions with LUCAS 2 (Medtronic, Minneapolis, MN) automated mechanical compression-decompression device were initiated. Coronary angiography showed total occlusion of the left main coronary artery and primary percutaneous coronary intervention (PCI) was performed. After the PCI, his heart started to generate effective contractions and LUCAS could be discontinued. Return of spontaneous circulation was achieved after 90 minutes of cardiac arrest. The patient died of cardiogenic shock 11 hours later. An autopsy revealed a transmural anterolateral myocardial infarction but also massive subepicardial hemorrhage and interstitial edema and hemorrhages on histologic samples from regions of the myocardium outside the infarction itself and also from the right ventricle. These lesions were concluded to be a myocardial contusion. The true incidence of myocardial contusion as a consequence of mechanical chest compressions is not known. We speculate that severe myocardial contusion might have influenced outcome of our patient. PMID:27574387

  11. Radiation-induced osteochondroma of the T4 vertebra causing spinal cord compression

    Energy Technology Data Exchange (ETDEWEB)

    Gorospe, Luis; Madrid-Muniz, Carmen; Royo, Aranzazu; Garcia-Raya, Pilar [Department of Radiology, La Paz University Hospital, Madrid (Spain); Alvarez-Ruiz, Fernando [Department of Neurosurgery, La Paz University Hospital, Madrid (Spain); Lopez-Barea, Fernando [Department of Pathology, La Paz University Hospital, Madrid (Spain)

    2002-04-01

    A case of a radiation-induced osteochondroma arising from the vertebral body of T4 in an 18-year-old man is reported. The patient presented with a history of progressive left lower extremity weakness. At 7 years of age, he had undergone resection of a cerebellar medulloblastoma and received adjunctive craniospinal irradiation and systemic chemotherapy. Both CT and MR imaging revealed an extradural mass contiguous with the posteroinferior endplate of the T4 vertebral body. This case indicates that radiation-induced osteochondroma should be considered in the differential diagnosis of patients with symptoms of myelopathy or nerve root compression and a history of radiation therapy involving the spine in childhood. (orig.)

  12. Non-compressive myelopathy: clinical and radiological study.

    Science.gov (United States)

    Prabhakar, S; Syal, P; Singh, P; Lal, V; Khandelwal, N; Das, C P

    1999-12-01

    Fifty seven patients (42 males and 15 females) with non-compressive myelopathy were studied from 1997 to 1999. Acute transverse myelitis (ATM) was the commonest (31) followed by Vit B12 deficiency myelopathy (8), primary progressive multiple sclerosis (5), hereditary spastic paraplegia (3), tropical spastic paraplegia (2), subacute necrotising myelitis (1), radiation myelitis (1), syphilitic myelitis (1) and herpes zoster myelitis (1). 4 cases remained unclassified. In the ATM group, mean age was 30.35 years, antecedent event was observed in 41.9% case, 25 cases had symmetrical involvement and most of the cases had severe deficit at onset. CSF study carried out in 23 patients of ATM revealed rise in proteins (mean 147.95mg%, range 20-1200 mg/dL) and pleocytosis (mean 20.78/cumm, range 0-200 mm3). Oligoclonal band (OCB) was present in 28% of cases of ATM. The most common abnormality detected was a multisegment hyperintense lesion on T2W images, that occupied the central area on cross section. In 6 patients hyperintense signal was eccentric in location. MRI was normal in 4 cases of ATM. Thus ATM is the leading cause of non-compressive myelopathy. Clinical features combined with MRI findings are helpful in defining the cause of ATM. PMID:10625902

  13. Non-compressive myelopathy : clinical and radiological study.

    Directory of Open Access Journals (Sweden)

    Prabhakar S

    1999-10-01

    Full Text Available Fifty seven patients (42 males and 15 females with non-compressive myelopathy were studied from 1997 to 1999. Acute transverse myelitis (ATM was the commonest (31 followed by Vit B12 deficiency myelopathy (8, primary progressive multiple sclerosis (5, hereditary spastic paraplegia (3, tropical spastic paraplegia (2, subacute necrotising myelitis (1, radiation myelitis (1, syphilitic myelitis (1 and herpes zoster myelitis (1. 4 cases remained unclassified. In the ATM group, mean age was 30.35 years, antecedent event was observed in 41.9% case, 25 cases had symmetrical involvement and most of the cases had severe deficit at onset. CSF study carried out in 23 patients of ATM revealed rise in proteins (mean 147.95mg%, range 20-1200 mg/dL and pleocytosis (mean 20.78/cumm, range 0-200 mm3. Oligoclonal band (OCB was present in 28% of cases of ATM. The most common abnormality detected was a multisegment hyperintense lesion on T2W images, that occupied the central area on cross section. In 6 patients hyperintense signal was eccentric in location. MRI was normal in 4 cases of ATM. Thus ATM is the leading cause of non-compressive myelopathy. Clinical features combined with MRI findings are helpful in defining the cause of ATM.

  14. Mechanisms of postural instability in hereditary spastic paraplegia

    NARCIS (Netherlands)

    Nonnekes, J.; Niet, M. de; Nijhuis, L.B.; Bot, S.T. de; Warrenburg, B.P.C. van de; Bloem, B.R.; Geurts, A.C.H.; Weerdesteyn, V.G.M.

    2013-01-01

    Hereditary spastic paraplegia (HSP) is characterized by progressive lower extremity spasticity and weakness, due to retrograde axonal degeneration of the corticospinal tract and posterior spinal columns. HSP patients fall frequently. We hypothesized that delayed postural responses contribute to thei

  15. Unusual cause for ventriculoperitoneal shunt failure: Carcinoma breast compressing distal catheter

    Directory of Open Access Journals (Sweden)

    Roka Yam

    2010-01-01

    Full Text Available Insertion of a ventriculoperitoneal (VP shunt is one of the most common surgical procedures in any neurosurgery unit worldwide. Distal catheter obstruction outside the peritoneum is a rare cause of shunt failure. We report the first case of distal obstruction in a 70-year old female by carcinoma breast engulfing the catheter and causing kinking. Intraoperatively, the catheter was intratumoral with no flow of cerebrospinal fluid distally. She underwent relocation of a new catheter to the opposite side of the abdomen and modified mastectomy with resolution of the hydrocephalus. The postoperative course has been uneventful.

  16. Evaluation of the Effects of Sativex (THC BDS: CBD BDS) on Inhibition of Spasticity in a Chronic Relapsing Experimental Allergic Autoimmune Encephalomyelitis: A Model of Multiple Sclerosis.

    Science.gov (United States)

    Hilliard, A; Stott, C; Wright, S; Guy, G; Pryce, G; Al-Izki, S; Bolton, C; Giovannoni, G

    2012-01-01

    This study investigated the antispasticity potential of Sativex in mice. Chronic relapsing experimental allergic encephalomyelitis was induced in adult ABH mice resulting in hind limb spasticity development. Vehicle, Sativex, and baclofen (as a positive control) were injected intravenously and the "stiffness" of limbs assessed by the resistance force against hind limb flexion. Vehicle alone caused no significant change in spasticity. Baclofen (5 mg/kg) induced approximately a 40% peak reduction in spasticity. Sativex dose dependently reduced spasticity; 5 mg/kg THC + 5 mg/kg CBD induced approximately a 20% peak reduction; 10 mg/kg THC + 10 mg/kg CBD produced approximately a 40% peak reduction in spasticity. Sativex has the potential to reduce spasticity in an experimental mouse model of multiple sclerosis (MS). Baclofen reduced spasticity and served as a positive control. Sativex (10 mg/kg) was just as effective as baclofen, providing supportive evidence for Sativex use in the treatment of spasticity in MS. PMID:22928118

  17. Effect of whole-body vibration on muscle strength, spasticity, and motor performance in spastic diplegic cerebral palsy children

    Directory of Open Access Journals (Sweden)

    Marwa M. Ibrahim

    2014-04-01

    Conclusion: The obtained results suggest that 12-weeks’ intervention of whole-body vibration training can increase knee extensors strength and decrease spasticity with beneficial effects on walking speed and motor development in spastic diplegic CP children.

  18. Hereditary spastic paraplegia with cerebellar ataxia

    DEFF Research Database (Denmark)

    Nielsen, J E; Johnsen, B; Koefoed, P;

    2004-01-01

    identified in those individuals who were clinically affected by a complex phenotype consisting of HSP and cerebellar ataxia. Other features noted in this kindred including epilepsy, cognitive impairment, depression, and migraine did not segregate with the HSP phenotype or mutation, and therefore the...... significantly relatively decreased regional cerebral blood flow in most of the cerebellum. We conclude that this kindred demonstrates a considerable overlap between cerebellar ataxia and spastic paraplegia, emphasizing the marked clinical heterogeneity of HSP associated with spastin mutations.......Complex forms of hereditary spastic paraplegia (HSP) are rare and usually transmitted in an autosomal recessive pattern. A family of four generations with autosomal dominant hereditary spastic paraplegia (AD-HSP) and a complex phenotype with variably expressed co-existing ataxia, dysarthria...

  19. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks.

    Science.gov (United States)

    Haninec, Pavel; Mencl, Libor; Bačinský, Peter; Kaiser, Radek

    2013-12-01

    A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months. PMID:23696291

  20. A ganglion cyst at the elbow causing superficial radial nerve compression: a case report

    OpenAIRE

    McFarlane John; Trehan Ravi; Oliveira Miguel; Jones Carl; Blease Simon; Davey Paul

    2008-01-01

    Abstract Introduction We report a rare case of a ganglion cyst at the elbow causing neurological symptoms by stretching the superficial radial nerve alone. Ganglia associated with radial nerve palsy at the elbow have been reported previously involving the deep branch of the posterior interosseous nerve and the superficial radial nerve, but not the superficial radial nerve alone. Case presentation A 45-year-old woman presented with a 4-month history of a painful lump in the anterior aspect of ...

  1. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu

    2014-01-01

    Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

  2. Leg Spasticity and Ambulation in Multiple Sclerosis

    Science.gov (United States)

    Balantrapu, Swathi; Sosnoff, Jacob J.; Pula, John H.; Sandroff, Brian M.; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = −0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = −0.45), and walking velocity (P < 0.05, d = −0.53) and cadence (P < 0.05, d = −0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking. PMID:24999434

  3. Blocking of Snow/Water Slurry Flow in Pipeline Caused by Compression-Strengthening of Snow Column

    Directory of Open Access Journals (Sweden)

    Masataka Shirakashi

    2014-01-01

    Full Text Available In earlier works by the present authors, two systems for sustainable energy were proposed: (i a system for urban snow removal in winter and storage for air conditioning in summer, applied to Nagaoka City, which suffers heavy snow fall every winter, and (ii a district cooling system utilizing latent heat of ice to reduce the size of storage reservoir and transportation pipeline system. In these systems, the hydraulic conveying of snow or ice through pump-and-pipeline is the key technique to be developed, since characteristics of snow (ice/ water slurry is largely different from those of conventional non-cohesive solid particle slurries. In this study, the blocking of pipeline of snow/water slurry is investigated experimentally. While the blocking of conventional slurry occurs due to deposition of heavy particles at low flow velocity or arching of large rigid particles, that of snow/water slurry is caused by a compressed plug of snow formed due to cohesive nature of snow particles. This is because the strength of snow plug formed at a high resistance piping element, such as an orifice, becomes higher when the compression velocity is lower, resulting in a solid-like plug filling the whole channel upstream the element.

  4. Non-compressive myelopathy : clinical and radiological study.

    OpenAIRE

    Prabhakar S; Syal P; Singh P; Lal V; Khandelwal N; Das C

    1999-01-01

    Fifty seven patients (42 males and 15 females) with non-compressive myelopathy were studied from 1997 to 1999. Acute transverse myelitis (ATM) was the commonest (31) followed by Vit B12 deficiency myelopathy (8), primary progressive multiple sclerosis (5), hereditary spastic paraplegia (3), tropical spastic paraplegia (2), subacute necrotising myelitis (1), radiation myelitis (1), syphilitic myelitis (1) and herpes zoster myelitis (1). 4 cases remained unclassified. In the ATM group, mean age...

  5. Pathophysiology, assessment and management of multiple sclerosis spasticity: an update.

    Science.gov (United States)

    Haas, Judith

    2011-04-01

    Spasticity is one of the most common and disabling symptoms associated with multiple sclerosis (MS). MS spasticity occurs through both myelin and nerve fiber (axonal) degradation, which commence in the early stages of the disease. More than 80% of MS patients experienced spasticity in a large UK survey, with more than 50% of patients reporting their spasticity to be `moderate' or `severe'. Data from a large US registry show that patients with moderate-to-severe MS spasticity experience levels of disability that correlate closely with being wheelchair-bound and/or bedridden. The Ashworth scale is the most commonly used scale for assessing the degree of MS spasticity. However, the validity, reliability and sensitivity of this scale have been challenged and it is not considered an ideal scale for assessing the severity of MS spasticity. The numerical rating scale, a well-established standard pain assessment tool, provides a reliable, valid and simplified scale for patient self-rated assessment of the mean level of spasticity over the previous 24 h (0 = no spasticity, 10 = worst possible spasticity). According to data from the German MS Register, almost a third of MS patients with spasticity were untreated. Despite the availability of oral agents for generalized spasticity (often used in conjunction with physical/rehabilitation management strategies), including baclofen, tizanidine, dantrolene and gabapentin, there is limited clinical evidence to support their use and there is a need for improved and better tolerated pharmacological therapies for MS spasticity. The endocannabinoid system modulator, Sativex(®) (nabiximols, USAN name), provides an alternative therapeutic approach in the management of MS spasticity. PMID:21449853

  6. Surface electromyography activity in the upper limbs of patients following surgery for compressive cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Ananth P Abraham

    2015-01-01

    Conclusion: Surface EMG is an objective tool to detect improvement in spasticity following decompressive surgery for compressive cervical myelopathy even in those patients who showed no improvement on the MMAS.

  7. Flow of material under compression in weak lower continental crust can cause post-rift uplift of passive continental margins

    Science.gov (United States)

    Chalmers, James

    2014-05-01

    therefore accumulates in the proximal rift and rift margin, thickening them and lifting them by isostatic response to the thickening. Flow into the rift margin is opposed by uplift and folding of the upper, strong crust, which imposes an additional normal stress, until crust thickens no more. However, flow continues through this thickened crust, thickening and uplifting the area "downstream", so widening the thickened area. Flow and uplift can continue until a reduction in imposed far-field compressive stress causes a consequent large reduction in inflow, thereby 'freezing' the thickened crust in place. Erosion of the uplifted area will lead to further uplift of the uneroded material because of the isostatic response to the erosion. Reference Cloetingh, S. & Burov, E. 2010: Lithospheric folding and sedimentary basin evolution: a review and analysis of formation mechanisms. Basin Research 22, 1365-2117. doi:10.1111/j.1365-2117.2010.00490.x.

  8. Compression Myelopathy due to Proliferative Changes around C2 Pars Defects without Instability

    Science.gov (United States)

    Kimura, Tetsuya; Tezuka, Fumitake; Abe, Mitsunobu; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Sairyo, Koichi

    2016-01-01

    We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal. On magnetic resonance imaging, the spinal cord was compressed and intramedullary high signal change was found. A diagnosis of compression myelopathy due to proliferative changes around the C2 pars defects was made. We performed posterior decompression. Postoperatively, symptoms have been alleviated and images revealed sufficient decompression and no apparent instability. In patients with the cervical spondylolysis, myelopathy caused by instability or slippage have been periodically reported. The present case involving C2 spondylolysis is extremely rare. PMID:27340539

  9. Compression Myelopathy due to Proliferative Changes around C2 Pars Defects without Instability.

    Science.gov (United States)

    Kimura, Tetsuya; Sakai, Toshinori; Tezuka, Fumitake; Abe, Mitsunobu; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Sairyo, Koichi

    2016-06-01

    We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal. On magnetic resonance imaging, the spinal cord was compressed and intramedullary high signal change was found. A diagnosis of compression myelopathy due to proliferative changes around the C2 pars defects was made. We performed posterior decompression. Postoperatively, symptoms have been alleviated and images revealed sufficient decompression and no apparent instability. In patients with the cervical spondylolysis, myelopathy caused by instability or slippage have been periodically reported. The present case involving C2 spondylolysis is extremely rare. PMID:27340539

  10. An investigation of the neurophysiologic effect of tone-reducing AFOs on reflex excitability in subjects with spasticity following stroke while standing.

    Science.gov (United States)

    Ibuki, Aileen; Bach, Timothy; Rogers, Douglas; Bernhardt, Julie

    2010-06-01

    Tone-reducing ankle-foot orthoses (TRAFOs) are said to improve the control and functioning of spastic lower limbs by their biomechanic and neurophysiologic effects. Unfortunately, there is limited evidence in literature to support the theory that TRAFOs can effectively decrease spasticity in the foot and ankle neurophysiologically. The primary purpose of this investigation was to determine the neurophysiologic effect of TRAFOs on soleus muscle reflex excitability in subjects with spasticity following stroke while standing. A repeated-measures intervention study was conducted on 15 adult subjects with stroke who were recruited from the community. Custom-made articulated ankle-foot orthoses (AFOs) and TRAFOs with orthokinetic compression garments (OCGs) were fabricated for each subject. Five conditions were tested: (1) Shoes only, (2) AFO, (3) TRAFO, (4) TRAFO with OCG, (5) shoes only, to determine if the TRAFOs were most effective in decreasing spasticity as assessed by the ratio of maximum Hoffmann reflex amplitude to maximum muscle response amplitude (Hmax:Mmax ratio) of the soleus. The results found that there were no significant treatment effects for the interventions (F = 0.992, df = 2.167, p = 0.388), however, when analysed subject-by-subject, four subjects displayed significant increases in their Hmax:Mmax ratios to at least one treatment condition. Overall, the results demonstrated that the tone-reducing devices had no significant neurophysiologic effect on soleus reflex excitability in subjects with spasticity, however individual responses showed that the TRAFOs increased spasticity in some individuals. PMID:20184503

  11. Incidence estimate and guideline-oriented treatment for post-stroke spasticity: an analysis based on German statutory health insurance data

    Directory of Open Access Journals (Sweden)

    Egen-Lappe V

    2013-03-01

    Full Text Available Veronika Egen-Lappe, Ingrid Köster, Ingrid SchubertPMV Research Group, Department of Child and Adolescence Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyBackground: Spasticity after stroke has been internationally recognized as an important health problem causing impairment of mobility, deformity, and pain. The aim of this study was to assess the frequency of first-ever and recurrent stroke and of subsequent spastic and flaccid paresis. Factors influencing the development of spasticity were analyzed. A further major aim was to provide a "real-life" assessment of the treatment of spasticity in Germany and to discuss this in view of the treatment recommended by German and international clinical guidelines.Methods: The database used in this study comprised a cohort of 242,090 insurants from a large statutory health insurance fund in the federal state of Hesse, Germany. A first hospital discharge diagnosis in 2009 with any of the International Classification of Diseases, Tenth Revision (ICD-10 codes I60–I64 was used to identify patients with acute stroke (hemorrhage and ischemic. These patients were followed up six months after stroke to monitor whether they developed spastic or flaccid paresis (hospital or ambulatory care diagnoses ICD-10 code G81–G83 [excluding G82.6/G83.4/G83.8]. For patients with spastic paresis after stroke the spasticity treatment was analyzed for a six-month period (physiotherapy, oral muscle relaxants, intrathecal baclofen, and botulinum toxin.Results: Standardized to the population of Germany, 3.7 per 1000 persons suffered a stroke in 2009 (raw 5.2/1000. Of all surviving patients, 10.2% developed spasticity within 6 months. Cox regression revealed no significant influence of patient age, gender, morbidity (diabetes, hypertensive diseases, ischemic heart diseases or type of stroke on development of spasticity. 97% of surviving patients with spasticity received physiotherapy (inpatient care 89

  12. Paravertebral cutaneous hemangiosarcoma in dog causing medular compression /
    Hemangiossarcoma cutâneo paravertebral em cão causando compressão medular

    OpenAIRE

    Ana Paula Frederico Rodrigues Loureiro Bracarense; Paula Cava Rodrigues; Mônica Vicky Bahr Arias; Rogério Anderson Marcasso

    2010-01-01

    A seven-year-old male Scottish terrier was examined at the Veterinary Hospital of the Universidade Estadual de Londrina due to a toracolumbar syndrome classified as V degree and a mass in lumbar region back right of slow growth with evaluation of two months. Myelography showed an interruption of the column of contrast between the 11th and 12th thoracic vertebrae. A hemilaminectomy was performed in this region. Spinal cord compression at this location was not observed, however during the cauda...

  13. Comparison of Developmental Pattern Change in Preschool Children with Spastic Diplegic and Quadriplegic Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Alice May-Kuen Wong

    2010-08-01

    Full Text Available Background: This study compares the longitudinal change of developmental patterns inpreschool children with spastic diplegic (SD and spastic quadriplegic (SQcerebral palsy (CP.Methods: Sixty children with spastic CP, aged 1-5 years (3.2

  14. Pharmacologic interventions for reducing spasticity in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R; Soyode, Olufemi

    2005-10-01

    Motor function abnormalities are a key feature of cerebral palsy. Spasticity is one of the main motor abnormalities seen in children with cerebral palsy. Spasticity is a velocity dependent increased resistance to movement. While in some children, spasticity may adversely impact the motor abilities, in others, it may help maintain posture and ability to ambulate. Thus, treatment to reduce spasticity requires careful consideration of various factors. Non-pharmacologic interventions used to reduce spasticity include physiotherapy, occupational therapy, use of adaptive equipment, various orthopedic surgical procedures and neurosurgical procedures. Pharmacologic interventions used for reducing spasticity in children with cerebral palsy reviewed in this article include oral administration of baclofen, diazepam, dantrolene and tizanidine, intrathecal baclofen, and local injections of botulinum toxin, phenol, and alcohol. PMID:16272661

  15. Spasticity in disorders of consciousness: a behavioral study

    OpenAIRE

    Thibaut, Aurore; Chatelle, Camille; Wannez, Sarah; Deltombe, Thierry; Stender, Johan; Schnakers, Caroline

    2015-01-01

    Background: Spasticity is a frequent complication after severe brain injury, which may impede the rehabilitation process and diminish the patients’ quality of life. Aim: We here investigate the presence of spasticity in a population of non-communicative patients with disorders of consciousness. We also evaluate the correlation between spasticity and potential factors of co-morbidity, frequency of physical therapy, time since insult presence of pain, presence of tendon retraction, etiology...

  16. Preliminary Results for the Treatment of a Pain-Causing Osteoporotic Vertebral Compression Fracture with a Sky Bone Expander

    International Nuclear Information System (INIS)

    Vertebral compression fractures (VCFs) are common complications of osteoporosis. The expansion of VCFs with a Sky Bone Expander is a new procedure which improves kyphotic deformities and decreases pain associated with VCFs. The purpose of this study was to investigate the preliminary results for the treatment of painful osteoporotic VCFs with a Sky Bone Expander. Twenty-six patients with pain-causing VCFs were treated with a Sky Bone Expander. This operation involved the percutaneous insertion of the Sky Bone Expander into a fractured vertebral body transpedicularly. Following the expansion, the Sky Bone Expander was contracted and removed, resulting in a cavity to be filled with bone cement. All fractures were analyzed for improvement in sagittal alignment. Clinical complications, pain relief and ambulation status were evaluated 1 day, 1 week, 1 month, and 3 months after the operation. Twenty-four hours after the operation, all the patients treated experienced some degree of pain relief. In addition, no postoperative neurologic complications were noted. The average operative time was 42.4 ± 15.5 min per vertebra. Moreover, an average cement volume of 3.5 mL (range, 2.5 ± 5.0 mL) was injected per vertebra. The average anterior height was 18.4 ± 5.1 mm preoperatively and 20.5 ± 5.3 mm postoperatively (p < 0.01). Furthermore, the average midline height was 15.5 ± 5.2 mm preoperatively and 18.9 ± 4.0 mm postoperatively (p < 0.01). The Cobb angle improved from 18.5 ± 8.2 degrees preoperatively to 9.2 ± 4.0 degrees postoperatively (p < 0.01). The Visual Anabog Scale scores decreased from 7.7 ± 1.8 points preoperatively to 3.1 ± 2.0, 2.9 ± 1.7, 2.6 ± 1.5 and 2.9 ± 11.3 after 1 day, 1 week, 1 month and 3 months after the operation, respectively. Cement extrusion was observed in four patients without any neurologic symptoms. As a result of this study, we can postulate that the expansion of compressed vetrebra with a Sky Bone Expander is a safe and minimally

  17. Preliminary Results for the Treatment of a Pain-Causing Osteoporotic Vertebral Compression Fracture with a Sky Bone Expander

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jin Bo; Tang, Xue Ming; Xu, Nan Wei; Bao, Hong Tao [Changzhou No 2. Hospital, Changzhou (China)

    2008-10-15

    Vertebral compression fractures (VCFs) are common complications of osteoporosis. The expansion of VCFs with a Sky Bone Expander is a new procedure which improves kyphotic deformities and decreases pain associated with VCFs. The purpose of this study was to investigate the preliminary results for the treatment of painful osteoporotic VCFs with a Sky Bone Expander. Twenty-six patients with pain-causing VCFs were treated with a Sky Bone Expander. This operation involved the percutaneous insertion of the Sky Bone Expander into a fractured vertebral body transpedicularly. Following the expansion, the Sky Bone Expander was contracted and removed, resulting in a cavity to be filled with bone cement. All fractures were analyzed for improvement in sagittal alignment. Clinical complications, pain relief and ambulation status were evaluated 1 day, 1 week, 1 month, and 3 months after the operation. Twenty-four hours after the operation, all the patients treated experienced some degree of pain relief. In addition, no postoperative neurologic complications were noted. The average operative time was 42.4 {+-} 15.5 min per vertebra. Moreover, an average cement volume of 3.5 mL (range, 2.5 {+-} 5.0 mL) was injected per vertebra. The average anterior height was 18.4 {+-} 5.1 mm preoperatively and 20.5 {+-} 5.3 mm postoperatively (p < 0.01). Furthermore, the average midline height was 15.5 {+-} 5.2 mm preoperatively and 18.9 {+-} 4.0 mm postoperatively (p < 0.01). The Cobb angle improved from 18.5 {+-} 8.2 degrees preoperatively to 9.2 {+-} 4.0 degrees postoperatively (p < 0.01). The Visual Anabog Scale scores decreased from 7.7 {+-} 1.8 points preoperatively to 3.1 {+-} 2.0, 2.9 {+-} 1.7, 2.6 {+-} 1.5 and 2.9 {+-} 11.3 after 1 day, 1 week, 1 month and 3 months after the operation, respectively. Cement extrusion was observed in four patients without any neurologic symptoms. As a result of this study, we can postulate that the expansion of compressed vetrebra with a Sky Bone Expander

  18. Radioiodine plus recombinant human thyrotropin do not cause acute airway compression and are effective in reducing multinodular goiter

    Energy Technology Data Exchange (ETDEWEB)

    Albino, C.C., E-mail: ccalbino@uol.com.b [Instituto de Diabetes e Endocrinologia de Maringa, PR (Brazil); Graf, H.; Paz-Filho, G. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital das Clinicas. Servico de Endocrinologia e Metabologia; Diehl, L.A. [Universidade Estadual de Londrina (UEL), PR (Brazil); Olandoski, M.; Sabbag, A. [Pontificia Univ. Catolica do Parana (PUCPR), Curitiba, PR (Brazil). Nucleo de Bioestatistica; Buchpiguel, C. [Universidade de Sao Paulo (USP), SP (Brazil). Dept. de Radiologia

    2006-03-15

    Recombinant human thyrotropin (rhTSH) reduces the activity of radioiodine required to treat multinodular goiter (MNG), but acute airway compression can be a life-threatening complication. In this prospective, randomized, double-blind, placebo-controlled study, we assessed the efficacy and safety (including airway compression) of different doses of rhTSH associated with a fixed activity of {sup 131}I for treating MNG. Euthyroid patients with MNG (69.3 +- 62.0 mL, 20 females, 2 males, 64 +- 7 years) received 0.1 mg (group I, N = 8) or 0.01 mg (group II, N = 6) rhTSH or placebo (group III, N = 8), 24 h before 1.11 GBq {sup 131}I. Radioactive iodine uptake was determined at baseline and 24 h after rhTSH and thyroid volume (TV, baseline and 6 and 12 months after treatment) and tracheal cross-sectional area (TCA, baseline and 2, 7, 180, and 360 days after rhTSH) were determined by magnetic resonance; antithyroid antibodies and thyroid hormones were determined at frequent intervals. After 6 months, TV decreased significantly in groups I (28.5 +- 17.6%) and II (21.6 +- 17.8%), but not in group III (2.7 +- 15.3%). After 12 months, TV decreased significantly in groups I (36.7 +- 18.1%) and II (37.4 +- 27.1%), but not in group III (19.0 +- 24.3%). No significant changes in TCA were observed. T3 and free T4 increased transiently during the first month. After 12 months, 7 patients were hypothyroid (N 3 in group I and N = 2 in groups II and III). rhTSH plus a 1.11-GBq fixed {sup 131}I activity did not cause acute or chronic changes in TCA. After 6 and 12 months, TV reduction was more pronounced among patients treated with rhTSH plus {sup 131}I (author)

  19. Evaluation of the Effects of Sativex (THC BDS: CBD BDS) on Inhibition of Spasticity in a Chronic Relapsing Experimental Allergic Autoimmune Encephalomyelitis: A Model of Multiple Sclerosis

    OpenAIRE

    Hilliard, A.; Stott, C.; Wright, S; Guy, G.; Pryce, G.; Al-Izki, S.; Bolton, C; Giovannoni, G.

    2012-01-01

    This study investigated the antispasticity potential of Sativex in mice. Chronic relapsing experimental allergic encephalomyelitis was induced in adult ABH mice resulting in hind limb spasticity development. Vehicle, Sativex, and baclofen (as a positive control) were injected intravenously and the “stiffness” of limbs assessed by the resistance force against hind limb flexion. Vehicle alone caused no significant change in spasticity. Baclofen (5 mg/kg) induced approximately a 40% peak reducti...

  20. Differential Local Spasticity in Myocardial Bridges

    OpenAIRE

    Angelini, Paolo; Uribe, Carlo; Lozano, Pablo

    2012-01-01

    To illustrate the effect of myocardial bridges on coronary vascular tone, we describe the cases of 2 patients with different clinical presentations in the context of reproducible increased spasticity at the site of myocardial bridging. One had an episode of takotsubo cardiomyopathy, and one developed typical Prinzmetal angina while receiving desmopressin treatment for pituitary insufficiency. In both patients, acetylcholine challenge clearly revealed both the presence and the severity of myoc...

  1. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  2. Efficiency of work production by spastic muscles.

    Science.gov (United States)

    Stoquart, G G; Detrembleur, C; Nielens, H; Lejeune, T M

    2005-12-01

    The present study compared the muscular efficiency in spastic and healthy lower limbs producing the same mechanical work. Sixteen chronic post-stroke hemiparetic and spastic patients and 14 age-matched healthy subjects were submitted to a submaximal stepwise exercise testing on a bicycle ergometer, pedalling with only one lower limb. Net energetic expenditure was computed from oxygen consumption above resting values. Electrical activity of antagonistic muscles in the thigh and in the shank was recorded and co-contraction was defined as the percentage of the pedalling cycle when antagonistic muscles were activated simultaneously. The efficiency was calculated as the ratio between the mechanical work done on the ergometer and the net energetic expenditure. Spasticity was quantitatively evaluated by measuring passive ankle plantar flexor muscle stiffness. The working capacity of the patients' paretic lower limb was very low (<40W). The energy expenditure increased linearly as a function of work intensity, without statistical difference between the patients paretic lower limb (PPL), the patients healthy lower limb (PHL) and the healthy subjects lower limb (HSL). Shank co-contraction was 2.9 times greater in PPL (p<0.05) and 2.3 times greater in PHL (p<0.05) than in HSL. Thigh co-contraction was also 1.8 times greater in PPL than in HSL (p<0.05). The ankle plantar flexor muscle stiffness was statistically greater in PPL than in PHL and HSL (p<0.05). The efficiency was not statistically different between the three groups (p=0.155). In conclusion, the efficiency of work production by paretic and spastic lower limb muscles was normal ( congruent with 20%) despite significant neurological impairments. PMID:16274915

  3. Paravertebral cutaneous hemangiosarcoma in dog causing medular compression / Hemangiossarcoma cutâneo paravertebral em cão causando compressão medular

    Directory of Open Access Journals (Sweden)

    Ana Paula Frederico Rodrigues Loureiro Bracarense

    2010-07-01

    Full Text Available A seven-year-old male Scottish terrier was examined at the Veterinary Hospital of the Universidade Estadual de Londrina due to a toracolumbar syndrome classified as V degree and a mass in lumbar region back right of slow growth with evaluation of two months. Myelography showed an interruption of the column of contrast between the 11th and 12th thoracic vertebrae. A hemilaminectomy was performed in this region. Spinal cord compression at this location was not observed, however during the caudal enlargement of hemilaminectomy it was visualized in the region of the fourth lumbar vertebrae, a spinal cord deviation to the left, due to the presence of a reddish mass at the right side that was diagnosed as a tumor infiltration in the vertebrae with cord compression. Surgical removal with appropriate margin was not possible. In histology, the tumor was classified as hemangiosarcoma. This report emphasizes the importance of considering the possibility of cancer as differential diagnosis of paraplegias, even in acute clinical changes.Um cão macho, Scottish Terrier, de sete anos foi atendido no Hospital Veterinário da Universidade Estadual de Londrina por apresentar paraplegia grau V e um nódulo em região dorso lombar direita de crescimento lento, com evolução de dois meses. Foi realizado mielografia, visibilizando-se interrupção na coluna de contraste entre as vértebras torácicas 11ª e 12ª. Assim, procedeu-se à hemilaminectomia nesta região, não sendo constatado compressão medular, procedendo-se a ampliação caudal da abertura da lâmina vertebral T12. Na região da quarta vértebra lombar observou-se um desvio da medula espinhal para o lado esquerdo devido à presença de uma massa de coloração avermelhada proveniente do lado direito, diagnosticando-se infiltração tumoral em vértebras com compressão medular, não sendo possível sua remoção cirúrgica. Na histologia classificou-se o tumor como hemangiossarcoma. Este relato

  4. Botulinum Toxin Treatment for Limb Spasticity in Childhood Cerebral Palsy

    Science.gov (United States)

    Pavone, Vito; Testa, Gianluca; Restivo, Domenico A.; Cannavò, Luca; Condorelli, Giuseppe; Portinaro, Nicola M.; Sessa, Giuseppe

    2016-01-01

    CP is the most common cause of chronic disability in childhood occurring in 2–2.5/1000 births. It is a severe disorder and a significant number of patients present cognitive delay and difficulty in walking. The use of botulinum toxin (BTX) has become a popular treatment for CP especially for spastic and dystonic muscles while avoiding deformity and pain. Moreover, the combination of physiotherapy, casting, orthotics and injection of BTX may delay or decrease the need for surgical intervention while reserving single-event, multi-level surgery for fixed musculotendinous contractures and bony deformities in older children. This report highlights the utility of BTX in the treatment of cerebral palsy in children. We include techniques for administration, side effects, and possible resistance as well as specific use in the upper and lower limbs muscles. PMID:26924985

  5. Symptomatic thoracic spinal cord compression caused by postsurgical pseudomeningocele Compressão medular torácica sintomática causada por pseudomeningocele pós-operatória

    OpenAIRE

    Arthur de Azambuja Pereira Filho; Gustavo de David; Gustavo Azambuja Pereira Filho; Albert Vincent Berthier Brasil

    2007-01-01

    We report the first case of symptomatic thoracic spinal cord compression caused by postsurgical pseudomeningocele. A 49-year-old man sought treatment for progressive loss of strength in the lower extremities ten months after full neurological recovery for a thoracic (T11) intradural-extramedullary schwannoma. Magnetic resonance imaging revealed a postsurgical thoracic (T11-T12) pseudomeningocele. The surgical approach showed an inadequate dural closure with spontaneous cerebrospinal fluid fis...

  6. Quantitative evaluation for spasticity of calf muscle after botulinum toxin injection in patients with cerebral palsy: a pilot study

    OpenAIRE

    Lin, Yu-Ching; Lin, I-Ling; Chou, Te-Feng Arthur; Lee, Hsin-Min

    2016-01-01

    Background Cerebral palsy (CP) is the most common pediatric disease to cause motor disability. Two common symptoms in CP are spasticity and contracture. If this occurred in the ankle plantar flexors of children with CP, it will impair their gait and active daily living profoundly. Most children with CP receive botulinum toxin type A (BoNT-A) injection to reduce muscle tone, but a knowledge gap exists in the understanding of changes of neural and non-neural components of spasticity after injec...

  7. Gastrocnemius and soleus spasticity and muscle length in Friedreich's ataxia.

    Science.gov (United States)

    Milne, Sarah C; Corben, Louise A; Yiu, Eppie; Delatycki, Martin B; Georgiou-Karistianis, Nellie

    2016-07-01

    Lower limb spasticity compromises the independence of people with Friedreich's ataxia (FRDA). This study sought to examine lower limb spasticity in FRDA in order to offer new insight as to the best approach and timing of spasticity management. Gastrocnemius and soleus spasticity and muscle length were measured by the Modified Tardieu Scale (MTS) in 31 participants with typical and late-onset FRDA. Relationships between the MTS and the Friedreich Ataxia Rating Scale (FARS), Functional Independence Measure (FIM), and disease duration were analysed. Differences between ambulant (n=18) and non-ambulant (n=13) participants were also examined. All participants had spasticity in at least one muscle, and 38.9% of ambulant and 69.2% of non-ambulant participants had contracture in one or both of their gastrocnemius muscles. Significant negative correlations were found between both gastrocnemius and soleus angle of catch and the FARS score. The FIM score also demonstrated significant correlations with gastrocnemius muscle length and angle of catch. Gastrocnemius and soleus spasticity and contracture is apparent in people with FRDA. Spasticity is evident early in the disease and in ambulant participants. Management of spasticity and reduced muscle length should be considered in people with FRDA at disease onset to optimise function. PMID:27021226

  8. [Treatment of spasticity with a transcutaneous neurostimulator. A pilot study].

    Science.gov (United States)

    Kirkeby, R; Jordt, M; Hansen, E

    1995-04-24

    In this pilot study the neurostimulator KDC 5000 is used with efficacy on seven out of 11 patients with spastic palsy, and treatment was given without any side-effects. No other treatment has sufficiently helped these patients, and we therefore conclude that such treatment with a neuro-stimulator could be beneficial for selected patients with spastic palsy of extremities. PMID:7762102

  9. Botulinum Toxin Treatment of Spasticity in Adults and Children.

    Science.gov (United States)

    Moeini-Naghani, Iman; Hashemi-Zonouz, Taraneh; Jabbari, Bahman

    2016-02-01

    Spasticity is a frequent symptom in stroke, multiple sclerosis, cerebral or spinal trauma, and cerebral palsy that affects and disables a large number of adults and children. In this review, we discuss the pathophysiology and nonpharmacologic and pharmacologic treatments of spasticity with emphasis on the role of botulinum neurotoxins (BoNTs). The world literature is reviewed on double-blind and placebo-controlled clinical trials reporting safety and efficacy of BoNT treatment in adult spasticity and spasticity of children with cerebral palsy. The evidence for efficacy is presented from recommendations of the Assessment and Therapeutics subcommittee of the American Academy of Neurology. A technical section describes the techniques and recommended doses of BoNTs in spasticity. PMID:26866498

  10. Extrinsic tracheal compression caused by scoliosis of the thoracic spine and chest wall degormity: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Kyong min Sarah; Lee, Bae Young; Kim, Hyeon Sook; Song, Kyung Sup; Kang, Hyeon Hul; Lee, Sang Haak; Moon, Hwa Sik [St. Paul' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2014-05-15

    Extrinsic airway compression due to chest wall deformity is not commonly observed. Although this condition can be diagnosed more easily with the help of multidetector CT, the standard treatment method has not yet been definitely established. We report a case of an eighteen-year-old male who suffered from severe extrinsic tracheal compression due to scoliosis and straightening of the thoracic spine, confirmed on CT and bronchoscopy. The patient underwent successful placement of tracheal stent but later died of bleeding from the tracheostomy site probably due to tracheo-brachiocephalic artery fistula. We describe the CT and bronchoscopic findings of extrinsic airway compression due to chest wall deformity as well as the optimal treatment method, and discuss the possible explanation for bleeding in the patient along with review of the literature.

  11. Muscle synergies in cycling after incomplete spinal cord injury: correlation with clinical measures of motor function and spasticity

    Directory of Open Access Journals (Sweden)

    Filipe O. Barroso

    2016-01-01

    Conclusion: Overall, the results of this study support the hypothesis that the analysis of muscle synergies during cycling can provide detailed quantitative assessment of functional motor impairments and symptoms of spasticity caused by abnormal spatiotemporal muscle co-activation following iSCI.

  12. Bronchial compression by an enlarged left atrium in infants; a cause of hypovascularity of the left lung

    Energy Technology Data Exchange (ETDEWEB)

    Corr, L.; Hallidie-Smith, K.A.; McCarthy, P.A.; Lavender, J.P.

    1988-09-01

    In three infants seen recently at our institution we noted signs of compression of the left main bronchus associated with enlarged left atria. None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected side. In addition, hypoperfusion of the left lung was noted in each case. We believe that bronchial compression due to an enlarged left atrium, with consequent hypoxic vasoconstriction is a clinically significant entity, which is not well described and may be unappreciated in infants in whom the typical signs of hyperinflation are absent.

  13. Reappearance of Cranial Nerve Dysfunction Symptoms Caused by New Artery Compression More than 20 Years after Initially Successful Microvascular Decompression: Report of Two Cases.

    Science.gov (United States)

    Inoue, Hiroto; Kondo, Akinori; Shimano, Hiroshi; Yasuda, Soichiro; Murao, Kenichi

    2016-01-01

    Reappearance of symptoms of cranial nerve dysfunction is not uncommon after successful microvascular decompression (MVD). The purpose of this study was to report two quite unusual cases of recurrent and newly developed hemifacial spasm (HFS) caused by a new conflicting artery more than 20 years after the first successful surgery. In Case 1, the first MVD was performed for HFS caused by the posterior inferior cerebellar artery (PICA) when the patient was 38 years old. After 26 symptom-free years, HFS recurred on the same side of the face due to compression by the newly developed offending AICA. In Case 2, the patient was first operated on for trigeminal neuralgia by transposition of the AICA at 49 years old, but 20 symptom-free years after the first MVD, a new offending PICA compressed the facial nerve on the same side, causing HFS. These two patients underwent reoperation and gained satisfactory results postoperatively. Reappearance of symptoms related to compression of the root exit zone (REZ) by a new offending artery after such a long symptom-free interval since the first effective MVD is rare. Here, we describe two such unusual cases and discuss how to manage and prevent such reappearance of symptoms after a long time interval. PMID:26804190

  14. Invasive Treatment Modalities for Spasticity and Pain in Spinal Cord Injury - Education

    Directory of Open Access Journals (Sweden)

    Sabri Aydın

    2010-12-01

    Full Text Available Spasticity secondary to spinal cord injury may impair function or ease of care or may cause discomfort or poor body image. The treatment of spasticity and pain requires a multidisciplinary approach with treatment aimed at modulating the movement disorder through oral medication, injectable drugs, surgical intervention and physical therapy. Surgical treatment of the neurologic effects of the central movement disorders include selective dorsal rhizotomy, intrathecal baclofen pump placement, and potentially deep brain stimulation. Techniques may be combined for greater efficacy and better tailoring to the needs of the patient. This article provides an overview of each approach, with a review of significant research findings in support of each. Turk J Phys Med Rehab 2010; 56 Suppl 2: 102-4

  15. Multilevel botulinum toxin type a as a treatment for spasticity in children with cerebral palsy: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ece Unlu

    2010-01-01

    Full Text Available INTRODUCTION: Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients. OBJECTIVE: The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients. METHODS: Data from 71 cerebral palsy patients (64% male, 36% female, mean age 6.7 ±3.2 years were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88, and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V. Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months. RESULTS: We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p0.05. Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments. CONCLUSION: We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.

  16. [Continuous intrathecal infusion of baclofen. A new therapeutic method for spasticity].

    Science.gov (United States)

    Berg-Johnsen, J; Røste, G K; Solgaard, T; Lundar, T

    1998-09-10

    Intrathecal administration of baclofen is now generally accepted as a powerful treatment of spasticity caused by spinal lesions. 35 patients with severe spasticity, 29 of spinal origin and six of supraspinal origin resistant to conservative treatment, had a programmable pump (Synchromed, Medtronic) for continuous intrathecal baclofen infusion implanted. The patients were followed-up for an average of 29 months (0-68). The initial effect of the treatment was positive for all patients; spasms were less frequent, there was remission of pain caused by cramps, and in some cases improved ambulation. In five patients, however, the pump was later removed: in two patients the pump ceased to be effective, two patients became infected, and one experienced multiple catheter problems. Problems with the catheter was the most common complication experienced, and this was seen in nine patients. Three patients died of the underlying disease. The majority of patients became accommodated to intrathecal baclofen and it was necessary to administer increasingly larger doses to maintain the clinical effect. Long-term control of spinal spasticity by intrathecal baclofen can be achieved in most patients, but close follow-up is necessary for assessing efficacy and refilling the pump. PMID:9772811

  17. The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model

    OpenAIRE

    Belagaje, S. R.; C. Lindsell; Moomaw, C. J.; Alwell, K.; Flaherty, M. L.; Woo, D; Dunning, K; P. Khatri; Adeoye, O.; D. Kleindorfer; Broderick, J.; Kissela, B

    2014-01-01

    Several devices and medications have been used to address poststroke spasticity. Yet, spasticity's impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS) as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was define...

  18. IgM multiple myeloma presenting with spinal cord compression caused by a plasmacytoma: A case report

    OpenAIRE

    Tahan, Ihssan; Seale, Jim; Edwards, David

    2008-01-01

    Background IgM multiple myeloma is rare disorder, which has clinical, laboratory and radiological manifestations that are consistent with both multiple myeloma and Waldenstrom's macroglobulinaemia. Case presentation An 83 years Welsh lady presented with clinical and radiological features consistent with spinal cord compression. Further investigations confirmed the diagnosis of IgM multiple myeloma. Following localized radiotherapy and five courses of melphalan and prednisolone, the patient ac...

  19. Stretch reflex regulation in healthy subjects and patients with spasticity

    DEFF Research Database (Denmark)

    Nielsen, Jens Bo; Petersen, Nicolas; Crone, Clarissa;

    2005-01-01

    In recent years, part of the muscle resistance in spastic patients has been explained by changes in the elastic properties of muscles. However, the adaptive spinal mechanisms responsible for the exaggeration of stretch reflex activity also contribute to muscle stiffness. The available data suggest...... is increased during voluntary muscle contraction in part because of depression of the inhibitory mechanisms that are affected in spasticity. In spastic patients, these inhibitory mechanisms are already depressed at rest and cannot be depressed further in connection with a contraction. In relation to...

  20. Obturator neurolysis using 65% alcohol for adductor muscle spasticity

    Directory of Open Access Journals (Sweden)

    Anju Ghai

    2012-01-01

    Full Text Available Spasticity is motor alteration characterized by muscle hypertonia and hyperreflexia. It is an important complication of spinal cord injury, traumatic brain injury, cerebral palsy, and multiple sclerosis. If uncorrected, fibrosis and eventually bony deformity lock the joint into a fixed contracture. Chemical neurolysis using various agents is one of the therapeutic possibilities to alleviate spasticity. We are, hereby, reporting 3 patients in whom 65% alcohol was used as neurolytic agent for the treatment of hip adductor spasticity, and the effect lasted for a variable period.

  1. Pain treatment with ziconotide and baclofen in a case of spasticity associated with neuropathic pain

    Directory of Open Access Journals (Sweden)

    Danilo G. Quarta

    2009-03-01

    Full Text Available This study presents the clinical case of a patient with paraparesis, subjected for a long period of time to treatment with intrathecal baclofen and morphine to control spasticity and neuropathic pain, resulting from spinal cord injury due to road trauma. After several years of treatment the pain was not controlled with high doses of intrathecal morphine combined with transmucosal fentanyl that were given when needed. It was therefore decided to switch to intrathecal ziconotide. Starting with high levels of intrathecal morphine, the patient was referred first to weaning from morphine to a gradual titration of ziconotide doses of up to 7.4 mcg/die associated with 680 mcg/die of baclofen. A technical problem related to the infusion pump has led to the abrupt interruption of the administration of ziconotide and baclofen, which did not cause side effects, except for a poorly controlled pain. The spasticity, however, did not recur. After replacing the intrathecal pump and restarting the gradual titration of ziconotide alone, the patient has once again regained a good pain control with no recurrence to date of spasticity.

  2. A hereditary spastic paraplegia mutation in kinesin-1A/KIF5A disrupts neurofilament transport

    Directory of Open Access Journals (Sweden)

    Brown Anthony

    2010-11-01

    Full Text Available Abstract Background Hereditary spastic paraplegias are a group of neurological disorders characterized by progressive distal degeneration of the longest ascending and descending axons in the spinal cord, leading to lower limb spasticity and weakness. One of the dominantly inherited forms of this disease (spastic gait type 10, or SPG10 is caused by point mutations in kinesin-1A (also known as KIF5A, which is thought to be an anterograde motor for neurofilaments. Results We investigated the effect of an SPG10 mutation in kinesin-1A (N256S-kinesin-1A on neurofilament transport in cultured mouse cortical neurons using live-cell fluorescent imaging. N256S-kinesin-1A decreased both anterograde and retrograde neurofilament transport flux by decreasing the frequency of anterograde and retrograde movements. Anterograde velocity was not affected, whereas retrograde velocity actually increased. Conclusions These data reveal subtle complexities to the functional interdependence of the anterograde and retrograde neurofilament motors and they also raise the possibility that anterograde and retrograde neurofilament transport may be disrupted in patients with SPG10.

  3. Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological-pathological correlation

    International Nuclear Information System (INIS)

    We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented. (orig.)

  4. Compression of the Right Pulmonary Artery by a Massive Descending Aortic Aneurysm Causing Bilateral Perfusion Defects on Pulmonary Scintigraphy

    OpenAIRE

    Makis, William; Derbekyan, Vilma

    2011-01-01

    A 67-year-old woman, who presented with a 2 month history of dyspnea, had a ventilation and perfusion lung scan that showed absent perfusion of the entire right lung with normal ventilation, as well as a rounded matched defect in the left lower lung adjacent to midline, suspicious for an aortic aneurysm or dissection. CT pulmonary angiography revealed a massive descending aortic aneurysm compressing the right pulmonary artery as well as the left lung parenchyma, accounting for the bilateral p...

  5. MRI of autosomal dominant pure spastic paraplegia

    DEFF Research Database (Denmark)

    Krabbe, K; Nielsen, J E; Fallentin, E;

    1997-01-01

    callosum on one midsagittal slice and the area of the brain on one axial slice were measured and a "corpus-callosum index" expressing the size of the corpus callosum relative to that of the brain was calculated. Cross-sectional areas and anteroposterior and transverse diameters of the spinal cord at the...... levels of C 2, C 5, T 3, T 6, T 9 and T 11 were measured. No significant differences between patients and controls were found on qualitative evaluation of the images. The patients had a significantly smaller corpus callosum and "corpus-callosum index" than controls. This finding, not reported previously......We examined 16 patients with autosomal dominant pure spastic paraplegia (HSP) and 15 normal controls matched for age and sex using MRI of the brain and spinal cord. Images were assessed qualitatively by two independent radiologists, blinded to the clinical diagnosis. Areas of the brain and corpus...

  6. Functional effects of botulinum toxin type-A treatment and subsequent stretching of spastic calf muscles: a study in patients with hereditary spastic paraplegia

    NARCIS (Netherlands)

    Niet, M. de; Bot, S.T. de; Warrenburg, B.P.C. van de; Weerdesteijn, V.G.M.; Geurts, A.C.H.

    2015-01-01

    OBJECTIVE: Although calf muscle spasticity is often treated with botulinum toxin type-A, the effects on balance and gait are ambiguous. Hereditary spastic paraplegia is characterized by progressive spasticity and relatively mild muscle weakness of the lower limbs. It is therefore a good model to eva

  7. Genetics Home Reference: infantile-onset ascending hereditary spastic paralysis

    Science.gov (United States)

    ... and paraplegia result from degeneration (atrophy) of motor neurons , which are specialized nerve cells in the brain and spinal cord that control muscle movement. Hereditary spastic paraplegias are divided into two types: pure and complicated. The pure types involve only ...

  8. Clinical case reviews in multiple sclerosis spasticity: experiences from around Europe.

    Science.gov (United States)

    Koehler, Jürgen; Amato, Maria P; Oreja-Guevara, Celia; Lycke, Jan

    2013-12-01

    Spasticity is one of the main symptoms associated with multiple sclerosis (MS). Epidemiological studies indicate that approximately two-thirds of MS patients experience spasticity and, in a relevant proportion of this group, spasticity is moderate to severe. Yet, spasticity remains largely undertreated. The most commonly used oral antispasticity agents (e.g., baclofen, tizanidine, gabapentin) generally do not reduce spasticity adequately at dosages that are well tolerated by patients. This review of MS spasticity cases from around Europe presents current knowledge of considerations for administration of a new agent (tetrahydrocannabinol/cannabidiol-based nabiximols [Sativex®] oromucosal spray) for management of MS spasticity, with the aim of ensuring appropriate and optimal use for best outcomes. Assessment of the European clinical experience is intended to provide a better understanding of the prescribing regulations for MS spasticity treatments, facilitate identification of suitable candidate patients for Sativex and increase awareness of alternative management approaches for MS-related spasticity. PMID:24289846

  9. Strumpellin and Spartin, Hereditary Spastic Paraplegia Proteins, are Binding Partners.

    Science.gov (United States)

    Zhao, Jiali; Hedera, Peter

    2015-01-01

    Hereditary spastic paraplegia (HSP) is one of the most heterogeneous neurodegenerative diseases with more than 50 identified genes causing a relatively stereotypical phenotypic presentation. Recent studies of HSP pathogenesis have suggested the existence of shared biochemical pathways that are crucial for axonal maintenance and degeneration. We explored possible interactions of several proteins associated with this condition. Here we report interactions of endogenous and overexpressed strumpellin with another HSP-associated protein, spartin. This biochemical interaction does not appear to be a part of the Wiskott-Aldrich syndrome protein and Scar homologue (WASH) complex because spartin is not co-immunoprecipitated with WASH1 protein. The spartin-strumpellin association does not require the presence of the microtubule interacting and trafficking domain of spartin. Over-expression of mutant forms of strumpellin with the introduced HSP-causing mutations does not alter the colocalization of these two proteins. Knockdown of strumpellin in cultured cortical rat neurons interferes with development of neuronal branching and results in reduced expression of endogenous spartin. Proteosomal inhibition stabilized the levels of spartin and WASH1 proteins, supporting increased spartin degradation in the absence of strumpellin. PMID:25987849

  10. Risk Factors of Undernutrition in Children with Spastic Cerebral Palsy

    OpenAIRE

    Jen-Wen Hung; Te-Jui Hsu; Pi-Chuan Wu; Chau-Peng Leong

    2003-01-01

    Background: This study was undertaken to investigate the nutritional status of childrenwith spastic cerebral palsy (CP) and to identify the risk factors of undernutrition.Methods: Seventy-five spastic CP children, 47 boys and 28 girls, (ages, 5 months to 10years) underwent anthropometric assessment, including body weight, recumbentlength, and knee height. Their functional status, medical condition, andfeeding status were also recorded. The data were analyzed to estimate theinfluences of vario...

  11. Physiological effects of selective tibial neurotomy on lower limb spasticity

    OpenAIRE

    Feve, A; Decq, P; Filipetti, P; Verroust, J; Harf, A; N'Guyen, J; Keravel, Y

    1997-01-01

    OBJECTIVES—To assess by electrophysiology the effect of tibial selective neurotomy on muscle imbalance of the spastic ankle.
METHOD—The amplitudes of the H reflexes, M responses (muscle contractions recorded after stimulation of the tibial nerve), and Hmax:Mmax ratio were recorded in 12 patients with chronic lower limb spasticity, before and one month after tibial selective neurotomy. Recordings were done on medial and lateral gastrocnemius and soleus muscles.
 Clinical eva...

  12. Cardiovascular disease risk in adults with spastic bilateral cerebral palsy

    OpenAIRE

    Slot, Wilma; Roebroeck, Marij; Nieuwenhuijsen, Channah; Bergen, Michael; Stam, Henk; Burdorf, Alex; Berg-Emons, Rita

    2013-01-01

    textabstractObjective: To explore: (i) cardiovascular disease risk factors and the 10-year clustered risk of a fatal cardiovascular event in adults with spastic bilateral cerebral palsy; and (ii) relationships between the 10-year risk and body fat, aerobic fitness and physical activity. Design: Cross-sectional study. Subjects: Forty-three adults with spastic bilateral cerebral palsy without severe cognitive impairment (mean age 36.6 years (standard deviation 6); 27 men). Methods: Biological a...

  13. Intrathecal baclofen for management of spastic cerebral palsy: multicenter trial.

    Science.gov (United States)

    Gilmartin, R; Bruce, D; Storrs, B B; Abbott, R; Krach, L; Ward, J; Bloom, K; Brooks, W H; Johnson, D L; Madsen, J R; McLaughlin, J F; Nadell, J

    2000-02-01

    Intrathecal baclofen infusion has demonstrated effectiveness in decreasing spasticity of spinal origin. Oral antispasticity medication is minimally effective or not well tolerated in cerebral palsy. This study assessed the effectiveness of intrathecal baclofen in reducing spasticity in cerebral palsy. Candidates were screened by randomized, double-blind, intrathecal injections of baclofen and placebo. Responders were defined as those who experienced an average reduction of 1.0 in the lower extremities on the Ashworth Scale for spasticity. Responders received intrathecal baclofen via the SynchroMed System and were followed for up to 43 months. Fifty-one patients completed screening and 44 entered open-label trials. Lower-extremity spasticity decreased from an average baseline score of 3.64 to 1.90 at 39 months. A decrease in upper extremity spasticity was evidenced over the same study period. Forty-two patients reported adverse events. Most common reports were hypotonia, seizures (no new onset), somnolence, and nausea or vomiting. Fifty-nine percent of the patients experienced procedural or system-related events. Spasticity in patients with cerebral palsy can be treated effectively by continuous intrathecal baclofen. Adverse events, although common, were manageable. PMID:10695888

  14. Giant Saphenous Venous Graft Aneurysm with Compression of the Pulmonary Artery: A Rare Cause of Heart Failure

    Directory of Open Access Journals (Sweden)

    Jagadeesh K. Kalavakunta

    2015-01-01

    Full Text Available We report a case of a 74-year-old man who presented with dyspnea on exertion and pedal edema. He had five-vessel coronary artery bypass graft (CABG surgery twenty-six years ago and redo three-vessel CABG done thirteen years later. Computed tomographic angiography (CTA of the heart and coronary vessels demonstrated a giant aneurysm arising from the saphenous venous graft (SVG to the first obtuse marginal of the left circumflex artery compressing the pulmonary artery (PA. He underwent coronary angiography, confirming the CTA findings. Surgical and percutaneous interventions were offered, but the patient opted for conservative management due to the high risk of morbidity and mortality.

  15. Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

    OpenAIRE

    Singh Gurpreet; Hughes Peter L; Oo Tun; Soni Bakul M; Vaidyanathan Subramanian; Watt John WH; Sett Pradipkumar

    2003-01-01

    Abstract Background Increased spasms in spinal cord injury (SCI) patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency) drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from...

  16. Epidural cement leakage through pedicle violation after balloon kyphoplasty causing paraparesis in osteoporotic vertebral compression fractures - a report of two cases

    Directory of Open Access Journals (Sweden)

    Noh Won

    2010-08-01

    Full Text Available Abstract Kyphoplasty is advantageous over vertebroplasty in terms of better kyphosis correction and diminished risk of cement extravasations. Literature described cement leakage causing neurological injury mainly after vertebroplasty procedure; only a few case reports show cement leakage with kyphoplasty without neurological injury or proper cause of leakage. We present a report two cases of osteoporotic vertebral compression fracture treated with kyphoplasty and developed cement leakage causing significant neurological injury. In both cases CT scan was the diagnostic tool to identify cause of cement leakage. CT scan exhibited violation of medial pedicle wall causing cement leakage in the spinal canal. Both patients displayed clinical improvement after decompression surgery with or without instrumentation. Retrospectively looking at stored fluoroscopic images, we found that improper position of trocar in AP and lateral view simultaneously while taking entry caused pedicle wall violation. We suggest not to cross medial pedicle wall in AP image throughout the entire procedure and keeping the trocar in the center of pedicle in lateral image would be the most important precaution to prevent such complication. Our case reports adds the neurological complications with kyphoplasty procedure and suggested that along with other precautions described in the literature, entry with trocar along the entire procedure keeping the oval shape of pedicle in mind (under C-arm will probably help to prevent such complications.

  17. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines.

    Science.gov (United States)

    Gold, Ralf; Oreja-Guevara, Celia

    2013-12-01

    Symptomatic therapy of multiple sclerosis (MS) is an important part of a comprehensive treatment plan that aims to improve patients' quality of life. In the current era of medical progress, several factors have led to the development of guidelines for MS management. There is continued need for an evidence-based approach supported by high-quality data from controlled clinical trials. Most healthcare systems require this approach and include it in the reimbursement process. Guidelines are usually committed by national or continental neurological societies. The Spanish Society of Neurology demyelinating diseases working group has developed a consensus document on spasticity in patients with MS. MS experts from the group used the metaplan method to sum up the most important recommendations about spasticity for inclusion in the guidance. Recommendations were classified according to the Scottish Intercollegiate Guidelines Network system and approved by all members of the group. In Germany, the guideline panel of the German Neurological Society endorsed the national competence network for multiple sclerosis (Krankheitsbezogenes Kompetenznetz Multiple Sklerose) to update the existing recommendations. The most recent fifth edition of the guidelines (dated April 2012) now also includes recommendations for treatment of key symptoms such as spasticity. More than 30 MS neurologists contributed to the new edition reflecting the need for broad expertise. After a first round in which key topics were defined, a web-based decision process was undertaken to further develop individual topics such as symptomatic therapy. The draft manuscript was reviewed once again by the group prior to submission to the official review process. The aims of spasticity treatment are to improve mobility and dexterity, achieve physiological movement patterns, reduce pain, facilitate nursing measures and avoid complications such as contractures. Representative antispasticity medications include baclofen

  18. Rehabilitation treatment for 30 cases of compression fracture of vertebral body caused by osteoporosis%骨质疏松性椎体压缩性骨折康复治疗 30例

    Institute of Scientific and Technical Information of China (English)

    兰青; 张海鹏; 孙杰

    2003-01-01

    @@ INTRODUCTION Osteoporosis has become a health protection problem in all over the world.According to American epidemiological statistical data,70% of fractures are caused by osteoporosis in patients over 45 years and fracture of vertebral body is the most common kind of fracture caused by osteoporosis.Nearly 90% of fracture of vertebral body are caused by osteoporosis.If compression fracture of vertebral body isn't treated in time,it will cause pain at chest and waist,vertebral canal might be influenced causing compression on spine and neural symptoms.Traditional treatment on osteoporosis are bed rest,functional exercises of lumbodorsal muscles and fixation of chest and waist by support.But effects of above methods for fracture reduction are not satisfying.In this article,we explore the effects of AF internal fixation system combined with drugs on compression fracture of vertebral body of chest and waist caused by osteoporosis.

  19. Genetics Home Reference: autosomal recessive spastic ataxia of Charlevoix-Saguenay

    Science.gov (United States)

    ... Genetics Home Health Conditions ARSACS autosomal recessive spastic ataxia of Charlevoix-Saguenay Enable Javascript to view the ... Open All Close All Description Autosomal recessive spastic ataxia of Charlevoix-Saguenay , more commonly known as ARSACS , ...

  20. Botulinum toxin type A chemodenervation treatment in spastic forms of cerebral palsy

    OpenAIRE

    A. L. Kurenkov; S. S. Nikitin; A. R. Artemenko; B. I. Bursagova; Kuzenkova, L.M.; Petrova, S. A.; O. A. Klochkova; A. M. Mamedyarov

    2015-01-01

    Cerebral palsy (CP) is one of the most serious outcomes of the perinatal lesion of central nervous system and the most common reason for neurological disability in children. Being the key cause of pathological dynamic stereotypes that frequently result in pathological posture and contractures, spasticity is critically important for CP. The use of botulinum toxin type A (BTA) in complex treatment 2-6 years old CP patients allows significantly to improve motor abilities, help to change the surg...

  1. Cost Effectiveness of Oromucosal Cannabis-Based Medicine (Sativex) for Spasticity in Multiple Sclerosis

    OpenAIRE

    Lanting Lu; Hilary Pearce; Chris Roome; James Shearer; Lang, Iain A; Ken Stein

    2012-01-01

    Background:Background: Spasticity is common in patients with multiple sclerosis (MS) and is a major contributor to disability. Sativex, an oromucosal spray containing cannabis-based medicinal products, has been found to be effective in reducing spasticity symptoms. Abstract: Objective:Objective: Our objective was to estimate the cost effectiveness of Sativex plus oral anti-spasticity medicines compared with the current standard treatment for moderate or severe spasticity in MS in the UK. Abst...

  2. Perceived Impact of Spasticity Is Associated with Spatial and Temporal Parameters of Gait in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Brian M. Sandroff; Sosnoff, Jacob J.; Motl, Robert W.

    2012-01-01

    Background. Spasticity is prevalent and disabling in persons with multiple sclerosis (MS), and the development of the Multiple Sclerosis Spasticity Scale-88 (MSSS-88) provides an opportunity for examining the perceived impact of spasticity and its association with gait in this population. Purpose. This study examined the association between the perceived impact of spasticity and spatio-temporal parameters of gait in persons with MS. Methods. The sample included 44 adults with MS who completed...

  3. Botulinum toxin injection techniques for the management of adult spasticity.

    Science.gov (United States)

    Walker, Heather W; Lee, Michael Y; Bahroo, Laxman B; Hedera, Peter; Charles, David

    2015-04-01

    Spasticity is often experienced by individuals with injury or illness of the central nervous system from etiologies such as stroke, spinal cord injury, brain injury, multiple sclerosis, or other neurologic conditions. Although spasticity may provide benefits in some patients, it more often leads to complications negatively impacting the patient. Nonpharmacologic treatment options often do not provide long-term reduction of spasticity, and systemic interventions, such as oral medications, can have intolerable side effects. The use of botulinum neurotoxin injections is one option for management of focal spasticity. Several localization techniques are available to physicians that allow for identification of the selected target muscles. These methods include anatomic localization in isolation or in conjunction with electromyography guidance, electrical stimulation guidance, or ultrasound guidance. This article will focus on further description of each of these techniques in relation to the treatment of adult spasticity and will discuss the advantages and disadvantages of each technique, as well as review the literature comparing the techniques. PMID:25305369

  4. The pathogenesis of tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy.

    Science.gov (United States)

    Casseb, J; Penalva-de-Oliveira, A C

    2000-12-01

    Tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy (TSP/HAM) is caused by a human T-cell leukemia virus type I (HTLV-I) after a long incubation period. TSP/HAM is characterized by a chronic progressive paraparesis with sphincter disturbances, no/mild sensory loss, the absence of spinal cord compression and seropositivity for HTLV-I antibodies. The pathogenesis of this entity is not completely known and involves a multivariable phenomenon of immune system activation against the presence of HTLV-I antigens, leading to an inflammatory process and demyelination, mainly in the thoracic spinal cord. The current hypothesis about the pathogenesis of TSP/HAM is: 1) presence of HTLV-I antigens in the lumbar spinal cord, noted by an increased DNA HTLV-I load; 2) CTL either with their lytic functions or release/production of soluble factors, such as CC-chemokines, cytokines, and adhesion molecules; 3) the presence of Tax gene expression that activates T-cell proliferation or induces an inflammatory process in the spinal cord; 4) the presence of B cells with neutralizing antibody production, or complement activation by an immune complex phenomenon, and 5) lower IL-2 and IFN-gamma production and increased IL-10, indicating drive to a cytokine type 2 pattern in the TSP/HAM subjects and the existence of a genetic background such as some HLA haplotypes. All of these factors should be implicated in TSP/HAM and further studies are necessary to investigate their role in the development of TSP/HAM. PMID:11105090

  5. The pathogenesis of tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy

    Directory of Open Access Journals (Sweden)

    Casseb J.

    2000-01-01

    Full Text Available Tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy (TSP/HAM is caused by a human T-cell leukemia virus type I (HTLV-I after a long incubation period. TSP/HAM is characterized by a chronic progressive paraparesis with sphincter disturbances, no/mild sensory loss, the absence of spinal cord compression and seropositivity for HTLV-I antibodies. The pathogenesis of this entity is not completely known and involves a multivariable phenomenon of immune system activation against the presence of HTLV-I antigens, leading to an inflammatory process and demyelination, mainly in the thoracic spinal cord. The current hypothesis about the pathogenesis of TSP/HAM is: 1 presence of HTLV-I antigens in the lumbar spinal cord, noted by an increased DNA HTLV-I load; 2 CTL either with their lytic functions or release/production of soluble factors, such as CC-chemokines, cytokines, and adhesion molecules; 3 the presence of Tax gene expression that activates T-cell proliferation or induces an inflammatory process in the spinal cord; 4 the presence of B cells with neutralizing antibody production, or complement activation by an immune complex phenomenon, and 5 lower IL-2 and IFN-gamma production and increased IL-10, indicating drive to a cytokine type 2 pattern in the TSP/HAM subjects and the existence of a genetic background such as some HLA haplotypes. All of these factors should be implicated in TSP/HAM and further studies are necessary to investigate their role in the development of TSP/HAM.

  6. Modulation of the soleus H-reflex during pedalling in normal humans and in patients with spinal spasticity.

    OpenAIRE

    Boorman, G.; Becker, W J; Morrice, B L; Lee, R. G.

    1992-01-01

    Soleus H-reflexes were recorded in 10 normal subjects and seven patients with spasticity caused by incomplete spinal cord injury while they pedalled on a stationary bicycle which had been modified to trigger electrical stimuli to the tibial nerve at eight precise points in the pedal cycle. Stimulus strength was adjusted to yield M-waves of constant amplitude at each pedal position. During active pedalling, all normal subjects showed modulation of the H-reflex with the amplitude being increase...

  7. Inter-rater Reliability of the Modified Ashworth Scale for Spasticity in Hemiplegic Patients.

    Science.gov (United States)

    Sloan, R. L.; And Others

    1992-01-01

    This study tested the interrater reliability of the Modified Ashworth Scale in measuring upper and lower limb spasticity in 34 hemiplegic adult patients examined by 2 physiotherapists and 2 doctors. Findings indicated satisfactory reliability for upper limb spasticity but less satisfactory results for lower limb spasticity. (DB)

  8. Novel missense mutation in the L1 gene in a child with corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus

    NARCIS (Netherlands)

    Sztriha, L; Frossard, P; Hofstra, RMW; Verlind, E; Nork, M

    2000-01-01

    Corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus (CRASH syndrome) is an X-linked recessive disorder caused by mutations in the neuronal cell adhesion molecule L1 (L1CAM) gene. L1 plays a key role in axon outgrowth and pathfinding during the development o

  9. In Vivo Evidence for Lysosome Depletion and Impaired Autophagic Clearance in Hereditary Spastic Paraplegia Type SPG11.

    Directory of Open Access Journals (Sweden)

    Rita-Eva Varga

    2015-08-01

    Full Text Available Hereditary spastic paraplegia (HSP is characterized by a dying back degeneration of corticospinal axons which leads to progressive weakness and spasticity of the legs. SPG11 is the most common autosomal-recessive form of HSPs and is caused by mutations in SPG11. A recent in vitro study suggested that Spatacsin, the respective gene product, is needed for the recycling of lysosomes from autolysosomes, a process known as autophagic lysosome reformation. The relevance of this observation for hereditary spastic paraplegia, however, has remained unclear. Here, we report that disruption of Spatacsin in mice indeed causes hereditary spastic paraplegia-like phenotypes with loss of cortical neurons and Purkinje cells. Degenerating neurons accumulate autofluorescent material, which stains for the lysosomal protein Lamp1 and for p62, a marker of substrate destined to be degraded by autophagy, and hence appears to be related to autolysosomes. Supporting a more generalized defect of autophagy, levels of lipidated LC3 are increased in Spatacsin knockout mouse embryonic fibrobasts (MEFs. Though distinct parameters of lysosomal function like processing of cathepsin D and lysosomal pH are preserved, lysosome numbers are reduced in knockout MEFs and the recovery of lysosomes during sustained starvation impaired consistent with a defect of autophagic lysosome reformation. Because lysosomes are reduced in cortical neurons and Purkinje cells in vivo, we propose that the decreased number of lysosomes available for fusion with autophagosomes impairs autolysosomal clearance, results in the accumulation of undegraded material and finally causes death of particularly sensitive neurons like cortical motoneurons and Purkinje cells in knockout mice.

  10. Dysesthesia perceived as painful spasticity: A report of 3 cases.

    Science.gov (United States)

    Ordia, J I; Fischer, E; Adamski, E; Spatz, E L

    2001-05-01

    Lesions of the central nervous system often involve the pyramidal tracts and the sensory pathways to produce spasticity, paresthesias, and dysesthesia. Three patients with intractable spasticity were treated with intrathecal baclofen. Two had an implanted Medtronic SynchroMed pump for long-term delivery of the muscle relaxant. The third patient had undergone a screening trial in which the baclofen was delivered into the intrathecal space through a lumbar catheter. All had excellent relief of spasms on clinical examination, but they reported painful spasms particularly at night. Two of the patients were successfully treated for dysesthesia. PMID:11346852

  11. Cranial and Cervical Muscular Weakness in Mitochondrial Myopathy Is Associated With Resolution of Migraine Headaches: Further Evidence That Muscular Compression of Cranial and Peripheral Nerves Is a Cause of Headache in a Subset of Patients With Migraine

    OpenAIRE

    Miranda, Edward P.

    2015-01-01

    Objective: A significant subset of patients with migraine headaches has pain relief after neuroplasty/muscular decompression of select cranial and cervical nerves. In the majority of cases, compression occurs secondary to compression of the nerves by adjacent muscles. Previous studies have shown that both surgical decompression and chemical denervation (eg, botulinum toxin) provide relief of migraine headaches; however, controversy remains. If some migraine headaches are caused by muscular co...

  12. Modulation of the soleus H-reflex during pedalling in normal humans and in patients with spinal spasticity.

    Science.gov (United States)

    Boorman, G; Becker, W J; Morrice, B L; Lee, R G

    1992-12-01

    Soleus H-reflexes were recorded in 10 normal subjects and seven patients with spasticity caused by incomplete spinal cord injury while they pedalled on a stationary bicycle which had been modified to trigger electrical stimuli to the tibial nerve at eight precise points in the pedal cycle. Stimulus strength was adjusted to yield M-waves of constant amplitude at each pedal position. During active pedalling, all normal subjects showed modulation of the H-reflex with the amplitude being increased during the downstroke portion of the pedal cycle and the reflex suppressed or absent during the upstroke. This modulation was not present during passive pedalling, with the experimenter cranking the pedals by hand, or when the pedals were locked at each of the eight positions. In five of the seven patients with spasticity, there was reduced or absent modulation of the H-reflex during active pedalling and the reflex remained large during pedal upstroke. It is concluded that descending motor commands that produce patterned voluntary activity during pedalling normally cause cyclical gating of spinal reflexes by either presynaptic or postsynaptic inhibitory mechanisms. Loss of supraspinal control over these spinal inhibitory systems could result in failure to produce appropriate suppression of reflexes during patterned voluntary movements such as pedalling or walking, and may be an important factor contributing to the functional disability in spasticity. PMID:1479394

  13. Hereditary spastic paraplegia in Greece: characterisation of a previously unexplored population using next-generation sequencing.

    Science.gov (United States)

    Lynch, David S; Koutsis, Georgios; Tucci, Arianna; Panas, Marios; Baklou, Markella; Breza, Marianthi; Karadima, Georgia; Houlden, Henry

    2016-06-01

    Hereditary Spastic Paraplegia (HSP) is a syndrome characterised by lower limb spasticity, occurring alone or in association with other neurological manifestations, such as cognitive impairment, seizures, ataxia or neuropathy. HSP occurs worldwide, with different populations having different frequencies of causative genes. The Greek population has not yet been characterised. The purpose of this study was to describe the clinical presentation and molecular epidemiology of the largest cohort of HSP in Greece, comprising 54 patients from 40 families. We used a targeted next-generation sequencing (NGS) approach to genetically assess a proband from each family. We made a genetic diagnosis in >50% of cases and identified 11 novel variants. Variants in SPAST and KIF5A were the most common causes of autosomal dominant HSP, whereas SPG11 and CYP7B1 were the most common cause of autosomal recessive HSP. We identified a novel variant in SPG11, which led to disease with later onset and may be unique to the Greek population and report the first nonsense mutation in KIF5A. Interestingly, the frequency of HSP mutations in the Greek population, which is relatively isolated, was very similar to other European populations. We confirm that NGS approaches are an efficient diagnostic tool and should be employed early in the assessment of HSP patients. PMID:26374131

  14. Review of Intrathecal Baclofen Therapy for Spastic and Rigidity Disorders

    Science.gov (United States)

    Obringer, S. John; Coffey, Kenneth M.

    2002-01-01

    Intrathecal baclofen therapy, a treatment for cerebral palsy and other spastic and rigidity disorders, is showing promise as an effective intervention. This article synthesizes both the medical and rehabilitation conceptual literature to update educators and related service providers as to the efficacy of this intervention. Implications for…

  15. Altered sense of agency in children with spastic cerebral palsy

    DEFF Research Database (Denmark)

    Ritterband-Rosenbaum, Anina; Christensen, Mark S; Kliim-Due, Mette;

    2011-01-01

    ABSTRACT: Background Children diagnosed with spastic Cerebral Palsy (CP) often show perceptual and cognitive problems, which may contribute to their functional deficit. Here we investigated if altered ability to determine whether an observed movement is performed by themselves (sense of agency...

  16. Mental Imagery Abilities in Adolescents with Spastic Diplegic Cerebral Palsy

    Science.gov (United States)

    Courbois, Yanick; Coello, Yann; Bouchart, Isabelle

    2004-01-01

    Four visual imagery tasks were presented to three groups of adolescents with or without spastic diplegic cerebral palsy. The first group was composed of six adolescents with cerebral palsy who had associated visual-perceptual deficits (CP-PD), the second group was composed of five adolescents with cerebral palsy and no associated visual-perceptual…

  17. Effect of treatment with botulinum toxin on spasticity.

    OpenAIRE

    Das, T K; Park, D M

    1989-01-01

    Botulinum toxin, a product of Clostridium botulinum, produces presynaptic neuromuscular block by preventing release of acetylcholine from nerve endings. The toxin was injected directly into the skeletal muscles of six patients with severe spasticity due to stroke-related hemiplegia. It produced both subjective and objective improvement. The toxin injections were well tolerated and no significant side effect was reported.

  18. Maximum Performance Tests in Children with Developmental Spastic Dysarthria.

    Science.gov (United States)

    Wit, J.; And Others

    1993-01-01

    Three Maximum Performance Tasks (Maximum Sound Prolongation, Fundamental Frequency Range, and Maximum Repetition Rate) were administered to 11 children (ages 6-11) with spastic dysarthria resulting from cerebral palsy and 11 controls. Despite intrasubject and intersubject variability in normal and pathological speakers, the tasks were found to be…

  19. Treatment of the spasticity in children with cerebral palsy.

    Science.gov (United States)

    Meholjić-Fetahović, Ajsa

    2007-11-01

    Botulinum toxin is a natural purified protein and one of the strongest biological poisons--neurotoxin. It is produced by the bacterium Clostridium botulinum. Its medical usage started in USA in 1981 and in Europe in 1992. There are seven different immune types of the toxin: A, B, C1, D, E, F and G. Toxin types A and B are used to decrease muscular spasticity. Botulinum toxin prevents the formation of acetylcholine from cholinergic nerve tissues in muscles, which in the end irreversibly destroys neuromuscular synapses. It is called temporary local chemodenervation. It does not affect the synthesis of acetylcholine. As it affects neuromuscular bond it also affects one of the symptoms of cerebral palsy--spasticity. Decreasing the spasticity of children with cerebral palsy leads to the improvement of conscious movements, muscles are less toned, passive mobility is improved, orthosis tolerance is also improved, and the child is enabled to perform easier and better motor functions such as crawling, standing and walking. Since the action of Botulinum toxin is limited to 2-6 months, new neural collaterals are formed and neuromuscular conductivity is reestablished which in the end once again develops a muscular spasm. This leads to a conclusion that botulinum toxin should again be applied into spastic muscles. It is very important for good effect of Botulinum toxin to set the goals of the therapy in advance. The goals include improvement of a function, prevention of contractions and deformities, ease of care and decrease of pain for children with cerebral palsy. After application of botulinum toxin, it is necessary to perform adequate and intensive physical treatment with regular monitoring of effects. This work shows a case of a boy with spastic form of cerebral palsy. After being rehabilitated using Vojta therapy and Bobath concept and the conduct of certain physical procedures, botulinum toxin is administered into his lower limbs' muscles and kinesiotherapy is

  20. Compression for leg wounds.

    Science.gov (United States)

    Partsch, H; Mortimer, P

    2015-08-01

    The main points in this scholarly review on the use of compression therapy in leg ulcers are the different modes of action of this treatment and the tools that are available including their practical applicability and use for self management. Due to its effect of counteracting gravity, compression is also suggested for ulcers with aetiologies that are not usually thought to require compression. The clinical evidence reported in ulcer-healing studies are discussed and some considerations are made relating to the cost-effectiveness of this management. In general, the failures of compression therapy are not caused by poor compression material but due to poor knowledge and application techniques of the care providers. Future studies comparing different compression devices should also report details concerning the compression material used and the pressure exerted. PMID:26094638

  1. [Treatment of spasticity in multiple sclerosis: new perspectives regarding the use of cannabinoids].

    Science.gov (United States)

    Oreja-Guevara, Celia

    2012-10-01

    Spasticity remains a prevalent symptom in multiple sclerosis, with a significant associated disability and quality of life impairment. A significant improvement in therapy aimed at reducing multiple sclerosis relapses and modifying its course has been achieved in recent years. Both general and specific traditional treatments have, however, major limitations. Thus, its use in real practice is lower than expected. Cannabinoids provide a new way for therapy. A delta-9-tetrahydrocannabinol plus cannabidiol (1:1) association, administered through an oromucosal route, has been approved in several countries including Spain; it causes a specific effect on CB(1) and CB(2) receptors, with traditional psychotropic cannabis actions being minimized. Randomized, placebo-controlled trials, as well as longer-term open-label extensions, have shown a clear-cut efficacy to reduce spasticity and their associated symptoms in those patients refractory to other therapies, with a good tolerability/safety profile. No tolerance, abuse or addictive issues have been found. New studies will be needed to find out potential new cannabinoid-related therapies. PMID:23011861

  2. The adverse effect of spasticity on 3-month poststroke outcome using a population-based model.

    Science.gov (United States)

    Belagaje, S R; Lindsell, C; Moomaw, C J; Alwell, K; Flaherty, M L; Woo, D; Dunning, K; Khatri, P; Adeoye, O; Kleindorfer, D; Broderick, J; Kissela, B

    2014-01-01

    Several devices and medications have been used to address poststroke spasticity. Yet, spasticity's impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS) as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question "Did you have spasticity following your stroke?" on direct interview at 3 months from stroke onset. Patients who had expired by 90 days (n = 30) or did not have spasticity data available (n = 102) were excluded. Spasticity affected the 3-month functional status (β = 0.420, 95 CI = 0.194 to 0.645) after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model's R (2) changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors. PMID:25147752

  3. Coeliac artery compression syndrome

    OpenAIRE

    OKTAY, Özgür; MEMİŞ, Ahmet; Parildar, Mustafa; Oran, İsmail

    2003-01-01

    Celiac artery compression syndrome, also called median arcuate ligament compression syndrome, causes gastrointestinal ischemia secondary to compression of the proximal portion of the celiac artery just beyond its origin by the median arcuate ligament of the diaphragm. This syndrome is frequently demonstrated on aortography performed in patients without complaints of intestinal angina. Isolated stenosis or even occlusion of the celiac artery is always compensated for by collateral circul...

  4. A comparison of the effect of doxorubicin and phenol on the skeletal muscle. May doxorubicin be a new alternative treatment agent for spasticity?

    Science.gov (United States)

    Cullu, Emre; Ozkan, Ilhan; Culhaci, Nil; Alparslan, Bulent

    2005-03-01

    Since spasticity is still an unsolved problem for orthopaedic surgeons, different chemical agents are tried before surgery. Phenol is a chemical agent which has been used for spasticity treatment for a long time. Doxorubicin is an antitumoral agent that has recently been used for chemomyectomy. The intramuscular effects of phenol and two different dose of doxorubicin were compared in that experimental study. In the first group 0.5 mg/0.5 cm3 doxorubicin, in the second group 1 mg/0.5 doxorubicin and in the third group 5% aqueous solution of fenol/0.5 injection were applied into left quadriceps muscle of rats. Degeneration areas were wider in the high dose doxorubicin group (29.9%; 8.5-61), in comparison with the low dose doxorubicin group (6.4%; 3.1-12) and phenol group (4%; 0-14) after 6 weeks. Differences in degeneration area among three groups were statistically significant (P<0.001). The difference was significant between the high dose doxorubicin group and the phenol group (P=0.001) and also between the high dose doxorubicin group and the low dose doxorubicin group (P<0.001). The results of this study suggested that doxorubicin could provide an alternative treatment modality for neuromuscular disease causing spasticity and it has a dose-dependent effect. Further studies are needed for long-term comparison and clinical use of doxorubicin for spasticity treatment. PMID:15703526

  5. Sativex in the Management of Multiple Sclerosis-Related Spasticity: Role of the Corticospinal Modulation

    OpenAIRE

    Margherita Russo; Rocco Salvatore Calabrò; Antonino Naro; Edoardo Sessa; Carmela Rifici; Giangaetano D’Aleo; Antonino Leo; Rosaria De Luca; Angelo Quartarone; Placido Bramanti

    2015-01-01

    Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS). This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to bett...

  6. Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity

    OpenAIRE

    Leussink, Verena Isabell; Husseini, Leila; Warnke, Clemens; Broussalis, Erasmia; Hartung, Hans-Peter; Kieseier, Bernd C

    2012-01-01

    A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebo-controlled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of Δ-9-tetrahydrocannabinol and cannabidiol extracted f...

  7. Development and evaluation of a new method to objectively measure spasticity

    OpenAIRE

    Gäverth, Johan

    2013-01-01

    Spasticity is a neurological symptom that can occur after stroke and traumatic brain injury due to a lesion of the motor pathways descending from the brain to the brainstem and spinal cord. Spasticity is characterised by a velocity-dependent increase in resistance when muscles are passively stretched. There is a lack of valid measures of spasticity, which creates difficulties both in following the development of symptoms and in evaluation of potential treatment interventions. The overal...

  8. Hereditary spastic paraplegia with a thin corpus callosum

    Energy Technology Data Exchange (ETDEWEB)

    Somasundaram, Sivaraman; Kesavadas, Chandrasekharan [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India); Raghavendra, Seetharam; Singh, Atampreet; Nair, Muraleedharan [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Neurology, Trivandrum (India)

    2007-05-15

    We report a 15-year-old boy with autosomal recessive complicated hereditary spastic paraplegia with a thin corpus callosum (HSP-TCC). The involvement of the corpus callosum was characteristic with the genu and body predominantly affected with relative sparing of the splenium. HSP-TCC is being increasingly recognized over a wider geographical area than earlier believed. We now report a case of HSP-TCC from the Indian subcontinent. (orig.)

  9. Hereditary spastic paraplegia with a thin corpus callosum

    International Nuclear Information System (INIS)

    We report a 15-year-old boy with autosomal recessive complicated hereditary spastic paraplegia with a thin corpus callosum (HSP-TCC). The involvement of the corpus callosum was characteristic with the genu and body predominantly affected with relative sparing of the splenium. HSP-TCC is being increasingly recognized over a wider geographical area than earlier believed. We now report a case of HSP-TCC from the Indian subcontinent. (orig.)

  10. RESULTS OF ADDUCTORS MUSCLE TENOTOMY IN SPASTIC CEREBRAL PALSY

    OpenAIRE

    Guglielmetti, Luiz Gabriel Betoni; Santos, Ruy Mesquita Maranhao; Mendonça, Rodrigo Góes Medea de; Yamada, Helder Henzo; Assumpçao, Rodrigo Montezuma César de; Fucs, Patricia Maria de Moraes Barros

    2015-01-01

    Objective: Radiographic evaluation of the evolution of hips that underwent soft-tissue release. Methods: This was a retrospective evaluation on 101 spastic cerebral palsy patients who underwent soft-tissue release between 1991 and 2006. Forty-four patients met the inclusion criteria: 23 boys and 21 girls; 34 diparetic and 10 quadriparetic. Functionally, 29 were non-walkers, five were able to walk at home and 10 were able to walk within the community. Reimers' index (RI) and the acetabular ind...

  11. Direct spinal effect of a benzodiazepine (midazolam) on spasticity in man.

    Science.gov (United States)

    Dahm, L S; Beric, A; Dimitrijevic, M R; Wall, P D

    1989-01-01

    The water-soluble benzodiazepine, midazolam, was administered epidurally over the lumbar enlargement 18 times to 9 patients with spasticity due to severe spinal cord injury. Doses of 1.25-3.75 mg produced a rapid decrease of spasticity which lasted 1 h. After the maximal reduction of spasticity, the patients became drowsy. While the results suggest a direct action of midazolam on the spinal cord to reduce spasticity, the effect does not contribute to its usefulness as a therapeutic tool. PMID:2626605

  12. Leg-robot with MR clutch to realize virtual spastic movements

    International Nuclear Information System (INIS)

    In this study, we propose a leg-robot with an MR clutch to realize virtual haptic control for spastic movements of brain-injured patients. This system can be used in the practical training for trainees of physical therapy. Additionally, we will study to figure out the physiological mechanism of spastic movements of human with the process to simulate patientlike spastic motion by this robot. In this paper, basic structure and mechanism of the leg-robot with the MR clutch are explained. Finally, experimental results of some kinds of haptic control for spastic movements are described.

  13. The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model

    Directory of Open Access Journals (Sweden)

    S. R. Belagaje

    2014-01-01

    Full Text Available Several devices and medications have been used to address poststroke spasticity. Yet, spasticity’s impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question “Did you have spasticity following your stroke?” on direct interview at 3 months from stroke onset. Patients who had expired by 90 days (n=30 or did not have spasticity data available (n=102 were excluded. Spasticity affected the 3-month functional status (β=0.420, 95 CI=0.194 to 0.645 after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model’s R2 changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors.

  14. Leg-robot with MR clutch to realize virtual spastic movements

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, T; Oda, K; Yamaguchi, S; Furusho, J [Osaka University, Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

    2009-02-01

    In this study, we propose a leg-robot with an MR clutch to realize virtual haptic control for spastic movements of brain-injured patients. This system can be used in the practical training for trainees of physical therapy. Additionally, we will study to figure out the physiological mechanism of spastic movements of human with the process to simulate patientlike spastic motion by this robot. In this paper, basic structure and mechanism of the leg-robot with the MR clutch are explained. Finally, experimental results of some kinds of haptic control for spastic movements are described.

  15. Risk Factors of Undernutrition in Children with Spastic Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Jen-Wen Hung

    2003-06-01

    Full Text Available Background: This study was undertaken to investigate the nutritional status of childrenwith spastic cerebral palsy (CP and to identify the risk factors of undernutrition.Methods: Seventy-five spastic CP children, 47 boys and 28 girls, (ages, 5 months to 10years underwent anthropometric assessment, including body weight, recumbentlength, and knee height. Their functional status, medical condition, andfeeding status were also recorded. The data were analyzed to estimate theinfluences of various factors on the nutritional status of the spastic CP children.Results: The nutritional status of 31 of the 75 children (41.3% were below the 10thpercentile (undernutrition and three (4% were above 90th percentile (overnutritionof healthy children. In the multivariate analysis, we found thatundernutrition was significantly associated with: (1 girls ( p = 0.006, (2more feeding problems ( p = 0.018, (3 shorter duration per meal ( p=0.022,and (4 poor communication ability ( p = 0.001Conclusion: It appears that periodic anthropometric assessments of CP children are indicatedfor the early identification of nutritional risk. Further nutritional managementshould be arranged for undernourished children to promote theirnutritional status and improve growth and functional capacity.

  16. Cannabinoids in the management of spasticity associated with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Anna Maria Malfitano

    2008-08-01

    Full Text Available Anna Maria Malfitano, Maria Chiara Proto, Maurizio BifulcoDipartimento di Scienze Farmaceutiche, Università degli Studi di SalernoAbstract: The endocannabinoid system and cannabinoid-based treatments have been involved in a wide number of diseases. In particular, several studies suggest that cannabinoids and endocannabinoids may have a key role in the pathogenesis and therapy of multiple sclerosis (MS. In this study we highlight the main findings reported in literature about the relevance of cannabinoid drugs in the management and treatment of MS. An increasing body of evidence suggests that cannabinoids have beneficial effects on the symptoms of MS, including spasticity and pain. In this report we focus on the effects of cannabinoids in the relief of spasticity describing the main findings in vivo, in the mouse experimental allergic encephalomyelitis model of MS. We report on the current treatments used to control MS symptoms and the most recent clinical studies based on cannabinoid treatments, although long-term studies are required to establish whether cannabinoids may have a role beyond symptom amelioration in MS.Keywords: cannabinoids, multiple sclerosis, spasticity

  17. Effects of low-level laser therapy (LLLT 808 nm) on lower limb spastic muscle activity in chronic stroke patients.

    Science.gov (United States)

    das Neves, Marcele Florêncio; Dos Reis, Mariana César Ribeiro; de Andrade, Eliana Aparecida Fonseca; Lima, Fernanda Pupio Silva; Nicolau, Renata Amadei; Arisawa, Emília Ângela Loschiavo; Andrade, Adriano Oliveira; Lima, Mário Oliveira

    2016-09-01

    A cerebrovascular accident (CVA) may affect basic motor functions, including spasticity that may be present in the upper extremity and/or the lower extremity, post-stroke. Spasticity causes pain, muscle force reduction, and decreases the time to onset of muscle fatigue. Several therapeutic resources have been employed to treat CVA to promote functional recovery. The clinical use of low-level laser therapy (LLLT) for rehabilitation of muscular disorders has provided better muscle responses. Thus, the aim of this study was to evaluate the effect of the application of LLLT in spastic muscles in patients with spasticity post-CVA. A double-blind clinical trial was conducted with 15 volunteer stroke patients who presented with post-stroke spasticity. Both males and females were treated; the average age was 51.5 ± 11.8 years old; the participants entered the study ranging from 11 to 48 months post-stroke onset. The patients participated in three consecutive phases (control, placebo, and real LLLT), in which all tests of isometric endurance of their hemiparetic lower limb were performed. LLLT (diode laser, 100 mW 808 nm, beam spot area 0.0314 cm(2), 127.39 J/cm(2)/point, 40 s) was applied before isometric endurance. After the real LLLT intervention, we observed significant reduction in the visual analogue scale for pain intensity (p = 0.0038), increased time to onset of muscle fatigue (p = 0.0063), and increased torque peak (p = 0.0076), but no significant change in the root mean square (RMS) value (electric signal in the motor unit during contraction, as obtained with surface electromyography). Our results suggest that the application of LLLT may contribute to increased recruitment of muscle fibers and, hence, to increase the onset time of the spastic muscle fatigue, reducing pain intensity in stroke patients with spasticity, as has been observed in healthy subjects and athletes. PMID:27299571

  18. Zdravljenje spastičnosti z intratekalnim baklofenom: Intrathecal baclofen therapy of spasticity: Intrathecal baclofen therapy of spasticity:

    OpenAIRE

    Bošnjak, Roman; Grabljevec, Klemen; Gregorič, Milan

    2009-01-01

    In some patients, severe spasticity of cerebral or spinal origin cannot be treated succesfully with conventional oral medication or physical modalities. Intrathecal baclofen therapy with implanted pump represents an effective treatment since mid 80's. Baclofen (Lioresal) is a muscle relaxant and potent GABA agonist that acts via GABAb receptors at the posterior coloumns of spinal cord level to inhibit the release of excitatory neurotransmiters by inhibiting calcium ions influx into presynapti...

  19. A Case of Purple Urine Bag Syndrome in a Spastic Partial Quadriplegic Male.

    Science.gov (United States)

    Tul Llah, Sibghat; Khan, Salman; Dave, Atman; Morrison, Amelia Jane A; Jain, Swapna; Hermanns, David

    2016-01-01

    Purple bag urine syndrome (PUBS) is a benign and unique phenomenon of the urine turning a deep violet color within the urinary catheter tubing and bag. This phenomenon is commonly encountered in patients indicated with long-term catheter placement or, in certain conditions like chronic constipation, alkaline urine, limited ambulation, and, in terms of gender distribution, the female sex, predominates. PUBS gets its name from a unique phenomenon that takes places inside the gut where tryptophan (an amino acid) is metabolized, producing blue and red hues which together emanate a deep violet color. Here, the case of a middle-aged male patient with a suprapubic catheter in situ, following trauma causing spastic partial quadriplegia, is being presented with PUBS due to UTI secondary to Proteus vulgaris. The risk factors, in this case, include chronic constipation and recurrent urinary tract infections (UTIs).​. PMID:27182466

  20. Cervical osteochondroma as a cause of spinal cord compression in a patient with hereditary multiple exostoses: computed tomography and magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    Spinal cord compression is a rare but extremely serious complication of hereditary multiple exostoses (HME). Imaging of the spine is important for surgical planning and follow up. We present CT and MR findings in a male patient with HME who developed spinal cord compression from a cervical osteochondroma, demonstrating the origin, size and extent of the lesion and its relationship with the spinal canal or neural foramina. MRI should be used in the evaluation and follow-up of the patients. Complete recovery was achieved following surgery. Copyright (2002) Blackwell Science Pty Ltd

  1. The hereditary spastic paraplegia protein strumpellin: Characterisation in neurons and of the effect of disease mutations on WASH complex assembly and function

    OpenAIRE

    Freeman, Caroline; Seaman, Matthew N J; Reid, Evan

    2013-01-01

    Mutations in the gene encoding strumpellin cause autosomal dominant hereditary spastic paraplegia (HSP), in which there is degeneration of corticospinal tract axons. Strumpellin is a component of the WASH complex, an actin-regulating complex that is recruited to endosomes by interactions with the retromer complex. The WASH complex and its relationship to retromer have not been fully characterised in neurons, and the molecular pathological mechanism of strumpellin mutation is unclear. Here we ...

  2. Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

    OpenAIRE

    van Rhijn Lodewijk W; Weber Wim E; Staal Heleen M; van Zundert Jan; van Kleef Maarten; Vles Johan S; Vles Georges F; Soudant Dan; Graham H Kerr; de Louw Anton J

    2010-01-01

    Abstract Background Cerebral palsy (CP) may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG) could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. Methods We performed an RF-DRG p...

  3. Clinical assessment of spasticity in children with cerebral palsy: A critical review of available instruments

    NARCIS (Netherlands)

    V.A.B. Scholtes; J.G. Becher; A. Beelen; G.J. Lankhorst

    2006-01-01

    This study reviews the instruments used for the clinical assessment of spasticity in children with cerebral palsy, and evaluates their compliance with the concept of spasticity, defined as a velocity-dependent increase in muscle tone to passive stretch. Searches were performed in Medline, Embase, an

  4. Prevalence and risk factors for epilepsy in children with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Dedy Rahmat

    2010-03-01

    Conclusions The prevalence of epilepsy in spastic CP is 39%. The risk factors for epilepsy in spastic CP are post central nervous system infection, and ocurrence of seizure in the first year of life. [Paediatr Indones. 2010;50:11-7].

  5. Botulinum therapy for poststroke spasticity of the lower extremity (clinical cases

    Directory of Open Access Journals (Sweden)

    L. V. Krylova

    2014-01-01

    Full Text Available The paper deals with the topical problem – the medical rehabilitation of patients with poststroke spasticity. It describes clinical cases of patients with poststroke spasticity of the upper and lower extremities who have received combined therapy using botulinum toxin type A (Botox injections.

  6. Intensive Voice Treatment (LSVT LOUD) for Children with Spastic Cerebral Palsy and Dysarthria

    Science.gov (United States)

    Fox, Cynthia Marie; Boliek, Carol Ann

    2012-01-01

    Purpose: The purpose of this study was to examine the effects of an intensive voice treatment (Lee Silverman Voice Treatment, commonly known as LSVT LOUD) for children with spastic cerebral palsy (CP) and dysarthria. Method: A nonconcurrent multiple baseline single-subject design with replication across 5 children with spastic CP was used.…

  7. Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity.

    Science.gov (United States)

    Leussink, Verena Isabell; Husseini, Leila; Warnke, Clemens; Broussalis, Erasmia; Hartung, Hans-Peter; Kieseier, Bernd C

    2012-09-01

    A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebo-controlled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of Δ-9-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, received approval for treating MS-related spasticity in various countries around the globe. In this article we review the current understanding of cannabinoid biology and the value of cannabinoids as a symptomatic treatment option addressing spasticity in patients with MS. PMID:22973422

  8. Effect of Sativex on spasticity-associated symptoms in patients with multiple sclerosis.

    Science.gov (United States)

    Meuth, Sven G; Vila, Carlos; Dechant, Kerry L

    2015-01-01

    Individuals with multiple sclerosis (MS) spasticity may experience a range of symptoms, such as bladder dysfunction, pain, impaired sleep quality and mobility restrictions that worsen as spasticity severity increases. In this review, the effects of Sativex(®) oromucosal spray on symptoms and functional impairment associated with MS-related spasticity were examined. Across Sativex studies, there was a clear trend for improvement in spasticity-associated symptoms that was more pronounced and sustained over time in Sativex responders. Meaningful symptomatic improvement was achieved within the recommended dosage limit of ≤12 sprays per day. In appropriate patients, Sativex has the potential to minimize the consequences of spasticity-related symptoms on quality of life and reduce the economic burden on healthcare systems. PMID:26166264

  9. A patient-derived stem cell model of hereditary spastic paraplegia with SPAST mutations

    Directory of Open Access Journals (Sweden)

    Greger Abrahamsen

    2013-03-01

    Hereditary spastic paraplegia (HSP leads to progressive gait disturbances with lower limb muscle weakness and spasticity. Mutations in SPAST are a major cause of adult-onset, autosomal-dominant HSP. Spastin, the protein encoded by SPAST, is a microtubule-severing protein that is enriched in the distal axon of corticospinal motor neurons, which degenerate in HSP patients. Animal and cell models have identified functions of spastin and mutated spastin but these models lack the gene dosage, mutation variability and genetic background that characterize patients with the disease. In this study, this genetic variability is encompassed by comparing neural progenitor cells derived from biopsies of the olfactory mucosa from healthy controls with similar cells from HSP patients with SPAST mutations, in order to identify cell functions altered in HSP. Patient-derived cells were similar to control-derived cells in proliferation and multiple metabolic functions but had major dysregulation of gene expression, with 57% of all mRNA transcripts affected, including many associated with microtubule dynamics. Compared to control cells, patient-derived cells had 50% spastin, 50% acetylated α-tubulin and 150% stathmin, a microtubule-destabilizing enzyme. Patient-derived cells were smaller than control cells. They had altered intracellular distributions of peroxisomes and mitochondria and they had slower moving peroxisomes. These results suggest that patient-derived cells might compensate for reduced spastin, but their increased stathmin expression reduced stabilized microtubules and altered organelle trafficking. Sub-nanomolar concentrations of the microtubule-binding drugs, paclitaxel and vinblastine, increased acetylated α-tubulin levels in patient cells to control levels, indicating the utility of this cell model for screening other candidate compounds for drug therapies.

  10. Time Compression

    OpenAIRE

    Aadland, David; Shaffer, Sherrill

    2012-01-01

    Economists have generally ignored the notion that perceived time may differ from clock time. Borrowing from the behavioral psychology literature, we investigate the case of time compression whereby perceived time passes more quickly than actual time. A framework is presented to embed time compression in economic models. We then apply the principle to a standard lifecycle permanent income model with endogenous labor. Time compression provides an alternative explanation of why older indi...

  11. Gait analysis of children with spastic hemiplegic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    Xin Wang; Yuexi Wang

    2012-01-01

    An experiment was carried out in the key laboratory for Technique Diagnosis and Function Assessment of Winter Sports of China to investigate the differences in gait characteristics between healthy children and children with spastic hemiplegic cerebral palsy. With permission of their parents, 200 healthy children aged 3 to 6 years in the kindergarten of Northeastern University were enrolled in this experiment. Twenty children aged 3 to 6 years with spastic hemiplegic cerebral palsy from Shengjing Hospital, China were also enrolled in this experiment. Standard data were collected by simultaneously recording gait information from two digital cameras.DVracker was used to analyze the standard data. The children with hemiplegic cerebral palsy had a longer gait cycle, slower walking speed, and longer support phase than did the healthy children.The support phase was longer than the swing phase in the children with hemiplegic cerebral palsy. There were significant differences in the angles of the hip, knee, and ankle joint between children with cerebral palsy and healthy children at the moment of touching the ground and buff -ering, and during pedal extension. Children with hemiplegic cerebral palsy had poor motor coordination during walking, which basically resulted in a short stride, high stride frequency to maintain speed, more obvious swing, and poor stability.

  12. Numerical analysis of hemodynamics in spastic middle cerebral arteries.

    Science.gov (United States)

    Wen, Jun; Wang, Qingfeng; Wang, Qingyuan; Khoshmanesh, Khashayar; Zheng, Tinghui

    2016-11-01

    Cerebral vasospasm (CVS) is the most common serious complication of subarachnoid hemorrhage. Among the many factors that are associated with the pathogenesis of CVS, hemodynamics plays an important role in the initiation and development of CVS. Numerical simulation was carried out to obtain the flow patterns and wall shear stress (WSS) distribution in spastic middle cerebral arteries. The blood was assumed to be incompressible, laminar, homogenous, Newtonian, and steady. Our simulations reveal that flow velocity and WSS level increase at the stenosis segment of the spastic vessels, but further downstream of stenosis, the WSS significantly decreases along the inner wall, and flow circulation and stagnation are observed. The hydrodynamic resistance increases with the increase of vessel spasm. Moreover, the change of flow field and hydrodynamic forces are not linearly proportional to the spasm level, and the rapid change of hemodynamic parameters is observed as the spasm is more than 50%. Accordingly, in the view of hemodynamic physiology, vessels with less than 30% stenosis are capable of self-restoration towards normal conditions. However, vessels with more than 50% stenosis may eventually lose their capacity to adapt to differing physiologic conditions due to the extreme non-physilogic hemodynamic environment, and the immediate expansion of the vessel lumen might be needed to minimize serious and non-reversible effects. PMID:26942314

  13. The Efficacy and Safety of Tizanidine in Treating Spasticity in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Ali Nikkhah

    2011-06-01

    Full Text Available ObjectiveSpastic cerebral palsy (CP is one of the most difficult and disabling conditions that requires medical attention and treatment. The aim of this study was to assess the efficacy and safety of oral tizanidine in treating spasticity in children with spastic CP.Materials & MethodsSixty children with spastic cerebral palsy were enrolled in a double-blind, placebo-controlled, randomized clinical trial. These patients were randomly assigned to receive tizanidine or a matching placebo. Sample normalization was not performed either before or after the study in these two separate groups. Nevertheless, no significant statistical difference was found between the two concerned groups in terms of age, sex, or type of spasticity. Each patient received the treatment for 2 weeks between May 2010 and February 2011.ResultsThirty-one boys and 29 girls with a mean age of 7.3 ± 3.4 years were evaluated. Our study revealed that spasticity was reduced in 50% of the patients receivingthe drug tizanidine compared to only 6.7% of the patients receiving the placebo. Additionally, 66.7% of patients reported less pain on the affected side receivingtizanidine (group A compared to 13.3% of patients receiving the placebo (group B. No serious side effects were reported in this study.ConclusionTizanidine is effective and safe in decreasing the spastic hypertonia associated with cerebral palsy in children.

  14. Development, Test and Validation of a Mechatronic Device for Spasticity Quantification

    Directory of Open Access Journals (Sweden)

    João F. Ferreira

    2013-05-01

    Full Text Available Spasticity is a common pathological phenomenon in clinical practices, frequently expressed as a stroke, multiple sclerosis or cerebral palsy. The accurate quantification of spasticity allows early action to prevent the potentially irreversible consequences. The aim of this work is to develop and implement a mechatronic device for the accurate quantification of spasticity, which is able to differentiate spasticity from other motor disorders. The proposed method is based on the quantification of the tonic stretch reflex threshold (TSRT for the assessment of the range of motion of the limb affected by spasticity. In order to validate the developed device, experimental trials have been conducted, considering the flexor muscle of the elbow joint. The developed device was tested, first in a laboratory environment with healthy subjects and secondly, in a clinical environment with the collaboration of patients with spasticity. The evaluations in th clinical environment were performed on three different days in order to evaluate the reproducibility of the obtained results. The experimental trials confirm the sensibility, reproducibility and reliability of spasticity quantification based on the TSRT method. This project has been developed in cooperation with the Hospital of Braga and Fisimaia rehabilitation clinic, both in Portugal.

  15. Effects of static bicycle training on gross motor function, muscle strength and spasticity of adolescents with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    CHRISTOS TSIGKANOS

    2013-01-01

    Full Text Available The purpose of the present study was to examine the effects of an 8- week lower limb strengthening program on gross motor function, muscle strength and spasticity levels of both the quadriceps and hip adductors of adolescents 14 to 19 years of age with spastic cerebral palsy using a specific static bicycle (Thera-Vital exerciser. Eight students were assigned to the experimental group and another 8 to the control group. The strengthening program took place 3 times a week (6 sets of 10 to 15 full cycling circles. The Gross Motor Function Measure (GMFM (dimensions D and E, an isometric hand-held dynamometer and Asworth scale were the measurement instruments used in the study. A multivariance analysis of variance (MANOVA was applied for identifying the statistical importance of the results of the intervention protocol. A statistically significant improvement in both gross motor function (p = 0.016 and muscle strength (p = 0.039 was found without a statistically significant alteration of the muscle tone of the quadriceps and hip adductors of the participants (p = 0.13 and p = 0.33. The results of the present study indicate that static bicycle is a safe and effective means of exercise since it improves the gross motor function of adolescents with cerebral palsy without increasing the muscle tone of the lower limb.

  16. Compressed Teleportation

    CERN Document Server

    Jaffe, Arthur; Wozniakowski, Alex

    2016-01-01

    In a previous paper we introduced holographic software for quantum networks, inspired by work on planar para algebras. This software suggests the definition of a compressed transformation. Here we utilize the software to find a CT protocol to teleport compressed transformations. This protocol serves multiple parties with multiple persons.

  17. Outcomes in spasticity after repetitive transcranial magnetic and transcranial direct current stimulations

    Institute of Scientific and Technical Information of China (English)

    Aysegul Gunduz; Hatice Kumru; Alvaro Pascual-Leone

    2014-01-01

    Non-invasive brain stimulations mainly consist of repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Repetitive transcranial magnetic stimulation exhib-its satisfactory outcomes in improving multiple sclerosis, stroke, spinal cord injury and cerebral palsy-induced spasticity. By contrast, transcranial direct current stimulation has only been studied in post-stroke spasticity. To better validate the effcacy of non-invasive brain stimulations in im-proving the spasticity post-stroke, more prospective cohort studies involving large sample sizes are needed.

  18. Tau Accumulation in Primary Motor Cortex of Variant Alzheimer's Disease with Spastic Paraparesis.

    Science.gov (United States)

    Lyoo, Chul Hyoung; Cho, Hanna; Choi, Jae Yong; Hwang, Mi Song; Hong, Sang Kyoon; Kim, Yun Joong; Ryu, Young Hoon; Lee, Myung Sik

    2016-02-16

    We studied topographic distribution of tau and amyloid-β in a patient with variant Alzheimer's disease with spastic paraparesis (VarAD) by comparing AD patients. The proband developed progressive memory impairment, dysarthria, and spastic paraparesis at age 23. Heterozygous missense mutation (L166P) was found in exon 6 of presenilin-1 gene. The proband showed prominently increased amyloid binding in striatum and cerebellum and asymmetrical tau binding in the primary sensorimotor cortex contralateral to the side more affected by spasticity. We suspect that upper motor neuron dysfunctions may be attributed to excessive abnormal tau accumulation rather than amyloid-β in the primary motor cortex. PMID:26890779

  19. Three Case Reports of Successful Vibration Therapy of the Plantar Fascia for Spasticity Due to Cerebral Palsy-Like Syndrome, Fetal-Type Minamata Disease

    Science.gov (United States)

    Usuki, Fusako; Tohyama, Satsuki

    2016-01-01

    Abstract Fetal-type Minamata disease is caused by the exposure to high concentrations of methylmercury in the fetal period and shows cerebral palsy-like clinical features. Relief of spasticity is a major task of rehabilitation to improve their activities of daily living. Here we report the effect of long-term vibration therapy on bilateral lower-limb spasticity in 3 patients with fetal-type Minamata disease. We used a simple, inexpensive, and noninvasive approach with hand-held vibration massagers, which were applied to the plantar fascia at 90 Hz for 15 minutes. The effect was observed soon after the first treatment and resulted in better performance of the repetitive facilitation. Vibration therapy for 1 year improved Modified Ashworth Scale for the ankle flexors in 2 cases. The labored gait improved and gait speed increased in another case. Continued vibration therapy for another 1 year further improved Modified Ashworth Scale score and range of motion of ankle dorsiflexion in 1 case. This case showed the decreased amplitude of soleus H-reflex after the 15-minute vibration therapy, suggesting that α-motor neuron excitability was suppressed. Vibration therapy using a hand-held vibration massager may offer safe and effective treatment for lower-limb spasticity in patients with chronic neurological disorders. PMID:27082608

  20. Abnormal Paraplegin Expression in Swollen Neurites, τ- and α-Synuclein Pathology in a Case of Hereditary Spastic Paraplegia SPG7 with an Ala510Val Mutation

    Directory of Open Access Journals (Sweden)

    Dietmar R. Thal

    2015-10-01

    Full Text Available Mutations in the SPG7 gene are the most frequent cause of autosomal recessive hereditary spastic paraplegias and spastic ataxias. Ala510Val is the most common SPG7 mutation, with a frequency of up to 1% in the general population. Here we report the clinical, genetic, and neuropathological findings in a homozygous Ala510Val SPG7 case with spastic ataxia. Neuron loss with associated gliosis was found in the inferior olivary nucleus, the dentate nucleus of the cerebellum, the substantia nigra and the basal nucleus of Meynert. Neurofilament and/or paraplegin accumulation was observed in swollen neurites in the cerebellar and cerebral cortex. This case also showed subcortical τ-pathology in an unique distribution pattern largely restricted to the brainstem. α-synuclein containing Lewy bodies (LBs were observed in the brainstem and the cortex, compatible with a limbic pattern of Braak LB-Disease stage 4. Taken together, this case shows that the spectrum of pathologies in SPG7 can include neuron loss of the dentate nucleus and the inferior olivary nucleus as well as neuritic pathology. The progressive supranuclear palsy-like brainstem predominant pattern of τ pathology and α-synuclein containing Lewy bodies in our SPG7 cases may be either coincidental or related to SPG7 in addition to neuron loss and neuritic pathology.

  1. Therapeutic Effect of Extracorporeal Shock Wave Therapy According to Treatment Session on Gastrocnemius Muscle Spasticity in Children With Spastic Cerebral Palsy: A Pilot Study

    Science.gov (United States)

    Park, Dong-Soon; Park, Gi-Young; Lee, Michael Y.

    2015-01-01

    Objective To investigate the therapeutic effect of extracorporeal shockwave therapy (ESWT) according to treatment session on gastrocnemius muscle spasticity in children with spastic cerebral palsy (CP). Methods Twelve children with spastic CP underwent 1 ESWT and 2 sham ESWT sessions for gastrocnemius (group 1) or 3 ESWT sessions (group 2) once per week for 3 weeks. Modified Ashworth Scale (MAS) score, passive range of motion (PROM) of the ankle plantar-flexor muscles with knee extension, and median red pixel intensity (RPI) of color histogram of medial gastrocnemius on real-time sonoelastography (RTS) were measured before ESWT, immediately after the first and third ESWT, and at 4 weeks after the third ESWT. Results Mean ankle PROM was significantly increased whereas as mean ankle MAS and median gastrocnemius RPI were significantly decreased in both groups after the first ESWT. Clinical and RTS parameters before ESWT were not significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 1. However, they were significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 2. Mean ankle PROM, mean ankle MAS, and median gastrocnemius RPI in group 2 were significantly different from that in group 1 at 4 weeks or immediately after the third ESWT. Conclusion The therapeutic effect of ESWT on spastic medial gastrocnemius in children with spastic CP is dependent on the number of ESWT sessions. PMID:26798605

  2. Surgical Treatment Guidelines for Digital Deformity Associated With Intrinsic Muscle Spasticity (Intrinsic Plus Foot) in Adults With Cerebral Palsy.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C

    2015-01-01

    Intrinsic plus foot deformity has primarily been associated with cerebral palsy and involves spastic contracture of the intrinsic musculature with resultant toe deformities. Digital deformity is caused by a dynamic imbalance between the intrinsic muscles in the foot and extrinsic muscles in the lower leg. Spastic contracture of the toes frequently involves curling under of the lesser digits or contracture of the hallux into valgus or plantarflexion deformity. Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. Four different patterns of intrinsic plus foot deformity have been observed by the authors that likely relate to the different patterns of muscle involvement. Case examples are provided of the 4 patterns of intrinsic plus foot deformity observed, including global intrinsic plus lesser toe deformity, isolated intrinsic plus lesser toe deformity, intrinsic plus hallux valgus deformity, and intrinsic plus hallux flexus deformity. These case examples are presented to demonstrate each type of deformity and our approach for surgical management according to the contracture pattern. The surgical approach has typically involved tenotomy, capsulotomy, or isolated joint fusion. The main goals of surgical treatment are to relieve pain and reduce pressure points through digital realignment in an effort to decrease the risk of pressure sores and allow more effective bracing to ultimately improve the patient's mobility. PMID:25154656

  3. An Electrical Communication System for a Nonverbal, Profoundly Retarded Spastic Quadriplegic.

    Science.gov (United States)

    Kucherawy, David A.; Kucherawy, Jenny M.

    1978-01-01

    The article describes the use of an electrical communication system (the Cocom Center Model 25) to establish communication with and more accurately assess an apparently profoundly retarded, nonverbal, 28-year-old spastic quadriplegic female. (Author/PHR)

  4. Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

    Science.gov (United States)

    Pozzilli, Carlo

    2013-12-01

    Although spasticity of varying severity affects up to 80% of patients with multiple sclerosis (MS) during the course of their disease, the symptom is often overlooked and undertreated. Despite the availability of oral antispasticity treatments (baclofen, tizanidine and others), approximately one-third of MS patients in Europe and the USA experience moderate or severe nonfocalized spasticity. At present, a thorough clinical evaluation of MS-related spasticity that takes into account the patient's own perception of spasms, spasticity-related pain and other associated symptoms is not common in daily neurological practice. Some of the usual spasticity scales, such as the Ashworth and modified Ashworth scales, reflect the observer's measurement of spasticity at a particular point in time. Herbal (smoked) cannabis has long been recognized as a possible option for relief of spasticity and neuropathic pain, but pertinent concerns about psychoactive effects and addiction risk have prevented its common use. An innovative method of benefiting from the mode of action of cannabinoids while limiting their drawbacks is to reduce peak plasma levels of 9-delta-tetrahydrocannabinol and counteract psychoactivity with higher than naturally occurring proportions of a second cannabinoid, cannabidiol. Sativex® oromucosal spray (1:1 ratio of 9-delta-tetrahydrocannabinol/cannabidiol) has recently been approved in a number of EU countries and elsewhere for use in patients with MS-related spasticity who are resistant to treatment with other antispasticity medications. In clinical trials, Sativex provided initial relief of spasticity symptoms within the first 4 weeks of treatment (trial period) in up to about half of patients resistant to other available oral antispasticity medications and demonstrated clinically significant improvement in spasticity (30% or higher reduction from baseline) in three-quarters of the initial responders. Adverse events were limited mainly to mild or moderate

  5. Emerging treatment options for spasticity in multiple sclerosis – clinical utility of cannabinoids

    OpenAIRE

    Ashton JC

    2011-01-01

    John C AshtonDepartment of Pharmacology and Toxicology, Otago School of Medical Sciences, University of Otago, Dunedin, New ZealandAbstract: Multiple sclerosis (MS) is a widespread and common disabling autoimmune disease of the central nervous system. The main disabling symptom is muscle spasticity, which occurs in most patients. Treatment of spasticity with existing drugs is often poor, and there is a need for new and additional treatments. This article reviews the use of cannabinoids for th...

  6. Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review

    Directory of Open Access Journals (Sweden)

    Rowland Marie

    2009-12-01

    Full Text Available Abstract Background Cannabis therapy has been considered an effective treatment for spasticity, although clinical reports of symptom reduction in multiple sclerosis (MS describe mixed outcomes. Recently introduced therapies of combined Δ9-tetrahydrocannabinol (THC and cannabidiol (CBD extracts have potential for symptom relief with the possibility of reducing intoxication and other side effects. Although several past reviews have suggested that cannabinoid therapy provides a therapeutic benefit for symptoms of MS, none have presented a methodical investigation of newer cannabinoid treatments in MS-related spasticity. The purpose of the present review was to systematically evaluate the effectiveness of combined THC and CBD extracts on MS-related spasticity in order to increase understanding of the treatment's potential effectiveness, safety and limitations. Methods We reviewed MEDLINE/PubMed, Ovid, and CENTRAL electronic databases for relevant studies using randomized controlled trials. Studies were included only if a combination of THC and CBD extracts was used, and if pre- and post-treatment assessments of spasticity were reported. Results Six studies were systematically reviewed for treatment dosage and duration, objective and subjective measures of spasticity, and reports of adverse events. Although there was variation in the outcome measures reported in these studies, a trend of reduced spasticity in treated patients was noted. Adverse events were reported in each study, however combined TCH and CBD extracts were generally considered to be well-tolerated. Conclusion We found evidence that combined THC and CBD extracts may provide therapeutic benefit for MS spasticity symptoms. Although some objective measures of spasticity noted improvement trends, there were no changes found to be significant in post-treatment assessments. However, subjective assessment of symptom relief did often show significant improvement post-treatment. Differences in

  7. New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids

    OpenAIRE

    Smith, Paul

    2010-01-01

    Paul F SmithDepartment of Pharmacology and Toxicology, School of Medical Sciences, University of Otago, Dunedin, New ZealandAbstract: Cannabinoids such as Cannabis-based medicinal extracts (CBMEs) are increasingly being used in the treatment of spasticity associated with multiple sclerosis (MS). They have been shown to have a beneficial effect on spasticity; however, this evidence is largely based on subjective rating scales. Objective measurements using the Ashworth scale have tended to show...

  8. Effects of Prolonged Standing on Gait in Children with Spastic Cerebral Palsy

    Science.gov (United States)

    Salem, Yasser; Lovelace-Chandler, Venita; Zabel, Reta J.; McMillan, Amy Gross

    2010-01-01

    The purpose of this study was to determine the effects of prolonged standing on gait characteristics in children with spastic cerebral palsy. Six children with spastic cerebral palsy participated in this study with an average age of 6.5 years (SD = 2.5, range = 4.0-9.8 years). A reverse baseline design (A-B-A) was used over a 9-week period. During…

  9. Presurgical 3D gait analysis findings in four children with spastic cerebral palsy

    OpenAIRE

    Smith, Víctor Manuel; Postigo, Sergio; Postigo, María José; Prado, María; Núñez, María José; Ros, Bienvenido; Fernández, Victoria

    2014-01-01

    Introduction: Children with spastic palsy present usually with an altered gait pattern. This pattern presents various superimposed alterations, due to spasticity and due to musculosqueletal deformities; some of them are principal and some of them are compensatory mechanisms developed by the patient. Due to the complexity of the clinical analysis of these patients, automatic gait analysis is a very usefull tool Material y methods: We have studied four children: 2 of 5, one of 4 and another ...

  10. Lasting reduction of severe spasticity after ending chronic treatment with intrathecal baclofen.

    OpenAIRE

    Dressnandt, J; Conrad, B

    1996-01-01

    OBJECTIVE--To investigate whether the dose of intrathecal baclofen necessary for a sufficient reduction of muscle tone and spasms changes during treatment of severe spasticity. METHODS--A group of 27 patients received intrathecal baclofen for 61 (SD 18) months. RESULTS--Spasticity remained absent or strongly reduced after stopping the intrathecal baclofen infusion in seven patients. The dose of baclofen could be reduced to 40% of that dose which was originally necessary in 10 patients. The do...

  11. The Efficacy and Safety of Tizanidine in Treating Spasticity in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Ali Nikkhah

    2011-09-01

    Full Text Available ObjectiveSpastic cerebral palsy (CP is one of the most difficult and disabling conditions that requires medical attention and treatment. The aim of this study was to assess the efficacy and safety of oral tizanidine in treating spasticity in children with spastic CP.Materials & MethodsSixty children with spastic cerebral palsy were enrolled in a double-blind, placebo-controlled, randomized clinical trial. These patients were randomly assigned to receive tizanidine or a matching placebo. Sample normalization was not performed either before or after the study in these two separate groups. Nevertheless, no significant statistical difference was found between the two concerned groups in terms of age, sex, or type of spasticity. Each patient received the treatment for 2 weeks between May 2010 and February 2011.ResultsThirty-one boys and 29 girls with a mean age of 7.3 ± 3.4 years were evaluated. Our study revealed that spasticity was reduced in 50% of the patients receivingthe drug tizanidine compared to only 6.7% of the patients receiving the placebo. Additionally, 66.7% of patients reported less pain on the affected side receivingtizanidine (group A compared to 13.3% of patients receiving the placebo (group B. No serious side effects were reported in this study.ConclusionTizanidine is effective and safe in decreasing the spastic hypertonia associated with cerebral palsy in children.Keywords: Tizanidine; spasticity; cerebral palsy; children    

  12. Effects of interactive games on motor performance in children with spastic cerebral palsy

    OpenAIRE

    AlSaif, Amer A.; Alsenany, Samira

    2015-01-01

    [Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Method...

  13. Spasticity and Electrophysiologic Changes after Extracorporeal Shock Wave Therapy on Gastrocnemius

    OpenAIRE

    Sohn, Min Kyun; Cho, Kang Hee; Kim, Young-Jae; Hwang, Seon Lyul

    2011-01-01

    Objective To evaluate the spasticity and electrophysiologic effects of applying extracorporeal shock wave therapy (ESWT) to the gastrocnemius by studying F wave and H-reflex. Method Ten healthy adults and 10 hemiplegic stroke patients with ankle plantarflexor spasticity received one session of ESWT on the medial head of the gastrocnemius. The modified Ashworth scale (MAS), tibial nerve conduction, F wave, and H-reflex results were measured before and immediately after the treatment. The Visua...

  14. The Effect of Electrical Passive Cycling on Spasticity in War Veterans with Spinal Cord Injury

    OpenAIRE

    Seyed M Rayegani; Hadi eShojaee; Leyla eSedighipour; Mohammad Reza eSoroush; Mohmmad eBaghbani; Omm’Ol Banin eAmirani

    2011-01-01

    Introduction: Muscle atrophy, spasticity, and deformity are among long term complication of spinal cord injury (SCI) veterans. There are numerous studies evaluating effect of functional electrical stimulation on muscle properties of SCI people, but less research has focused on the benefits of passive cycling in the management of spasticity and improving ROM of lower limbs in individuals with SCI. Aims: To evaluate the effect of electrical passive cycling on passive range of movement spasticit...

  15. A total of 220 patients with autosomal dominant spastic paraplegia do not display mutations in the SLC33A1 gene (SPG42)

    OpenAIRE

    Schlipf, Nina A; Beetz, Christian; Schüle, Rebecca; Stevanin, Giovanni; Erichsen, Anne Kjersti; Forlani, Sylvie; Zaros, Cécile; Karle, Kathrin; Klebe, Stephan; Klimpe, Sven; Durr, Alexandra; Otto, Susanne; Tallaksen, Chantal M. E.; Riess, Olaf; Brice, Alexis

    2010-01-01

    The most frequent causes of autosomal dominant (AD) hereditary spastic paraplegias (HSP) (ADHSP) are mutations in the SPAST gene (SPG4 locus). However, roughly 60% of patients are negative for SPAST mutations, despite their family history being compatible with AD inheritance. A mutation in the gene for an acetyl-CoA transporter (SLC33A1) has recently been reported in one Chinese family to cause ADHSP-type SPG42. In this study, we screened 220 independent SPAST mutation-negative ADHSP samples ...

  16. Sativex in the Management of Multiple Sclerosis-Related Spasticity: Role of the Corticospinal Modulation

    Directory of Open Access Journals (Sweden)

    Margherita Russo

    2015-01-01

    Full Text Available Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS. This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect. The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability.

  17. Sativex in the management of multiple sclerosis-related spasticity: role of the corticospinal modulation.

    Science.gov (United States)

    Russo, Margherita; Calabrò, Rocco Salvatore; Naro, Antonino; Sessa, Edoardo; Rifici, Carmela; D'Aleo, Giangaetano; Leo, Antonino; De Luca, Rosaria; Quartarone, Angelo; Bramanti, Placido

    2015-01-01

    Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS). This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect. The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability. PMID:25699191

  18. Perceived Impact of Spasticity Is Associated with Spatial and Temporal Parameters of Gait in Multiple Sclerosis

    Science.gov (United States)

    Balantrapu, Swathi; Sandroff, Brian M.; Sosnoff, Jacob J.; Motl, Robert W.

    2012-01-01

    Background. Spasticity is prevalent and disabling in persons with multiple sclerosis (MS), and the development of the Multiple Sclerosis Spasticity Scale-88 (MSSS-88) provides an opportunity for examining the perceived impact of spasticity and its association with gait in this population. Purpose. This study examined the association between the perceived impact of spasticity and spatio-temporal parameters of gait in persons with MS. Methods. The sample included 44 adults with MS who completed the MSSS-88 and 4 walking trials on a 26-foot GAITRiteTM electronic walkway for measurement of spatio-temporal components of gait including velocity, cadence, base of support, step time, single support, double support, and swing phase. Results. The overall MSSS-88 score was significantly associated with velocity (r = −0.371), cadence (r = −0.306), base of support (r = 0.357), step time (r = 0.305), single leg support (r = −0.388), double leg support (r = 0.379), and swing phase (r = −0.386). Conclusions. The perceived impact of spasticity coincides with alterations of the spatio-temporal parameters of gait in MS. This indicates that subsequent interventions might target a decrease in spasticity or its perceived impact as an approach for improving mobility in MS. PMID:22462022

  19. Alterations in body composition and spasticity following subtetanic neuromuscular electrical stimulation training in spinal cord injury

    Directory of Open Access Journals (Sweden)

    Louis Crowe, MB, BCh, BAO

    2013-04-01

    Full Text Available The objective of this prospective cohort study was to investigate alterations in body composition variables and spasticity following subtetanic neuromuscular electrical stimulation (NMES training in an adult population with spinal cord injury (SCI. Fourteen sedentary adults with SCI (thoracic [T]4–T11; American Spinal Injury Association Impairment Scale A/B; time since injury: 10.17 +/– 11.17 yr were recruited from the National SCI database. Four adhesive electrodes (175 cm2 each were placed bilaterally on the proximal and distal quadriceps and hamstrings muscle groups and subtetanic contractions were elicited using a handheld NMES device. Lean body mass (LBM and other body composition variables were measured using dual-energy X-ray absorptiometry. Spasticity was measured using the Spinal Cord Assessment Tool for Spastic Reflexes (SCATs and visual analog scales. Verbal and written feedback was obtained to subjectively evaluate spasticity. LBM and spasticity measurements were taken before and after an 8 wk NMES training program in order to assess change. A statistically significant increase in lower-limb LBM, i.e., muscle tissue (p > 0.001, and a reduction in SCATs (p < 0.001 score, indicating reduced spasticity, was observed. Subjective responses were positive. Improvements in body composition and SCATs scores indicate that subtetanic NMES training elicits favorable responses and may have important clinical implications for an SCI population.

  20. Method of motor function recovery in patients with muscle spasticity after stroke

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    Potokii V.S.

    2014-02-01

    Full Text Available Purpose: to prove the effectiveness of an innovative method of recovery of motor function of persons with spasticity after stroke. Material: in the experiment involved 26 patients aged 45-68 years who have had an ischemic stroke, a period of illness from 6 months to 5 years. Results: the analysis of specialized literature on the problem of reduced mobility due to spasticity confirms that spastic muscle condition after stroke significantly reduces the possibility of movement after stroke. The results of applying the method of recovery of motor function of persons with post-stroke spasticity of the muscles, which is based on the use of the second phase of post isometric relaxation - passive stretching muscles after heat-treatment procedures. This study confirms the high efficiency of this method for reducing pain in the shoulder and restore motor function of persons with spasticity after stroke. Conclusions: the implementation of the proposed method of recovery of motor function of persons with spasticity of muscles can increase the amplitude of the active movements of the shoulder and elbow joints, and, consequently, improve motor function in patients after stroke.

  1. Split tendon transfers for the correction of spastic varus foot deformity: a case series study

    Directory of Open Access Journals (Sweden)

    Dimitriadis Dimitris

    2010-12-01

    Full Text Available Abstract Background Overactivity of anterior and/or posterior tibial tendon may be a causative factor of spastic varus foot deformity. The prevalence of their dysfunction has been reported with not well defined results. Although gait analysis and dynamic electromyography provide useful information for the assessment of the patients, they are not available in every hospital. The purpose of the current study is to identify the causative muscle producing the deformity and apply the most suitable technique for its correction. Methods We retrospectively evaluated 48 consecutive ambulant patients (52 feet with spastic paralysis due to cerebral palsy. The average age at the time of the operation was 12,4 yrs (9-18 and the mean follow-up 7,8 yrs (4-14. Eigtheen feet presented equinus hind foot deformity due to gastrocnemius and soleus shortening. According to the deformity, the feet were divided in two groups (Group I with forefoot and midfoot inversion and Group II with hindfoot varus. The deformities were flexible in all cases in both groups. Split anterior tibial tendon transfer (SPLATT was performed in Group I (11 feet, while split posterior tibial tendon transfer (SPOTT was performed in Group II (38 feet. In 3 feet both procedures were performed. Achilles tendon sliding lengthening (Hoke procedure was done in 18 feet either preoperatively or concomitantly with the index procedure. Results The results in Group I, were rated according to Hoffer's clinical criteria as excellent in 8 feet and satisfactory in 3, while in Group II according to Kling's clinical criteria were rated as excellent in 20 feet, good in 14 and poor in 4. The feet with poor results presented residual varus deformity due to intraoperative technical errors. Conclusion Overactivity of the anterior tibial tendon produces inversion most prominent in the forefoot and midfoot and similarly overactivity of the posterior tibial tendon produces hindfoot varus. The deformity can be

  2. Pregnancy in a quadriplegic patient treated with continuous intrathecal baclofen infusion to manage her severe spasticity. Case report.

    Science.gov (United States)

    Delhaas, E M; Verhagen, J

    1992-07-01

    A report on pregnancy in a quadriplegic patient treated with a high dose of 1000 mcg/24 h continuous intrathecal baclofen infusion using an implanted drug delivery system (Synchromed, Medtronic, USA). Spasticity could be managed up to the 35th week of gestation. However, uterine contractions evoke enormous spastic symptoms which we, even with maximum values of the spasticity scales, could not classify. The recurrence of spasticity was associated with autonomic dysregulation. With continuous epidurally infused bupivacaine (11.25 mg/h) adequate relaxation could be reached and gestation was terminated by a primary caesarean section. A healthy girl was born (2040 g, Apgar 9 and 10). PMID:1508570

  3. Plasma proteome analysis in HTLV-1-associated myelopathy/tropical spastic paraparesis

    Directory of Open Access Journals (Sweden)

    Stumpf Michael PH

    2011-10-01

    Full Text Available Abstract Background Human T lymphotropic virus Type 1 (HTLV-1 causes a chronic inflammatory disease of the central nervous system known as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM which resembles chronic spinal forms of multiple sclerosis (MS. The pathogenesis of HAM remains uncertain. To aid in the differential diagnosis of HAM and to identify pathogenetic mechanisms, we analysed the plasma proteome in asymptomatic HTLV-1 carriers (ACs, patients with HAM, uninfected controls, and patients with MS. We used surface-enhanced laser desorption-ionization (SELDI mass spectrometry to analyse the plasma proteome in 68 HTLV-1-infected individuals (in two non-overlapping sets, each comprising 17 patients with HAM and 17 ACs, 16 uninfected controls, and 11 patients with secondary progressive MS. Candidate biomarkers were identified by tandem Q-TOF mass spectrometry. Results The concentrations of three plasma proteins - high [β2-microglobulin], high [Calgranulin B], and low [apolipoprotein A2] - were specifically associated with HAM, independently of proviral load. The plasma [β2-microglobulin] was positively correlated with disease severity. Conclusions The results indicate that monocytes are activated by contact with activated endothelium in HAM. Using β2-microglobulin and Calgranulin B alone we derive a diagnostic algorithm that correctly classified the disease status (presence or absence of HAM in 81% of HTLV-1-infected subjects in the cohort.

  4. Possible etiologies for tropical spastic paraparesis and human T lymphotropic virus I-associated myelopathy

    Directory of Open Access Journals (Sweden)

    V. Zaninovic'

    2004-01-01

    Full Text Available The epidemiology of tropical spastic paraparesis/human T lymphotropic virus I (HTLV-I-associated myelopathy (TSP/HAM is frequently inconsistent and suggests environmental factors in the etiology of these syndromes. The neuropathology corresponds to a toxometabolic or autoimmune process and possibly not to a viral disease. Some logical hypotheses about the etiology and physiopathology of TSP and HAM are proposed. Glutamate-mediated excitotoxicity, central distal axonopathies, cassava, lathyrism and cycad toxicity may explain most cases of TSP. The damage caused to astrocytes and to the blood-brain barrier by HTLV-I plus xenobiotics may explain most cases of HAM. Analysis of the HTLV-I/xenobiotic ratio clarifies most of the paradoxical epidemiology of TSP and HAM. Modern neurotoxicology, neuroimmunology and molecular biology may explain the neuropathology of TSP and HAM. It is quite possible that there are other xenobiotics implicated in the etiology of some TSP/HAMs. The prevention of these syndromes appears to be possible today.

  5. The mouse rumpshaker mutation of the proteolipid protein in human X-linked recessive spastic paraplegia

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, H.; Hoffman, E.P.; Matise, T.C. [and others

    1994-09-01

    X-linked recessive spastic paraplegia is a rare neurodegenerative disorder characterized by slowly progressive weakness and spasticity of the lower extremities. We have recently genetically analyzed the original X-linked recessive spastic paraplegia family reported by Johnston and McKusick in 1962. We employed a fluorescent multiplex CA repeat strategy using a 22 locus, 10 cM framework map of the human X chromosome and localized the gene within a 36 cM region of Xq2l.3-q24 which includes the PLP locus. Saugier-Veber et al. recently reported a point mutation (His139Tyr) in exon 3B of the PLP gene in an X-linked recessive spastic paraplegia family (SPG2). This family shows no optic atrophy, in contrast to the family we have studied. This data showed that SPG2 and Pelizaeus-Merzbacher disease were allelic disorders. We investigated the PLP gene as a candidate gene for the original X-linked recessive spastic paraplegia family using SSCP and direct sequencing methods. We found a point mutation (T to C) in exon 4 of affected males which alters the amino-acid (Ile to Thr) at residue 186. This change was absent in the unaffected males of the family and in 40 unrelated control females (80 X chromosomes). Surprisingly, this mutation is identical to the mutation previously identified in the rumpshaker mouse model. The complete homology between both the mouse and human PLP sequence, and the mouse rumpshaker mutation and human spastic paraplegia mutation in our family, permit direct parallels to be drawn with regards to pathophysiology. Our data indicates that the well-documented and striking clinical differences between Pelizaeus-Merzbacher disease and X-linked recessive spastic paraplegia is due to the specific effect of different mutations of the human PLP gene on oligodendrocyte differentiation and development and on later myelin production and maintenance.

  6. [Compression material].

    Science.gov (United States)

    Perceau, Géraldine; Faure, Christine

    2012-01-01

    The compression of a venous ulcer is carried out with the use of bandages, and for less exudative ulcers, with socks, stockings or tights. The system of bandages is complex. Different forms of extension and therefore different types of models exist. PMID:22489428

  7. Wellhead compression

    Energy Technology Data Exchange (ETDEWEB)

    Harrington, Joe [Sertco Industries, Inc., Okemah, OK (United States); Vazquez, Daniel [Hoerbiger Service Latin America Inc., Deerfield Beach, FL (United States); Jacobs, Denis Richard [Hoerbiger do Brasil Industria de Equipamentos, Cajamar, SP (Brazil)

    2012-07-01

    Over time, all wells experience a natural decline in oil and gas production. In gas wells, the major problems are liquid loading and low downhole differential pressures which negatively impact total gas production. As a form of artificial lift, wellhead compressors help reduce the tubing pressure resulting in gas velocities above the critical velocity needed to surface water, oil and condensate regaining lost production and increasing recoverable reserves. Best results come from reservoirs with high porosity, high permeability, high initial flow rates, low decline rates and high total cumulative production. In oil wells, excessive annulus gas pressure tends to inhibit both oil and gas production. Wellhead compression packages can provide a cost effective solution to these problems by reducing the system pressure in the tubing or annulus, allowing for an immediate increase in production rates. Wells furthest from the gathering compressor typically benefit the most from wellhead compression due to system pressure drops. Downstream compressors also benefit from higher suction pressures reducing overall compression horsepower requirements. Special care must be taken in selecting the best equipment for these applications. The successful implementation of wellhead compression from an economical standpoint hinges on the testing, installation and operation of the equipment. Key challenges and suggested equipment features designed to combat those challenges and successful case histories throughout Latin America are discussed below.(author)

  8. Low dose tubulin-binding drugs rescue peroxisome trafficking deficit in patient-derived stem cells in Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Yongjun Fan

    2014-05-01

    Full Text Available Hereditary Spastic Paraplegia (HSP is a genetically heterogeneous group of disorders, diagnosed by progressive gait disturbances with muscle weakness and spasticity, for which there are no treatments targeted at the underlying pathophysiology. Mutations in spastin are a common cause of HSP. Spastin is a microtubule-severing protein whose mutation in mouse causes defective axonal transport. In human patient-derived olfactory neurosphere-derived (ONS cells, spastin mutations lead to lower levels of acetylated α-tubulin, a marker of stabilised microtubules, and to slower speed of peroxisome trafficking. Here we screened multiple concentrations of four tubulin-binding drugs for their ability to rescue levels of acetylated α-tubulin in patient-derived ONS cells. Drug doses that restored acetylated α-tubulin to levels in control-derived ONS cells were then selected for their ability to rescue peroxisome trafficking deficits. Automated microscopic screening identified very low doses of the four drugs (0.5 nM taxol, 0.5 nM vinblastine, 2 nM epothilone D, 10 µM noscapine that rescued acetylated α-tubulin in patient-derived ONS cells. These same doses rescued peroxisome trafficking deficits, restoring peroxisome speeds to untreated control cell levels. These results demonstrate a novel approach for drug screening based on high throughput automated microscopy for acetylated α-tubulin followed by functional validation of microtubule-based peroxisome transport. From a clinical perspective, all the drugs tested are used clinically, but at much higher doses. Importantly, epothilone D and noscapine can enter the central nervous system, making them potential candidates for future clinical trials.

  9. Clinical efficacy and effectiveness of Sativex, a combined cannabinoid medicine, in multiple sclerosis-related spasticity.

    Science.gov (United States)

    Oreja-Guevara, Celia

    2012-04-01

    Multiple sclerosis (MS) is associated with a wide range of disease symptoms and amongst these, spasticity is one of the most disabling and has the greatest impact on patient well-being and quality of life. Until now, available drug therapies for spasticity appear to have limited benefit and are often associated with poor tolerability. In a recent Spanish survey it was noted that multidrug therapy and a low control rate were common features for a large proportion of patients with MS-related spasticity, suggesting that currently available monotherapies lack significant activity. Sativex is a 1:1 mixture of δ-9-tetrahydrocannabinol and cannabidiol derived from Cannabis sativa chemovars, which is available as an oromucosal spray. Clinical experience with Sativex in patients with MS-related spasticity is steadily accumulating. Results from randomized, controlled trials have reported a reduction in the severity of symptoms associated with spasticity, leading to a better ability to perform daily activities and an improved perception of patients and their carers regarding functional status. These are highly encouraging findings that provide some much needed optimism for the treatment of this disabling and often painful symptom of MS. PMID:22509985

  10. Clinical and neuroimaging profile of congenital brain malformations in children with spastic cerebral palsy

    International Nuclear Information System (INIS)

    Purpose: Analysis of the incidence of congenital brain malformations in children with spastic cerebral palsy (CP) in a hospital based study. Material and Methods: The present study included 74 boys and 56 girls with spastic tetraplegia, diplegia, and hemiplegia CP. Magnetic resonance imaging MRI findings were analyzed in children with CP. Results: Significant abnormalities relevant to the CP were evident on MRI in 124 (95.3%) subjects. Periventicular leukomalacia (PVL) was detected more frequently in children with spastic diplegia than in patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 15 (10.7%) children with spastic CP. Brain malformations included: schizencephaly (5), agenesis corpus callosum (4), polymicrogyria (2), holoprosencephaly (2) and lissencephaly (2). Intractable epilepsy and mental retardation were observed more often in children with brain anomalies. Twelve patients with congenital brain malformations were born at term and three born at preterm. Conclusions: Neuroimaging results in children with CP may help determine the etiology and make better prognosis of CP. (authors)

  11. The effect of cannabinoids on the stretch reflex in multiple sclerosis spasticity.

    Science.gov (United States)

    Marinelli, Lucio; Mori, Laura; Canneva, Stefania; Colombano, Federica; Currà, Antonio; Fattapposta, Francesco; Bandini, Fabio; Capello, Elisabetta; Abbruzzese, Giovanni; Trompetto, Carlo

    2016-07-01

    The aim of this observational study was to assess the efficacy of a tetrahydrocannabinol-cannabidiol (THC : CBD) oromucosal spray on spasticity using the stretch reflex in patients with multiple sclerosis (MS). Numeric rating scale (NRS) for spasticity, modified Ashworth scale (MAS), and the stretch reflex were assessed before and during treatment in 57 MS patients with spasticity eligible for THC : CBD treatment. A significant reduction in stretch reflex amplitude as well as significant reductions of NRS and MAS scores were observed. There was a low concordance between the three measures (stretch reflex, NRS, and MAS), likely related to the different aspects of muscle hypertonia assessed. Stretch reflex responders were taking a significantly higher number of puffs, whereas no differences were found in the responders by the other scales, suggesting that a higher dosage would add benefit if tolerated. The present study confirms the efficacy of cannabinoids in reducing spasticity in patients with MS, suggesting a higher sensitivity and specificity of the stretch reflex compared with other measures. As an objective and quantitative measure of spasticity, the stretch reflex is particularly useful to assess the effects of cannabinoids on spinal excitability and may play a role in future pharmacological studies. PMID:27003093

  12. The effect of penile vibratory stimulation on male fertility potential, spasticity and neurogenic detrusor overactivity in spinal cord lesioned individuals

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Læssøe, Line; Sønksen, J;

    2005-01-01

    Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS).......Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS)....

  13. Inter-Rater Reliability of the Modified Ashworth Scale and Modified Modified Ashworth Scale in Assessing Poststroke Elbow Flexor Spasticity

    Science.gov (United States)

    Kaya, Taciser; Goksel Karatepe, Altinay; Gunaydin, Rezzan; Koc, Aysegul; Altundal Ercan, Ulku

    2011-01-01

    The Modified Ashworth Scale (MAS) is commonly used in clinical practice for grading spasticity. However, it was modified recently by omitting grade "1+" of the MAS and redefining grade "2". The aim of this study was to investigate the inter-rater reliability of MAS and modified MAS (MMAS) for the assessment of poststroke elbow flexor spasticity.…

  14. Muscle specific changes in length-force characteristics of the calf muscles in the spastic Han-Wistar rat

    DEFF Research Database (Denmark)

    Olesen, Annesofie Thorup; Jensen, Bente Rona; Uhlendorf, Toni L;

    2014-01-01

    normally-developed Han-Wistar rats. In addition, the extent of epimuscular myofascial force transmission between synergistic GA, SO and PL, as well as between the calf muscles and antagonistic tibialis anterior (TA) was investigated. Active length-force characteristics of spastic GA and PL were narrower...... with a reduced maximal active force. In contrast, active length-force characteristics of spastic SO were similar to those of controls. In reference position (90° ankle and knee angle), higher resistance to ankle dorsiflexion and increased passive stiffness was found for the spastic calf muscle group....... At optimum length, passive stiffness and passive force of spastic GA were decreased whereas those of spastic SO were increased. No mechanical interaction between the calf muscles and TA was found. As GA was lengthened, force from SO and PL declined despite a constant muscle-tendon unit length of SO...

  15. A literature review on the efficacy and safety of botulinum toxin: An injection in post-stroke spasticity

    Directory of Open Access Journals (Sweden)

    Majid Ghasemi

    2013-01-01

    Full Text Available Background: A variety of techniques for the management of spasticity have been suggested, including positioning, cryotherapy, splinting and casting, biofeedback, electrical stimulation, and medical management by pharmacological agents, Botulinum toxin A (BTA is now the pharmacological treatment of choice in focal spasticity. BTA by blocking acetylcholine release at neuromuscular junctions accounts for its therapeutic action to relieve spasticity. Methods: A computerized search of Pub Med was carried out to find the latest result about efficacy of BTA in management of post stroke spasticity. Result: Among 84 articles were found, frothy of them included in this review and divided to lower and upper extremity. Conclusions: BTA is a treatment choice in reducing tone and managing post stroke spasticity .

  16. Sativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosis.

    Science.gov (United States)

    Leocani, Letizia; Nuara, Arturo; Houdayer, Elise; Schiavetti, Irene; Del Carro, Ubaldo; Amadio, Stefano; Straffi, Laura; Rossi, Paolo; Martinelli, Vittorio; Vila, Carlos; Sormani, Maria Pia; Comi, Giancarlo

    2015-11-01

    Despite the proven efficacy of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol) oromucosal spray in reducing spasticity symptoms in multiple sclerosis (MS), little is known about the neurophysiological correlates of such effects. The aim of the study was to investigate the effects of Sativex on neurophysiological measures of spasticity (H/M ratio) and corticospinal excitability in patients with progressive MS. This was a randomized, double-blind, placebo-controlled, crossover study. Consecutive subjects with progressive MS and lower limb spasticity referred to our center were randomized to 4 weeks' treatment (including 2 weeks' titration) with Sativex or placebo, with crossover after a 2-week washout. Clinical and neurophysiological measures (H/M ratio and cortical excitability) of spasticity were assessed. The H/M ratio was the primary outcome, with sample size calculation of 40 patients. Of 44 recruited patients, 34 were analyzed due to 6 drop-outs and 4 exclusions, which lowered the power of the study to show differences between treatments. Neurophysiological measures did not differ significantly according to treatment and did not correlate significantly with clinical response. Response on the modified Ashworth scale (at least 20 % improvement) was significantly more frequent after Sativex than placebo (50 vs 23.5 %; p = 0.041; McNemar). Side effects did not differ significantly according to treatment. Our findings confirm the clinical benefit of Sativex on MS spasticity. The lack of corresponding changes in corticospinal excitability and on the monosynaptic component, of the stretch reflex, although in a limited sample size, points to the involvement of other spinal and supraspinal mechanisms in the physiopathology of spasticity in progressive MS. PMID:26289497

  17. The efficacy of traditional Thai massage in decreasing spasticity in elderly stroke patients

    Directory of Open Access Journals (Sweden)

    Thanakiatpinyo T

    2014-08-01

    Full Text Available Thanitta Thanakiatpinyo,1 Supakij Suwannatrai,2 Ueamphon Suwannatrai,2 Phanitanong Khumkaew,2 Dokmai Wiwattamongkol,2 Manmas Vannabhum,2 Somluck Pianmanakit,1 Vilai Kuptniratsaikul1 1Department of Rehabilitation Medicine, 2Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Purpose: To study the efficacy of traditional Thai massage (TTM versus conventional physical therapy (PT programs in treating muscle spasticity, functional ability, anxiety, depression, and quality of life (QoL in Thai stroke patients.Methods: This randomized controlled trial with a blinded assessor was carried out at the Department of Rehabilitation Medicine, Siriraj Hospital (Bangkok, Thailand. The study included 50 stroke (onset ≥3 months outpatients experiencing spasticity at the elbow or knee muscles at a grade of ≥1+ on the modified Ashworth Scale who were ≥50 years old and able to communicate. The subjects were randomly allocated to the treatment group receiving TTM (24 subjects or the control group receiving the PT program (26 subjects. Both groups received treatment (either TTM or PT twice a week for 6 weeks. Spasticity grade, functional ability, anxiety, depression, and QoL were measured at Week 0 and Week 6.Results: At Week 6, the percentage of patients whose modified Ashworth Scale score had decreased by at least one grade was not statistically significant between the two groups. Both TTM and PT groups experienced a significant increase in functional ability and QoL, but no difference was found between the groups. Anxiety and depression scores showed a decreasing trend in the TTM group.Conclusion: This preliminary report showed no evidence that TTM differed from the PT program in decreasing spasticity. However, both interventions may relieve spasticity, increase functional ability, and improve QoL after 6 weeks. Only TTM can decrease anxiety and depression scores. Further studies with

  18. Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

    Science.gov (United States)

    Vaidyanathan, Subramanian; Soni, Bakul M; Oo, Tun; Hughes, Peter L; Singh, Gurpreet; Watt, John WH; Sett, Pradipkumar

    2003-01-01

    Background Increased spasms in spinal cord injury (SCI) patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency) drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from intrathecal space. Case Presentation A 44-year-old male sustained a fracture of C5/6 and incomplete tetraplegia at C-8 level. Medtronic Synchromed pump for intrathecal baclofen therapy was implanted 13 months later to control severe spasticity. The tip of catheter was placed at T-10 level. The initial dose of baclofen was 300 micrograms/day of baclofen, administered by a simple continuous infusion. During a nine-month period, he required increasing doses of baclofen (875 micrograms/day) to control spasticity. X-ray of abdomen showed multiple radio opaque shadows in the region of urinary bladder. No malfunction of the pump was detected. Therefore, increased spasticity was attributed to bladder stones. Electrohydraulic lithotripsy of bladder stones was carried out successfully. Even after removal of bladder stones, this patient required further increases in the dose of intrathecal baclofen (950, 1050, 1200 and then 1300 micrograms/day). Careful evaluation of pump-catheter system revealed that the catheter had extruded spontaneously and was lying in the paraspinal space at L-4, where the catheter had been anchored before it entered the subarachnoid space. A new catheter was passed into the subarachnoid space and the tip of catheter was located at T-8 level. The dose of intrathecal baclofen was decreased to 300 micrograms/day. Conclusion Vesical calculi acted as red herring for resurgence of spasticity. The real cause for increased spasms was spontaneous extrusion of whole length of

  19. Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

    Directory of Open Access Journals (Sweden)

    Singh Gurpreet

    2003-03-01

    Full Text Available Abstract Background Increased spasms in spinal cord injury (SCI patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from intrathecal space. Case Presentation A 44-year-old male sustained a fracture of C5/6 and incomplete tetraplegia at C-8 level. Medtronic Synchromed pump for intrathecal baclofen therapy was implanted 13 months later to control severe spasticity. The tip of catheter was placed at T-10 level. The initial dose of baclofen was 300 micrograms/day of baclofen, administered by a simple continuous infusion. During a nine-month period, he required increasing doses of baclofen (875 micrograms/day to control spasticity. X-ray of abdomen showed multiple radio opaque shadows in the region of urinary bladder. No malfunction of the pump was detected. Therefore, increased spasticity was attributed to bladder stones. Electrohydraulic lithotripsy of bladder stones was carried out successfully. Even after removal of bladder stones, this patient required further increases in the dose of intrathecal baclofen (950, 1050, 1200 and then 1300 micrograms/day. Careful evaluation of pump-catheter system revealed that the catheter had extruded spontaneously and was lying in the paraspinal space at L-4, where the catheter had been anchored before it entered the subarachnoid space. A new catheter was passed into the subarachnoid space and the tip of catheter was located at T-8 level. The dose of intrathecal baclofen was decreased to 300 micrograms/day. Conclusion Vesical calculi acted as red herring for resurgence of spasticity. The real cause for increased spasms was spontaneous extrusion

  20. REEPing the benefits of an animal model of hereditary spastic paraplegia

    OpenAIRE

    Deutch, Ariel Y.; Hedera, Peter; Roger J Colbran

    2013-01-01

    The hereditary spastic paraplegias (HSPs) are characterized by spasticity of the leg muscles due to axonal degeneration of corticospinal neurons. Beetz et al. report that the core motor phenotype and axonal pathology of HSPs are recapitulated in mice lacking the HSP-associated gene Reep1. REEP1 is shown to regulate ER structure in motor cortex neurons. The Reep1 knockout mouse should be a very useful model in which to study the mechanisms of progressive axon loss in HSPs and other disorders.

  1. Asphyxia-related risk factors and their timing in spastic cerebral palsy

    DEFF Research Database (Denmark)

    Nielsen, Lene F.; Schendel, Diana; Grove, Jakob;

    2008-01-01

    Objective To investigate the association of asphyxia-related conditions (reducing blood flow or blood oxygen levels in the fetus) with spastic cerebral palsy (CP) considering different gestational age groups and the timing of risk. Design Population-based case-control study. Setting Danish Cerebral...... Palsy Register in eastern Denmark and Danish Medical Birth Register. Population or Sample 271 singletons with spastic CP and 217 singleton controls, frequency matched by gestational age group, born 1982-1990 in eastern Denmark. Methods Data were abstracted from medical records, and a priori asphyxia...

  2. Development of spasticity with age in a total population of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2008-11-01

    Full Text Available Abstract Background The development of spasticity with age in children with cerebral palsy (CP has, to our knowledge, not been studied before. In 1994, a register and a health care program for children with CP in southern Sweden were initiated. In the programme the child's muscle tone according to the modified Ashworth scale is measured twice a year until six years of age, then once a year. We have used this data to analyse the development of spasticity with age in a total population of children with cerebral palsy. Methods All measurements of muscle tone in the gastrocnemius-soleus muscle in all children with CP from 0 to 15 years during the period 1995–2006 were analysed. The CP subtypes were classified according to the Surveillance of Cerebral Palsy in Europe network system. Using these criteria, the study was based on 6218 examinations in 547 children. For the statistical analysis the Ashworth scale was dichotomized. The levels 0–1 were gathered in one category and levels 2–4 in the other. The pattern of development with age was evaluated using piecewise logistic regression in combination with Akaike's An Information Criterion. Results In the total sample the degree of muscle tone increased up to 4 years of age. After 4 years of age the muscle tone decreased each year up to 12 years of age. A similar development was seen when excluding the children operated with selective dorsal rhizotomy, intrathecal baclofen pump or tendo Achilles lengthening. At 4 years of age about 47% of the children had spasticity in their gastro-soleus muscle graded as Ashworth 2–4. After 12 years of age 23% of the children had that level of spasticity. The CP subtypes spastic bilateral and spastic unilateral CP showed the same pattern as the total sample. Children with dyskinetic type of CP showed an increasing muscle tone up to age 6, followed by a decreasing pattern up to age 15. Conclusion In children with CP, the muscle tone as measured with the Ashworth

  3. Mutations in DARS Cause Hypomyelination with Brain Stem and Spinal Cord Involvement and Leg Spasticity

    OpenAIRE

    Taft, Ryan J.; Vanderver, Adeline; Leventer, Richard J.; Damiani, Stephen A.; Simons, Cas; Grimmond, Sean M.; Miller, David; Schmidt, Johanna; Lockhart, Paul J.; Pope, Kate; Ru, Kelin; Crawford, Joanna; Rosser, Tena; de Coo, Irenaeus F.M.; Juneja, Monica

    2013-01-01

    Inherited white-matter disorders are a broad class of diseases for which treatment and classification are both challenging. Indeed, nearly half of the children presenting with a leukoencephalopathy remain without a specific diagnosis. Here, we report on the application of high-throughput genome and exome sequencing to a cohort of ten individuals with a leukoencephalopathy of unknown etiology and clinically characterized by hypomyelination with brain stem and spinal cord involvement and leg sp...

  4. Compressive beamforming

    DEFF Research Database (Denmark)

    Xenaki, Angeliki; Mosegaard, Klaus

    2014-01-01

    Sound source localization with sensor arrays involves the estimation of the direction-of-arrival (DOA) from a limited number of observations. Compressive sensing (CS) solves such underdetermined problems achieving sparsity, thus improved resolution, and can be solved efficiently with convex...... optimization. The DOA estimation problem is formulated in the CS framework and it is shown that CS has superior performance compared to traditional DOA estimation methods especially under challenging scenarios such as coherent arrivals and single-snapshot data. An offset and resolution analysis is performed to...

  5. Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

    Directory of Open Access Journals (Sweden)

    van Rhijn Lodewijk W

    2010-06-01

    Full Text Available Abstract Background Cerebral palsy (CP may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. Methods We performed an RF-DRG procedure in 17 consecutive CP patients with severe hip flexor/adductor spasms accompanied by pain or care-giving difficulties. Six children were systematically evaluated at baseline, and 1 month and 6 months after treatment by means of the Modified Ashworth Scale (MAS, Gross Motor Function Measure (GMFM and a self-made caregiver's questionnaire. Eleven subsequent children were evaluated using a Visual Analogue Scale (VAS for spasticity, pain and ease of care. Results A total of 19 RF-DRG treatments were performed in 17 patients. We found a small improvement in muscle tone measured by MAS, but no effect on the GMFM scale. Despite this, the caregivers of these six treated children unanimously stated that the quality of life of their children had indeed improved after the RF-DRG. In the subsequent 11 children we found improvements in all VAS scores, in a range comparable to the conventional treatment options. Conclusion RF-DRG is a promising new treatment option for severe spasticity in CP patients, and its definitive effectiveness remains to be defined in a randomised controlled trial.

  6. Compressed convolution

    CERN Document Server

    Elsner, F

    2013-01-01

    We introduce the concept of compressed convolution, a technique to convolve a given data set with a large number of non-orthogonal kernels. In typical applications our technique drastically reduces the effective number of computations. The new method is applicable to convolutions with symmetric and asymmetric kernels and can be easily controlled for an optimal trade-off between speed and accuracy. It is based on linear compression of the collection of kernels into a small number of coefficients in an optimal eigenbasis. The final result can then be decompressed in constant time for each desired convolved output. The method is fully general and suitable for a wide variety of problems. We give explicit examples in the context of simulation challenges for upcoming multi-kilo-detector cosmic microwave background (CMB) missions. For a CMB experiment with O(10,000) detectors with similar beam properties, we demonstrate that the algorithm can decrease the costs of beam convolution by two to three orders of magnitude...

  7. Cortical somatosensory reorganization in children with spastic cerebral palsy: a multimodal neuroimaging study

    Directory of Open Access Journals (Sweden)

    CHRISTOS ePAPADELIS

    2014-09-01

    Full Text Available Although cerebral palsy (CP is among the most common causes of physical disability in early childhood, we know little about the functional and structural changes of this disorder in the developing brain. Here, we investigated with three different neuroimaging modalities (magnetoencephalography (MEG, diffusion tension imaging (DTI, and resting state fMRI whether spastic CP is associated with functional and anatomical abnormalities in the sensorimotor network. Ten children participated in the study: four with diplegic CP (DCP, three with hemiplegic CP (HCP, and three typically-developing (TD children. Somatosensory evoked fields (SEFs were recorded in response to pneumatic stimuli applied to digits D1, D3, and D5 of both hands. Several parameters of water diffusion were calculated from DTI between the thalamus and the precentral and postcentral gyri in both hemispheres. The sensorimotor resting state networks (RSNs were examined by using an independent component analysis method. Tactile stimulation of the fingers elicited the first prominent cortical response at ~50 ms, in all except one child, localized over the primary somatosensory cortex (S1. In five CP children, abnormal somatotopic organization was observed in the affected (or more affected hemisphere. Euclidean distances were markedly different between the two hemispheres in the HCP children, and between DCP and TD children for both hemispheres. DTI analysis revealed decreased fractional anisotropy and increased apparent diffusion coefficient for the thalamocortical pathways in the more affected compared to less affected hemisphere in CP children. Rs-fMRI results indicated absent and/or abnormal sensorimotor RSNs for children with HCP and DCP consistent with the severity and location of their lesions. Our findings suggest an abnormal somatosensory processing mechanism in the sensorimotor network of children with CP possibly as a result of diminished thalamocortical projections.

  8. Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Lorentzen, Jakob; Sinkjær, Thomas;

    2013-01-01

    children with spastic CP (21 males, 14 females; mean age 9y, SD 3y 4mo; range 3-15y) and 28 control children without CP (19 males, nine females; mean age 8y 11mo, SD 2y 10mo; range 3-15y). Twenty-seven children were diagnosed as having spastic hemiplegia, six with spastic diplegia, and two with spastic...... tetraplegia. According to the Gross Motor Function Classification System, 31 children were classified in level I, two in level II, and two in level III. RESULTS: Only seven children with spastic CP showed reflex stiffness outside the range of the control children. In contrast, 20 children with spastic CP......AIM: Clinical determination of spasticity is confounded by the difficulty in distinguishing reflex from passive contributions to muscle stiffness. There is, therefore, a risk that children with cerebral palsy (CP) receive antispasticity treatment unnecessarily. To investigate this, we aimed to...

  9. Electrophysiological and clinical evaluation of the effects of transcutaneous electrical nerve stimulation on the spasticity in the hemiplegic stroke patients.

    Science.gov (United States)

    Karakoyun, Ahmet; Boyraz, İsmail; Gunduz, Ramazan; Karamercan, Ayşe; Ozgirgin, Nese

    2015-11-01

    To investigate whether transcutaneous electrical nerve stimulation (TENS) mitigates the spasticity of hemiplegic stroke patients, as assessed by electrophysiological variables, and the effects, if any, on the clinical appearance of spasticity. [Subjects and Methods] Twenty-seven subjects who had acute hemiplegia and 24 healthy people as the control group, were enrolled in this study. Some of the acute cerebrovascular disease patients could walk. Subjects who did not have spasticity, who were taking antispasticity medicine, or had a previous episode of cerebrovascular disease were excluded. The walking speed of the patients was recorded before and after TENS. EMG examinations were performed on the healthy controls and in the affected side of the patients. A 30-minute single session of TENS was applied to lower extremity. At 10 minutes after TENS, the EMG examinations were repeated. [Results] A statistically significant decrease in the spasticity variables, and increased walking speed were found post-TENS. The lower M amplitude and higher H reflex amplitude, H/M maximum amplitude ratio, H slope, and H slope/M slope ratio on the spastic side were found to be statistically significant. [Conclusion] TENS application for hemiplegic patients with spastic lower extremities due to cerebrovascular disease resulted in marked improvement in clinical scales of spasticity and significant changes in the electrophysiological variables. PMID:26696708

  10. The effect of Sativex in neuropathic pain and spasticity in spinal cord injury

    DEFF Research Database (Denmark)

    Andresen, Sven Robert; Hansen, Rikke Bod Middelhede; Johansen, Inger Lauge;

    2014-01-01

    injury. Aims: To investigate the effect of Sativex (cannabinoid agonist given as an oral mucosal spray), on neuropathic pain and spasticity in patients with spinal cord injury. Methods: A randomized, double-blind, placebo-controlled crossover study. We will include 30 patients with neuropathic pain and......, it is presently illegal to drive when using Sativex, which impedes the inclusion of patients....

  11. Cost-effectiveness of Sativex in multiple sclerosis spasticity: new data and application to Italy.

    Science.gov (United States)

    Slof, John; Ruiz, Leonardo; Vila, Carlos

    2015-06-01

    Multiple sclerosis (MS) is a chronic progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and contributes to MS-related disability. This study aims to evaluate the cost-effectiveness of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol oromucosal spray) when used as add-on therapy for management of resistant MS-related spasticity in the context of the Italian healthcare system. A previously published Markov model-based analysis for the German and Spanish context was replicated, adapting it to the Italian setting. Model parameters were updated to reflect recent findings about MS-related spasticity and use of Sativex in daily clinical practice. The base case incremental cost-effectiveness ratio for Sativex use in Italy over a 5-year period was estimated to be €4968 per quality-adjusted life-year gained (year of costing: 2013). Sativex remained an efficient option in the Italian healthcare context - below the commonly accepted incremental threshold of €30,000 per quality-adjusted life-year gained - when deterministic and probabilistic sensitivity analyses were conducted. Sativex can be regarded as a cost-effective treatment option for patients with MS-related spasticity in Italy. PMID:25771713

  12. Clinical Observation on Acupuncture Treatment for Post-stroke Spastic Hemiplegia

    Institute of Scientific and Technical Information of China (English)

    Zhang Yan; Liu Guo-cheng; Wang Jin-yu; Sun Yun-guang; Yang Liu-jiang

    2013-01-01

    Objective:To observe the clinical effect of contralateral needling plus rehabilitation for post-stroke spastic hemiplegia.Methods:Thirty-six patients with post-stroke spastic hemiplegia were randomly divided into a treatment group and a control group,18 cases in each group.The two groups were all given rehabilitation training.The contralateral needling was adopted in the treatment group on the acupoints group of brain-refreshing and orifice-opening needling method.The routine acupuncture was applied in the control group on the same acupoints.Respectively before and after the treatment,the modified Ashworth scale (MAS) and clinical spasticity index (CSI) were used to assess the therapeutic effects.Results:The total effective rate was 94.4% in the treatment group and 67.7% in the control group,with a statistical difference in comparison of the two groups (P<0.05).In comparison of MAS and CSl scores after the treatment between the treatment group and control group,the differences were statistically significant (P<0.05).Conclusion:The contralateral needling plus rehabilitation training is an effective method for the treatment of post-stroke spastic hemiplegia.

  13. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    Science.gov (United States)

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that…

  14. Reproducibility and validity of video screen measurements of gait in children with spastic cerebral palsy

    NARCIS (Netherlands)

    S. Grunt; P.J. van Kampen; M.M. van der Krogt; M.A. Brehm; C.A.M. Doorenbosch; J.G. Becher

    2010-01-01

    PURPOSE: To determine the reproducibility and validity of video screen measurement (VSM) of sagittal plane joint angles during gait. METHODS: 17 children with spastic cerebral palsy walked on a 10m walkway. Videos were recorded and 3d-instrumented gait analysis was performed. Two investigators measu

  15. Validation of the Serbian Version of Multiple Sclerosis Spasticity Scale 88 (MSSS-88.

    Directory of Open Access Journals (Sweden)

    Sindi Z Rodic

    Full Text Available Multiple Sclerosis Spasticity Scale (MSSS-88 has been developed for self-assessment of spasticity symptoms in patients with multiple sclerosis (MS. The objective of this study was to validate MSSS-88 and evaluate the psychometric properties in patients with MS in Serbia.The study comprised 65 MS patients with spasticity. MSSS-88 consists of 88 items grouped in eight sections. Internal consistency of the MSSS-88SR subscales was determined using Cronbach's alpha coefficient. Test/retest reliability with an intra-class correlation coefficient (ICC for each MSSS-88SR subscale was performed. Clinical validity of MSSS-88SR was determined by correlations with the Numeric Rating Scale (NRS and the Modified Ashworth Scale (MAS.The range of Cronbach's alpha for all scales and ICC was 0.91-0.96 and 0.84-0.91, respectively. All ICCs were statistically significant (p<0.05. All evaluated subscales of MSSS-88 were significantly correlated with the NRS scale. The highest correlation coefficients were registered between the WL subscale and the EDSS and MAS, while the strongest relationship was observed between the MSS subscale and the NRS.The Serbian translated version of this instrument may be useful as a clinical measure for spasticity and functionality in patients with MS.

  16. Possibilities of applying the method of radiofrequency (RFthermal destruction to correct spasticity in childrenwith cerebral palsy

    Directory of Open Access Journals (Sweden)

    Alexey Vasilievich Zvozil

    2015-03-01

    Full Text Available For the treatment of focal spasticity in the TurnerInstitute we developed and applied the approach toreduce spasticity in children with cerebral palsy byapplying the method of radiofrequency thermal de-struction of peripheral nerves and muscle motorpoints. This method is based on the effect of heatrelease during the passage through biological tissueof radiofrequency currents. The procedure was totally performed in 112 patients aged 1,2 to 14 yearsold with a level of spasticity over 3 points on a scaleAshworth. In order to reduce hypertonia of femuradductors, the target for RF ablation was obturatornerve; we targeted on the motor point of the gastrocnemius muscle in equinus, to reduce forearm flexorhypertonia we targeted on the musculo-cutaneousnerve, flexor muscles of the hand we intervened on their motor points. A positive result was maintained at follow-up of 6 months to one year in all patients, maximum - 2 years. The obtained results are preliminary and subject to further statistical processing, but they are quite comparable with the results of the use of type A botulinum toxin preparations. The proposed method of treatment is minimally invasive, virtually devoid of the risk of postoperative complications, can cut one stage spasticity in the muscles of various motor segments in children with cerebral palsy of great age range, including children up to 2 years old.

  17. Rapidly deteriorating course in Dutch hereditary spastic paraplegia type 11 patients

    NARCIS (Netherlands)

    de Bot, Susanne T.; Burggraaff, Rogier C.; Herkert, Johanna C.; Schelhaas, Helenius J.; Post, Bart; Diekstra, Adinda; van Vliet, Reinout O.; van der Knaap, Marjo S.; Kamsteeg, Erik-Jan; Scheffer, Hans; van de Warrenburg, Bart P.; Verschuuren-Bemelmans, Corien C.; Kremer, Hubertus P. H.

    2013-01-01

    Although SPG11 is the most common complicated hereditary spastic paraplegia, our knowledge of the long-term prognosis and life expectancy is limited. We therefore studied the disease course of all patients with a proven SPG11 mutation as tested in our laboratory, the single Dutch laboratory providin

  18. Cost analysis of the treatment of severe spinal spasticity with a continuous intrathecal baclofen infusion system

    NARCIS (Netherlands)

    Postma, TJBM; Oenema, D; Terpstra, S; Bouma, J; Kuipers-Upmeijer, H; Staal, MJ; Middel, BJ

    1999-01-01

    Objective: The purpose of our study was to analyse and evaluate the costs of continuous intrathecal baclofen administration as a modality in the treatment of severe spasticity in the Netherlands. Design: A cost analysis was conducted as part of a prospective, multicentre, multidisciplinary, randomis

  19. Tendon structure and extracellular matrix components are affected by spasticity in cerebral palsy patients

    OpenAIRE

    Gagliano, Nicoletta; Menon, Alessandra; Martinelli, Carla; Pettinari, Letizia; Panou, Artemisia; Milzani, Aldo; Dalle-Donne, Isabella; Portinaro, Nicola Marcello

    2013-01-01

    We studied the effect of spasticity-induced overload on tendons from the gracilis and semitendinosus muscles from cerebral palsy (CP) and healthy subjects (CT) stained with haematoxylineosin, Sirius red and Alcian blue. Vascularity was also characterized using an anti-CD34 antibody.

  20. Cognitive profiles and visuoperceptual abilities in preterm and term spastic diplegic children with periventricular leukomalacia.

    Science.gov (United States)

    Pagliano, Emanuela; Fedrizzi, Ermellina; Erbetta, Alessandra; Bulgheroni, Sara; Solari, Alessandra; Bono, Renata; Fazzi, Elisa; Andreucci, Elena; Riva, Daria

    2007-03-01

    Although relations between the extent of periventricular leukomalacia and neuropsychological performance in preterm children with spastic diplegia have been extensively investigated, studies on term children with spastic diplegia are rare. The authors examined 15 preterm children and 9 term children with spastic diplegia, all of whom had periventricular leukomalacia as a main magnetic resonance imaging (MRI) finding (excluding full-term spastic diplegic children with other MRI findings). Cognitive abilities (Griffith scale) and visuoperceptual abilities (Developmental Test of Visual Perception) were compared in the 2 groups and related to periventricular leukomalacia severity. Cognitive performance was substantially similar in the 2 groups. However, the overall Developmental Test of Visual Perception scores were below normal in the preterm and were normal in the term children; furthermore, visuoperceptual abilities were differentially affected in the preterm children, with visuomotor abilities more compromised than nonmotor visuoperceptual abilities. These children had similar cognitive performance and MRI findings, so the greater visuoperceptual compromise in the preterm group suggests a direct influence of prematurity, which may have adversely influenced the reorganization of visual centers and pathways following the initial developmental insult. The strabismus present in most preterm children would also have contributed to their greater visuoperceptual compromise. The authors conclude that the management of preterm and term children should differ, with concentration on visuoperceptual skills and rehabilitation in the former. PMID:17621497

  1. Combinational spinal GAD65 gene delivery and systemic GABA-mimetic treatment for modulation of spasticity.

    Directory of Open Access Journals (Sweden)

    Osamu Kakinohana

    Full Text Available BACKGROUND: Loss of GABA-mediated pre-synaptic inhibition after spinal injury plays a key role in the progressive increase in spinal reflexes and the appearance of spasticity. Clinical studies show that the use of baclofen (GABA(B receptor agonist, while effective in modulating spasticity is associated with major side effects such as general sedation and progressive tolerance development. The goal of the present study was to assess if a combined therapy composed of spinal segment-specific upregulation of GAD65 (glutamate decarboxylase gene once combined with systemic treatment with tiagabine (GABA uptake inhibitor will lead to an antispasticity effect and whether such an effect will only be present in GAD65 gene over-expressing spinal segments. METHODS/PRINCIPAL FINDINGS: Adult Sprague-Dawley (SD rats were exposed to transient spinal ischemia (10 min to induce muscle spasticity. Animals then received lumbar injection of HIV1-CMV-GAD65 lentivirus (LVs targeting ventral α-motoneuronal pools. At 2-3 weeks after lentivirus delivery animals were treated systemically with tiagabine (4, 10, 20 or 40 mg/kg or vehicle and the degree of spasticity response measured. In a separate experiment the expression of GAD65 gene after spinal parenchymal delivery of GAD65-lentivirus in naive minipigs was studied. Spastic SD rats receiving spinal injections of the GAD65 gene and treated with systemic tiagabine showed potent and tiagabine-dose-dependent alleviation of spasticity. Neither treatment alone (i.e., GAD65-LVs injection only or tiagabine treatment only had any significant antispasticity effect nor had any detectable side effect. Measured antispasticity effect correlated with increase in spinal parenchymal GABA synthesis and was restricted to spinal segments overexpressing GAD65 gene. CONCLUSIONS/SIGNIFICANCE: These data show that treatment with orally bioavailable GABA-mimetic drugs if combined with spinal-segment-specific GAD65 gene overexpression can

  2. Evaluation of mammogram compression efficiency

    International Nuclear Information System (INIS)

    quality of 0.6 bpp and 0.1 bpp reconstructions was decreased. The compression performance of the most effective reversible coders is rather unsatisfactory. The subjective rating with the diagnostic criteria of image quality was more sensitive to distortions caused by lossy compression compared with the pathology detection test. The observers constituted 14:1 as the accepted ratio of lossy wavelet compression for test mammograms. This is significantly higher than the mean ratio of 2:1 achieved with lossless methods. (author)

  3. Adaptive GIS Image Compression and Restoration Using Neural Networks

    OpenAIRE

    Al-Bastaki, Yousif

    2003-01-01

    This study aims to describe research into the field of GIS image compression, decompression and restoration. Geographical Information System (GIS) data comprises huge size into memory. For this purpose, it needs compression, which has high compression rate. But high compression rate cause of some distortion and losses. Restoration is a process by which an image suffering some form of distortion or degradation can be recovered to its original form. The proposed windows-based image compression ...

  4. Fractal image compression

    OpenAIRE

    Žemlo, Gražina

    2004-01-01

    One of the images compression methods – fractal image compression is analyzed in the work. After work carried out, it is possible to state, that selecting parameters of method of fractal compression depends on user’s demands.

  5. Compression limits in cascaded quadratic soliton compression

    DEFF Research Database (Denmark)

    Bache, Morten; Bang, Ole; Krolikowski, Wieslaw;

    2008-01-01

    Cascaded quadratic soliton compressors generate under optimal conditions few-cycle pulses. Using theory and numerical simulations in a nonlinear crystal suitable for high-energy pulse compression, we address the limits to the compression quality and efficiency.......Cascaded quadratic soliton compressors generate under optimal conditions few-cycle pulses. Using theory and numerical simulations in a nonlinear crystal suitable for high-energy pulse compression, we address the limits to the compression quality and efficiency....

  6. Satellite data compression

    CERN Document Server

    Huang, Bormin

    2011-01-01

    Satellite Data Compression covers recent progress in compression techniques for multispectral, hyperspectral and ultra spectral data. A survey of recent advances in the fields of satellite communications, remote sensing and geographical information systems is included. Satellite Data Compression, contributed by leaders in this field, is the first book available on satellite data compression. It covers onboard compression methodology and hardware developments in several space agencies. Case studies are presented on recent advances in satellite data compression techniques via various prediction-

  7. Lossy Image Compression

    CERN Document Server

    Shukla, KK

    2011-01-01

    Image compression is concerned with minimization of the number of information carrying units used to represent an image. Lossy compression techniques incur some loss of information which is usually imperceptible. In return for accepting this distortion, we obtain much higher compression ratios than is possible with lossless compression. Salient features of this book include: four new image compression algorithms and implementation of these algorithms; detailed discussion of fuzzy geometry measures and their application in image compression algorithms; new domain decomposition based algorithms

  8. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study

    Institute of Scientific and Technical Information of China (English)

    Yong Wook Kim; Ji Cheol Shin; Jeong-Gyu Yoon; Yong-Kyun Kim; Sang Chul Lee

    2013-01-01

    Background There are not many studies about treatment of shoulder spasticity.Although botulinum toxin injection has been reported to be effective for shoulder spasticity,the effectiveness was judged by pain and limited motion change,but not the spasticity itself.Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder.However,the subscapularis muscle,unlike the pectoralis major muscle,is located deep beneath scapula,where conventional injection is difficult to perform.As extracorporeal shock wave therapy (ESWT) has been reported to be effective for spasticity relief,and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment.This study was to evaluate the beneficial effects of radial ESWT (rESWT) on spastic subscapularis muscle in stroke patients.Methods This is an uncontrolled,prospective,unicenter,clinical pilot study.Stroke patients (n=57; mean age 55.4years) with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital.rESWT was administered to each patient every two or three days for two weeks (five total treatments).Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks.Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale (MAS),and passive range of motion (ROM) of the shoulder in external rotation was recorded.Pain was measured using a visual analogue scale (VAS) during passive ROM of the shoulder in external rotation,and was additionally recorded for patients who preserved cognitive and communicative ability (Pain group).Results Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline.The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the

  9. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization

    Science.gov (United States)

    Corleto, Jose A.; Bravo-Hernández, Mariana; Kamizato, Kota; Kakinohana, Osamu; Santucci, Camila; Navarro, Michael R.; Platoshyn, Oleksandr; Cizkova, Dasa; Lukacova, Nadezda; Taylor, Julian; Marsala, Martin

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection model of muscle spasticity in Sprague-Dawley (SD) rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i) ankle-rotation-evoked peripheral muscle resistance (PMR) and corresponding electromyography (EMG) activity, ii) Hoffmann reflex, and iii) EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist), tizanidine (α2-adrenergic agonist) and NGX424 (AMPA receptor antagonist) was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  10. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization.

    Directory of Open Access Journals (Sweden)

    Jose A Corleto

    Full Text Available The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI. The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9 complete transection model of muscle spasticity in Sprague-Dawley (SD rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i ankle-rotation-evoked peripheral muscle resistance (PMR and corresponding electromyography (EMG activity, ii Hoffmann reflex, and iii EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist, tizanidine (α2-adrenergic agonist and NGX424 (AMPA receptor antagonist was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  11. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization.

    Science.gov (United States)

    Corleto, Jose A; Bravo-Hernández, Mariana; Kamizato, Kota; Kakinohana, Osamu; Santucci, Camila; Navarro, Michael R; Platoshyn, Oleksandr; Cizkova, Dasa; Lukacova, Nadezda; Taylor, Julian; Marsala, Martin

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection model of muscle spasticity in Sprague-Dawley (SD) rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i) ankle-rotation-evoked peripheral muscle resistance (PMR) and corresponding electromyography (EMG) activity, ii) Hoffmann reflex, and iii) EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist), tizanidine (α2-adrenergic agonist) and NGX424 (AMPA receptor antagonist) was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  12. Changing the main indicators to assess motor function in children with cerebral palsy spastic form by hydrokinesitherapy

    OpenAIRE

    Taran I.V.

    2013-01-01

    The aim of the study is to identify the efficiency of the developed technique hydrokinetic system of physical rehabilitation for children 3-5 years old with cerebral palsy spastic form. Examined the impact of comparing the effectiveness of exercise in the water by two techniques: the author and accepted. In experiment involved 24 people aged 3-5 years old with cerebral palsy spastic form. The experiment lasted one year, classes were held hydrokinesitherapy 2 times a week. In the study recorde...

  13. Evaluationof efficiency of methods of neuromodulation in the treatment of spastic syndromes in patients with spinal cord injury

    OpenAIRE

    Smolkin А.А.; Ninel V.G.; Korshunova G.A.

    2014-01-01

    Objective: to evaluate the efficiency of the neuromodulation methods and to determine their role in complex rehabilitation of patients with spastic syndromes after spinal cord injury. Material and methods: Based on the study and treatment of 105 patients with spastic syndromes after injury of the spinal cord, electrical stimulation of the spinal cord, epidural drug therapy in combination with electrical nerve stimulation and local hypothermia spinal cord have been consistently applied for the...

  14. Plantarflexor training affects propulsive force generation during gait in children with spastic hemiplegic cerebral palsy: a pilot study

    OpenAIRE

    Ishihara, Misako; Higuchi, Yumi; Yonetsu, Ryo; Kitajima, Hiromi

    2015-01-01

    [Purpose] The purpose of this preliminary study was to assess the trade-off relationship between the hip and ankle joints after plantarflexor training in children with spastic hemiplegic cerebral palsy (CP). [Subjects and Methods] Three boys aged 9, 10, and 13 years with spastic hemiplegic CP participated in the study. Gait analysis was performed using a three-dimensional motion analysis device and a floor reaction force detection device before and after plantarflexor training. Data on gait s...

  15. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization

    OpenAIRE

    Corleto, Jose A.; Mariana Bravo-Hernández; Kota Kamizato; Osamu Kakinohana; Camila Santucci; Navarro, Michael R.; Oleksandr Platoshyn; Dasa Cizkova; Nadezda Lukacova; Julian Taylor; Martin Marsala

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection mode...

  16. Somatosensory inputs by application of KinesioTaping: Effects on spasticity, balance, and gait in chronic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Federica eTamburella

    2014-05-01

    Full Text Available Introduction: Leg paralysis, spasticity, reduced inter limb coordination and impaired balance are considered the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI. In the last years KinesioTaping (KT application has been proposed for enhancing sensory inputs, decreasing spasticity via proprioception feedback and relieving abnormal muscle tension. No studies addressed KT technique on SCI subjects: our goal was to analyze effects of ankle joint KT application on spasticity, balance and gait. Material and Methods: A randomized cross-over case control design was used to compare KT and conventional non-elastic silk tape (ST application’s effects in 11 chronic SCI subjects, AIS level D, with soleus/gastrocnemius (S/G muscles’ spasticity , balance and gait impairments. Treatment: 48 hours of either KT or ST treatment was followed after 1 week interval by a reverse protocol. Patient treated with KT were subjected to 48 hours of ST treatment and viceversa. Single Y-stripe of Cure©tape (KT and ST were applied to S and G with 0% stretch. Before and after 48 hours of KT and ST application, clinical data of range of motion (ROM, spasticity, clonus, pain, balance and gait were collected. Stabilometric platform assessment of Centre of Pressure (COP movements, bi-dimensional gait analysis and electromyograpich (EMG activity of S, G, Tibialis Anterior and Extensor Hallicus Lungus muscles were also collected. Results: Only After KT treatment significant effects on spasticity, clonus and COP movements, kinematic gait parameters and EMG activities were recorded. Comparison between KT and ST improvements pointed out significant differences for ROM, spasticity, clonus, pain, COP parameters and most of all kinematic gait data. Discussion: KT short term application reduces spasticity and pain and improves balance and gait performances in chronic incomplete SCI subjects.

  17. Somatosensory inputs by application of KinesioTaping: effects on spasticity, balance, and gait in chronic spinal cord injury

    OpenAIRE

    Tamburella, Federica; Scivoletto, Giorgio; Molinari, Marco

    2014-01-01

    Introduction: Leg paralysis, spasticity, reduced interlimb coordination, and impaired balance are the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI). In recent years, the application of KinesioTaping (KT) has been proposed to enhance sensory inputs, decreasing spasticity by proprioception feedback and relieving abnormal muscle tension. Because no studies have examined KT-based techniques in SCI subjects, our goal was to analyze the effects of a...

  18. Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS: typical clinical and neuroimaging features in a Brazilian family

    Directory of Open Access Journals (Sweden)

    J L Pedroso

    2011-01-01

    Full Text Available Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS is a neurodegenerative disorder characterized by late-infantile onset spastic ataxia and other neurological features. ARSACS has a high prevalence in northeastern Quebec, Canada. Several ARSACS cases have been reported outside Canada in recent decades. This is the first report of typical clinical and neuroimaging features in a Brazilian family with probable diagnosis of ARSACS.

  19. Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS): typical clinical and neuroimaging features in a Brazilian family

    OpenAIRE

    Pedroso, J.L.; P Braga-Neto; A Abrahão; R L M Rivero; C Abdalla; N. Abdala; O G P Barsottini

    2011-01-01

    Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a neurodegenerative disorder characterized by late-infantile onset spastic ataxia and other neurological features. ARSACS has a high prevalence in northeastern Quebec, Canada. Several ARSACS cases have been reported outside Canada in recent decades. This is the first report of typical clinical and neuroimaging features in a Brazilian family with probable diagnosis of ARSACS.

  20. Identification of the neural component of torque during manually-applied spasticity assessments in children with cerebral palsy

    OpenAIRE

    Bar-On, Lynn; Desloovere, Kaat; Molenaers, Guy; Harlaar, J.; Kindt, T; Aertbeliën, Erwin

    2014-01-01

    Clinical assessment of spasticity is compromised by the difficulty to distinguish neural from non-neural components of increased joint torque. Quantifying the contributions of each of these components is crucial to optimize the selection of anti-spasticity treatments such as botulinum toxin (BTX). The aim of this study was to compare different biomechanical parameters that quantify the neural contribution to ankle joint torque measured during manually-applied passive stretches to the gastrocs...

  1. A new multiple sclerosis spasticity treatment option: effect in everyday clinical practice and cost-effectiveness in Germany.

    Science.gov (United States)

    Flachenecker, Peter

    2013-02-01

    Sativex® (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain), a cannabinoid oromucosal spray containing a 1:1 ratio of 9-δ-tetrahydrocannabinol and cannabidiol, has been licensed in Germany since July 2011 as add-on therapy for moderate-to-severe multiple sclerosis (MS) treatment-resistant spasticity symptoms. The 'MOVE 2' study evaluated clinical outcomes, treatment satisfaction, quality of life (QoL) and provision of care in MS patients with spasticity receiving Sativex in everyday clinical practice. Data from 300 patients were collected from 42 specialized MS centers across Germany and were available for this analysis. Assessments, including the MS spasticity 0-10 numerical rating scale, modified Ashworth scale, patients' and physicians' clinical impressions, and QoL scales were rated at baseline and at 1 and 3 months after starting treatment with Sativex. Sativex provided relief of MS-related spasticity in the majority of patients who were previously resistant to treatment. In addition, clear improvements were noted in MS spasticity-associated symptoms (e.g., sleep quality, bladder function and mobility), activities of daily living and QoL. Sativex was generally well tolerated. The majority of patients (84%) reported no adverse events, and there was only a limited risk of serious adverse reactions. Furthermore, based on data from Sativex clinical trials, a Markov model-based analysis has shown that Sativex is a cost-effective treatment option for patients with MS spasticity in Germany. PMID:23369055

  2. Influence of Botulinum Toxin Therapy on Postural Control and Lower Limb Intersegmental Coordination in Children with Spastic Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Bernard Dan

    2013-01-01

    Full Text Available Botulinum toxin injections may significantly improve lower limb kinematics in gait of children with spastic forms of cerebral palsy. Here we aimed to analyze the effect of lower limb botulinum toxin injections on trunk postural control and lower limb intralimb (intersegmental coordination in children with spastic diplegia or spastic hemiplegia (GMFCS I or II. We recorded tridimensional trunk kinematics and thigh, shank and foot elevation angles in fourteen 3–12 year-old children with spastic diplegia and 14 with spastic hemiplegia while walking either barefoot or with ankle-foot orthoses (AFO before and after botulinum toxin infiltration according to a management protocol. We found significantly greater trunk excursions in the transverse plane (barefoot condition and in the frontal plane (AFO condition. Intralimb coordination showed significant differences only in the barefoot condition, suggesting that reducing the degrees of freedom may limit the emergence of selective coordination. Minimal relative phase analysis showed differences between the groups (diplegia and hemiplegia but there were no significant alterations unless the children wore AFO. We conclude that botulinum toxin injection in lower limb spastic muscles leads to changes in motor planning, including through interference with trunk stability, but a combination of therapies (orthoses and physical therapy is needed in order to learn new motor strategies.

  3. Botulinum toxin injection improved voluntary motor control in selected patients with post-stroke spasticity

    Institute of Scientific and Technical Information of China (English)

    Shuo-Hsiu Chang; Gerald E Francisco; Sheng Li

    2012-01-01

    The effect of botulinum toxin type A injection on voluntary grip control was examined in a 53-year-old female, who sustained a hemorrhagic right middle cerebral artery stroke 3 years previously, which resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injection each to the motor points (2 sites/muscle) of the left flexor digitorum superficialis and flexor digitorum profundus, respectively. Botulinum toxin injection led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor electromyography activity, and improved release time likely correlated with blocked co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

  4. Laser acupuncture as an adjunctive therapy for spastic cerebral palsy in children.

    Science.gov (United States)

    Dabbous, Ola A; Mostafa, Yousry M; El Noamany, Hossam A; El Shennawy, Shrouk A; El Bagoury, Mohammed A

    2016-08-01

    Laser acupuncture is widely used as an alternative line of treatment in several chronic pediatric diseases. To investigate whether biostimulation by low-level laser on acupuncture points adds a clinical benefit to conventional physiotherapy in hemiplegic spastic cerebral palsy (CP) children. Forty spastic hemiplegic cerebral palsy children by age 1-4 years were chosen from the pediatric outpatient clinic of the National Institute of Laser Enhanced Sciences (NILES), Cairo University, and Menofyia University hospitals. They were randomly divided into control and study groups; 20 children each. Both groups received physiotherapy for 3 months, while only the study group also received laser acupuncture (low-level laser 650 nm with 50 mW power was applied at each acupoint for 30 s giving an energy density of 1.8 J/cm(2)). Preassessment and postassessment of muscle tone, the range of motion (ROM), and gross motor function measurements (GMFMs) were obtained, and the results were statistically analyzed. Comparison between posttreatment measures for the control vs. study groups showed significant difference in muscle tone (wrist flexors and plantar flexors) in favor of the study group, while range of motion showed no significant differences. GMFM showed no significant difference in total score while there was a significant difference in goal total score (sum of % scores for each dimension identified as goal area divided by number of goal areas) in favor of the study group. Laser acupuncture has a beneficial effect on reducing spasticity in spastic cerebral palsy and may be helpful in improving their movement. PMID:27147077

  5. Pain treatment with ziconotide and baclofen in a case of spasticity associated with neuropathic pain

    OpenAIRE

    Danilo G. Quarta; Allegra Cionini Ciardi; Daniela Clerici; Patrizia Spina; Luigi Parigi

    2009-01-01

    This study presents the clinical case of a patient with paraparesis, subjected for a long period of time to treatment with intrathecal baclofen and morphine to control spasticity and neuropathic pain, resulting from spinal cord injury due to road trauma. After several years of treatment the pain was not controlled with high doses of intrathecal morphine combined with transmucosal fentanyl that were given when needed. It was therefore decided to switch to intrathecal ziconotide. Starting with ...

  6. Cost analysis of the treatment of severe spinal spasticity with a continuous intrathecal baclofen infusion system

    OpenAIRE

    Postma, TJBM; Oenema, D.; Terpstra, S.; Bouma, J; Kuipers-Upmeijer, H; Staal, MJ; Middel, BJ

    1999-01-01

    Objective: The purpose of our study was to analyse and evaluate the costs of continuous intrathecal baclofen administration as a modality in the treatment of severe spasticity in the Netherlands. Design: A cost analysis was conducted as part of a prospective, multicentre, multidisciplinary, randomised and placebo-controlled clinical trial. The study covered the period from December 1991 to September 1995. The data on medical consumption and costs were collected over a 3-year period from diffe...

  7. Surgical Correction of Scoliosis in Children with Spastic Quadriplegia: Benefits, Adverse Effects, and Patient Selection

    OpenAIRE

    Legg, Julian; Davies, Evan; Raich, Annie L.; Dettori, Joseph R.; Sherry, Ned

    2014-01-01

    Study Rationale Cerebral palsy (CP) is a group of nonprogressive syndromes of posture and motor impairment associated with lesions of the immature brain. Spastic quadriplegia is the most severe form with a high incidence of scoliosis, back pain, respiratory compromise, pelvic obliquity, and poor sitting balance. Surgical stabilization of the spine is an effective technique for correcting deformity and restoring sitting posture. The decision to operate in this group of patients is challenging....

  8. Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review

    OpenAIRE

    Rowland Marie; Lakhan Shaheen E

    2009-01-01

    Abstract Background Cannabis therapy has been considered an effective treatment for spasticity, although clinical reports of symptom reduction in multiple sclerosis (MS) describe mixed outcomes. Recently introduced therapies of combined Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) extracts have potential for symptom relief with the possibility of reducing intoxication and other side effects. Although several past reviews have suggested that cannabinoid therapy provides a therapeutic be...

  9. Influence of dance therapy on the functional mobility of children with spastic hemiparetic cerebral palsy

    OpenAIRE

    D.C. Garção

    2011-01-01

    The aim of this study was to investigate the influence of dance therapy on the functional mobility of children with spastic hemiparetic cerebral palsy. Ten female children (mean age 7.2 ± 1.2 years) diagnosed with cerebral palsy were included. In order to evaluate their functional mobility, standing (D) and walking, running and jumping (E) dimensions from GMFM were applied, and measurements were carried out in two phases: 1) control, six weeks without any motor intervention, and 2) activity, ...

  10. Effect of intrathecal baclofen on gait control in human hereditary spastic paraparesis.

    OpenAIRE

    Dan, Bernard; Bouillot, Ethel; Bengoetxea, Ana; Chéron, Guy

    2000-01-01

    The covariation between thigh, shank and foot elevation angles during locomotion was analysed by means of orthogonal planar regression in a patient with pure hereditary spastic paraparesis before and after an intrathecal bolus of baclofen and in seven healthy subjects. The size, shape and spatial orientation of the loop defining patient's planar covariation (thigh angle vs. shank angle vs. foot angle) significantly differed from the controls' before baclofen, whereas these features resumed no...

  11. Management of severe spasticity with intrathecal baclofen delivered by a manually operated pump.

    OpenAIRE

    Patterson, V; Watt, M.; Byrnes, D; Crowe, D; Lee, A.

    1994-01-01

    Intrathecal baclofen abolishes spasticity in many patients with neurological diseases but there are few studies on its long-term effectiveness. Since 1986 a manually operated subcutaneous pump has been used to deliver baclofen intrathecally in 21 patients with a follow up of at least one year. Most patients had multiple sclerosis and all were wheelchair-bound. Sixteen patients had a complete and sustained benefit. In four other patients the treatment was effective in the short term but not in...

  12. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    OpenAIRE

    Cristina Castro-Fernández; Manuel Arias; Patricia Blanco-Arias; Luis Santomé-Collazo; Jorge Amigo; Ángel Carracedo; Maria-Jesús Sobrido

    2015-01-01

    Next generation sequencing (NGS) is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this...

  13. [Tropical spastic paraparesis in the tropics and Brazil. A historical analysis].

    Science.gov (United States)

    de Castro-Costa, C M; Carton, H; Goubau, P; de Figueiredo, E G; Giffoni, S D

    1994-03-01

    The tropical spastic paraparesis (TSP) is a chronic myelopathy, predominant in the tropics, recently known to be of retroviral origin (HTLV-I). This paper aims at delineating the clinico-etiological evolution of this entity. The historical analysis of it showed that the TSP has had, along decades, many different denominations and the discovery of the retroviral origin for some of them has stimulated new paths of research and epidemiological interest in the tropics and Brazil. PMID:8002798

  14. Lumbar Epidural Steroid Injection for Painful Spasticity in Cervical Spinal Cord Injury: A Case Report

    OpenAIRE

    Bang, Hyun; Chun, Seong Min; Park, Hee Won; Bang, Moon Suk; Kim, Keewon

    2015-01-01

    We report a case of a 53-year-old male with traumatic cervical spinal cord injury (SCI). He could not maintain a standing position because of painful spasticity in his lower limbs. A magnetic resonance imaging and electromyography indicated chronic lumbosacral radiculopathy, explaining his chronic low back pain before the injury. For diagnostic as well as therapeutic purposes, transforaminal epidural steroid injection (ESI) to the right L5 root was performed. After the intervention, the spast...

  15. Contribution of thixotropy, spasticity, and contracture to ankle stiffness after stroke

    OpenAIRE

    Vattanasilp, W.; Ada, L.; Crosbie, J.

    2000-01-01

    OBJECTIVES—Increased resistance to stretch of muscles after stroke may be the result of centrally mediated neural factors such as spasticity or local, peripheral factors such as muscle contracture or thixotropy. The aim was to investigate evidence for an abnormal thixotropic response and compare this with two other factors—contracture and spasticity—which could potentially contribute to muscle stiffness after stroke.
METHODS—Thirty patients with stroke whose calf muscles ...

  16. Functional Stretching Exercise Submitted for Spastic Diplegic Children: A Randomized Control Study

    OpenAIRE

    Mohamed Ali Elshafey; Adel Abd-Elaziem; Rana Elmarzouki Gouda

    2014-01-01

    Objective. Studying the effect of the functional stretching exercise in diplegic children. Design. Children were randomly assigned into two matched groups. Setting. Outpatient Clinic of the Faculty of Physical Therapy, Cairo University. Participants. Thirty ambulant spastic diplegic children, ranging in age from five to eight years, participated in this study. Interventions. The control group received physical therapy program with traditional passive stretching exercises. The study group rece...

  17. Correlation of knee proprioception with muscle strength and spasticity in stroke patients

    OpenAIRE

    Yang, Jin-Mo; Kim, Suhn-yeop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the relationship of knee proprioception with muscle strength and spasticity in stroke patients. [Subjects and Methods] The subjects were 31 stroke patients. The subjects received an explanation of the procedures and methods and provided informed consent before the experiment. A measurement board was used to determine the the proprioception deficit of the knee as a proprioception test. The proprioception test consisted of a passive and act...

  18. Lower limb spasticity assessment using an inertial sensor: a reliability study

    International Nuclear Information System (INIS)

    Spasticity is a common motor impairment in patients with neurological disorders that can prevent functional recovery after rehabilitation. In the clinical setting, its assessment is carried out using standardized clinical scales. The aim of this study was to verify the applicability of inertial sensors for an objective measurement of quadriceps spasticity and evaluate its test–retest and inter-rater reliability during the implementation of the Wartenberg pendulum test. Ten healthy subjects and 11 patients in vegetative state with severe brain damage were enrolled in this study. Subjects were evaluated three times on three consecutive days. The test–retest reliability of measurement was assessed in the first two days. The third day was devoted to inter-rater reliability assessment. In addition, the lower limb muscle tone was bilaterally evaluated at the knee joint by the modified Ashworth scale. The factorial ANOVA analysis showed that the implemented method allowed us to discriminate between healthy and pathological conditions. The fairly low SEM and high ICC values obtained for the pendulum parameters indicated a good test–retest and inter-rater reliability of measurement. This study shows that an inertial sensor can be reliably used to characterize leg kinematics during the Wartenberg pendulum test and provide quantitative evaluation of quadriceps spasticity. (paper)

  19. New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids

    Directory of Open Access Journals (Sweden)

    Paul F Smith

    2010-02-01

    Full Text Available Paul F SmithDepartment of Pharmacology and Toxicology, School of Medical Sciences, University of Otago, Dunedin, New ZealandAbstract: Cannabinoids such as Cannabis-based medicinal extracts (CBMEs are increasingly being used in the treatment of spasticity associated with multiple sclerosis (MS. They have been shown to have a beneficial effect on spasticity; however, this evidence is largely based on subjective rating scales. Objective measurements using the Ashworth scale have tended to show no significant effect; however, the validity of this scale has been questioned. The available clinical trial data suggest that the adverse side effects associated with using CBMEs are generally mild, such as dry mouth, dizziness, somnolence, nausea and intoxication. However, most of these trials were run over a period of months and it is possible that other adverse side effects could develop with long-term use. There may be reason to be concerned about the use of therapeutic cannabinoids by adolescents, people predisposed to psychosis and pregnant women.Keywords: multiple sclerosis, spasticity, cannabinoids, Cannabis

  20. Establishing a rat model of spastic cerebral palsy by targeted ethanol injection

    Institute of Scientific and Technical Information of China (English)

    Yadong Yu; Liang Li; Xinzhong Shao; Fangtao Tian; Qinglu Sun

    2013-01-01

    Spastic cerebral palsy is general y considered to result from cerebral cortical or pyramidal tract damage. Here, we precisely targeted the left pyramidal tract of 2-month-old Sprague-Dawley rats placed on a stereotaxic instrument under intraperitoneal anesthesia. Based on the rat brain ste-reotaxic map, a 1-mm hole was made 10 mm posterior to bregma and 0.8 mm left of sagittal suture. A microsyringe was inserted perpendicularly to the surface of the brain to a depth of 9.7 mm, and 15μL of ethanol was slowly injected to establish a rat model of spastic cerebral palsy. After modeling, the rats appeared to have necrotic voids in the pyramidal tract and exhibited typical signs and symptoms of flexion spasms that lasted for a long period of time. These findings indicate that this is an effective and easy method of establishing a rat model of spastic cerebral palsy with good re-producibility. Ethanol as a chemical ablation agent specifical y and thoroughly damages the pyra-midal tract, and therefore, the animals display flexion spasms, which are a typical symptom of the disease.

  1. Spinal cord magnetic resonance imaging in autosomal dominant hereditary spastic paraplegia

    International Nuclear Information System (INIS)

    Hereditary spastic paraplegia (HSP) is a genetically heterogeneous group of neurodegenerative disorders characterized by progressive lower extremity weakness and spasticity. HSP pathology involves axonal degeneration that is most pronounced in the terminal segments of the longest descending (pyramidal) and ascending (dorsal columns) tracts. In this study, we compared spinal cord magnetic resonance imaging (MRI) in 13 HSP patients with four different types of autosomal dominant hereditary spastic paraplegia (SPG3A, SPG4, SPG6, and SPG8) with age-matched control subjects. The cross-section area of HSP subjects at cervical level C2 was 59.42±12.57 mm2 and at thoracic level T9 was 28.58±5.25 mm2. Both of these values were less than in the healthy controls (p2 at C2, 21.40±2.4 mm2 at T9) than in subjects with SPG3 and SPG4 (66.0±8.94 mm2 at C2, p2 at T9, p<0.001). These observations indicate that spinal cord atrophy is a common finding in the four genetic types of HSP. Spinal cord atrophy was more severe in SPG6 and SPG8 HSP subjects than in other types of HSP we studied. This may suggest a different disease mechanism with more prominent axonal degeneration in these two types of HSP when compared with HSP due to spastin and atlastin mutations. (orig.)

  2. Effects of vojta therapy on gait of children with spastic diplegia.

    Science.gov (United States)

    Lim, Hyungwon; Kim, Tackhoon

    2013-12-01

    [Purpose] This study aimed to investigate the effects of Vojta therapy on spatiotemporal gait parameters in children with spastic diplegia. [Methods] The study population consisted of 3 children diagnosed with spastic diplegia. The subjects were treated with Vojta therapy for 8 weeks and followed up for 8 weeks after completion of the therapy. Vicon motion analysis was used to determine the subjects' spatiotemporal gait parameters. [Results] The following results were noted in the changes of each joint angle in the sagittal plane after Vojta therapy. Subject 1 remained in phase throughout the entire gait cycle and did not show any noticeable improvement, even demonstrating a negative range of motion when compared to the baseline. Subject 2 showed a normal anti-phase in heel strike, and the mid-stance, and swing phases. Subject 3 showed a normal anti-phase in heel strike and mid-stance, but the anti-phase during the swing phase was not significantly different from the baseline. For subjects 2 and 3, compared to the baseline, the range of motion of the hip and knee increased but the range of motion of the ankle decreased. [Conclusion] The findings of this study indicate that Vojta therapy can do a good role in improve the spatiotemporal gait parameters of children with spastic diplegia. PMID:24409030

  3. Pseudoelastic Nitinol-Based Device for Relaxation of Spastic Elbow in Stroke Patients

    Science.gov (United States)

    Viscuso, S.; Pittaccio, S.; Caimmi, M.; Gasperini, G.; Pirovano, S.; Villa, E.; Besseghini, S.; Molteni, F.

    2009-08-01

    A compliant brace (EDGES) promoting spastic elbow relaxation was designed to investigate the potentialities of pseudoelastic NiTi in orthotics. By exploiting its peculiar characteristics, EDGES could improve elbow posture without constraining movements and thus avoiding any pain to the patient. A commercial Ni50.7-Ti49.3 alloy heat treated at 400 °C 1 h + WQ was selected for this application. A prototype of EDGES was assembled with two thermoplastic shells connected by polycentric hinges. Four 2-mm-diameter NiTi bars were encastred in the upper-arm shell and let slide along tubular fixtures on the forearm. Specially designed bending tests demonstrated suitable moment-angle characteristics. Two post-stroke subjects (aged 62 and 64, mild elbow flexors spasticity) wore EDGES for 1 week, at least 10 h a day. No additional treatment was applied during this period or the following week. A great improvement (20° ± 5°) of the resting position was observed in both patients as early as 3 h after starting the treatment. Acceptability was very good. A slight decrease in spasticity was also observed in both subjects. All the effects disappeared 1 week after discontinuation. EDGES appears to be a good alternative to traditional orthoses in terms of acceptability and effectiveness in improving posture, especially whenever short-term splinting is planned.

  4. Emerging treatment options for spasticity in multiple sclerosis – clinical utility of cannabinoids

    Directory of Open Access Journals (Sweden)

    Ashton JC

    2011-06-01

    Full Text Available John C AshtonDepartment of Pharmacology and Toxicology, Otago School of Medical Sciences, University of Otago, Dunedin, New ZealandAbstract: Multiple sclerosis (MS is a widespread and common disabling autoimmune disease of the central nervous system. The main disabling symptom is muscle spasticity, which occurs in most patients. Treatment of spasticity with existing drugs is often poor, and there is a need for new and additional treatments. This article reviews the use of cannabinoids for the treatment of symptoms in MS, focusing on the pharmacology of Δ9-tetrahydrocannabinol (Δ9-THC, cannabidiol and analog drugs in various formulations, the rationale for their use, and their efficacy and safety in the treatment of MS. It is concluded that of all currently available formulations, only sublingual spray containing Δ9-THC has a sufficient evidence base to justify its use in treatment of spasticity and patient quality of life, particularly in patients' refractory to current treatments.Keywords: MS, Δ9-tetrahydrocannabinol, Δ9-THC, cannabis

  5. Effects of interactive games on motor performance in children with spastic cerebral palsy.

    Science.gov (United States)

    AlSaif, Amer A; Alsenany, Samira

    2015-06-01

    [Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Methods] Forty children with cerebral palsy spastic diplegia aged 6-10 years diagnosed with level-3 functional capabilities according to the Gross Motor Classification System (GMFCS) were enrolled. Participants were divided randomly into equal groups: group (A) that practiced with the Nintendo Wii Fit game for at least 20 minutes/day for 12 weeks and group (B) that underwent no training (control group). The Movement Assessment Battery for Children-2 (mABC-2) was used to assess motor performance, because it mainly involves motor tasks very similar to those involved in playing Nintendo Wii Fit games, e.g., goal-directed arm movements, balancing, and jumping. [Results] There were significant improvements in the subscales of the motor performance test of those who practiced with the Nintendo Wii, while the control group showed no significant changes. [Conclusion] Using motion interactive games in home rehabilitation is feasible for children with cerebral palsy. PMID:26180367

  6. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy

    Science.gov (United States)

    Karabicak, Gul Oznur; Balcı, Nilay Comuk; Gulsen, Mustafa; Ozturk, Basar; Cetin, Nuri

    2016-01-01

    [Purpose] The aim of the study was to investigate the relationships between femoral anteversion and functional balance and postural control in children with spastic cerebral palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ± 4.5) with grosss motor functional classification system levels I, II, and III were recruited for this study. Functional balance was evaluated using the Pediatric Balance Scale, postural control was evaluated using the Trunk Control Measurement Scale, and femoral anteversion was assessed with a handheld goniometer using the great trochanter prominence method. [Results] The results indicated that there was significant correlation between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score. There were no significant correlation between femoral anteversion and the Trunk Control Measurement Scale static sitting balance, Trunk Control Measurement Scale selective movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale results. [Conclusion] Increased femoral anteversion has not correlation with functional balance, static sitting, and selective control of the trunk. Femoral anteversion is related to dynamic reaching activities of the trunk, and this may be the result of excessive internal pelvic rotation. It is important for the health professionals to understand that increased femoral anteversion needs to be corrected because in addition to leading to femoral internal rotation during walking, it also effects dynamic reaching activities of spastic children with cerebral palsy. PMID:27390397

  7. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Graham Laura

    2008-10-01

    Full Text Available Abstract Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group or upper limb therapy alone (control group. Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT. Secondary outcomes include: spasticity (Modified Ashworth Scale; grip strength; dexterity (Nine Hole Peg Test; disability (Barthel Activities of Daily Living Index; quality of life (Stroke Impact Scale, Euroqol EQ-5D and attainment of patient-selected goals (Canadian Occupational Performance Measure. Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment

  8. Current situation of clinical research in acupuncture and moxibustion treatment of apoplexy spastic paralysis%针灸治疗中风后痉挛性瘫痪临床研究现状

    Institute of Scientific and Technical Information of China (English)

    罗杨飞; 韩舰华; 徐嘉营

    2013-01-01

    中风痉挛性瘫痪是由于脑卒中(脑梗死或脑出血)导致皮层运动投射区和上运动中枢性瘫神经元径路(皮层脊髓束和皮层脑干束)损害而引起。临床以瘫痪患者的肌肉张力增高、腱反射亢进、浅反射消失为特点。对近5年来针灸治疗中风后痉挛性瘫痪疗效的临床研究文献进行总结。针灸治疗中风后痉挛性瘫痪的治法多样、操作方便、无不良反应,纵观文献,体针、头针、腹针及其他特殊针刺疗法,显示出针灸治疗中风后痉挛性瘫痪具有其独特优势,并已证实有显著的疗效。%Apoplexy spastic paralysis is due to the damage caused by stroke(infarction or cerebral hemorrhage),which induced the impairment in motor cortex projection area and upper motor neuron pathway. Apoplexy spastic paralysis is clinically characterized by increased muscle tone,hyperreflexia and decreased superficial reflex. This study summarized the past five-year-literatures on clinical research of acupuncture treatment for apoplexy spastic paralysis. There are varied methods in the acupuncture treatment of spastic paralysis after stroke. It is easy to operate and no adverse reactions. Throughout the literature,there are body acupuncture,scalp acupuncture,abdominal acupuncture and other special acupuncture. All of these acupuncture therapies show the unique advantages and significant effect on the spastic paralysis after stroke.

  9. Medial gastrocnemius muscle fascicle active torque-length and Achilles tendon properties in young adults with spastic cerebral palsy.

    Science.gov (United States)

    Barber, Lee; Barrett, Rod; Lichtwark, Glen

    2012-10-11

    Individuals with spastic cerebral palsy (CP) typically experience muscle weakness. The mechanisms responsible for muscle weakness in spastic CP are complex and may be influenced by the intrinsic mechanical properties of the muscle and tendon. The purpose of this study was to investigate the medial gastrocnemius (MG) muscle fascicle active torque-length and Achilles tendon properties in young adults with spastic CP. Nine relatively high functioning young adults with spastic CP (GMFCS I, 17±2 years) and 10 typically developing individuals (18±2 years) participated in the study. Active MG torque-length and Achilles tendon properties were assessed under controlled conditions on a dynamometer. EMG was recorded from leg muscles and ultrasound was used to measure MG fascicle length and Achilles tendon length during maximal isometric contractions at five ankle angles throughout the available range of motion and during passive rotations imposed by the dynamometer. Compared to the typically developing group, the spastic CP group had 33% lower active ankle plantarflexion torque across the available range of ankle joint motion, partially explained by 37% smaller MG muscle and 4% greater antagonistic co-contraction. The Achilles tendon slack length was also 10% longer in the spastic CP group. This study confirms young adults with mild spastic CP have altered muscle-tendon mechanical properties. The adaptation of a longer Achilles tendon may facilitate a greater storage and recovery of elastic energy and partially compensate for decreased force and work production by the small muscles of the triceps surae during activities such as locomotion. PMID:22867763

  10. Selection of acupoints for managing upper-extremity spasticity in chronic stroke patients

    Directory of Open Access Journals (Sweden)

    Wang BH

    2014-01-01

    Full Text Available Bi-Huei Wang,1,* Chien-Lin Lin,1,2,* Te-Mao Li,2,3 Shih-Din Lin,3 Jaung-Geng Lin,2 Li-Wei Chou1,2,4 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital; 2School of Chinese Medicine, College of Chinese Medicine; 3Graduate Institute of Acupuncture Science, 4Acupuncture Research Center, China Medical University, Taichung, Taiwan *These authors contributed equally to this work Background: This study investigated the clinical efficacy of electroacupuncture (EA in inhibiting upper-extremity spasticity in chronic stroke patients, and also in mapping a unique preliminary acupoint-selection protocol. Methods: Fifteen patients were divided into two groups: patients in the control group (n=6 received minimal acupuncture (MA, and those in the experimental group (n=9 received EA. Four acupoints, which include Neiguan (PC6, Shaohai (HT3, Zeqian (Ex-UE, A32, and Shounizhu (EX-UE, were treated near the motor points of the muscles for elbow flexion, forearm pronation, and finger flexion. Both groups were treated for twelve sessions, 20 minutes per session, for 6 weeks (two sessions per week. The outcome measures in this study included angle of muscle reaction (R1, passive range of motion (R2, and dynamic component (R2–R1. Results: In the experimental group, the R2–R1 of the elbow joint was significantly decreased at 1 (P=0.0079, 3 (P=0.0013, and 6 weeks (P=0.0149 after treatment compared with pretreatment levels (P<0.05. The between-group difference in the R2–R1 of the elbow joint after the 6-week treatment was statistically significant. Conclusion: Combining the 6-week EA and standard rehabilitation treatment reduced the spasticity of the elbow for chronic stroke survivors. However, no significant effect was observed in the spasticity of the wrist joints. The choice of acupoints and the frequency of EA have to be taken into account to achieve a positive treatment effect. The correlation between acupoints and motor points

  11. Immunogenetics and the Pathological Mechanisms of Human T-Cell Leukemia Virus Type 1- (HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP

    Directory of Open Access Journals (Sweden)

    Mineki Saito

    2010-01-01

    Full Text Available Human T-cell leukemia virus type 1 (HTLV-1 is a replication-competent human retrovirus associated with two distinct types of disease only in a minority of infected individuals: the malignancy known as adult T-cell leukemia (ATL and a chronic inflammatory central nervous system disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP. Although the factors that cause these different manifestations of HTLV-1 infection are not fully understood, accumulating evidence suggests that complex virus-host interactions play an important role in determining the risk of HAM/TSP. This review focuses on the role of the immune response in controlling or limiting viral persistence in HAM/TSP patients, and the reason why some HTLV-1-infected people develop HAM/TSP whereas the majority remains asymptomatic carriers of the virus.

  12. Comparative study of muscular tonus in spastic tetra paretic cerebral palsy in children with predominantly cortical and subcortical lesions in computerized tomography of the skull

    International Nuclear Information System (INIS)

    The objective was to compare distribution and intensity of muscular tonus in spastic tetra paretic cerebral palsy (CP), correlating the clinical data with lesion location in the central nervous system. Twelve children aged two to four years old with predominantly cortical lesions (six children) and subcortical lesions (six children) were included. The tonus was analyzed in the upper (UULL) and lower limbs (LLLL) based on Durigon and Piemonte protocol. The result showed that there was no significant difference regarding tonus intensity and distribution in the UULL and LLLL in both groups. Comparing the upper and lower limbs of subjects in the same group, the LLLL presented more asymmetry and higher tonus intensity than the UULL. It was concluded that in this study children with CP as a result of predominantly cortical or subcortical lesions present a similar deficit in tonus modulation, causing a symmetric and homogeneous distribution of hypertonicity, which is predominant in the LLLL. (author)

  13. Learning in compressed space.

    Science.gov (United States)

    Fabisch, Alexander; Kassahun, Yohannes; Wöhrle, Hendrik; Kirchner, Frank

    2013-06-01

    We examine two methods which are used to deal with complex machine learning problems: compressed sensing and model compression. We discuss both methods in the context of feed-forward artificial neural networks and develop the backpropagation method in compressed parameter space. We further show that compressing the weights of a layer of a multilayer perceptron is equivalent to compressing the input of the layer. Based on this theoretical framework, we will use orthogonal functions and especially random projections for compression and perform experiments in supervised and reinforcement learning to demonstrate that the presented methods reduce training time significantly. PMID:23501172

  14. Insulin growth factors may explain relationship between spasticity and skeletal muscle size in men with spinal cord injury

    Directory of Open Access Journals (Sweden)

    David R. Gater, MD, PhD

    2012-04-01

    Full Text Available The major objectives of this cross-sectional study were to (1 measure insulin-like growth factor-1 (IGF-1 in individuals with complete spinal cord injury (SCI and spasticity and (2 determine the relationships between IGF-1 and cross-sectional areas (CSAs of thigh skeletal muscle groups. Eight individuals with motor complete SCI underwent magnetic resonance imaging to measure the CSA of the whole thigh, knee extensor, and knee flexor skeletal muscle groups and dual-emission X-ray absorptiometry to measure fat-free mass. After participants fasted for 12 h, we measured their IGF-1 levels and determined spasticity using the Modified Ashworth Scale (MAS. Spearman rho correlations were used to test for the relationships among the tested variables, and independent t-tests were used to determine the difference in plasma IGF-1. Plasma IGF-1 was 44% greater in those with MAS scores of 2 or higher (p < 0.05. Plasma IGF-1 was positively related to knee extensor skeletal muscle CSA (r = 0. 83, p < 0.01. IGF-1 was strongly related to knee extensor and flexor spasticity (r = 0.88, p < 0.004. The findings suggest that IGF-1 is greater in SCI individuals with increased spasticity, and this may explain the strong positive relationships that were noted between spasticity and skeletal muscle CSA.

  15. Spinal Cord Kinking in Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

    Institute of Scientific and Technical Information of China (English)

    Ting Wang; Min Pan; Chu-Qiang Yin; Xiu-Jun Zheng; Ya-Nan Cong; De-Chun Wang; Shu-Zhong Li

    2015-01-01

    Background:Ossification of the ligamentum flavum (OLF) is being increasingly recognized as a cause of thoracic myelopathy.This study was to describe a rare clinical entity of spinal cord kinking (SK) in thoracic myelopathy secondary to OLF.Methods:The data of 95 patients with thoracic myelopathy secondary to OLF were analyzed retrospectively.The incidence and location of SK were determined using preoperative magnetic resonance imaging (MRI).The clinical presentation and radiological characteristics in patients with SK were analyzed.Posterior en bloc laminectomy with OLF was performed,and the surgical results were evaluated.Results:SK was found in seven patients (7.4%) based on preoperative MRI.The patients included one male and six females with an average age of 55.6 years (range,48-64 years).Five patients presented with radiculomyelopathy and two presented with typical thoracic myelopathy of spastic paraparesis.In all cases,the kinking was located just above the end of the spinal cord where the conus medullaris (CM) was compressed by the OLF.The degree of SK varied from mild to severe.The tip of the CM was located between the upper third of T1 1 to the lower third of L 1,above the lower edge of L 1.With an average follow-up of 30.4 months,the modified Japanese Orthopedic Association score significantly improved from 5.7 ± 1.8 preoperatively to 8.9 ± 1.4 postoperatively (t =12.05;P < 0.0001) with an improvement rate of 63.1 ± 12.3%.Conclusions:SK is a rare radiological phenomenon.It is typically located at the thoracolumbar junction,where the CM is compressed by the OLF.Our findings indicate that these patients may benefit from a posterior decompressive procedure.

  16. A Compressive Superresolution Display

    KAUST Repository

    Heide, Felix

    2014-06-22

    In this paper, we introduce a new compressive display architecture for superresolution image presentation that exploits co-design of the optical device configuration and compressive computation. Our display allows for superresolution, HDR, or glasses-free 3D presentation.

  17. Compressing Binary Decision Diagrams

    CERN Document Server

    Hansen, Esben Rune; Tiedemann, Peter

    2008-01-01

    The paper introduces a new technique for compressing Binary Decision Diagrams in those cases where random access is not required. Using this technique, compression and decompression can be done in linear time in the size of the BDD and compression will in many cases reduce the size of the BDD to 1-2 bits per node. Empirical results for our compression technique are presented, including comparisons with previously introduced techniques, showing that the new technique dominate on all tested instances.

  18. Microbunching and RF Compression

    International Nuclear Information System (INIS)

    Velocity bunching (or RF compression) represents a promising technique complementary to magnetic compression to achieve the high peak current required in the linac drivers for FELs. Here we report on recent progress aimed at characterizing the RF compression from the point of view of the microbunching instability. We emphasize the development of a linear theory for the gain function of the instability and its validation against macroparticle simulations that represents a useful tool in the evaluation of the compression schemes for FEL sources.

  19. Hyperspectral data compression

    CERN Document Server

    Motta, Giovanni; Storer, James A

    2006-01-01

    Provides a survey of results in the field of compression of remote sensed 3D data, with a particular interest in hyperspectral imagery. This work covers topics such as compression architecture, lossless compression, lossy techniques, and more. It also describes a lossless algorithm based on vector quantization.

  20. Compressing Binary Decision Diagrams

    DEFF Research Database (Denmark)

    Hansen, Esben Rune; Satti, Srinivasa Rao; Tiedemann, Peter

    The paper introduces a new technique for compressing Binary Decision Diagrams in those cases where random access is not required. Using this technique, compression and decompression can be done in linear time in the size of the BDD and compression will in many cases reduce the size of the BDD to 1...

  1. Compressible turbulent mixing: Effects of compressibility

    Science.gov (United States)

    Ni, Qionglin

    2016-04-01

    We studied by numerical simulations the effects of compressibility on passive scalar transport in stationary compressible turbulence. The turbulent Mach number varied from zero to unity. The difference in driven forcing was the magnitude ratio of compressive to solenoidal modes. In the inertial range, the scalar spectrum followed the k-5 /3 scaling and suffered negligible influence from the compressibility. The growth of the Mach number showed (1) a first reduction and second enhancement in the transfer of scalar flux; (2) an increase in the skewness and flatness of the scalar derivative and a decrease in the mixed skewness and flatness of the velocity-scalar derivatives; (3) a first stronger and second weaker intermittency of scalar relative to that of velocity; and (4) an increase in the intermittency parameter which measures the intermittency of scalar in the dissipative range. Furthermore, the growth of the compressive mode of forcing indicated (1) a decrease in the intermittency parameter and (2) less efficiency in enhancing scalar mixing. The visualization of scalar dissipation showed that, in the solenoidal-forced flow, the field was filled with the small-scale, highly convoluted structures, while in the compressive-forced flow, the field was exhibited as the regions dominated by the large-scale motions of rarefaction and compression.

  2. Impact of Sativex(®) on quality of life and activities of daily living in patients with multiple sclerosis spasticity.

    Science.gov (United States)

    Arroyo, Rafael; Vila, Carlos; Dechant, Kerry L

    2014-07-01

    In individuals with multiple sclerosis (MS) spasticity, associated symptoms such as spasms, pain, mobility restrictions and sleep disturbances can interfere with the ability to perform activities of daily living and reduce quality of life (QoL). Recent cross-sectional studies from Europe have confirmed that advancing severity of MS spasticity correlates directly with worsening QoL. The treatment effect of Sativex(®) (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain) on QoL has been evaluated in randomized controlled trials, observational studies conducted under everyday clinical practice conditions and a survey in long-term users. Symptomatic relief of MS spasticity in responders to Sativex was associated with quantifiable improvements in QoL and activities of daily living that were maintained over time. Benefits were perceived by both patients and caregivers. PMID:25275238

  3. Hereditary spastic paraplegia with cerebellar ataxia: a complex phenotype associated with a new SPG4 gene mutation

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Erik; Johnson, B; Koefoed, Pernille;

    2004-01-01

    identified in those individuals who were clinically affected by a complex phenotype consisting of HSP and cerebellar ataxia. Other features noted in this kindred including epilepsy, cognitive impairment, depression, and migraine did not segregate with the HSP phenotype or mutation, and therefore the...... significantly relatively decreased regional cerebral blood flow in most of the cerebellum. We conclude that this kindred demonstrates a considerable overlap between cerebellar ataxia and spastic paraplegia, emphasizing the marked clinical heterogeneity of HSP associated with spastin mutations......Complex forms of hereditary spastic paraplegia (HSP) are rare and usually transmitted in an autosomal recessive pattern. A family of four generations with autosomal dominant hereditary spastic paraplegia (AD-HSP) and a complex phenotype with variably expressed co-existing ataxia, dysarthria...

  4. Management of spastic cerebral palsy through multiple Ayurveda treatment modalities

    OpenAIRE

    Bhinde, Sagar M.; Patel, Kalpana S.; Kori, Virendra Kumar; Rajagopala, S.

    2014-01-01

    Background: Cerebral palsy (CP) is a leading cause of childhood disability affecting function and development. The global incidence of CP is 2:1000. It has been reported that children with CP and their caretaker have impaired health-related quality of life (QOL). Of the many types and subtypes of CP, none has any known cure. For a detailed description of the disease CP, though, there is no one to one correlation in Ayurvedic classics; it can be taken as Vata Vyadhi as far as its etiology and ...

  5. Gray and white matter alterations in hereditary spastic paraplegia type SPG4 and clinical correlations.

    Science.gov (United States)

    Lindig, Tobias; Bender, Benjamin; Hauser, Till-Karsten; Mang, Sarah; Schweikardt, Daniel; Klose, Uwe; Karle, Kathrin N; Schüle, Rebecca; Schöls, Ludger; Rattay, Tim W

    2015-08-01

    Hereditary spastic paraplegias (HSP) are a group of clinically and genetically heterogeneous disorders with the hallmark of progressive spastic gait disturbance. We used advanced neuroimaging to identify brain regions involved in SPG4, the most common HSP genotype. Additionally, we analyzed correlations between imaging and clinical findings. We performed 3T MRI scans including isotropic high-resolution 3D T1, T2-FLAIR, and DTI sequences in 15 adult patients with genetically confirmed SPG4 and 15 age- and sex-matched healthy controls. Brain volume loss of gray and white matter was evaluated through voxel-based morphometry (VBM) for supra- and infratentorial regions separately. DTI maps of axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), fractional anisotropy (FA), and measured anisotropy (MA1) were analyzed through tract-based special statistics (TBSS). VBM and TBSS revealed a widespread affection of gray and white matter in SPG4 including the corpus callosum, medio-dorsal thalamus, parieto-occipital regions, upper brainstem, cerebellum, and corticospinal tract. Significant correlations with correlation coefficients r > 0.6 between clinical data and DTI findings could be demonstrated for disease duration and disease severity as assessed by the spastic paraplegia rating scale for the pontine crossing tract (AD) and the corpus callosum (RD and FA). Imaging also provided evidence that SPG4 underlies a primarily axonal rather than demyelinating damage in accordance with post-mortem data. DTI is an attractive tool to assess subclinical affection in SPG4. The correlation of imaging findings with disease duration and severity suggests AD, RD, and FA as potential progression markers in interventional studies. PMID:26050637

  6. Spinal cord magnetic resonance imaging in autosomal dominant hereditary spastic paraplegia

    Energy Technology Data Exchange (ETDEWEB)

    Hedera, P. [University of Michigan, Department of Neurology, Ann Arbor, MI (United States); Vanderbilt University, Department of Neurology, Nashville, TN (United States); Eldevik, O.P.; Maly, P. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Rainier, S. [University of Michigan, Department of Neurology, Ann Arbor, MI (United States); Fink, J.K. [University of Michigan, Department of Neurology, Ann Arbor, MI (United States); Ann Arbor Veterans Affairs Medical Center, Geriatric Research Education and Clinical Center, Ann Arbor, MI (United States)

    2005-10-01

    Hereditary spastic paraplegia (HSP) is a genetically heterogeneous group of neurodegenerative disorders characterized by progressive lower extremity weakness and spasticity. HSP pathology involves axonal degeneration that is most pronounced in the terminal segments of the longest descending (pyramidal) and ascending (dorsal columns) tracts. In this study, we compared spinal cord magnetic resonance imaging (MRI) in 13 HSP patients with four different types of autosomal dominant hereditary spastic paraplegia (SPG3A, SPG4, SPG6, and SPG8) with age-matched control subjects. The cross-section area of HSP subjects at cervical level C2 was 59.42{+-}12.57 mm{sup 2} and at thoracic level T9 was 28.58{+-}5.25 mm{sup 2}. Both of these values were less than in the healthy controls (p<0.001). The degree of cord atrophy was more prominent in patients with SPG6 and SPG8 who had signs of severe cord atrophy (47.60{+-}6.58 mm{sup 2} at C2, 21.40{+-}2.4 mm{sup 2} at T9) than in subjects with SPG3 and SPG4 (66.0{+-}8.94 mm{sup 2} at C2, p<0.02; 31.75{+-}2.76 mm{sup 2} at T9, p<0.001). These observations indicate that spinal cord atrophy is a common finding in the four genetic types of HSP. Spinal cord atrophy was more severe in SPG6 and SPG8 HSP subjects than in other types of HSP we studied. This may suggest a different disease mechanism with more prominent axonal degeneration in these two types of HSP when compared with HSP due to spastin and atlastin mutations. (orig.)

  7. Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

    Science.gov (United States)

    Li, Tsung-Ying; Chang, Chih-Ya; Chou, Yu-Ching; Chen, Liang-Cheng; Chu, Heng-Yi; Chiang, Shang-Lin; Chang, Shin-Tsu; Wu, Yung-Tsan

    2016-01-01

    Abstract Recently, studies have reported that extracorporeal shock wave therapy (ESWT) is a safe, noninvasive, alternative treatment for spasticity. However, the effect of ESWT on spasticity cannot be determined, because most studies to date have enrolled small patient numbers and have lacked placebo-controlled groups and/or long-term follow-up. In addition, whether varying the number of ESWT sessions would affect the duration of the therapeutic effect has not been investigated in a single study. Hence, we performed a prospective, randomized, single blind, placebo-controlled study to investigate the long-term effect of radial ESWT (rESWT) in patients with poststroke spasticity and surveyed the outcome of functional activity. Sixty patients were randomized into 3 groups. Group A patients received 1 session of rESWT per week for 3 consecutive weeks; group B patients received a single session of rESWT; group C patients received one session of sham rESWT per week for 3 consecutive weeks. The primary outcome was Modified Ashworth Scale of hand and wrist, whereas the secondary outcomes were Fugl-Meyer Assessment of hand function and wrist control. Evaluations were performed before the first rESWT treatment and immediately 1, 4, 8, 12, and 16 weeks after the last session of rESWT. Compared to the control group, the significant reduction in spasticity of hand and wrist lasted at least 16 and 8 weeks in group A and B, respectively. Three sessions of rESWT had a longer-lasting effect than one session. Furthermore, the reduction in spasticity after 3 sessions of rESWT may be beneficial for hand function and wrist control and the effect was maintained for 16 and 12 weeks, respectively. rESWT may be valuable in decreasing spasticity of the hand and wrist with accompanying enhancement of wrist control and hand function in chronic stroke patients. PMID:27149465

  8. Cervical vestibular evoked myogenic potentials in children with spastic cerebral palsy and normal children with 7-12 years of age

    Directory of Open Access Journals (Sweden)

    Nazila Akbarfahimi

    2014-10-01

    Full Text Available Background and Aim: Cervical vestibular-evoked myogenic potential (cVEMP is one of the diagnostic tests used in assessing vestibular function. Two aims of this study were to investigate implications of cervical vestibular evoked myogenic potential in children with spastic cerebral palsy (7-12 years, and to compare vestibular function in these children and normal children.Methods: In this cross-sectional study, myogenic potential was recorded in 31 children with spastic cerebral palsy (8 girls, 23 boys,7-12 years of age, with mean age of 8.77 years old and standard deviation of 1.52 years and 31 normal children (13 girls, 18 boys with mean age of 8.77 years and standard deviation of 1.52 years. Cervical vestibular evoked myogenic potential was recorded with 500 Hz tone burst. The recorded parameters included p13 and n23 latency, p13-n23 pick to pick amplitude, and threshold.Results: Myogenic Potential was recorded in 31 normal children. They had bilateral responses. In children with cerebral palsy, 21 children showed bilateral responses, 3 children had only right-sided responses, 8 children had only left-sided responses, and two children did not show any responses. The statistical significant differences were shown between the two groups in n23, p13-n23 pick to pick amplitude, and threshold (p<0.05.Conclusion: These findings showed that cervical vestibular evoked myogenic potential can be used in children with cerebral palsy. There were significant differences in myogenic potential parameters between the two groups. More studies are needed to investigate the causes of these differences.

  9. Similar barriers and facilitators to physical activity across different clinical groups experiencing lower limb spasticity.

    Science.gov (United States)

    Hundza, Sandra; Quartly, Caroline; Kim, Jasmine M; Dunnett, James; Dobrinsky, Jill; Loots, Iris; Choy, Kim; Chow, Brayley; Hampshire, Alexis; Temple, Viviene A

    2016-07-01

    Purpose Given the importance of physical activity in maintaining health and wellness, an improved understanding of physical activity patterns across different clinical populations is required. This study examines the facilitators for, and barriers to, participation in physical activity across multiple contexts for three clinical groups with chronic lower limb spasticity (individuals with stroke, multiple sclerosis and incomplete spinal cord injury). Method This cross-sectional study employed quantitative measures for spasticity, ankle range of motion, pain, falls, cognition, mobility, and physical activity as well as qualitative semi-structured interviews. Results There were similar impairments in body functions and structures and limitations in activities across the clinical groups. These impairments and limitations negatively impacted participation in physical activity, which was low. Environmental and personal factors exacerbated or mitigated the limiting effects of body functions and structures and activities on physical activity in many areas of life. Conclusions In this population, participation in physical activity includes activities such as housework which are different than what is typically considered as physical activity. Further, the presence of similar barriers and facilitators across the groups suggests that support and services to promote valued forms of physical activity could be organised and delivered based on limitations in mobility and functioning rather than clinical diagnosis. Implications for rehabilitation Physical activity is of utmost importance in maintaining health and wellness in clinical populations. This research highlights the desired and actual physical activity for these populations can look different than what may traditionally be considered as physical activity (e.g. housework is not typically considered participation physical activity). Therefore, rehabilitation interventions need to be directly designed to enhance clients

  10. Brain State Before Error Making in Young Patients With Mild Spastic Cerebral Palsy.

    Science.gov (United States)

    Hakkarainen, Elina; Pirilä, Silja; Kaartinen, Jukka; van der Meere, Jaap J

    2015-10-01

    In the present experiment, children with mild spastic cerebral palsy and a control group carried out a memory recognition task. The key question was if errors of the patient group are foreshadowed by attention lapses, by weak motor preparation, or by both. Reaction times together with event-related potentials associated with motor preparation (frontal late contingent negative variation), attention (parietal P300), and response evaluation (parietal error-preceding positivity) were investigated in instances where 3 subsequent correct trials preceded an error. The findings indicated that error responses of the patient group are foreshadowed by weak motor preparation in correct trials directly preceding an error. PMID:25762584

  11. The biology that underpins the therapeutic potential of cannabis-based medicines for the control of spasticity in multiple sclerosis.

    Science.gov (United States)

    Baker, David; Pryce, Gareth; Jackson, Samuel J; Bolton, Chris; Giovannoni, Gavin

    2012-04-01

    Cannabis-based medicines have recently been approved for the treatment of pain and spasticity in multiple sclerosis (MS). This supports the original perceptions of people with MS, who were using illegal street cannabis for symptom control and pre-clinical testing in animal models of MS. This activity is supported both by the biology of the disease and the biology of the cannabis plant and the endocannabinoid system. MS results from disease that impairs neurotransmission and this is controlled by cannabinoid receptors and endogenous cannabinoid ligands. This can limit spasticity and may also influence the processes that drive the accumulation of progressive disability. PMID:25876933

  12. Compression of the Deep Palmar Branch of the Ulnar Nerve by a Ganglion: A Case Report

    OpenAIRE

    Duggal, A; Anastakis, D. J.; Salonen, D.; Becker, E.

    2006-01-01

    A ganglion originating from the pisotriquetral joint is the most common cause of distal ulnar nerve compression. Midpalmar ganglions causing ulnar nerve compression are rare. This case describes a ganglion arising from the third carpometacarpal joint causing compression of the deep motor branch of the ulnar nerve.

  13. Tree compression with top trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Landau, Gad M.;

    2015-01-01

    navigational queries directly on the compressed representation. We show that the new compression scheme achieves close to optimal worst-case compression, can compress exponentially better than DAG compression, is never much worse than DAG compression, and supports navigational queries in logarithmic time....

  14. Tree compression with top trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Landau, Gad M.;

    2013-01-01

    navigational queries directly on the compressed representation. We show that the new compression scheme achieves close to optimal worst-case compression, can compress exponentially better than DAG compression, is never much worse than DAG compression, and supports navigational queries in logarithmic time....

  15. Magnetic resonance imaging of vertebral compression fractures

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) imaging was performed on 112 patients with 210 vertebral compression fractures. Forty fractures were due to malignancy; 170 were caused by benign process. Pathological fractures showed low signal intensity (SI) on T1 weighted image (WI) and various SI on T2 WI. In 39 of the 40 fractures caused by malignancy, MRI showed complete replacement of normal bone marrow. Other findings of pathological fractures, such as involvement of posterior structures, paraspinal soft tissue masses, are useful for discrimination between benign and pathologic compression fractures. In 120 of the 157 fractures caused osteoporosis had complete preservation of normal bone marrow and isointense or high intense marrow SI on T1 WI and T2 WI. Compression fractures caused by trauma showed low SI on T1 WI and high SI on T2 WI with an irregular pattern. We suppose MRI may be a useful modality in differenciating benign and metastatic fractures. (author)

  16. Rapidly deteriorating course in Dutch hereditary spastic paraplegia type 11 patients

    Science.gov (United States)

    de Bot, Susanne T; Burggraaff, Rogier C; Herkert, Johanna C; Schelhaas, Helenius J; Post, Bart; Diekstra, Adinda; van Vliet, Reinout O; van der Knaap, Marjo S; Kamsteeg, Erik-Jan; Scheffer, Hans; van de Warrenburg, Bart P; Verschuuren-Bemelmans, Corien C; Kremer, Hubertus PH

    2013-01-01

    Although SPG11 is the most common complicated hereditary spastic paraplegia, our knowledge of the long-term prognosis and life expectancy is limited. We therefore studied the disease course of all patients with a proven SPG11 mutation as tested in our laboratory, the single Dutch laboratory providing SPG11 mutation analysis, between 1 January 2009 and 1 January 2011. We identified nine different SPG11 mutations, four of which are novel, in nine index patients. Eighteen SPG11 patients from these nine families were studied by means of a retrospective chart analysis and additional interview/examination. Ages at onset were between 4 months and 14 years; 39% started with learning difficulties rather than gait impairment. Brain magnetic resonance imaging showed a thin corpus callosum and typical periventricular white matter changes in the frontal horn region (known as the ‘ears-of the lynx'-sign) in all. Most patients became wheelchair bound after a disease duration of 1 to 2 decades. End-stage disease consisted of loss of spontaneous speech, severe dysphagia, spastic tetraplegia with peripheral nerve involvement and contractures. Several patients died of complications between ages 30 and 48 years, 3–4 decades after onset of gait impairment. Other relevant features during the disease were urinary and fecal incontinence, obesity and psychosis. Our study of 18 Dutch SPG11-patients shows the potential serious long-term consequences of SPG11 including a possibly restricted life span. PMID:23443022

  17. Retinal nerve fibre layer loss in hereditary spastic paraplegias is restricted to complex phenotypes

    Directory of Open Access Journals (Sweden)

    Wiethoff Sarah

    2012-11-01

    Full Text Available Abstract Background Reduction of retinal nerve fibre layer (RNFL thickness was shown as part of the neurodegenerative process in a range of different neurodegenerative pathologies including Alzheimer′s disease (AD, idiopathic Parkinson’s disease (PD, spinocerebellar ataxia (SCA and multiple system atrophy (MSA. To further clarify the specificity of RNFL thinning as a potential marker of neurodegenerative diseases we investigated RNFL thickness in Hereditary Spastic Paraplegia (HSP, an axonal, length-dependent neurodegenerative pathology of the upper motor neurons. Methods Spectral domain optical coherence tomography (OCT was performed in 28 HSP patients (clinically: pure HSP = 22, complicated HSP = 6; genetic subtypes: SPG4 = 13, SPG5 = 1, SPG7 = 3, genetically unclassified: 11 to quantify peripapillary RNFL thickness. Standardized examination assessed duration of disease, dependency on assistive walking aids and severity of symptoms quantified with Spastic Paraplegia Rating Scale (SPRS. Results HSP patients demonstrated no significant thinning of global RNFL (pglobal = 0.61. Subgroup analysis revealed significant reduction in temporal and temporal inferior sectors for patients with complex (p Conclusion Clinically pure HSP patients feature no significant reduction in RNFL, whereas complex phenotypes display an abnormal thinning of temporal and temporal inferior RNFL. Our data indicate that RNFL thinning does not occur unspecifically in all neurodegenerative diseases but is in HSP restricted to subtypes with multisystemic degeneration.

  18. Evaluation on the Therapeutic Effects of Digital Acupoint Pressure for Obstetric Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To probe the evaluation methods for effects of TCM treatment of cerebral palsy through clinical observation on the digital acupoint pressure in treating obstetric spastic cerebral palsy. From 1998-2003,40 cases of spastic cerebral palsy were treated with digital acupoint pressure therapy. Ten indexes including intelligence, language, salivation, hand-grasping, thumb-adduction, turnover, sitting, standing,walking, and scissors-gait were divided into the 4 grades of normal, mild abnormal, moderate abnormal,and severe abnormal (dysfunction), respectively marked as 6, 4, 2, and 0 point, with 2 points increased for improving each grade of each item after the treatment. Meanwhile, the ranges were recorded and evaluated before and after the treatment on shoulder-abduction, elbow-extension, wrist-extension,forearm-backward-rotation, hip-abduction, straight-leg-lifting, knee-extension, and ankle-dorsiflexion.Those with the improvement of 10° , 15° , 20° , 25° , and 30° in the range of movement of their contractured joints would obtain respectively 1, 2, 3, 4, and 5 points. There were significant differences before and after the treatment in the 18 items under observation except for intelligence, with obvious improvement shown after the treatment (P<0.01), the effective rate being 92.5%. The therapeutic criteria set in this research are well established in reflecting the functional improvements of the patient.

  19. Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity

    Directory of Open Access Journals (Sweden)

    Jessica Maria D'Amico

    2014-05-01

    Full Text Available The state of areflexia and muscle weakness that immediately follows a spinal cord injury is gradually replaced by the recovery of neuronal and network excitability, leading to both improvements in residual motor function and the development of spasticity. In this review we summarize recent animal and human studies that describe how motoneurons and their activation by sensory pathways become hyperexcitable to compensate for the reduction of descending and movement-induced sensory inputs and the eventual impact on the muscle. We discuss how replacing lost patterned activation of the spinal cord by activating synaptic inputs via assisted movements, pharmacology or electrical stimulation may help to recover lost spinal inhibition. This may lead to a reduction of uncontrolled activation of the spinal cord and thus, improve its controlled activation by synaptic inputs to ultimately normalize circuit function. Increasing the excitation of the spinal cord below an injury with spared descending and/or peripheral functional synaptic activation, instead of suppressing it pharmacologically, may provide the best avenue to improve residual motor function and manage spasticity after spinal cord injury.

  20. Complicated spastic paraplegia in patients with AP5Z1 mutations (SPG48)

    Science.gov (United States)

    Hirst, Jennifer; Madeo, Marianna; Smets, Katrien; Edgar, James R.; Schols, Ludger; Li, Jun; Yarrow, Anna; Deconinck, Tine; Baets, Jonathan; Van Aken, Elisabeth; De Bleecker, Jan; Datiles, Manuel B.; Roda, Ricardo H.; Liepert, Joachim; Züchner, Stephan; Mariotti, Caterina; De Jonghe, Peter; Blackstone, Craig

    2016-01-01

    Objective: Biallelic mutations in the AP5Z1 gene encoding the AP-5 ζ subunit have been described in a small number of patients with hereditary spastic paraplegia (HSP) (SPG48); we sought to define genotype–phenotype correlations in patients with homozygous or compound heterozygous sequence variants predicted to be deleterious. Methods: We performed clinical, radiologic, and pathologic studies in 6 patients with biallelic mutations in AP5Z1. Results: In 4 of the 6 patients, there was complete loss of AP-5 ζ protein. Clinical features encompassed not only prominent spastic paraparesis but also sensory and motor neuropathy, ataxia, dystonia, myoclonus, and parkinsonism. Skin fibroblasts from affected patients tested positive for periodic acid Schiff and autofluorescent storage material, while electron microscopic analysis demonstrated lamellar storage material consistent with abnormal storage of lysosomal material. Conclusions: Our findings expand the spectrum of AP5Z1-associated neurodegenerative disorders and point to clinical and pathophysiologic overlap between autosomal recessive forms of HSP and lysosomal storage disorders.

  1. PMCA4 (ATP2B4 mutation in familial spastic paraplegia.

    Directory of Open Access Journals (Sweden)

    Miaoxin Li

    Full Text Available Familial spastic paraplegia (FSP is a heterogeneous group of disorders characterized primarily by progressive lower limb spasticity and weakness. More than 50 disease loci have been described with different modes of inheritance. In this study, we identified a novel missense mutation (c.803G>A, p.R268Q in the plasma membrane calcium ATPase (PMCA4, or ATP2B4 gene in a Chinese family with autosomal dominant FSP using whole-exome sequencing and confirmed with Sanger sequencing. This mutation co-segregated with the phenotype in the six family members studied and is predicted to be pathogenic when multiple deleteriousness predictions were combined. This novel R268Q mutation was not present in over 7,000 subjects in public databases, and over 1,000 Han Chinese in our database. Prediction of potential functional consequence of R268Q mutation on PMCA4 by computational modeling revealed that this mutation is located in protein aggregation-prone segment susceptible to protein misfolding. Analysis for thermodynamic protein stability indicated that this mutation destabilizes the PMCA4 protein structure with higher folding free energy. As PMCA4 functions to maintain neuronal calcium homeostasis, our result showed that calcium dysregulation may be associated with the pathogenesis of FSP.

  2. The effect of oral sensorimotor stimulations on feeding performance in children with spastic cerebral palsy.

    Directory of Open Access Journals (Sweden)

    Maryam Kaviyani Baghbadorani

    2014-12-01

    Full Text Available Oral feeding difficulties are common in children with cerebral palsy (CP. The effect of oral-motor dysfunction on feeding problems has been proved in several studies. The purpose of the present study was to evaluate the effect of oral sensorimotor stimulations on feeding performance in children with spastic cerebral palsy. A total of 12 children with spastic cerebral palsy underwent 24 sessions of oral-motor stimulations (3 days per week. The effect of the intervention was assessed after the 12 and 24 sessions. Feeding skills were assessed using Oral Motor Assessment Scale (OMAS. Data were analyzed using Friedman test and intra class correlation coefficient (ICC.  The results of the study revealed a significant improvement in feeding skills including mouth closure, lip closure on the utensil, lip closure during deglutition, control of the food during swallowing, mastication, straw suction and control of liquid during deglutition. There were more improvement in mouth closure and less in straw suction. This study showed sensorimotor stimulation is useful for the treatment of the feeding problems, but the progress was not perfect. This could be due to the role of the position and cognitive skills in feeding functions. Thus, other strategies should be considered to achieve more improvement in feeding performance.

  3. Management of the spastic wrist and hand in cerebral palsy.

    Science.gov (United States)

    Leafblad, Nels D; Van Heest, Ann E

    2015-05-01

    Research from the last 5 years on the pathophysiology and treatment of upper extremity sequelae of cerebral palsy (CP) is presented. The development of new treatments of CP-affected limbs, utilizing the brain's inherent neuroplasticity, remains an area of promising and active research. Functional magnetic resonance imaging scans have evaluated the role of neuroplasticity in adapting to the initial central nervous system insult. Children with CP appear to have greater recruitment of the ipsilateral brain for motor and sensory functions of the affected upper limb. Studies have also shown that constraint-induced movement therapy results in localized increase in gray matter volume of the sensorimotor cortex contralateral to the affected arm targeted during rehabilitation. Recent therapy interventions have emphasized the role of home therapy programs, the transient effects of splinting, and the promise of constraint-induced movement therapy and bimanual hand training. The use of motion laboratory analysis to characterize the movement pattern disturbances in children with CP continues to expand. Classification systems for CP upper limb continue to expand and improve their reliability, including use of the House Classification, the Manual Ability Classification System, and the Shriner's Hospital Upper Extremity Evaluation. Surgical outcomes have greater patients' satisfaction when they address functional limitations, also in addition to aesthetics, which may improve patients' self-esteem. Surgical techniques for elbow, wrist, fingers, and thumb continue to be refined. Research into each of these areas continues to expand our understanding of the nervous system insults that cause CP, how they may be modified, and how hand surgeons can continue to serve patients by improving their upper limb function and aesthetics. PMID:25841769

  4. Spinal marrow compression in Hodgkin's disease

    International Nuclear Information System (INIS)

    Spinal marrow compression caused by tumorous tissue growth in vertebrae, epidural fatty tissue with the involvement of the dura mater encephali was noted in 23 (1.4%) out of 1600 patients with Hodgkin disease. Most patients were subjected to chemo- and radiotherapy. Therapeutic efficacy depended on the duration of the compression syndrome. Prognosis for patients was determined not by the nature of neurological disturbances but by the course of disease

  5. Femoral compressive neuropathy from iliopsoas haematoma complicating dengue hemorrhagic fever

    Institute of Scientific and Technical Information of China (English)

    Sneha Ganu; Yesha Mehta

    2013-01-01

    Dengue fever is a debilitating mosquito-borne disease caused by dengue virus. We reported a case of femoral compression neuropathy due to iliopsoas hematoma complicating dengue hemorrhagic fever. Iliopsoas muscle hematoma can cause femoral neuropathy with resultant pain and paralysis. Such manifestations are not well documented in the literature. The pathogenesis of hematoma and compressive neuropathy with its appropriate management is discussed.

  6. Compressed Sensing in Astronomy

    CERN Document Server

    Bobin, J; Ottensamer, R

    2008-01-01

    Recent advances in signal processing have focused on the use of sparse representations in various applications. A new field of interest based on sparsity has recently emerged: compressed sensing. This theory is a new sampling framework that provides an alternative to the well-known Shannon sampling theory. In this paper we investigate how compressed sensing (CS) can provide new insights into astronomical data compression and more generally how it paves the way for new conceptions in astronomical remote sensing. We first give a brief overview of the compressed sensing theory which provides very simple coding process with low computational cost, thus favoring its use for real-time applications often found on board space mission. We introduce a practical and effective recovery algorithm for decoding compressed data. In astronomy, physical prior information is often crucial for devising effective signal processing methods. We particularly point out that a CS-based compression scheme is flexible enough to account ...

  7. Ossified Posterior Longitudinal Ligament With Massive Ossification of the Anterior Longitudinal Ligament Causing Dysphagia in a Diffuse Idiopathic Skeletal Hyperostosis Patient.

    Science.gov (United States)

    Murayama, Kazuhiro; Inoue, Shinichi; Tachibana, Toshiya; Maruo, Keishi; Arizumi, Fumihiro; Tsuji, Shotaro; Yoshiya, Shinichi

    2015-08-01

    Descriptive case report.To report a case of a diffuse idiopathic skeletal hyperostosis (DISH) patient with both massive ossification of the anterior longitudinal ligament (OALL) leading to severe dysphagia as well as ossification of the posterior longitudinal ligament (OPLL) causing mild cervical myelopathy, warranting not only an anterior approach but also a posterior one.Although DISH can cause massive OALL in the cervical spine, severe dysphagia resulting from DISH is a rare occurrence. OALLs are frequently associated with OPLL. Treatment for a DISH patient with OPLL in setting of OALL-caused dysphagia is largely unknown.A 70-year-old man presented with severe dysphagia with mild cervical myelopathy. Neurological examination showed mild spastic paralysis and hyper reflex in his lower extremities. Plane radiographs and computed tomography of the cervical spine revealed a discontinuous massive OALL at C4-5 and continuous type OPLL at C2-6. Magnetic resonance imaging revealed pronounced spinal cord compression due to OPLL at C4-5. Esophagram demonstrated extrinsic compression secondary to OALL at C4-5.We performed posterior decompressive laminectomy with posterior lateral mass screw fixation, as well as both resection of OALL and interbody fusion at C4-5 by the anterior approach. We performed posterior decompressive laminectomy with posterior lateral mass screw fixation, as well as both resection of OALL and interbody fusion at C4-5 by the anterior approach. Severe dysphagia markedly improved without any complications.We considered that this patient not only required osteophytectomy and fusion by the anterior approach but also required decompression and spinal fusion by the posterior approach to prevent both deterioration of cervical myelopathy and recurrence of OALL after surgery. PMID:26266365

  8. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  9. Instruction-Steam Compression

    OpenAIRE

    Carrillo, Christian James

    2001-01-01

    This thesis presents formal elements of instruction-stream compression. We introduce notions of instruction representations, compressors and the general "patternization" function for representations to sequences. We further introduce the Lua-ISC language, an implementation of these elements. Instruction-stream compression algorithms are expressed, independently of the target architecture, in Lua-ISC. The language itself handles instruction decoding and encoding, patternization and compression...

  10. Weighted universal image compression

    OpenAIRE

    Effros, Michelle; Chou, Philip A.; Gray, Robert M.

    1999-01-01

    We describe a general coding strategy leading to a family of universal image compression systems designed to give good performance in applications where the statistics of the source to be compressed are not available at design time or vary over time or space. The basic approach considered uses a two-stage structure in which the single source code of traditional image compression systems is replaced with a family of codes designed to cover a large class of possible sources. To illustrate this ...

  11. THC and CBD oromucosal spray (Sativex®) in the management of spasticity associated with multiple sclerosis.

    Science.gov (United States)

    Sastre-Garriga, Jaume; Vila, Carlos; Clissold, Stephen; Montalban, Xavier

    2011-05-01

    People with multiple sclerosis may present with a wide range of disease symptoms during the evolution of the disease; among these, spasticity can have a marked impact on their well-being and quality of life. Symptom control, including spasticity, remains a key management strategy to improve the patient's well-being and functional status. However, available drug therapies for spasticity sometimes have limited benefit and they are often associated with poor tolerability. Sativex is a 1:1 mix of 9-delta-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, which is available as an oromucosal spray. Clinical experience with Sativex in patients with multiple sclerosis is accumulating steadily. Results from randomized, controlled trials have reported a reduction in the severity of symptoms associated with spasticity, leading to a better ability to perform daily activities and an improved perception of patients and their carers regarding functional status when Sativex was added to the current treatment regimen. Adverse events such as dizziness, diarrhea, fatigue, nausea, headache and somnolence occur quite frequently with Sativex, but they are generally of mild-to-moderate intensity and their incidence can be markedly reduced by gradual 'uptitration'. In summary, initial well-controlled studies with Sativex oromucosal spray administered as an add-on to usual therapy have produced promising results and highlight encouraging avenues for future research. PMID:21456949

  12. Physical Therapy in the Management of Pelvic Floor Muscles Hypertonia in a Woman with Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Aline Moreira Ribeiro

    2014-01-01

    Full Text Available Background. Pelvic floor (PF hypertonic disorders are a group of conditions that present with muscular hypertonia or spasticity, resulting in a diminished capacity to isolate, contract, and relax the PF. Their presentation includes voiding and sexual dysfunctions, pelvic pain, and constipation. Various factors are associated, such as complicated vaginal birth, muscular injury, scar tissue formation, and neuropathies. Study Design. The case of a single patient will be presented, together with the management strategies employed. Case Description. A woman with hereditary spastic paraparesis and a history of muscle spasticity and urinary and fecal complaints since childhood. She presented to this institution seeking treatment for pelvic pain, pain during intercourse, constipation, and micturition problems. A physical therapy protocol was developed, with the trial of several treatment modalities. Outcome. After some failed attempts, perineal and pelvic floor stretching proved to be very efficacious therapies for this patient’s complaint, leading to improved pain during intercourse, constipation, pelvic pain, and urinary stream. Discussion. PF spasticity can lead to severe disability and interfere with daily basic functions, such as micturition and evacuation. Physical therapy plays an essential role in the management of these patients and can lead to significant improvement in quality of life.

  13. Soleus Stretch Reflex Inhibition in the Early Swing Phase of Gait Using Deep Peroneal Nerve Stimulation in Spastic Stroke Participants

    NARCIS (Netherlands)

    Voormolen, Marco M.; Ladouceur, Michel; Veltink, Peter H.; Sinkjaer, Thomas

    2000-01-01

    Objectives: To investigate the feasibility of inhibiting the stretch reflex of the soleus muscle by a conditioning stimulus applied to the deep peroneal nerve in spastic stroke participants during the early swing phase of gait. - Materials and Methods: This study investigated the effect of an electr

  14. Inhibition of the triceps surae stretch reflex by stimulation of the deep peroneal nerve in persons with spastic stroke

    NARCIS (Netherlands)

    Veltink, Peter H.; Ladouceur, Michel; Sinkjaer, Thomas

    2000-01-01

    Inhibition of the triceps surae stretch reflex by stimulation of the deep peroneal nerve in persons with spastic stroke. Arch Phys Med Rehabil 2000;81:1016-24. Objective: To reduce the triceps surae stretch reflex by electrical stimulation of the deep peroneal nerve. Design: Intervention study. Sett

  15. Intrathecal Baclofen in Children with Spastic Cerebral Palsy: A Double-Blind, Randomized, Placebo-Controlled, Dose-Finding Study

    Science.gov (United States)

    Hoving, Marjanke A.; van Raak, Elisabeth P. M.; Spincemaille, Geert H. J. J.; Palmans, Liesbeth J.; Sleypen, Frans A. M.; Vles, Johan S. H.

    2007-01-01

    Intrathecal baclofen (ITB) therapy can be very effective in the treatment of intractable spasticity, but its effectiveness and safety have not yet been thoroughly studied in children with cerebral palsy (CP). The aims of this double-blind, randomized, placebo-controlled, dose-finding study were to select children eligible for continuous ITB…

  16. Physical Therapy in the Management of Pelvic Floor Muscles Hypertonia in a Woman with Hereditary Spastic Paraplegia

    Science.gov (United States)

    Ribeiro, Aline Moreira; Ferreira, Cristine Homsi Jorge; Cristine Lemes Mateus-Vasconcelos, Elaine; Moroni, Rafael Mendes; Brito, Luciane Maria Oliveira; Brito, Luiz Gustavo Oliveira

    2014-01-01

    Background. Pelvic floor (PF) hypertonic disorders are a group of conditions that present with muscular hypertonia or spasticity, resulting in a diminished capacity to isolate, contract, and relax the PF. Their presentation includes voiding and sexual dysfunctions, pelvic pain, and constipation. Various factors are associated, such as complicated vaginal birth, muscular injury, scar tissue formation, and neuropathies. Study Design. The case of a single patient will be presented, together with the management strategies employed. Case Description. A woman with hereditary spastic paraparesis and a history of muscle spasticity and urinary and fecal complaints since childhood. She presented to this institution seeking treatment for pelvic pain, pain during intercourse, constipation, and micturition problems. A physical therapy protocol was developed, with the trial of several treatment modalities. Outcome. After some failed attempts, perineal and pelvic floor stretching proved to be very efficacious therapies for this patient's complaint, leading to improved pain during intercourse, constipation, pelvic pain, and urinary stream. Discussion. PF spasticity can lead to severe disability and interfere with daily basic functions, such as micturition and evacuation. Physical therapy plays an essential role in the management of these patients and can lead to significant improvement in quality of life. PMID:25478261

  17. Preclinical models of muscle spasticity: valuable tools in the development of novel treatment for neurological diseases and conditions.

    Science.gov (United States)

    Bespalov, Anton; Mus, Liudmila; Zvartau, Edwin

    2016-05-01

    Poor validity of preclinical animal models is one of the most commonly discussed explanations for the failures to develop novel drugs in general and in neuroscience in particular. However, there are several areas of neuroscience such as injury-induced spasticity where etiological factor can be adequately recreated and models can focus on specific pathophysiological mechanisms that likely contribute to spasticity syndrome in humans (such as motoneuron hyperexcitability and spinal hyperreflexia). Methods used to study spasticity in preclinical models are expected to have a high translational value (e.g., electromyogram (EMG)-based electrophysiological tools) and can efficiently assist clinical development programs. However, validation of these models is not complete yet. First, true predictive validity of these models is not established as clinically efficacious drugs have been used to reverse validate preclinical models while newly discovered mechanisms effective in preclinical models are yet to be fully explored in humans (e.g., 5-HT2C receptor inverse agonists, fatty acid amid hydrolase inhibitors). Second, further efforts need to be invested into cross-laboratory validation of study protocols and tools, adherence to the highest quality standards (blinding, randomization, pre-specified study endpoints, etc.), and systematic efforts to replicate key sets of data. These appear to be readily achievable tasks that will enable development not only of symptomatic but also of disease-modifying therapy of spasticity, an area that seems to be currently not in focus of research efforts. PMID:26861550

  18. The Use of Botulinum Toxin for the Treatment of Muscle Spasticity in the First 2 Years of Life

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    Although there are sound theoretical reasons for the use of botulinum toxin (Btx) as early as possible in the management of severe childhood muscle spasticity, the experience with its safety in children younger than 2 years of age is limited and information about its possible effects on the development and maturation of the human motor system…

  19. Changes in Muscle Activation Following Ankle Strength Training in Children with Spastic Cerebral Palsy: An Electromyography Feasibility Case Report

    Science.gov (United States)

    Olsen, Jamie E.; Ross, Sandy A.; Foreman, Matthew H.; Engsberg, Jack R.

    2013-01-01

    Children with cerebral palsy (CP) are likely to experience decreased participation in activities and less competence in activities of daily living. Studies of children with spastic CP have shown that strengthening programs produce positive results in strength, gait, and functional outcomes (measured by the Gross Motor Function Measure). No…

  20. Reliability of the Modified Ashworth Scale in the Assessment of Plantarflexor Muscle Spasticity in Patients with Traumatic Brain Injury.

    Science.gov (United States)

    Allison, S. C.; And Others

    1996-01-01

    This attempt to determine the reliability of the Modified Ashworth Scale for assessing the severity of muscle spasticity for ankle plantarflexors in 30 patients with traumatic brain injury concluded that the reliability was minimally adequate to support the scale's continued use. Interrater reliability was less than that previously reported for…

  1. Classification of Posture in Poststroke Upper Limb Spasticity: A Potential Decision Tool for Botulinum Toxin A Treatment?

    Science.gov (United States)

    Hefter, Harald; Jost, Wolfgang H.; Reissig, Andrea; Zakine, Benjamin; Bakheit, Abdel Magid; Wissel, Jorg

    2012-01-01

    A significant percentage of patients suffering from a stroke involving motor-relevant central nervous system regions will develop a spastic movement disorder. Hyperactivity of different muscle combinations forces the limbs affected into abnormal postures or movement patterns. As muscular hyperactivity can effectively and safely be treated with…

  2. ADVANCED RECIPROCATING COMPRESSION TECHNOLOGY (ARCT)

    Energy Technology Data Exchange (ETDEWEB)

    Danny M. Deffenbaugh; Klaus Brun; Ralph E. Harris; J. Pete Harrell; Robert J. Mckee; J. Jeffrey Moore; Steven J. Svedeman; Anthony J. Smalley; Eugene L. Broerman; Robert A Hart; Marybeth G. Nored; Ryan S. Gernentz; Shane P. Siebenaler

    2005-12-01

    The U.S. natural gas pipeline industry is facing the twin challenges of increased flexibility and capacity expansion. To meet these challenges, the industry requires improved choices in gas compression to address new construction and enhancement of the currently installed infrastructure. The current fleet of installed reciprocating compression is primarily slow-speed integral machines. Most new reciprocating compression is and will be large, high-speed separable units. The major challenges with the fleet of slow-speed integral machines are: limited flexibility and a large range in performance. In an attempt to increase flexibility, many operators are choosing to single-act cylinders, which are causing reduced reliability and integrity. While the best performing units in the fleet exhibit thermal efficiencies between 90% and 92%, the low performers are running down to 50% with the mean at about 80%. The major cause for this large disparity is due to installation losses in the pulsation control system. In the better performers, the losses are about evenly split between installation losses and valve losses. The major challenges for high-speed machines are: cylinder nozzle pulsations, mechanical vibrations due to cylinder stretch, short valve life, and low thermal performance. To shift nozzle pulsation to higher orders, nozzles are shortened, and to dampen the amplitudes, orifices are added. The shortened nozzles result in mechanical coupling with the cylinder, thereby, causing increased vibration due to the cylinder stretch mode. Valve life is even shorter than for slow speeds and can be on the order of a few months. The thermal efficiency is 10% to 15% lower than slow-speed equipment with the best performance in the 75% to 80% range. The goal of this advanced reciprocating compression program is to develop the technology for both high speed and low speed compression that will expand unit flexibility, increase thermal efficiency, and increase reliability and integrity

  3. Compressed sensing & sparse filtering

    CERN Document Server

    Carmi, Avishy Y; Godsill, Simon J

    2013-01-01

    This book is aimed at presenting concepts, methods and algorithms ableto cope with undersampled and limited data. One such trend that recently gained popularity and to some extent revolutionised signal processing is compressed sensing. Compressed sensing builds upon the observation that many signals in nature are nearly sparse (or compressible, as they are normally referred to) in some domain, and consequently they can be reconstructed to within high accuracy from far fewer observations than traditionally held to be necessary. Apart from compressed sensing this book contains other related app

  4. Wavelet image compression

    CERN Document Server

    Pearlman, William A

    2013-01-01

    This book explains the stages necessary to create a wavelet compression system for images and describes state-of-the-art systems used in image compression standards and current research. It starts with a high level discussion of the properties of the wavelet transform, especially the decomposition into multi-resolution subbands. It continues with an exposition of the null-zone, uniform quantization used in most subband coding systems and the optimal allocation of bitrate to the different subbands. Then the image compression systems of the FBI Fingerprint Compression Standard and the JPEG2000 S

  5. Compressive Instability Phenomena During Springback

    International Nuclear Information System (INIS)

    Springback in sheet metal product makes difficulties in die design because small strain causes large displacement. Especially for the sheet metal product having small geometric constraints, springback displacement may become severe. After first stage of stamping of outer case of washing machine, a large amount of springback is observed. The stamping depth of the outer case is small while stamping area is very large compared to the stamping depth, and therefore, there exists small geometric constraints in the formed part. Also, a compressive instability during the elastic recovery takes place and this instability enlarged the elastic recovery and dimensional error. In this paper, the compressive instability during the elastic recovery is analyzed using bifurcation theory. The final deformed shape after springback is obtained by bifurcating the solution path from primary to secondary. The deformed shapes obtained by the finite element analysis are in good agreement with the experimental data. The bifurcation behavior and the springback displacement for different forming depth are investigated

  6. Growing concern following compression mammography.

    Science.gov (United States)

    van Netten, Johannes Pieter; Hoption Cann, Stephen; Thornton, Ian; Finegan, Rory

    2016-01-01

    A patient without clinical symptoms had a mammogram in October 2008. The procedure caused intense persistent pain, swelling and development of a haematoma following mediolateral left breast compression. Three months later, a 9×11 cm mass developed within the same region. Core biopsies showed a necrotizing high-grade ductal carcinoma, with a high mitotic index. Owing to its extensive size, the patient began chemotherapy followed by trastuzumab and later radiotherapy to obtain clear margins for a subsequent mastectomy. The mastectomy in October 2009 revealed an inflammatory carcinoma, with 2 of 3 nodes infiltrated by the tumour. The stage IIIC tumour, oestrogen and progesterone receptor negative, was highly HER2 positive. A recurrence led to further chemotherapy in February 2011. In July 2011, another recurrence was removed from the mastectomy scar. She died of progressive disease in 2012. In this article, we discuss the potential influence of compression on the natural history of the tumour. PMID:27581236

  7. Diagnostic imaging of compression neuropathy

    International Nuclear Information System (INIS)

    Compression-induced neuropathy of peripheral nerves can cause severe pain of the foot and ankle. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although clinical examination combined with electrophysiological studies remain the cornerstone of the diagnostic work-up, in certain cases, imaging may provide key information with regard to the exact anatomic location of the lesion or aid in narrowing the differential diagnosis. In other patients with peripheral neuropathies of the foot and ankle, imaging may establish the etiology of the condition and provide information crucial for management and/or surgical planning. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. Bony abnormalities contributing to nerve compression are best assessed by radiographs and CT. Knowledge of the anatomy, the etiology, typical clinical findings, and imaging features of peripheral neuropathies affecting the peripheral nerves of the foot and ankle will allow for a more confident diagnosis. (orig.)

  8. Efficacy and safety of nabiximols (Sativex(®)) on multiple sclerosis spasticity in a real-life Italian monocentric study.

    Science.gov (United States)

    Ferrè, Laura; Nuara, Arturo; Pavan, Giulia; Radaelli, Marta; Moiola, Lucia; Rodegher, Mariaemma; Colombo, Bruno; Keller Sarmiento, Ignacio Juan; Martinelli, Vittorio; Leocani, Letizia; Martinelli Boneschi, Filippo; Comi, Giancarlo; Esposito, Federica

    2016-02-01

    Multiple sclerosis (MS) patients frequently suffer from limb spasticity and pain despite antispastic treatments. To investigate nabiximols efficacy and safety in a real-world monocentric Italian cohort, the following data were collected at baseline, week 4, 14 and 48: Ambulation Index (AI), 10-min walking test (10MWT), combined Modified Ashworth scale (cMAS), scores at numerical rating scale for spasticity (sNRS) and pain (pNRS). Responder status was defined as a ≥20 % reduction in sNRS after 4 weeks of treatment. 144 MS patients (123 progressive and 21 relapsing-remitting) complaining of moderate-to-severe spasticity (mean sNRS: 7.5) were included: 138 (95.8 %) completed the first month of therapy and were classified as follows-23.2 % were non-responders, 5.1 % were responders but discontinued treatment due to side effects, 71.7 % were responders with a mean 32 % reduction in sNRS (p < 0.001). In responders sNRS further decreased between 4 and 14 weeks (p = 0.03). Similarly, pNRS improvement was seen during the first month and between 4 and 14 weeks (p < 0.001 and p = 0.004, respectively). Moreover, at 4 weeks responders showed a significant (p < 0.05) improvement in cMAS, AI and 10MWT, which was maintained at 14 weeks. At 1-year follow-up, a benefit was still evident on spasticity and painful symptoms with a low drop-out rate. Confusion/ideomotor slowing, fatigue and dizziness were the most frequent side effects; no major adverse events were reported. Shorter disease duration at treatment start was associated with better response. This real-world study confirms nabiximols efficacy and safety in the treatment of MS-related spasticity and pain, which is maintained up to 48 weeks. PMID:26474875

  9. Symptomatic Elbow Ganglion Causing Pronator Syndrome

    OpenAIRE

    Ross Blagg, MD; W. Bradford Rockwell, MD

    2014-01-01

    Summary: Descriptions of ganglion cysts date back to 400 BC. Ganglions causing peripheral nerve compression have been described most notably at the wrist. Ganglion compression of the median nerve at the elbow is rare. We report a case of a palmar elbow ganglion causing median nerve compression and the clinical presentation of pronator syndrome. After removal of the ganglion and median nerve decompression, the patient’s symptoms fully resolved.

  10. Symptomatic Elbow Ganglion Causing Pronator Syndrome

    Directory of Open Access Journals (Sweden)

    Ross Blagg, MD

    2014-02-01

    Full Text Available Summary: Descriptions of ganglion cysts date back to 400 BC. Ganglions causing peripheral nerve compression have been described most notably at the wrist. Ganglion compression of the median nerve at the elbow is rare. We report a case of a palmar elbow ganglion causing median nerve compression and the clinical presentation of pronator syndrome. After removal of the ganglion and median nerve decompression, the patient’s symptoms fully resolved.

  11. Joint Angular Velocity in Spastic Gait and the Influence of Muscle-Tendon Lengthening*

    Science.gov (United States)

    GRANATA, KEVIN P.; ABEL, MARK F.; DAMIANO, DIANE L.

    2006-01-01

    Background Joint angular velocity (the rate of flexion and extension of a joint) is related to the dynamics of muscle activation and force generation during walking. Therefore, the goal of this research was to examine the joint angular velocity in normal and spastic gait and changes resulting from muscle-tendon lengthening (recession and tenotomy) in patients who have spastic cerebral palsy. Methods The gait patterns of forty patients who had been diagnosed with spastic cerebral palsy (mean age, 8.3 years; range, 3.7 to 14.8 years) and of seventy-three age-matched, normally developing subjects were evaluated with three-dimensional motion analysis and electromyography. The patients who had cerebral palsy were evaluated before muscle-tendon lengthening and nine months after treatment. Results The gait patterns of the patients who had cerebral palsy were characterized by increased flexion of the knee in the stance phase, premature plantar flexion of the ankle, and reduced joint angular velocities compared with the patterns of the normally developing subjects. Even though muscle-tendon lengthening altered sagittal joint angles in gait, the joint angular velocities were generally unchanged at the hip and knee. Only the ankle demonstrated modified angular velocities, including reduced dorsiflexion velocity at foot-strike and improved dorsiflexion velocity through midstance, after treatment. Electromyographic changes included reduced amplitude of the gastrocnemius-soleus during the loading phase and decreased knee coactivity (the ratio of quadriceps and hamstring activation) at toe-off. Principal component analyses showed that, compared with joint-angle data, joint angular velocity was better able to discriminate between the gait patterns of the normal and cerebral palsy groups. Conclusions This study showed that muscle-tendon lengthening corrects biomechanical alignment as reflected by changes in sagittal joint angles. However, joint angular velocity and

  12. Arabic Short Text Compression

    Directory of Open Access Journals (Sweden)

    Eman Omer

    2010-01-01

    Full Text Available Problem statement: Text compression permits representing a document by using less space. This is useful not only to save disk space, but more importantly, to save disk transfer and network transmission time. With the continues increase in the number of Arabic short text messages sent by mobile phones, the use of a suitable compression scheme would allow users to use more characters than the default value specified by the provider. The development of an efficient compression scheme to compress short Arabic texts is not a straight forward task. Approach: This study combined the benefits of pre-processing, entropy reduction through splitting files and hybrid dynamic coding: A new technique proposed in this study that uses the fact that Arabic texts have single case letters. Experimental tests had been performed on short Arabic texts and a comparison with the well known plain Huffman compression was made to measure the performance of the proposed schema for Arabic short text. Results: The proposed schema can achieve a compression ratio around 4.6 bits byte-1 for very short Arabic text sequences of 15 bytes and around 4 bits byte-1 for 50 bytes text sequences, using only 8 Kbytes overhead of memory. Conclusion: Furthermore, a reasonable compression ratio can be achieved using less than 0.4 KB of memory overhead. We recommended the use of proposed schema to compress small Arabic text with recourses limited.

  13. Gait Deviation Index, Gait Profile Score and Gait Variable Score in children with spastic cerebral palsy

    DEFF Research Database (Denmark)

    Rasmussen, Helle Mätzke; Nielsen, Dennis Brandborg; Pedersen, Niels Wisbech;

    2015-01-01

    Abstract The Gait Deviation Index (GDI) and Gait Profile Score (GPS) are the most used summary measures of gait in children with cerebral palsy (CP). However, the reliability and agreement of these indices have not been investigated, limiting their clinimetric quality for research and clinical...... practice. The aim of this study was to investigate the intra-rater reliability and agreement of summary measures of gait (GDI; GPS; and the Gait Variable Score (GVS) derived from the GPS). The intra-rater reliability and agreement were investigated across two repeated sessions in 18 children aged 5......–12 years diagnosed with spastic CP. No systematic bias was observed between the sessions and no heteroscedasticity was observed in Bland–Altman plots. For the GDI and GPS, excellent reliability with intraclass correlation coefficient (ICC) values of 0.8–0.9 was found, while the GVS was found to have fair...

  14. Immunopathogenesis of HTLV-1-assoaciated myelopathy/tropical spastic paraparesis (HAM/TSP).

    Science.gov (United States)

    Fuzii, Hellen Thais; da Silva Dias, George Alberto; de Barros, Rodrigo Jose Saraiva; Falcão, Luiz Fabio Magno; Quaresma, Juarez Antonio Simoes

    2014-05-28

    Human T-cell lymphotropic virus type 1 (HTLV-1) is associated with adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Only a limited percentage of infected individuals develop disease in response to the virus while the majority remain asymptomatic, and HAM/TSP is the most common clinical manifestation of the virus. HAM/TSP is an inflammatory disease of the central nervous system (CNS); however, the mechanism by which HTLV-1 induces HAM/TSP is not yet clear. CD4(+) T lymphocytes are the main reservoirs of HTLV-1 in vivo and perform an important role in the immunological response to this retrovirus. This virus-host interaction may provoke changes in the immunological response, such as the enhanced production of inflammatory cytokines and the spontaneous proliferation of T CD4(+) lymphocytes, which are implicated in the pathogenesis of HAM/TSP. PMID:24704970

  15. Correction functions of equilibrium for children with the spastic forms of cerebral paralysis

    Directory of Open Access Journals (Sweden)

    Zelezniy M.N.

    2012-02-01

    Full Text Available The state of research question correction function of equilibrium is examined for children, patients with a cerebral paralysis. On the basis research of scientific labours the analysis methods and facilities of correction, which are used in the process of their physical rehabilitation, is carried out. It is shown that a process of correction function equilibrium for children with a cerebral paralysis must be sent to development of ability arbitrarily to weaken a skeletal and respiratory musculature, forming of the new corporal feeling and coordination of motions. The aim of article is to research a state of question of correction of function of equilibrium at children with spastic forms of cerebral paralysis at modern stage.

  16. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    Directory of Open Access Journals (Sweden)

    Cristina Castro-Fernández

    2015-06-01

    Full Text Available Next generation sequencing (NGS is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this group of disorders includes gene panel and exome sequencing, in this sample only the spatacsin gene region was captured and subsequently searched for mutations. Two probably pathogenic variants were quickly and clearly identified, confirming the diagnosis of SPG11. This case illustrates how combination of expert clinical characterization with highly oriented NGS protocols leads to a fast, cost-efficient diagnosis, minimizing the risk of findings with unclear significance.

  17. Genetic disorders producing compressive radiculopathy.

    Science.gov (United States)

    Corey, Joseph M

    2006-11-01

    Back pain is a frequent complaint seen in neurological practice. In evaluating back pain, neurologists are asked to evaluate patients for radiculopathy, determine whether they may benefit from surgery, and help guide management. Although disc herniation is the most common etiology of compressive radiculopathy, there are many other causes, including genetic disorders. This article is a discussion of genetic disorders that cause or contribute to radiculopathies. These genetic disorders include neurofibromatosis, Paget's disease of bone, and ankylosing spondylitis. Numerous genetic disorders can also lead to deformities of the spine, including spinal muscular atrophy, Friedreich's ataxia, Charcot-Marie-Tooth disease, familial dysautonomia, idiopathic torsional dystonia, Marfan's syndrome, and Ehlers-Danlos syndrome. However, the extent of radiculopathy caused by spine deformities is essentially absent from the literature. Finally, recent investigation into the heritability of disc degeneration and lumbar disc herniation suggests a significant genetic component in the etiology of lumbar disc disease. PMID:17048153

  18. Genetic mapping of a susceptibility locus for disc herniation and spastic paraplegia on 6q23.3-q24.1

    OpenAIRE

    Zortea, M.; Vettori, A; Trevisan, C; Bellini, S.; Vazza, G.; Armani, M; Simonati, A; Mostacciuolo, M

    2002-01-01

    It has been suggested that a genetic factor(s) or a familial predisposition may contribute to the clinical manifestations of disc herniation; moreover, no genetic linkage between spinal disc herniation and spastic paraplegia has ever been described.

  19. THC:CBD spray and MS spasticity symptoms: data from latest studies.

    Science.gov (United States)

    Rekand, Tiina

    2014-01-01

    New clinical experience with 9-delta-tetrahydocannabinol (THC) and cannabidiol (CBD) oromucosal spray (Sativex®) involving more than an additional 1,000 patients with MS spasticity (approximately 150 in clinical studies and 900 in post-marketing surveillance studies) have become available in 2013 and are reviewed. A randomized, placebo controlled long-term follow-up clinical trial with THC:CBD spray versus placebo demonstrated that it was not associated with cognitive decline, depression or significant mood changes after 12 months of treatment. Furthermore, in a prospective observational pilot study involving 33 patients (60% female) aged 33-68 years and a mean disease duration of 6.6 years, THC:CBD oromucosal spray did not adversely influence standard driving ability in patients with moderate to severe MS spasticity. Other new long term observational data about the use of THC:CBD oromucosal spray in clinical practice are available from patient registries in the UK, Germany and Spain. Findings to date reinforce the efficacy and safety observed in Phase III clinical trials. It is of interest that in practice average dosages used by patients tended to be lower than those reported in clinical studies (5-6.4 vs. >8 sprays/day), and effectiveness was maintained in the majority of patients. Importantly, no additional safety concerns were identified in the registry studies which included findings from patients who have been treated for prolonged periods (in the German/UK registry 45% of patients had >2 years exposure). Thus, these new data support a positive benefit-risk relationship for THC:CBD oromucosal spray during longer-term use. PMID:24457846

  20. The Impacts of Spastic Cerebral Palsy Children on Dynamic Balance Performance

    Directory of Open Access Journals (Sweden)

    M.S. Saba

    2006-07-01

    Full Text Available Introduction & Objective: Despite of many studies on cerebral palsy (CP, the impacts of this disease on musculoskeletal function especially on the dynamic balance of the CP patients is not well understood. This information can improve the quality of the treatment. The objectives of this study were to evaluate the differences between the dynamic balance performance of normal and CP children in different conditions.Materials & Methods: Ten children with spastic diplegia cerebral palsy between 8 to15 years of age and with mean weight and height of 30.8±5.7kg and 1.35±0.09m respectively, underwent an exercise therapy program for 12 weeks. A stability platform system was used to measure the deviation on the mean point of the application of the center of gravity (COG from the center of base of support (COBOS. The balance tests were repeated on stable and unstable base of support as well as with and without shoes. Results: It was shown that the mean deviation of COG of the CP children improves about 25% after exercise therapy (p=0.001. The most improvement was in mid-stable and unstable of base of support as well as in AP direction. Mean deviations of COG was near to natural pattern Conclusion: The mean deviation of COG of the CP patients was significantly increased in dynamic standing which shows the poor function of the proprioceptive system in these children. Exercise therapy improves the mean deviation of COG in dynamic standing. These results show the importance of the shoes on the treatment procedures of the spastic CP children.

  1. The effect of hippotherapy on gait in patients with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Veronika Fízková

    2013-12-01

    Full Text Available BACKGROUND: Disorders of motor skills, especially regarding gait, are prevalent in nearly all forms of cerebral palsy. Through a horse’s back movement, the patient is exposed to proprioceptive stimulation, thus improvement in gait performance could be expected. OBJECTIVE: The aim of our study was to determine the effect of hippotherapy on gait in patients with spastic cerebral palsy. METHODS: Eleven subjects (age 14.3 ± 4.8 years, height 148.2 ± 17.6 cm, weight 43.3 ± 20.2 kg with spastic cerebral palsy participated in the study. Gait assessment was performed before and after a weeklong stay. The hippotherapy was conducted daily. Kinematic data from three trials for each child was obtained using the Vicon MX system (seven infrared cameras, frequency 200 Hz. Comparison of ankle, knee, hip and pelvis movement before and after hippotherapy intervention was performed in Statistica (version 10.0 using the Wilcoxon test. To determine the effect size, Cohen’s d was used. RESULTS: After completing the short-term hippotherapy intervention, we observed a decrease in the second plantar flexion during initial swing (p < .05, decrease in knee flexion during the stance phase (p < .05, decrease in the hip range of motion in sagittal plane (p < .05 and decrease in the pelvic obliquity (p < .05. The effect size for all statistically significant differences was low. CONCLUSIONS: Hippotherapy combined with individually defined physiotherapy can lead to some changes in bipedal locomotion in terms of improvement and thus contribute to greater self-sufficiency, self-reliance and independence of patients with cerebral palsy.

  2. Critical Data Compression

    CERN Document Server

    Scoville, John

    2011-01-01

    A new approach to data compression is developed and applied to multimedia content. This method separates messages into components suitable for both lossless coding and 'lossy' or statistical coding techniques, compressing complex objects by separately encoding signals and noise. This is demonstrated by compressing the most significant bits of data exactly, since they are typically redundant and compressible, and either fitting a maximally likely noise function to the residual bits or compressing them using lossy methods. Upon decompression, the significant bits are decoded and added to a noise function, whether sampled from a noise model or decompressed from a lossy code. This results in compressed data similar to the original. For many test images, a two-part image code using JPEG2000 for lossy coding and PAQ8l for lossless coding produces less mean-squared error than an equal length of JPEG2000. Computer-generated images typically compress better using this method than through direct lossy coding, as do man...

  3. Effects on the Treatments in Physical Therapy with the Wii Fit Plus Balance Board Concerning the Postural Changes on Children Suffering Spastics Hemiparesis. Case Report

    OpenAIRE

    Luisa Fernanda Córdoba Castillo; Viviana Carolina Gómez Lozano; Leidy Karina Tello Fernández; Luz Ángela Tovar Ruiz

    2015-01-01

    Introduction: This study tried to determine the effects on the treatments in physical therapy with the Wii Balance Board and Wii Fit Plus __both of Wii, Nintendo Company Limited__ concerning the postural changes on children suffering spastics hemiparesis. Material and methods: Longitudinal cohort case studies done with two children, from the municipality of Popayán, suffering cerebral palsy type spastic hemiparesis. This children had a test on static posture with the software APIC v. 2.0, pre...

  4. Differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy in comparison with normal controls

    OpenAIRE

    Kwon, Yong Hyun; Lee, Hye Young

    2015-01-01

    [Purpose] The purpose of this study was to determine differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy (CP) in comparison with children with normal development. [Subjects and Methods] Fourteen children with spastic diplegic CP, 11 children with hemiplegic CP, and 14 children with normal development were recruited. Respiratory pressure was measured and the pulmonary function test (PFT) was performed to evaluate the str...

  5. Surmounting the Effects of Lossy Compression on Steganography

    OpenAIRE

    Currie, Daniel L.; Irvine, Cynthia E.

    1996-01-01

    Steganographic techniques can be used to hide data within digital images with little or no visible change in the perceived appearance of the image and can be exploited to export sensitive information. Since images are frequently compressed for storage or transmission, effective steganography must employ coding techniques to counter the errors caused by lossy compression algorithms. The Joint Photographic Expert Group (JPEG) compression algorithm, while producing only a small...

  6. Ulnar Nerve Compression at Guyon's Canal by an Arteriovenous Malformation

    OpenAIRE

    Kim, Sung Soo; Kim, Jae Hoon; Kang, Hee In; Lee, Seung Jin

    2009-01-01

    Guyon's canal at the wrist is not the common site of ulnar nerve compression. Ganglion, lipoma, anomalous tendon and muscles, trauma related to an occupation, arthritis, and carpal bone fracture can cause ulnar nerve compression at the wrist. However, ulnar nerve compression at Guyon's canal by vascular lesion is rare. Ulnar artery aneurysm, tortous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. The authors experienced a case of ulnar nerve ...

  7. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst

    OpenAIRE

    Kwak, Kyung-Woo; Kim, Min-Su; Chang, Chul-Hoon; Kim, Seong-Ho

    2011-01-01

    Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve c...

  8. Impedance of tissue-mimicking phantom material under compression

    OpenAIRE

    Barry Belmont; Dodde, Robert E.; Shih, Albert J.

    2013-01-01

    The bioimpedance of tissues under compression is a field in need of study. While biological tissues can become compressed in a myriad of ways, very few experiments have been conducted to describe the relationship between the passive electrical properties of a material (impedance/admittance) during mechanical deformation. Of the investigations that have been conducted, the exodus of fluid from samples under compression has been thought to be the cause of changes in impedance, though until now ...

  9. Compressed Data Transmission Among Nodes in BigData

    OpenAIRE

    Thirunavukarasu B; Sudhahar V M; VasanthaKumar U; Dr Kalaikumaran T; Dr.Karthik.S

    2014-01-01

    Many organizations are now dealing with large amount of data. Traditionally they used relational data. But nowadays they are supposed to use structured and semi structured data. To work effectively these organizations uses virtualization, parallel processing in compression etc., out of which the compression is most effective one. The data transmission of high volume usually causes high transmission time. This compression of unstructured data is immediately done when the data is being trans...

  10. Focus on Compression Stockings

    Science.gov (United States)

    ... therapy may be recommended as part of a treatment plan. There are several situations when compression may be helpful, including: tired legs, varicose veins, chronic venous insufficiency (CVI), lymphedema, or deep vein thrombosis (DVT). This brochure focuses ...

  11. Fingerprint Image Compression

    OpenAIRE

    Mansi Kambli,; Shalini Bhatia

    2010-01-01

    Modified Set Partitioning in Hierarchical Tree with Run Length Encoding is a new framework proposed for fingerprint image compression. The Proposed method is better because more number of images related to the fingerprint image are retrieved. Experiments on an image database of grayscale bitmap images show that the proposed technique performs well in compression and decompression. We use Peak Signal to noise ratio [3] and Mean Square Error [3] to compute the picture quality of fingerprint ima...

  12. Compressibility of bilayer graphene

    OpenAIRE

    Borghi, Giovanni; Polini, Marco; Asgari, Reza; MacDonald, A. H.

    2010-01-01

    Bilayer graphene is a recently isolated and intriguing class of many-body systems with massive chiral quasiparticles. We present theoretical results for the electronic compressibility of bilayer graphene that are based on a four-band continuum band structure model combined with a random phase approximation treatment of electronic correlations. We find that the compressibility is strongly suppressed by electron-electron interactions at low carrier densities. Correlations do not lead to any qua...

  13. The compressibility of graphene

    OpenAIRE

    Abergel, D. S. L.

    2012-01-01

    We present a review of the electronic compressibility of monolayer and bilayer graphene. We focus on describing theoretical calculations of the effects of electron--electron interactions and various types of disorder, and also give a summary of current experiments and describe which aspects of theory they support. We also include a full analysis of all commonly-used contributions to the tight-binding Hamiltonian of bilayer graphene and their effects on the compressibility.

  14. A型肉毒毒素治疗痉挛型脑瘫的研究进展%Research progress of botulinum toxin type A in treatment of spastic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    刘春明(综述); 刘芸(审校)

    2015-01-01

    Cerebral palsy refers to brain injury caused by various reasons from before birth to 1 month after birth or movement disorders and abnormal posture caused by brain developmental defects. Children cerebral palsy is divided into 5 kinds in the clinic:spastic type, dyskinetic type, ataxia type, muscle hypotonia type and mixed type. Among them, the spastic type accounts for 60% ~70% , and is the main type which causes children physical disabilities. Once diagnosed, the comprehensive treatment method is ap-plied, including functional training, physical therapy, acupuncture, massage, medicine treatment, and so on. In recent years, the lo-cal injection of botulinum toxin A is used for treating the children with spastic cerebral palsy. A large number of clinical studies show that the drug is safe and effective; however, in the course of treatment, it should strictly control the drug indications and contraindica-tions. Especially, the dosage choice and the accurate localization of target muscle is the key factor to influence the treatment effect.%脑瘫是指出生前到出生后1个月内各种原因所引起的脑损伤或发育缺陷所致的运动障碍及姿势异常。小儿脑瘫临床上分为痉挛型,不随意运动型,共济失调型,肌张力低下型及混合型5种,其中,痉挛型占60%~70%,是造成儿童肢体残疾的最主要脑瘫类型。脑瘫一旦确诊多采用综合的治疗方法包括功能训练,物理疗法,中医针刺,按摩,药物治疗等。近年来,临床上开始广泛使用毒杆菌毒素 A(botuli-num toxin A,BTX-A)局部注射治疗痉挛型脑瘫儿童,大量临床研究结果显示该药安全、有效,但在治疗过程中应该严格掌握使用该药的适应证,禁忌证,而剂量的选择和靶肌的准确定位是影响治疗效果的关键因素。

  15. Error detection and response adjustment in youth with mild spastic cerebral palsy: an event-related brain potential study.

    Science.gov (United States)

    Hakkarainen, Elina; Pirilä, Silja; Kaartinen, Jukka; van der Meere, Jaap J

    2013-06-01

    This study evaluated the brain activation state during error making in youth with mild spastic cerebral palsy and a peer control group while carrying out a stimulus recognition task. The key question was whether patients were detecting their own errors and subsequently improving their performance in a future trial. Findings indicated that error responses of the group with cerebral palsy were associated with weak motor preparation, as indexed by the amplitude of the late contingent negative variation. However, patients were detecting their errors as indexed by the amplitude of the response-locked negativity and thus improved their performance in a future trial. Findings suggest that the consequence of error making on future performance is intact in a sample of youth with mild spastic cerebral palsy. Because the study group is small, the present findings need replication using a larger sample. PMID:22899795

  16. INTERFERON BETA-1A TREATMENT IN HTLV-1-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Graça Maria de Castro Viana

    2014-09-01

    Full Text Available Here a young patient (< 21 years of age with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP, and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF. Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved.

  17. Estimation of motive possibilities and manipulative activity of children with cerebral paralysis of spastic form 3-5 years

    OpenAIRE

    Baybuza I.V.

    2012-01-01

    In this work the conducted estimation of motive possibilities and manipulative activity of children is with the cerebral paralysis of spastic form 3-5 years accordingly standard norms. The experiment was attended by 30 children. Proven lack of fine motor skills and basic static and motor skills decreased muscle strength and improve muscle tone. Providing a more objective assessment of physical development of patients with this pathology would contribute a program hydrokinesotherapy as a means...

  18. Signaling proteins in spinal parenchyma and dorsal root ganglion in rat with spinal injury-induced spasticity

    Czech Academy of Sciences Publication Activity Database

    Kupcová Skalníková, Helena; Navarro, R.; Marsala, S.; Hrabáková, Rita; Vodička, Petr; Gadher, S. J.; Kovářová, Hana; Marsala, M.

    2013-01-01

    Roč. 91, č. 1 (2013), s. 41-57. ISSN 1874-3919 R&D Projects: GA MŠk(CZ) ME10044; GA TA ČR TA01011466; GA MŠk ED2.1.00/03.0124 Institutional support: RVO:67985904 Keywords : spinal cord trauma * spasticity * hyper-reflexia Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.929, year: 2013

  19. Contribution of Galvanic Vestibular Stimulation for the Diagnosis of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

    OpenAIRE

    Matos Cunha, Luciana Cristina; Campelo Tavares, Maurício; Tierra Criollo, Carlos Julio; Labanca, Ludimila; Cardoso dos Santos Couto Paz, Clarissa; Resende Martins, Henrique; de Freitas Carneiro-Proietti, Anna Bárbara; Utsch Goncalves, Denise

    2013-01-01

    Background and Purpose Galvanic vestibular stimulation (GVS) is a low-cost and safe examination for testing the vestibulospinal pathway. Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a slowly progressive disease that affects the vestibulospinal tract early in its course. This study compared the electromyographic (EMG) responses triggered by GVS of asymptomatic HTLV-1-infected subjects and subjects with HAM/TSP. Methods Bipolar galvanic s...

  20. Spatial Patterns of Whole Brain Grey and White Matter Injury in Patients with Occult Spastic Diplegic Cerebral Palsy

    OpenAIRE

    Mu, Xuetao; Nie, Binbin; Wang, Hong; Duan, Shaofeng; Zhang, Zan; Dai, Guanghui; Ma, Qiaozhi; Shan, Baoci; Ma, Lin

    2014-01-01

    Spastic diplegic cerebral palsy(SDCP)is a common type of cerebral palsy (CP), which presents as a group of motor-impairment syndromes. Previous conventional MRI studies have reported abnormal structural changes in SDCP, such as periventricular leucomalacia. However, there are roughly 27.8% SDCP patients presenting normal appearance in conventional MRI, which were considered as occult SDCP. In this study, sixteen patients with occult SDCP and 16 age- and sex-matched healthy control subjects we...

  1. Cannabis as a Possible Treatment for Spasticity in Multiple Sclerosis / Kanabis Kao Moguci Tretman U Lecenju Spasticnosti Kod Multiple Skleroze

    OpenAIRE

    Vesic Katarina; Dejanovic Slavica Djukic; Borovcanin Milica; Samardzic Janko; Toncev Gordana

    2016-01-01

    The therapeutic potential of cannabis has been known for centuries. Cannabinoids express their effects through two types of receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2). Present studies indicate that cannabis-based drugs can make a positive impact in the treatment of different diseases. For many years, multiple sclerosis patients have self-medicated with illegal street cannabis to alleviate spasticity, a common and debilitating symptom that impairs quality of life.

  2. Cannabis as a Possible Treatment for Spasticity in Multiple Sclerosis / Kanabis Kao Moguci Tretman U Lecenju Spasticnosti Kod Multiple Skleroze

    Directory of Open Access Journals (Sweden)

    Vesic Katarina

    2016-03-01

    Full Text Available The therapeutic potential of cannabis has been known for centuries. Cannabinoids express their effects through two types of receptors, cannabinoid receptor 1 (CB1 and cannabinoid receptor 2 (CB2. Present studies indicate that cannabis-based drugs can make a positive impact in the treatment of different diseases. For many years, multiple sclerosis patients have self-medicated with illegal street cannabis to alleviate spasticity, a common and debilitating symptom that impairs quality of life.

  3. A Randomized Controlled Trial Comparing Botulinum Toxin A Dosage in the Upper Extremity of Children with Spasticity

    Science.gov (United States)

    Kawamura, Anne; Campbell, Kent; Lam-Damji, Sophie; Fehlings, Darcy

    2007-01-01

    This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group…

  4. A gene for autosomal recessive symmetrical spastic cerebral palsy maps to chromosome 2q24-25.

    OpenAIRE

    McHale, D P; Mitchell, S.; Bundey, S; Moynihan, L; Campbell, D. A.; Woods, C G; LENCH, N. J.; Mueller, R F; Markham, A F

    1999-01-01

    Cerebral palsy has an incidence of approximately 1/500 births, although this varies between different ethnic groups. Genetic forms of the disease account for approximately 1%-2% of cases in most countries but contribute a larger proportion in populations with extensive inbreeding. We have clinically characterized consanguineous families with multiple children affected by symmetrical spastic cerebral palsy, to locate recessive genes responsible for this condition. The eight families studied we...

  5. Systematics of compression of hard materials

    International Nuclear Information System (INIS)

    Hard materials have the remarkable property that relatively little internal energy of shock compression is deposited as temperature and associated thermal pressure. As a result, the Hugoniot curve is nearly coincident with the 0-K isotherm. Since the isentrope is intermediate between isotherm and Hugoniot, all three curves of a given hard material are nearly coincident. Published data for diamond and Gd3Ga5O12 (GGG) show this to be the case up to 600 GPa and 80 GPa, respectively. Above 100 GPa on the Hugoniot the incompressibilities, defined to be the derivative of pressure with respect to compression, of GGG, other oxides and even CaF2 are significantly greater than that of diamond. In fact, above 100 GPa CaF2 might well be the least compressible of any known material. Little EOS data of weakly compressible materials have been measured in a diamond anvil cell (DAC) above a few tens of GPa at 300 K because these materials often become amorphous, which means density in a DAC cannot be measured by X-ray diffraction. Amorphization suggests the onset of a sluggish phase transition. On the other hand, Hugoniot experiments readily measure density changes caused by compression and phase transitions independent of material structure. Hugoniots of weakly compressible materials suggest experiments to determine structures and compressibilities in laser-heated DACs at 100 GPa pressures, as has been done with TiO2 and perovskite, and Hugoniot data might provide estimates of compressions of oxides representative of the deep interiors of rocky planets in other solar systems

  6. Evaluation of low-level laser therapy in the treatment of masticatory muscles spasticity in children with cerebral palsy

    Science.gov (United States)

    Santos, Maria Teresa Botti Rodrigues; Diniz, Michele Baffi; Gouw-Soares, Sheila Cynthia; Lopes-Martins, Rodrigo Alvaro Brandão; Frigo, Lucio; Baeder, Fernando Martins

    2016-02-01

    Spasticity is a motor disorder frequently present in individuals with cerebral palsy (CP). This study aimed to evaluate the effect of low-level laser therapy (LLLT) on the spasticity of the masseter and anterior temporal muscle fibers in children with CP over three weeks of intermittent laser exposures. The bite force (BF) of the masticatory muscles and the amplitude of mouth opening were evaluated before and after laser irradiation in 30 children with CP. Both sides of the masseter and temporalis muscles were irradiated with low-intensity diode laser pulses of 808-nm wavelength six times over three consecutive weeks. During the subsequent three weeks of postlaser exposures, although no laser treatment was applied, the evaluation parameters were measured and recorded. A significant improvement in the amplitude of mouth opening and a decrease in the BF were observed in the weeks following LLLT (Plow-level energy exposures from a 808-nm diode laser to be an effective short-term therapeutic tool. This method increased the amplitude of mouth opening and decreased the muscle tonus of children with spastic CP over a time course of three weeks of intermittent laser applications.

  7. Effects of Soft Tissue Surgery on Pelvic and Hip Rotation in Patients with Spastic Diplegia: A Meta-Analysis

    Science.gov (United States)

    Jung, Hun Jae; Yoon, Ji Yeon; Oh, Min Kyung; Kim, Young Chang; Kim, Jae Hyun; Eom, Tae Woong

    2016-01-01

    Background There are several different opinions regarding the improvements seen on the transverse plane after soft tissue surgery alone in independently ambulant patients with cerebral palsy. We performed a meta-analysis using data from previous studies to identify the effects of soft tissue surgery alone on pelvic and hip rotation in children with spastic diplegia. Methods We conducted a pilot study to evaluate the improvement in pelvic and hip rotation after muscle-tendon lengthening surgery in children with spastic diplegia. We also searched EMBASE and PubMed and selected 2 previous studies using the same test conditions with kinematic data on the pelvis and hip joints. A meta-analysis of the results of these 3 studies, including this pilot study, was then performed. Results The meta-analysis results showed an external rotation decrease (p = 0.005) in the mean difference of pelvic rotation of -3.61 (95% confidence interval [CI], -6.13 to –1.09) and a mean difference in hip rotation of 6.60 (95% CI, 3.34 to 9.86), indicating a significant increase in the hip external rotation after surgery (p < 0.001). Conclusions In independently community-ambulant pediatric patients with spastic diplegia, pelvic retraction and hip internal rotation could be improved after soft tissue surgery. PMID:27247745

  8. Changes in skeletal muscle perfusion and spasticity in patients with poststroke hemiparesis treated by robotic assistance (Gloreha) of the hand.

    Science.gov (United States)

    Bissolotti, Luciano; Villafañe, Jorge Hugo; Gaffurini, Paolo; Orizio, Claudio; Valdes, Kristin; Negrini, Stefano

    2016-03-01

    [Purpose] The purpose of this case series was to determine the effects of robot-assisted hand rehabilitation with a Gloreha device on skeletal muscle perfusion, spasticity, and motor function in subjects with poststroke hemiparesis. [Subjects and Methods] Seven patients, 2 women and 5 men (mean ± SD age: 60.5 ±6.3 years), with hemiparesis (>6 months poststroke), received passive mobilization of the hand with a Gloreha (Idrogenet, Italy), device (30 min per day; 3 sessions a week for 3 weeks). The outcome measures were the total hemoglobin profiles and tissue oxygenation index (TOI) in the muscle tissue evaluated through near-infrared spectroscopy. The Motricity Index and modified Ashworth Scale for upper limb muscles were used to assess mobility of the upper extremity. [Results] Robotic assistance reduced spasticity after the intervention by 68.6% in the upper limb. The Motricity Index was unchanged in these patients after treatment. Regarding changes in muscle perfusion, significant improvements were found in total hemoglobin. There were significant differences between the pre- and posttreatment modified Ashworth scale. [Conclusion] The present work provides novel evidence that robotic assistance of the hand induced changes in local muscle blood flow and oxygen supply, diminished spasticity, and decreased subject-reported symptoms of heaviness and stiffness in subjects with post-stroke hemiparesis. PMID:27134356

  9. Cerebral metabolic and structural alterations in hereditary spastic paraplegia with thin corpus callosum assessed by MRS and DTI

    International Nuclear Information System (INIS)

    Hereditary spastic paraplegia with thin corpus callosum (HSP-TCC) is a complicated form of autosomal-recessive hereditary spastic paraplegia. Characteristic clinical features comprise progressive spastic gait, cognitive impairment, and ataxia. Diagnostic MRI findings include thinning of the corpus callosum and non-progressive white matter (WM) alterations. To study the extent of axonal involvement, we performed localized proton magnetic resonance spectroscopy (MRS) of the cerebral WM and cortical grey matter (GM) in a patient with HSP-TCC at 20 and 25 years of age. The second investigation included diffusion tensor imaging (DTI). While MRS of the GM was normal, affected WM was characterized by major metabolic alterations such as reduced concentrations of N-acetylaspartate and N-acetylaspartyl-glutamate, creatine and phosphocreatine, and choline-containing compounds as well as elevated levels of myo-inositol. These abnormalities showed progression over a period of 5 years. DTI revealed increased mean diffusivity as well as reduced fractional anisotropy in periventricular WM. The metabolic and structural findings are consistent with progressive neuroaxonal loss in the WM accompanied by astrocytic proliferation - histopathological changes known to occur in HSP-TCC. Our results are in agreement with the hypothesis that the primary pathological process in HSP-TCC affects the axon, possibly due to impaired axonal trafficking. (orig.)

  10. Tropical spastic paraparesis and HTLV-1 associated myelopathy: clinical, epidemiological, virological and therapeutic aspects.

    Science.gov (United States)

    Gessain, A; Mahieux, R

    2012-03-01

    In 1980, Human T cell leukemia/lymphoma virus type 1 (HTLV-1) was the first oncogenic human retrovirus to be discovered. HTLV-1 belongs to the Retroviridae family, the Orthoretrovirinae subfamily and to the deltaretrovirus genus. HTLV-1 preferentially infects CD4(+) lymphoid cells in vivo. Three molecules have been identified for binding and/or entry of HTLV-1: heparan sulfate proteoglycans, neuropilin-1, and glucose transporter 1. An efficient transfer of the virus from an infected cell to a target cell can occur through the formation of a viral synapse and/or by virofilm structure. As for all retroviruses, HTLV-1 genome possesses three major ORFs (gag, pol and env) encoding the structural and enzymatic proteins. HTLV-1 encodes also some regulatory and auxillary proteins including the tax protein with transforming activities and the HBZ protein which plays a role in the proliferation and maintenance of the leukemic cells. HTLV-1 is present throughout the world with clusters of high endemicity including mainly Southern Japan, the Caribbean region, areas in South America and in intertropical Africa. The worldwide HTLV-1 infected population is estimated to be around 10-20 million. HTLV-1 has three modes of transmission: (1): mother to child, mainly linked to prolonged breast-feeding; (2): sexual, mainly occurring from male to female and (3): contaminated blood products. HTLV-1 possesses a remarkable genetic stability. HTLV-1 is the etiological agent of mainly two severe diseases: a malignant T CD4(+) cell lymphoproliferation, of very poor prognosis, named Adult T cell Leukemia/Lymphoma (ATLL), and a chronic neuro-myelopathy named Tropical spastic paraparesis/HTLV-1 Associated Myelopathy (TSP/HAM). The lifetime risk among HTLV-1 carriers is estimated to be around 0.25 to 3%. TSP/HAM mainly occurs in adults, with a mean age at onset of 40-50 years and it is more common in women than in men. Blood transfusion is a major risk factor for TSP/HAM development. Clinically

  11. Clinical Observation on Treatment of Spastic Cerebral Palsy with Tuina plus Music Therapy

    Institute of Scientific and Technical Information of China (English)

    马美美; 刘振寰; 赵勇; 罗冠君; 李诺; 招文健; 万瑞平; 韩丑萍

    2009-01-01

    目的:观察小儿推拿结合音乐疗法对改善痉挛型小儿脑性瘫痪患者踝关节活动度及下肢肌肉痉挛的作用.方法:对符合小儿脑性瘫痪诊断标准的286例痉挛型患儿,在背景音乐下进行通督循经点穴推拿、益肾健脾推拿、捏脊疗法、足底推拿、节段性推拿、促肌力恢复推拿及关节活动度推拿7种推拿治疗,每次25~30min,每日1~2次.30天为1个疗程.于治疗前后进行股内收肌角、足背屈角和综合痉挛量表(CompositeSpastic@Scale,CSS)评分,以评价疗效.结果:治疗前后足背屈角、股内收肌角、CSS评分统计学处理,差异有统计学意义(P<0.01).总体疗效为显效106例,有效172例,无效8例.结论:推拿结合音乐疗法治疗痉挛型小儿脑瘫,有滑利关节,松解肌腱挛缩,缓解肌肉痉挛作用,能改善剪刀步态和尖足步态.对患儿坐、跪、站、行大运动功能恢复有极积治疗作用.%Objective: To observe the effect oftuina plus music therapy on range of motion of ankle joints and muscle spasm of lower limbs in children with spastic cerebral palsy. Method:All of 286 cases that conformed to the diagnostic criteria of infantile cerebral palsy were treated with 7 types of tuina manipulations respectively to unblock the Governor Vessel, reinforce the kidney and strengthen the spleen, pinch along the spine, stimulate specific foot-reflex area and different spinal segments, accelerate recovery of muscle strength and increase joint range of motion, 25-30 rain each treatment, once or twice a day, 30 d constitute a course of treatment.After this, the efficacy on femoral medial adduction and dorsiflexion angle and composite spasticity score (CSS) was evaluated. Result: The statistical analysis showed significant differences in dorsiflexion and femoral medial adduction angle and CCS scores (P<0.01) after the treatments. Conclusion: Tuina plus music therapy can lubricate the joints, relax contraction of tendons, alleviate

  12. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst.

    Science.gov (United States)

    Kwak, Kyung-Woo; Kim, Min-Su; Chang, Chul-Hoon; Kim, Seong-Ho

    2011-02-01

    Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery. PMID:21519507

  13. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy.

    Directory of Open Access Journals (Sweden)

    Lynn Bar-On

    Full Text Available The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n = 35/19; 10.8 ± 3.8 yrs; bilateral/unilateral involvement n =  32/22; Gross Motor Functional Classification Score I-IV of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01. The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between

  14. Sciatica caused by pseudomyxoma peritonei.

    Science.gov (United States)

    Lin, Hung-Lin; Chen, Jung-Tsung; Liu, Yu-Fang; Cho, Der-Yang

    2009-01-01

    Many etiologies may cause sciatica, and intra-abdominal masses usually affect the lumbosacral plexus by local invasion or distal metastases. Lumbosacral plexopathy caused by compression of intra-abdominal tumors instead of invasion is rarely seen. A 67-year-old woman had a 3-month history of progressive neurogenic claudication, lumbago and left L5 radiculopathy with foot drop. Nocturia and progressive abdominal distension with voiding dysfunction were also noted. Imaging studies showed a huge pelvic mass with severe compression of the left lumbosacral trunk. There was no direct invasion of the lumbosacral plexus by the pelvic mass noted in the preoperative imaging studies or intraoperative findings. Bilateral ovarian borderline mucinous cystic tumor with pseudomyxoma peritonei (PMP) was diagnosed, and the sciatica was improved dramatically after subsequent abdominal debulking surgery. Although rare, neural compression caused by PMP and intra-abdominal masses needs to be considered in the differential diagnosis of sciatica. PMID:19181596

  15. Graph Compression by BFS

    Directory of Open Access Journals (Sweden)

    Alberto Apostolico

    2009-08-01

    Full Text Available The Web Graph is a large-scale graph that does not fit in main memory, so that lossless compression methods have been proposed for it. This paper introduces a compression scheme that combines efficient storage with fast retrieval for the information in a node. The scheme exploits the properties of the Web Graph without assuming an ordering of the URLs, so that it may be applied to more general graphs. Tests on some datasets of use achieve space savings of about 10% over existing methods.

  16. Comparison of colonic transit time findings between spastic pelvic floor syndrome and normal on defecogram

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Kwon; Choi, Sang Hee; Chung, Il Gyu; Lim, Hyo Keun; Choo, Sung Wook; Rhee, Poong Lyul [Samsung Medical Center, Seoul (Korea, Republic of)

    1998-05-01

    The purpose of this study is to evaluate colonic transit time (CTT) in patients with spastic pelvic floor syndrome (SPFS) diagnosed by defecography and compare findings with those of patients with normal defecography. Over a recent 15-month period, 140 patients underwent both defecography and CTT test because of chronic idiopathic constipation. Of these, 54 with SPFS diagnosed by defecography and 49 controls with normal defecography were included in our study. CTT test involved the radiopaque marker method. Subjects ingested 24 markers at 9:00 Am on three consecutive days and a plain film of the abdomen was obtained on day 4. We calculated total and segmental CTT test findings in the two groups. Delayed total CTT was found in 35% of patients (19/54) with SPFS. Segmental CTT in the right, left and rectosigmoid colon was delayed in 31 % of patients (15/49) with SPFS. Segmental CTT in the right, left and rectosigmoid colon was delayed in 19 % (10/54), 44 % (24/54), and 31 % of cases (17/54), respectively. Total CTT was delayed in 31 % of patients (15/49) with normal defecography. In this group, segmental CTT in the left colon was delayed in 39 % of cases. There was no significant difference in CTT findings between the SPFS and normal groups on defecogram. (author). 18 refs., 2 tabs., 5 figs.

  17. Proprioceptive neuromuscular facilitation in HTLV-I-associated myelopathy/tropical spastic paraparesis

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Santos de Britto

    2014-01-01

    Full Text Available Introduction: Human T cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP can impact the independence and motricity of patients. The aims of this study were to estimate the effects of physiotherapy on the functionality of patients with HAM/TSP during the stable phase of the disease using proprioceptive neuromuscular facilitation (PNF and to compare two methods of treatment delivery. Methods: Fourteen patients with human T cell lymphotropic virus type I (HTLV-I were randomly allocated into two groups. In group I (seven patients, PNF was applied by the therapist, facilitating the functional activities of rolling, sitting and standing, walking and climbing and descending stairs. In group II (seven patients, PNF was self-administered using an elastic tube, and the same activities were facilitated. Experiments were conducted for 1h twice per week for 12 weeks. Low-back pain, a modified Ashworth scale, the functional independence measure (FIM and the timed up and go test (TUG were assessed before and after the interventions. Results: In the within-group evaluation, low-back pain was significantly reduced in both groups, the FIM improved in group II, and the results of the TUG improved in group I. In the inter-group analysis, only the tone was lower in group II than in group I. Conclusions: Both PNF protocols were effective in treating patients with HAM/TSP.

  18. Influence of dance therapy on the functional mobility of children with spastic hemiparetic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Diogo Costa Garção

    2011-09-01

    Full Text Available The aim of this study was to investigate the influence of dance therapy on the functional mobility of children with spastic hemiparetic cerebral palsy. Ten female children (mean age 7.2 ± 1.2 years diagnosed with cerebral palsy were included. In order to evaluate their functional mobility, standing (D and walking, running and jumping (E dimensions from GMFM were applied, and measurements were carried out in two phases: 1 control, six weeks without any motor intervention, and 2 activity, 18 sessions of dancing. Children were assessed three times: first, before the control phase, second, after the control phase, and third, at the end of the dancing phase. Kruskal-Wallis (p < .05 and Dunn tests (p < .05 were used. There were no changes in performance between the two first phases of evaluation (p = 1.00, however, at the end of the dancing phase a significant increase was measured in relation to D (p < .01 and E dimensions (p < .01. Results showed that dance therapy influences children's functional mobility.

  19. Influence of dance therapy on the functional mobility of children with spastic hemiparetic cerebral palsy

    Directory of Open Access Journals (Sweden)

    D.C. Garção

    2011-01-01

    Full Text Available The aim of this study was to investigate the influence of dance therapy on the functional mobility of children with spastic hemiparetic cerebral palsy. Ten female children (mean age 7.2 ± 1.2 years diagnosed with cerebral palsy were included. In order to evaluate their functional mobility, standing (D and walking, running and jumping (E dimensions from GMFM were applied, and measurements were carried out in two phases: 1 control, six weeks without any motor intervention, and 2 activity, 18 sessions of dancing. Children were assessed three times: first, before the control phase, second, after the control phase, and third, at the end of the dancing phase. Kruskal-Wallis (p < .05 and Dunn tests (p < .05 were used. There were no changes in performance between the two first phases of evaluation (p = 1.00, however, at the end of the dancing phase a significant increase was measured in relation to D (p < .01 and E dimensions (p < .01. Results showed that dance therapy influences children's functional mobility.

  20. Electrophysiologic and Behavioral Assessment of Hearing Status in Children with Spastic Diplegia

    Directory of Open Access Journals (Sweden)

    Mohammad Kamali

    2011-06-01

    Full Text Available Background and Aim: High incidence of speech disorders in children with cerebral palsy could be related to a deficiency in processing of auditory stimuli. So it is vital to check out any peripheral or central disorders in auditory system using behavioral and electrophysiological auditory tests.Methods: In a cross-sectional study, 15 children with spastic diplegia, mean age 5.77, SD 2.26 years, and 15 normal children, mean age 5.33, SD 1.80 years, were tested using pure tone audiometry, immittance and auditory brainstem responses. The results were compared between the two groups.Results: Hearing thresholds and middle ear status were in normal range in all participants; however, contralateral acoustic reflex thresholds were mostly elevated. Comparing absolute latency and interpeak latency intervals of auditory brainstem responses between the two groups, absolute latency interval of later waves, and in specific the V wave, was significantly longer in diplegic children (p=0.04 resulting in a longer III-V interpeak latency intervals (p=0.02.Conclusion: Neurological disorders in ponto-reticulo-spinal pathway, pontine reticular nuclei and upper pons which are adjacent to auditory nuclei of lateral leminiscus and inferior colliculus result in auditory dys-synchrony and increased latency intervals in latter waves of auditory brainstem responses. This could also attributed to functional disorders in wave-generating sites in these patients.

  1. Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia.

    Science.gov (United States)

    Buckon, C E; Thomas, S S; Jakobson-Huston, S; Sussman, M; Aiona, M

    2001-06-01

    The purpose of this study was to examine the effectiveness of the hinged ankle-foot orthosis (HAFO), posterior leaf spring (PLS), and solid ankle-foot orthosis (SAFO), in preventing contracture, improving efficiency of gait, and enhancing performance of functional motor skills in 30 children (21 male, 9 female; mean age 9 years 4 months; age range 4 to 18 years,) with spastic hemiplegia. Following a 3-month baseline period of no ankle-foot orthosis (AFO) use, each AFO was worn for 3 months after which ankle range of motion, gait analysis, energy consumption, and functional motor skills were assessed. The HAFO and PLS increased passive ankle dorsiflexion and normalization of ankle rocker function during gait. Normalization of knee motion in stance was dependent upon the knee abnormality present and AFO configuration. The HAFO was the most effective in controlling knee hyperextension in stance, while PLS was the most effective in promoting knee extension in children with >10 degree knee flexion in stance. Energy efficiency was improved in 21 of the children, with 13 of these children demonstrating the greatest improvement in HAFO and PLS. Improvements in functional mobility were greatest in the HAFO and PLS. PMID:11409825

  2. MRI in spastic cerebral palsy - correlations with motor development and mental retardation

    International Nuclear Information System (INIS)

    The introduction of magnetic resonance (MR) has improved our understanding of the pathophysiology and early diagnosis of cerebral palsy (CP). The aim of this study was to evaluate types of lesions on MR in children with CP in correlations with motor development, cognitive impairment and risk factors. Twenty-two children aged 4-17 years (boys 12, girls 10) with CP diplegia - 16 and tetraplegia - 6 were studied. Routine MR images were performed in all children. Results: All patients had periventricular leukomalacia (PVL) in MR findings. In addition three different degrees of MRI lesion patterns were defined: a mild pattern (nucleus lentiformis and thalamus) moderate (nucleus lentiformis, thalamus and pericentral region)and a severe pattern (nucleus lentiformis , thalamus, pericentral region and hippocampus). Significant correlations of the MR findings with the motor development and mental retardation were found. No significant relationships between the MR findings and the etiological factors (prematurity, low birthweight, Apgar score, sepsis, seizures, pre-eclamsia , and gestational age) were noted. MR imaging is useful in the evaluation structural abnormalities in the brains in the children with spastic diplegia and tetraplegia. (author)

  3. Image compression in local helioseismology

    CERN Document Server

    Löptien, Björn; Gizon, Laurent; Schou, Jesper

    2014-01-01

    Context. Several upcoming helioseismology space missions are very limited in telemetry and will have to perform extensive data compression. This requires the development of new methods of data compression. Aims. We give an overview of the influence of lossy data compression on local helioseismology. We investigate the effects of several lossy compression methods (quantization, JPEG compression, and smoothing and subsampling) on power spectra and time-distance measurements of supergranulation flows at disk center. Methods. We applied different compression methods to tracked and remapped Dopplergrams obtained by the Helioseismic and Magnetic Imager onboard the Solar Dynamics Observatory. We determined the signal-to-noise ratio of the travel times computed from the compressed data as a function of the compression efficiency. Results. The basic helioseismic measurements that we consider are very robust to lossy data compression. Even if only the sign of the velocity is used, time-distance helioseismology is still...

  4. The possibilities of compressed sensing based migration

    KAUST Repository

    Aldawood, Ali

    2013-09-22

    Linearized waveform inversion or Least-square migration helps reduce migration artifacts caused by limited acquisition aperture, coarse sampling of sources and receivers, and low subsurface illumination. However, leastsquare migration, based on L2-norm minimization of the misfit function, tends to produce a smeared (smoothed) depiction of the true subsurface reflectivity. Assuming that the subsurface reflectivity distribution is a sparse signal, we use a compressed-sensing (Basis Pursuit) algorithm to retrieve this sparse distribution from a small number of linear measurements. We applied a compressed-sensing algorithm to image a synthetic fault model using dense and sparse acquisition geometries. Tests on synthetic data demonstrate the ability of compressed-sensing to produce highly resolved migrated images. We, also, studied the robustness of the Basis Pursuit algorithm in the presence of Gaussian random noise.

  5. Compressed beam directed particle nuclear energy generator

    International Nuclear Information System (INIS)

    This invention relates to the generation of energy from the fusion of atomic nuclei which are caused to travel towards each other along collision courses, orbiting in common paths having common axes and equal radii. High velocity fusible ion beams are directed along head-on circumferential collision paths in an annular zone wherein beam compression by electrostatic focusing greatly enhances head-on fusion-producing collisions. In one embodiment, a steady radial electric field is imposed on the beams to compress the beams and reduce the radius of the spiral paths for enhancing the particle density. Beam compression is achieved through electrostatic focusing to establish and maintain two opposing beams in a reaction zone

  6. Inelastic response of silicon to shock compression

    Science.gov (United States)

    Higginbotham, A.; Stubley, P. G.; Comley, A. J.; Eggert, J. H.; Foster, J. M.; Kalantar, D. H.; McGonegle, D.; Patel, S.; Peacock, L. J.; Rothman, S. D.; Smith, R. F.; Suggit, M. J.; Wark, J. S.

    2016-04-01

    The elastic and inelastic response of [001] oriented silicon to laser compression has been a topic of considerable discussion for well over a decade, yet there has been little progress in understanding the basic behaviour of this apparently simple material. We present experimental x-ray diffraction data showing complex elastic strain profiles in laser compressed samples on nanosecond timescales. We also present molecular dynamics and elasticity code modelling which suggests that a pressure induced phase transition is the cause of the previously reported ‘anomalous’ elastic waves. Moreover, this interpretation allows for measurement of the kinetic timescales for transition. This model is also discussed in the wider context of reported deformation of silicon to rapid compression in the literature.

  7. Fiber Effects on Compressibility of Peat

    Science.gov (United States)

    Johari, N. N.; Bakar, I.; Razali, S. N. M.; Wahab, N.

    2016-07-01

    Fibers found in the soil, especially in peaty soil play an important role in the determination of soil compressibility. Peat soils are the results from the decomposition of organic matter and the type of peat can be classified based on the fibrous material in the soil. In the engineering field, peat soil was mostly known as soils that has a serious settlement with high compressibility index. From the previous research, fibers in the soil were influenced in compressibility in terms of size, shape, fibric, soil arrangement and etc. Hence, this study attempts the determination of fibers effects on the compressibility of peat using a 1-D oedometer consolidation test. The reconstituted peat samples of different particle sizes were used to determine the consolidation parameters and the results obtained from reconstituted samples were also compared with the undisturbed sample. 1-D oedometer consolidation tests were performed on the samples by using the load increment method. The results shows, the higher particle size (R3.35), give higher moisture content (w = 401.20%) and higher initial void ratio (eo = 5.74). In settlement prediction, the higher the fiber content will results the higher the compression index, therefore, it will cause high of settlement.

  8. The Impacts of Hinged and Solid Ankle-Foot Orthoses on Standing and Walking in Children with Spastic Diplegia

    Directory of Open Access Journals (Sweden)

    Hamid DALVAND

    2013-11-01

    Full Text Available How to Cite This Article: Dalvand H, Dehghan L, Feizi A, Hosseini SA, Amirsalari S. Iran J Child Neurol. 2013 Autumn; 7(4:12-19.AbstractObjective The purpose of this study was to examine the impacts of hinged and solid anklefoot orthoses (AFOs on standing and walking abilities in children with spastic diplegia.Materials & MethodsIn a quasi-experimental design, 30 children with spastic diplegia, aged 4-6 years were recruited. They were matched in terms of age, IQ, and level of GMFCS E&R. Children were randomly assigned into 3 groups: a hinged AFO group (n=10 plus occupational therapy (OT, a solid AFO group (n=10 plus OT, a control group who used only OT for three months. Gross motor abilities weremeasured using Gross Motor Measure Function (GMFM.ResultsWe obtained statistically significant differences in the values between baseline and after treatment in all groups. The groups were also significantly different in total GMFM after intervention. Furthermore, there were differences between hinged AFOs and solid AFOs groups, and between hinged AFOs and control groups.ConclusionWe concluded that gross motor function was improved in all groups; however, hinged AFOs group appears to improve the gross motor function better than solid AFOs and control groups.ReferencesMiller F. Cerebral palsy. 1st ed. New York: Springer Science & Business Media; 2005.Wren TL, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: Influence of cerebral palsy subtype, age, and previous surgery. J Pediat Orthoped 2005;25(1:79-83.Knutosn L, Clark D. Orthotic devices for ambulation in children with cerebral palsy and myelomeningocele. Phys Ther 1991;71:947-60.Figueiredo EM, Ferreira GB, Maia Moreira RC, Kirkwood R, Fetters L. Efficacy of Ankle-Foot Orthoses on Gait of Children with Cerebral Palsy: Systematic Review of Literature. Pediat Phys Ther 2008; 20(3:207-23.Brehm MA, Harlaar J, Schwartz M. Effect of ankle

  9. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS-II Study

    Directory of Open Access Journals (Sweden)

    Klemens Fheodoroff

    2015-04-01

    Full Text Available In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A treatment in 456 adults with post-stroke upper limb spasticity (ULS. Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001, contractures (soft tissue shortening [STS] (p = 0.006 and spasticity (p = 0.02 than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001, contracture (p < 0.0001, spasticity (p < 0.001 and shorter time since stroke (p = 0.001. Patients setting goals for pain were older (p = 0.01 with more contractures (p = 0.008. The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (≤1 year vs. longer-term (>1 year post-stroke (80.0% vs. 79.2% or presence or absence of severe contractures (76.7% vs. 80.6%, although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  10. Data Compression for Helioseismology

    Science.gov (United States)

    Löptien, Björn

    2015-10-01

    Efficient data compression will play an important role for several upcoming and planned space missions involving helioseismology, such as Solar Orbiter. Solar Orbiter, to be launched in October 2018, will be the next space mission involving helioseismology. The main characteristic of Solar Orbiter lies in its orbit. The spacecraft will have an inclined solar orbit, reaching a solar latitude of up to 33 deg. This will allow, for the first time, probing the solar poles using local helioseismology. In addition, combined observations of Solar Orbiter and another helioseismic instrument will be used to study the deep interior of the Sun using stereoscopic helioseismology. The Doppler velocity and continuum intensity images of the Sun required for helioseismology will be provided by the Polarimetric and Helioseismic Imager (PHI). Major constraints for helioseismology with Solar Orbiter are the low telemetry and the (probably) short observing time. In addition, helioseismology of the solar poles requires observations close to the solar limb, even from the inclined orbit of Solar Orbiter. This gives rise to systematic errors. In this thesis, I derived a first estimate of the impact of lossy data compression on helioseismology. I put special emphasis on the Solar Orbiter mission, but my results are applicable to other planned missions as well. First, I studied the performance of PHI for helioseismology. Based on simulations of solar surface convection and a model of the PHI instrument, I generated a six-hour time-series of synthetic Doppler velocity images with the same properties as expected for PHI. Here, I focused on the impact of the point spread function, the spacecraft jitter, and of the photon noise level. The derived power spectra of solar oscillations suggest that PHI will be suitable for helioseismology. The low telemetry of Solar Orbiter requires extensive compression of the helioseismic data obtained by PHI. I evaluated the influence of data compression using

  11. Clinical Observation on Therapeutic Effects of the Point-Penetrating Method in Acupuncture Treatment of Spastic Hemiparalysis Due to Cerebrovascular Disorders

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the therapeutic effects of different acupuncture methods for spastic hemiparalysis due to cerebrovascular disorders. Methods: 90 cases of spastic hemiparalysis after wind-stroke were randomly divided into a control group of 30 cases, a body acupuncture group of 30 cases and a point-penetrating acupuncture group of 30 cases. All the patients were given 4 courses of treatment, with 7 sessions constituting one therapeutic course and with a one-day interval between courses. The evaluations were made 3 times, i.e. once before treatment and once every 15 days during the treatment. Results: The therapeutic effects in the point-penetrating acupuncture group were obviously superior to those of both the control group and the body acupuncture group. Conclusion: The point-penetrating acupuncture is an effective therapy for treating spastic hemiparalysis due to cerebrovascular disorders.

  12. Functional influence of botulinum neurotoxin type A treatment (Xeomin® of multifocal upper and lower limb spasticity on chronic hemiparetic gait

    Directory of Open Access Journals (Sweden)

    Maurizio Falso

    2012-05-01

    Full Text Available This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment.

  13. The usage of playing studies for development of spatial reasoning of 5-8-year-old children with spastic diplegi.

    Directory of Open Access Journals (Sweden)

    Shlapachenko O.A.

    2012-09-01

    Full Text Available In the article is shown the influence of rehabilitation-correction program with the usage of outdoor games on the level of influence of spatial thinking and constructive activity of 5-8-year-old children with spastic diplegi. 64 children took part in the experiment, all had main diagnosis - children cerebral paralysis, spastic diplegi. The experiment was conducted in a few phases during the year. It is proved that conducting of outdoor games promote positive influence on forming the level of influence of spatial thinking of children, increasing capacity of work. It is revealed that the level of development of spatial thinking of children with spastic diplegi depends on clinical display of an illness. It is mentioned that involving parents for participation in games with children promote rehabilitation of children in home conditions.

  14. A new intellectual disability syndrome caused by CTNNB1 haploinsufficiency.

    Science.gov (United States)

    Dubruc, Estelle; Putoux, Audrey; Labalme, Audrey; Rougeot, Christelle; Sanlaville, Damien; Edery, Patrick

    2014-06-01

    A girl patient born to healthy nonconsanguineous parents was referred at age 3 years and 2 months to our genetics department for testing due to developmental delay and postnatal microcephaly. Initial clinical evaluation revealed an overall developmental delay, mildly dysmorphic features, thin, sparse fair hair, and fair skin. Postnatal microcephaly and progressive ataxia and spasticity appeared later. Array CGH karyotyping showed a 333 kb de novo microdeletion on 3p22 covering the entire genomic sequence of a single gene, CTNNB1, which codes for β-catenin. β-catenin is a sub-unit of a multiprotein complex, which is part of the Wnt signaling pathway. In mice, a conditional homozygous β-catenin knockout displays loss of neurons, impaired craniofacial development, and hair follicle defects, which is similar to the phenotype presented by the patient described in this clinical report. Thus, CTNNB1 haploinsufficiency causes neuronal loss, craniofacial anomalies and hair follicle defects in both humans and mice. Point mutations in CTNNB1 in human have recently been reported but this is the first observation of a new recognizable multiple congenital anomaly/mental retardation syndrome caused by CTNNB1 haploinsufficiency. This clinical report should prompt a search for point mutations in CTNNB1 in patients presenting developmental delay, mild hair, skin and facial anomalies, and neurodegeneration characterized by postnatal microcephaly, and progressive ataxia and spasticity. © 2014 Wiley Periodicals, Inc. PMID:24668549

  15. Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosis.

    Science.gov (United States)

    Serpell, Michael G; Notcutt, William; Collin, Christine

    2013-01-01

    Sativex is an endocannabinoid system modulator principally containing Δ(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD). During a 6-week randomised controlled trial, Sativex had a clinically relevant effect on spasticity associated with multiple sclerosis (MS). Patients self-titrated oromucosal Sativex to symptom relief or maximum tolerated dose (maximum of 130 mg THC and 120 mg CBD daily). The primary objective was to evaluate the safety and tolerability of long-term treatment by recording the incidence and severity of adverse events (AEs). Secondary outcomes were to determine evidence of developing tolerance and to assess the long-term dosing profile of Sativex. A validated 11-point Numerical Rating Scale of spasticity severity was used to assess efficacy. A total of 146 patients elected to enter this open-label follow-up safety trial. Mean treatment exposure was 334 days (standard deviation, SD = 209 days), and patients administered on average 7.3 (SD = 4.42) actuations per day. Fifty-two (36 %) patients withdrew from the study in the first year, 14 % due to AEs and 9 % due to lack of efficacy. Most AEs were mild/moderate in severity. Common (>10 %) treatment-related AEs were dizziness (24.7 %) and fatigue (12.3 %). Serious AEs occurred in five patients (3.4 %), with two psychiatric events reported by one patient. No psychoses, psychiatric AE trends, or withdrawal symptoms occurred following abrupt cessation of treatment. Baseline symptoms including spasticity did not deteriorate but were maintained to study completion in those patients who did not withdraw. No new safety concerns were identified with chronic Sativex treatment, and serious AEs were uncommon. There was no evidence of tolerance developing, and patients who remained in the study reported continued benefit. PMID:22878432

  16. Delta-9-tetrahydrocannabinol/cannabidiol (Sativex®): a review of its use in patients with moderate to severe spasticity due to multiple sclerosis.

    Science.gov (United States)

    Syed, Yahiya Y; McKeage, Kate; Scott, Lesley J

    2014-04-01

    Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) [Sativex®] is an oromucosal spray formulation that contains principally THC and CBD at an approximately 1:1 fixed ratio, derived from cloned Cannabis sativa L. plants. The main active substance, THC, acts as a partial agonist at human cannabinoid receptors (CB1 and CB2), and thus, may modulate the effects of excitatory (glutamate) and inhibitory (gamma-aminobutyric acid) neurotransmitters. THC/CBD is approved in a number of countries, including Germany and the UK, as an add-on treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy. In the largest multinational clinical trial that evaluated the approved THC/CBD regimen in this population, 12 weeks' double-blind treatment with THC/CBD significantly reduced spasticity severity (primary endpoint) compared with placebo in patients who achieved a clinically significant improvement in spasticity after 4 weeks' single-blind THC/CBD treatment, as assessed by a patient-rated numerical rating scale. A significantly greater proportion of THC/CBD than placebo recipients achieved a ≥ 30% reduction (a clinically relevant reduction) in spasticity severity. The efficacy of THC/CBD has been also shown in at least one everyday clinical practice study (MOVE 2). THC/CBD was generally well tolerated in clinical trials. Dizziness and fatigue were reported most frequently during the first 4 weeks of treatment and resolved within a few days even with continued treatment. Thus, add-on THC/CBD is a useful symptomatic treatment option for its approved indication. PMID:24671907

  17. Carpal tunnel syndrome caused by cysticercosis

    OpenAIRE

    Sharma S; Sharma Nalini; Yeolekar M

    2010-01-01

    We present a case of carpal tunnel syndrome (CTS) due to compression of the median nerve within the carpal tunnel, caused by cysticercosis. Nerve conduction studies revealed severe CTS. Magnetic resonance imaging suggested an inflammatory mass compressing the median nerve in carpal tunnel. The histological diagnosis was consistent with cysticercosis. The case resolved with conservative treatment. Such solitary presentation of entrapment median neuropathy as CTS caused by cysticercosis is extr...

  18. Compressive Principal Component Pursuit

    CERN Document Server

    Wright, John; Min, Kerui; Ma, Yi

    2012-01-01

    We consider the problem of recovering a target matrix that is a superposition of low-rank and sparse components, from a small set of linear measurements. This problem arises in compressed sensing of structured high-dimensional signals such as videos and hyperspectral images, as well as in the analysis of transformation invariant low-rank recovery. We analyze the performance of the natural convex heuristic for solving this problem, under the assumption that measurements are chosen uniformly at random. We prove that this heuristic exactly recovers low-rank and sparse terms, provided the number of observations exceeds the number of intrinsic degrees of freedom of the component signals by a polylogarithmic factor. Our analysis introduces several ideas that may be of independent interest for the more general problem of compressed sensing and decomposing superpositions of multiple structured signals.

  19. Digital cinema video compression

    Science.gov (United States)

    Husak, Walter

    2003-05-01

    The Motion Picture Industry began a transition from film based distribution and projection to digital distribution and projection several years ago. Digital delivery and presentation offers the prospect to increase the quality of the theatrical experience for the audience, reduce distribution costs to the distributors, and create new business opportunities for the theater owners and the studios. Digital Cinema also presents an opportunity to provide increased flexibility and security of the movies for the content owners and the theater operators. Distribution of content via electronic means to theaters is unlike any of the traditional applications for video compression. The transition from film-based media to electronic media represents a paradigm shift in video compression techniques and applications that will be discussed in this paper.

  20. Advances in data compression

    Science.gov (United States)

    Davisson, L. D.; Gray, R. M.

    1975-01-01

    A rigorous real-variables treatment of general data compression and encoding problems, centered on formulation and proof of relevant existence theorems and a unified formulation of source coding (both noiseless and with a fidelity criterion) in inaccurately or incompletely specified statistical environments. Difficulties in modeling of sources with unknown or imperfectly known statistical descriptions are analyzed and source codes (SC) are classified (variable-rate noiseless SC, fixed-rate noiseless SC) and analyzed, along with types of code sequences (weighted-universal, maximin-universal, strongly or weakly minimax-universal). Universal coding on video data, variable-rate coding with distortion, and distortion-rate functions are discussed. Design strategies for universal coding algorithms are suggested, but the article is not oriented to specific methods of synthesizing data compression systems.

  1. Leg and Joint Stiffness in Children with Spastic Diplegic Cerebral Palsy during Level Walking.

    Directory of Open Access Journals (Sweden)

    Ting-Ming Wang

    Full Text Available Individual joint deviations are often identified in the analysis of cerebral palsy (CP gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in children with diplegic CP in terms of their leg stiffness, both skeletal and muscular components, and associated joint stiffness during gait. Twelve children with spastic diplegia CP and 12 healthy controls walked at a self-selected pace in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, mid-stance, terminal stance and pre-swing. For calculating the leg stiffness, each of the lower limbs was modeled as a non-linear spring, connecting the hip joint center and the corresponding center of pressure, with varying stiffness that was calculated as the slope (gradient of the axial force vs. the deformation curve. The leg stiffness was further decomposed into skeletal and muscular components considering the alignment of the lower limb. The ankle, knee and hip of the limb were modeled as revolute joints with torsional springs whose stiffness was calculated as the slope of the moment vs. the angle curve of the joint. Independent t-tests were performed for between-group comparisons of all the variables. The CP group significantly decreased the leg stiffness but increased the joint stiffness during stance phase, except during terminal stance where the leg stiffness was increased. They appeared to rely more on muscular contributions to achieve the required leg stiffness, increasing the muscular demands in maintaining the body posture against collapse. Leg stiffness plays a critical role in modulating the kinematics and kinetics of the locomotor system during gait in the diplegic CP.

  2. Dementia in SPG4 hereditary spastic paraplegia: clinical, genetic, and neuropathologic evidence.

    LENUS (Irish Health Repository)

    Murphy, S

    2012-02-01

    BACKGROUND: Cognitive impairment and dementia has been reported in autosomal dominant hereditary spastic paraparesis (HSP) linked to the SPG4 locus. There has only been one postmortem examination described; not all accept that progressive cognitive decline is a feature of this disorder. OBJECTIVE: A family with SPG4-HSP known to have a deletion of exon 17 in the spastin gene (SPG4delEx17) was cognitively assessed over a 7-year period. The index family member died and a postmortem examination was performed. METHODS: Thirteen family members older than 40 years were clinically and cognitively assessed using the Cambridge Cognitive Assessment over a 7-year period. The presence of SPG4delEx17 was assessed; a neuropathologic examination of the brain of the index family member was performed. RESULTS: Cognitive decline occurred in 6 of the 13 family members and in all 4 older than 60 years. Two genetic deletions were identified: SPG4delEx17 in 12 of the 13 family members and a deletion of SPG6 (SPG6del) in 5. Eight individuals had the SPG4delEx17 deletion only; 4 had evidence of progressive cognitive impairment. Four family members had both SPG4delEx17 and SPG6del; 2 of these had cognitive impairment. One family member with the SPG6del alone had neither HSP nor cognitive impairment. The index case with both deletions died with dementia; the brain showed widespread ubiquitin positivity within the neocortex and white matter. CONCLUSION: Cognitive decline and dementia is a feature of SPG4-HSP due to a deletion of exon 17 of the spastin gene.

  3. Compressible motion fields

    OpenAIRE

    Ottaviano, Giuseppe; Kohli, Pushmeet

    2013-01-01

    Traditional video compression methods obtain a compact representation for image frames by computing coarse motion fields defined on patches of pixels called blocks, in order to compensate for the motion in the scene across frames. This piecewise constant approximation makes the motion field efficiently encodable, but it introduces block artifacts in the warped image frame. In this paper, we address the problem of estimating dense motion fields that, while accurately predicting one frame from ...

  4. Compressibility of solids

    Science.gov (United States)

    Vinet, P.; Ferrante, J.; Rose, J. H.; Smith, J. R.

    1987-01-01

    A universal form is proposed for the equation of state (EOS) of solids. Good agreement is found for a variety of test data. The form of the EOS is used to suggest a method of data analysis, which is applied to materials of geophysical interest. The isothermal bulk modulus is discussed as a function of the volume and of the pressure. The isothermal compression curves for materials of geophysical interest are examined.

  5. Compression-based similarity

    OpenAIRE

    Vitányi, Paul

    2011-01-01

    First we consider pair-wise distances for literal objects consisting of finite binary files. These files are taken to contain all of their meaning, like genomes or books. The distances are based on compression of the objects concerned, normalized, and can be viewed as similarity distances. Second, we consider pair-wise distances between names of objects, like "red" or "christianity." In this case the distances are based on searches of the Internet. Such a search can be performed by any search...

  6. Compressibility of graphene

    OpenAIRE

    Abergel, D. S. L.; Hwang, E. H.; Sarma, S. Das

    2010-01-01

    We develop a theory for the compressibility and quantum capacitance of disordered monolayer and bilayer graphene including the full hyperbolic band structure and band gap in the latter case. We include the effects of disorder in our theory, which are of particular importance at the carrier densities near the Dirac point. We account for this disorder statistically using two different averaging procedures: first via averaging over the density of carriers directly, and then via averaging in the ...

  7. Estimation of motive possibilities and manipulative activity of children with cerebral paralysis of spastic form 3-5 years

    Directory of Open Access Journals (Sweden)

    Baybuza I.V.

    2012-03-01

    Full Text Available In this work the conducted estimation of motive possibilities and manipulative activity of children is with the cerebral paralysis of spastic form 3-5 years accordingly standard norms. The experiment was attended by 30 children. Proven lack of fine motor skills and basic static and motor skills decreased muscle strength and improve muscle tone. Providing a more objective assessment of physical development of patients with this pathology would contribute a program hydrokinesotherapy as a means of gradual formation of motor skills.

  8. Effect of r-TMS over standard therapy in decreasing muscle tone of spastic cerebral palsy patients.

    Science.gov (United States)

    Gupta, Meena; Lal Rajak, Bablu; Bhatia, Dinesh; Mukherjee, Arun

    2016-05-01

    Spastic cerebral palsy (CP) is the one of most common neurological disorders occurring due to damage to the immature brain or any other brain lesion at the time of birth. To aid in making the life of the CP patient meaningful, several interventions such as medical, surgical and rehabilitation have been employed to date. Besides these, recently repetitive Transcranial magnetic stimulation (r-TMS) is a new found approach which is being employed for treating various neurological and psychological conditions. The aim of this study was to observe the effects of r-TMS on muscle spasticity in CP patients by stimulating the motor cortex area of the brain, which is responsible for muscle movements. In this study, 20 subjects diagnosed with CP were recruited and 10 each were placed in two groups, namely the research group (RG) (mean age, height and weight were 7.99 (SD = 4.66) years, 116.7 (SD = 23.57) cm and 21.40 (SD = 10.95) kg, respectively) and the control group (CG) (mean age, height and weight were 8.41 (SD = 4.32) years, 107.9 (SD = 26.33) cm, 21.40 (SD = 12.63) kg, respectively). r-TMS frequencies of 5 Hz and 10 Hz were administered for 15 min daily to patients in RG followed by standard therapy (ST) of 1 h duration daily for 20 days. Moreover, the patients in the control group (CG) were given only standard therapy (ST) of 1 h duration for 20 days. Modified Ashworth Scale (MAS) was used as an outcome measure to determine the level of muscle spasticity. A pre- assessment of MAS score was performed on both RG and CG to determine the level of spasticity prior to starting therapy; and similarly post-assessment after 20 days was done to observe the changes post-therapy. Statistical analysis of pre vs post MAS scores showed that few muscles showed reduction in muscle tightness after administering only ST in the CG. On the contrary, the RG that underwent r-TMS therapy combined with ST showed a significant decrease (p < 0.05) in muscle tightness for all the

  9. Compressed random access memory

    CERN Document Server

    Jansson, Jesper; Sung, Wing-Kin

    2010-01-01

    Motivated by applications which need to store huge amounts of data in the main memory of a computer, this paper proposes a new dynamic data-structure for compressed random access memory. Ferragina and Venturini [SODA 2007, TCS 2007] recently gave a compressed data-structure for storing a string that allows substrings to be retrieved efficiently, but it requires the string to be static. Here, we extend their results in a non-trivial way to also allow the stored compressed string to be modified during execution. Our results are as follows. A memory (or string) $T[1..n]$, where each character $T[i]$ is of $\\log\\sigma$ bits, can be stored in $n H_k(T) + O(n \\log \\sigma \\frac{(k+1) (\\log \\sigma +\\log \\log n)}{\\log n})$ bits, where $H_k(T)$ is the $k$-th order empirical entropy of $T$, such that (1) accessing $T[i..j]$ takes optimal $O(1 + (j-i) / \\log_{\\sigma} n)$ time and (2) replacing $T[i..i+\\log_{\\sigma} n - 1]$ by another string of length $\\log_{\\sigma} n$ takes $O(\\log n/\\log\\log n)$ time. We can also suppor...

  10. Compressed sensing electron tomography

    Energy Technology Data Exchange (ETDEWEB)

    Leary, Rowan, E-mail: rkl26@cam.ac.uk [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge CB2 3QZ (United Kingdom); Saghi, Zineb; Midgley, Paul A. [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge CB2 3QZ (United Kingdom); Holland, Daniel J. [Department of Chemical Engineering and Biotechnology, University of Cambridge, New Museums Site, Pembroke Street, Cambridge CB2 3RA (United Kingdom)

    2013-08-15

    The recent mathematical concept of compressed sensing (CS) asserts that a small number of well-chosen measurements can suffice to reconstruct signals that are amenable to sparse or compressible representation. In addition to powerful theoretical results, the principles of CS are being exploited increasingly across a range of experiments to yield substantial performance gains relative to conventional approaches. In this work we describe the application of CS to electron tomography (ET) reconstruction and demonstrate the efficacy of CS–ET with several example studies. Artefacts present in conventional ET reconstructions such as streaking, blurring of object boundaries and elongation are markedly reduced, and robust reconstruction is shown to be possible from far fewer projections than are normally used. The CS–ET approach enables more reliable quantitative analysis of the reconstructions as well as novel 3D studies from extremely limited data. - Highlights: • Compressed sensing (CS) theory and its application to electron tomography (ET) is described. • The practical implementation of CS–ET is outlined and its efficacy demonstrated with examples. • High fidelity tomographic reconstruction is possible from a small number of images. • The CS–ET reconstructions can be more reliably segmented and analysed quantitatively. • CS–ET is applicable to different image content by choice of an appropriate sparsifying transform.

  11. Compression of Cake

    Science.gov (United States)

    Nason, Sarah; Houghton, Brittany; Renfro, Timothy

    2012-03-01

    The fall university physics class, at McMurry University, created a compression modulus experiment that even high school students could do. The class came up with this idea after a Young's modulus experiment which involved stretching wire. A question was raised of what would happen if we compressed something else? We created our own Young's modulus experiment, but in a more entertaining way. The experiment involves measuring the height of a cake both before and after a weight has been applied to the cake. We worked to derive the compression modulus by applying weight to a cake. In the end, we had our experimental cake and, ate it too! To cite this abstract, use the following reference: http://meetings.aps.org/link/BAPS.2012.TSS.B1.1 APS Home | APS Meetings | Join APS | Help | Contact APS Meetings var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); try var pageTracker = gat.getTracker("UA-324916-13"); pageTracker.trackPageview(); catch(err)

  12. Palmo-Plantar hyperkeratosis, intellectual disability, and spastic paraplegia in two maternal half brothers: further evidence for an X-linked inheritance.

    Science.gov (United States)

    Isidor, Bertrand; Lefebvre, Tiphaine; Barbarot, Sébastien; Perrier, Julie; Mercier, Sandra; Péréon, Yann; Le Caignec, Cédric; David, Albert

    2013-06-01

    In 1983, Fitzsimmons et al. reported four brothers with an unrecognized disorder characterized by intellectual disability, spastic paraplegia, and palmo-plantar hyperkeratosis (OMIM 309500). In this report, we describe a family in which two males, maternal half-brothers, had learning disabilities. Both patients also showed spasticity in the lower limbs and palmo-plantar hyperkeratosis. The mother of the affected boys had learning difficulties but did not show any dermatological symptoms. This report confirms that the association of features reported by Fitzsimmons et al. is a distinct entity and further suggests an X-linked mode of inheritance. PMID:23613454

  13. An unusual cause of trochlear nerve palsy and brainstem compression

    OpenAIRE

    Jasmit Singh; Hrushikesh Kharosekar; Vernon Velho; Praveen Survashe

    2016-01-01

    Schwannoma originates from the Schwann cells at the Obersteiner-Redlich zone, which marks the junction of central and peripheral myelin of the cranial nerves. Most frequently affected are the vestibular, trigeminal, and facial nerves followed by the lower cranial nerves. Trochlear schwannoma in the absence of neurofibromatosis is a rare entity. The purpose of this report is to serve as a reminder to consider trochlear nerve schwannoma in the list of differential diagnosis of such tumors as th...

  14. An unusual cause of trochlear nerve palsy and brainstem compression

    Directory of Open Access Journals (Sweden)

    Jasmit Singh

    2016-01-01

    Full Text Available Schwannoma originates from the Schwann cells at the Obersteiner-Redlich zone, which marks the junction of central and peripheral myelin of the cranial nerves. Most frequently affected are the vestibular, trigeminal, and facial nerves followed by the lower cranial nerves. Trochlear schwannoma in the absence of neurofibromatosis is a rare entity. The purpose of this report is to serve as a reminder to consider trochlear nerve schwannoma in the list of differential diagnosis of such tumors as the outcome is far better than the intraaxial tumor in that location.

  15. Ultraspectral sounder data compression review

    Institute of Scientific and Technical Information of China (English)

    Bormin HUANG; Hunglung HUANG

    2008-01-01

    Ultraspectral sounders provide an enormous amount of measurements to advance our knowledge of weather and climate applications. The use of robust data compression techniques will be beneficial for ultraspectral data transfer and archiving. This paper reviews the progress in lossless compression of ultra-spectral sounder data. Various transform-based, pre-diction-based, and clustering-based compression methods are covered. Also studied is a preprocessing scheme for data reordering to improve compression gains. All the coding experiments are performed on the ultraspectral compression benchmark dataset col-lected from the NASA Atmospheric Infrared Sounder (AIRS) observations.

  16. Compressed Data Transmission Among Nodes in BigData

    Directory of Open Access Journals (Sweden)

    Thirunavukarasu B

    2014-06-01

    Full Text Available Many organizations are now dealing with large amount of data. Traditionally they used relational data. But nowadays they are supposed to use structured and semi structured data. To work effectively these organizations uses virtualization, parallel processing in compression etc., out of which the compression is most effective one. The data transmission of high volume usually causes high transmission time. This compression of unstructured data is immediately done when the data is being transmitted from client to DataNode. Initially once unstructured or semi-structured data is ready for transmission, the data is compressed using some software tools or procedures. This compressed data is transmitted through certain medium that undertakes an effective transmission.

  17. Recommended frequency of ABPI review for patients wearing compression hosiery.

    Science.gov (United States)

    Furlong, Winnie

    2015-11-11

    This paper is a sequel to the article 'How often should patients in compression have ABPI recorded?' ( Furlong, 2013 ). Monitoring ankle brachial pressure index (ABPI) is essential, especially in those patients wearing compression hosiery, as it can change over time ( Simon et al, 1994 ; Pankhurst, 2004 ), particularly in the presence of peripheral arterial disease (PAD). Leg ulceration caused by venous disease requires graduated compression ( Wounds UK, 2002 ; Anderson, 2008). Once healed, compression hosiery is required to help prevent ulcer recurrence ( Vandongen and Stacey, 2000 ). The Royal College of Nursing ( RCN, 2006 ) guidelines suggest 3-monthly reviews, including ABPI, with no further guidance. Wounds UK (2002) suggests that patients who have ABPI<0.9, diabetes, reduced mobility or symptoms of claudication should have at least 3/12 Doppler, and that those in compression hosiery without complications who are able to report should have vascular assessment yearly. PMID:26559232

  18. Compressibility of municipal solid waste codisposed with fly ash.

    Science.gov (United States)

    Park, Hyun Il; Lee, Seung Rae

    2005-03-01

    If a municipal solid waste (MSW) landfill is used as the foundation for a construction site, the change in the loading conditions may cause considerable compression of the landfill. Therefore, reinforcement to compensate for the loose compression nature of a MSW landfill is a very important design factor for geotechnical engineers when considering the end-use of the landfill. In this study, we discuss a possible technique for stabilizing MSW landfills through the codisposal of municipal solid waste and fly ash. To estimate the stabilization based on the compression characteristics of the codisposed landfill, we performed tests using a large compression set and experimental cells. According to the test results, if the proportion of fly ash is increased, initial and long-term compression could be reduced. PMID:15828670

  19. Compression Aware Physical Database Design

    CERN Document Server

    Kimura, Hideaki; Syamala, Manoj

    2011-01-01

    Modern RDBMSs support the ability to compress data using methods such as null suppression and dictionary encoding. Data compression offers the promise of significantly reducing storage requirements and improving I/O performance for decision support queries. However, compression can also slow down update and query performance due to the CPU costs of compression and decompression. In this paper, we study how data compression affects choice of appropriate physical database design, such as indexes, for a given workload. We observe that approaches that decouple the decision of whether or not to choose an index from whether or not to compress the index can result in poor solutions. Thus, we focus on the novel problem of integrating compression into physical database design in a scalable manner. We have implemented our techniques by modifying Microsoft SQL Server and the Database Engine Tuning Advisor (DTA) physical design tool. Our techniques are general and are potentially applicable to DBMSs that support other co...

  20. Late-onset spastic paraplegia type 10 (SPG10) family presenting with bulbar symptoms and fasciculations mimicking amyotrophic lateral sclerosis.

    Science.gov (United States)

    Kaji, Seiji; Kawarai, Toshitaka; Miyamoto, Ryosuke; Nodera, Hiroyuki; Pedace, Lucia; Orlacchio, Antonio; Izumi, Yuishin; Takahashi, Ryosuke; Kaji, Ryuji

    2016-05-15

    Pathogenic mutations in the KIF5A-SPG10 gene, encoding the kinesin HC5A, can be associated with autosomal dominant hereditary spastic paraplegia (ADHSP). It accounts for about 10% of the complicated forms of ADHSP. Peripheral neuropathy, distal upper limb amyotrophy, and cognitive decline are the most common additional clinical features. We examined a 66-year-old Japanese woman manifesting gait disturbance and spastic dysarthria for 6years with positive family history. She showed evidence of upper and lower motor neuron involvement and fasciculations, thus mimicking amyotrophic lateral sclerosis (ALS). Genetic analysis revealed a heterozygous variant in KIF5A (c.484C>T, p.Arg162Trp) in 2 symptomatic members. The mutation was also identified in 4 asymptomatic members, including 2 elderly members aged over 78years. Electromyography in the 2 symptomatic members revealed evidence of lower motor neuron involvement and fasciculation potentials in distal muscles. This report describes the first known Asian family with a KIF5A mutation and broadens the clinical and electrophysiological spectrum associated with KIF5A-SPG10 mutations. Given that our cases showed pseudobulbar palsy, fasciculation and altered penetrance, KIF5A-SPG10 might well be considered as a differential diagnosis of sporadic ALS. PMID:27084214

  1. Loss of function of glucocerebrosidase GBA2 is responsible for motor neuron defects in hereditary spastic paraplegia.

    Science.gov (United States)

    Martin, Elodie; Schüle, Rebecca; Smets, Katrien; Rastetter, Agnès; Boukhris, Amir; Loureiro, José L; Gonzalez, Michael A; Mundwiller, Emeline; Deconinck, Tine; Wessner, Marc; Jornea, Ludmila; Oteyza, Andrés Caballero; Durr, Alexandra; Martin, Jean-Jacques; Schöls, Ludger; Mhiri, Chokri; Lamari, Foudil; Züchner, Stephan; De Jonghe, Peter; Kabashi, Edor; Brice, Alexis; Stevanin, Giovanni

    2013-02-01

    Spastic paraplegia 46 refers to a locus mapped to chromosome 9 that accounts for a complicated autosomal-recessive form of hereditary spastic paraplegia (HSP). With next-generation sequencing in three independent families, we identified four different mutations in GBA2 (three truncating variants and one missense variant), which were found to cosegregate with the disease and were absent in controls. GBA2 encodes a microsomal nonlysosomal glucosylceramidase that catalyzes the conversion of glucosylceramide to free glucose and ceramide and the hydrolysis of bile acid 3-O-glucosides. The missense variant was also found at the homozygous state in a simplex subject in whom no residual glucocerebrosidase activity of GBA2 could be evidenced in blood cells, opening the way to a possible measurement of this enzyme activity in clinical practice. The overall phenotype was a complex HSP with mental impairment, cataract, and hypogonadism in males associated with various degrees of corpus callosum and cerebellar atrophy on brain imaging. Antisense morpholino oligonucleotides targeting the zebrafish GBA2 orthologous gene led to abnormal motor behavior and axonal shortening/branching of motoneurons that were rescued by the human wild-type mRNA but not by applying the same mRNA containing the missense mutation. This study highlights the role of ceramide metabolism in HSP pathology. PMID:23332916

  2. Clinical pathophysiology of human T-lymphotropic virus-type1-associated myelopathy/tropical spastic paraparesis

    Directory of Open Access Journals (Sweden)

    YoshihisaYamano

    2012-11-01

    Full Text Available Human T-lymphotropic virus type 1 (HTLV-1, a human retrovirus, is the causative agent of a progressive neurological disease termed HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP. HAM/TSP is a chronic inflammatory disease of the central nervous system and is characterized by unremitting myelopathic symptoms such as spastic paraparesis, lower limb sensory disturbance, and bladder/bowel dysfunction. Approximately 0.25%–3.8% of HTLV-1-infected individuals develop HAM/TSP, which is more common in women than in men. Since the discovery of HAM/TSP, significant advances have been made with respect to elucidating the virological, molecular, and immunopathological mechanisms underlying this disease. These findings suggest that spinal cord invasion by HTLV-1-infected T cells triggers a strong virus-specific immune response and increases proinflammatory cytokine and chemokine production, leading to chronic lymphocytic inflammation and tissue damage in spinal cord lesions. However, little progress has been made in the development of an optimal treatment for HAM/TSP, more specifically in the identification of biomarkers for predicting disease progression and of molecular targets for novel therapeutic strategies targeting the underlying pathological mechanisms. This review summarizes current clinical and pathophysiological knowledge on HAM/TSP and discusses future focus areas for research on this disease.

  3. CYP2U1 mutations in two Iranian patients with activity induced dystonia, motor regression and spastic paraplegia

    Science.gov (United States)

    Kariminejad, A.; Schöls, L.; Schüle, R.; Tonekaboni, S.H.; Abolhassani, A.; Fadaee, M.; Rosti, R.O.; Gleeson, J.G.

    2016-01-01

    Hereditary spastic paraplegia (HSP) is a heterogeneous condition characterized by progressive spasticity and weakness in the lower limbs. It is divided into two major groups, complicated and uncomplicated, based on the presence of additional features such as intellectual disability, ataxia, seizures, peripheral neuropathy and visual problems. SPG56 is an autosomal recessive form of HSP with complicated and uncomplicated manifestations, complicated being more common. CYP2U1 gene mutations have been identified as responsible for SPG56. Intellectual disability, dystonia, subclinical sensory motor neuropathy, pigmentary degenerative maculopathy, thin corpus callosum and periventricular white-matter hyperintensities were additional features noted in previous cases of SPG56. Here we identified two novel mutations in CYP2U1 in two unrelated patients by whole exome sequencing. Both patients had complicated HSP with activity-induced dystonia, suggesting dystonia as an additional finding in SPG56. Two out of 14 previously reported patients had dystonia, and the addition of our patients suggests dystonia in a quarter of SPG56 patients. Developmental regression has not been reported in SPG56 patients so far but both of our patients developed motor regression in infancy. PMID:27292318

  4. The Role of Exercise – Rehabilitation on Energy Cost and Metabolic Efficiency in Dipelegic Spastic Cerebral Palsy Children

    Directory of Open Access Journals (Sweden)

    M. Izadi

    2005-07-01

    Full Text Available Introduction & Objective: The aim of this study was to compare the resting energy expenditure and metabolic efficiency before and after of aerobic exercise in spastic cerebral palsy children (mean age of 11 years and also to compare with those of normal children. Materials & Methods : Fifteen dipelegia spastic cerebral palsy children (experimental group participated in exercise–rehabilitation program by voluntarily and the peers eighteen able body children(control group were selected randomly. The experimental group(cp performed rehabilitation program for 3 months,3 session in week with work intensity(%HRR=462.5equal to144bpm of heart rate. The values were measured on tantory cycle ergometer according to Macmaster protocol.Results: Rest and exercise heart rate and exercise intensity(%HRR in patients decreased after rehabilitation program(P<0.05. The resting energy expenditure was similar in cp and normal groups. The rate of oxygen cost of patients decreased in post test(P<0.05 that showed increasing in metabolic efficiency.Conclusion: cerebral palsy children have greater exercise energy cost and lower cardiovascular fitness than normal children and exercise–rehabilitation leads to enhance of metabolic efficiency in this patients that is remarkable from clinical perception.

  5. Evaluation of the effect of the reduction of the hip spastic dislocation in adolescent and young adult with cerebral paralysis

    International Nuclear Information System (INIS)

    We present the results obtained in the Instituto de Ortopedia Infantil Roosevelt for the treatment of the hip dislocation in adolescent patients and young adults with spastic cerebral palsy with the open reduction of the hip, accompanied by femoral osteotomy and, if as necessary, pelvic osteotomy. 14 hips (10 patients) were intervened from January of 1996 to July of 2003. Pain was completely released in 54 percent and improved in 36 percent of cases. Abduction improved in 63 percent of patients allowing the perinea cleaning in 63 percent and better tolerance to scar in 64% of the cases. Our complications were one patient developed a sacred pressure ulcer with the spica cast treated with a free flap transposition; one hip had redislocation at 31 months from surgery; another hip had instability without clinical repercussion; one patient had a not displaced supracondylar femoral fracture treated with immobilization. The results of our study showed that the open reduction of the spastic hip in adolescents and young adults is a procedure that improves, in most of the cases, the stability, mobility and pain of the hip and provides better quality life for these patients

  6. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  7. Comparative data compression techniques and multi-compression results

    International Nuclear Information System (INIS)

    Data compression is very necessary in business data processing, because of the cost savings that it offers and the large volume of data manipulated in many business applications. It is a method or system for transmitting a digital image (i.e., an array of pixels) from a digital data source to a digital data receiver. More the size of the data be smaller, it provides better transmission speed and saves time. In this communication, we always want to transmit data efficiently and noise freely. This paper will provide some compression techniques for lossless text type data compression and comparative result of multiple and single compression, that will help to find out better compression output and to develop compression algorithms

  8. Comparative data compression techniques and multi-compression results

    Science.gov (United States)

    Hasan, M. R.; Ibrahimy, M. I.; Motakabber, S. M. A.; Ferdaus, M. M.; Khan, M. N. H.

    2013-12-01

    Data compression is very necessary in business data processing, because of the cost savings that it offers and the large volume of data manipulated in many business applications. It is a method or system for transmitting a digital image (i.e., an array of pixels) from a digital data source to a digital data receiver. More the size of the data be smaller, it provides better transmission speed and saves time. In this communication, we always want to transmit data efficiently and noise freely. This paper will provide some compression techniques for lossless text type data compression and comparative result of multiple and single compression, that will help to find out better compression output and to develop compression algorithms.

  9. Analysis by compression

    DEFF Research Database (Denmark)

    Meredith, David

    MEL is a geometric music encoding language designed to allow for musical objects to be encoded parsimoniously as sets of points in pitch-time space, generated by performing geometric transformations on component patterns. MEL has been implemented in Java and coupled with the SIATEC pattern...... discovery algorithm to allow for compact encodings to be generated automatically from in extenso note lists. The MEL-SIATEC system is founded on the belief that music analysis and music perception can be modelled as the compression of in extenso descriptions of musical objects....

  10. Compressive Fatigue in Wood

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben; Damkilde, Lars

    1999-01-01

    An investigation of fatigue failure in wood subjected to load cycles in compression parallel to grain is presented. Small clear specimens of spruce are taken to failure in square wave formed fatigue loading at a stress excitation level corresponding to 80% of the short term strength. Four...... frequencies ranging from 0.01 Hz to 10 Hz are used. The number of cycles to failure is found to be a poor measure of the fatigue performance of wood. Creep, maximum strain, stiffness and work are monitored throughout the fatigue tests. Accumulated creep is suggested identified with damage and a correlation is...

  11. Multiple snapshot compressive beamforming

    DEFF Research Database (Denmark)

    Gerstoft, Peter; Xenaki, Angeliki; Mecklenbrauker, Christoph F.;

    2015-01-01

    For sound fields observed on an array, compressive sensing (CS) reconstructs the multiple source signals at unknown directions-of-arrival (DOAs) using a sparsity constraint. The DOA estimation is posed as an underdetermined problem expressing the field at each sensor as a phase-lagged superposition...... of source amplitudes at all hypothetical DOAs. CS is applicable even for a single observation snapshot achieving a higher resolution than conventional beamforming. For multiple snapshots, CS outperforms conventional high-resolution methods, even with coherent arrivals and at low signal-to-noise ratio....

  12. Ultrasound beamforming using compressed data.

    Science.gov (United States)

    Li, Yen-Feng; Li, Pai-Chi

    2012-05-01

    The rapid advancements in electronics technologies have made software-based beamformers for ultrasound array imaging feasible, thus facilitating the rapid development of high-performance and potentially low-cost systems. However, one challenge to realizing a fully software-based system is transferring data from the analog front end to the software back end at rates of up to a few gigabits per second. This study investigated the use of data compression to reduce the data transfer requirements and optimize the associated trade-off with beamforming quality. JPEG and JPEG2000 compression techniques were adopted. The acoustic data of a line phantom were acquired with a 128-channel array transducer at a center frequency of 3.5 MHz, and the acoustic data of a cyst phantom were acquired with a 64-channel array transducer at a center frequency of 3.33 MHz. The receive-channel data associated with each transmit event are separated into 8 × 8 blocks and several tiles before JPEG and JPEG2000 data compression is applied, respectively. In one scheme, the compression was applied to raw RF data, while in another only the amplitude of baseband data was compressed. The maximum compression ratio of RF data compression to produce an average error of lower than 5 dB was 15 with JPEG compression and 20 with JPEG2000 compression. The image quality is higher with baseband amplitude data compression than with RF data compression; although the maximum overall compression ratio (compared with the original RF data size), which was limited by the data size of uncompressed phase data, was lower than 12, the average error in this case was lower than 1 dB when the compression ratio was lower than 8. PMID:22434817

  13. Compressive Bilateral Filtering.

    Science.gov (United States)

    Sugimoto, Kenjiro; Kamata, Sei-Ichiro

    2015-11-01

    This paper presents an efficient constant-time bilateral filter that produces a near-optimal performance tradeoff between approximate accuracy and computational complexity without any complicated parameter adjustment, called a compressive bilateral filter (CBLF). The constant-time means that the computational complexity is independent of its filter window size. Although many existing constant-time bilateral filters have been proposed step-by-step to pursue a more efficient performance tradeoff, they have less focused on the optimal tradeoff for their own frameworks. It is important to discuss this question, because it can reveal whether or not a constant-time algorithm still has plenty room for improvements of performance tradeoff. This paper tackles the question from a viewpoint of compressibility and highlights the fact that state-of-the-art algorithms have not yet touched the optimal tradeoff. The CBLF achieves a near-optimal performance tradeoff by two key ideas: 1) an approximate Gaussian range kernel through Fourier analysis and 2) a period length optimization. Experiments demonstrate that the CBLF significantly outperforms state-of-the-art algorithms in terms of approximate accuracy, computational complexity, and usability. PMID:26068315

  14. Fingerprints in Compressed Strings

    DEFF Research Database (Denmark)

    Bille, Philip; Cording, Patrick Hagge; Gørtz, Inge Li;

    2013-01-01

    The Karp-Rabin fingerprint of a string is a type of hash value that due to its strong properties has been used in many string algorithms. In this paper we show how to construct a data structure for a string S of size N compressed by a context-free grammar of size n that answers fingerprint queries....... That is, given indices i and j, the answer to a query is the fingerprint of the substring S[i,j]. We present the first O(n) space data structures that answer fingerprint queries without decompressing any characters. For Straight Line Programs (SLP) we get O(logN) query time, and for Linear SLPs (an SLP...... derivative that captures LZ78 compression and its variations) we get O(loglogN) query time. Hence, our data structures has the same time and space complexity as for random access in SLPs. We utilize the fingerprint data structures to solve the longest common extension problem in query time O(logNlogℓ) and O...

  15. Compressive Sensing DNA Microarrays

    Directory of Open Access Journals (Sweden)

    Sheikh Mona A

    2009-01-01

    Full Text Available Compressive sensing microarrays (CSMs are DNA-based sensors that operate using group testing and compressive sensing (CS principles. In contrast to conventional DNA microarrays, in which each genetic sensor is designed to respond to a single target, in a CSM, each sensor responds to a set of targets. We study the problem of designing CSMs that simultaneously account for both the constraints from CS theory and the biochemistry of probe-target DNA hybridization. An appropriate cross-hybridization model is proposed for CSMs, and several methods are developed for probe design and CS signal recovery based on the new model. Lab experiments suggest that in order to achieve accurate hybridization profiling, consensus probe sequences are required to have sequence homology of at least 80% with all targets to be detected. Furthermore, out-of-equilibrium datasets are usually as accurate as those obtained from equilibrium conditions. Consequently, one can use CSMs in applications in which only short hybridization times are allowed.

  16. MULTILEVEL SOFT TISSUE WITH BONY CORRECTIVE SURGERY IN LOWER LIMB DEFORMITIES AS ONE SITTING PROCEDURE IN SPASTIC CEREBRAL PALSY: AN EXPERIENCE FROM FREE DISABLED SURGICAL CAMPS

    Directory of Open Access Journals (Sweden)

    Antony R

    2015-06-01

    Full Text Available The study was intended to assess the results of multilevel soft tissue with bony corrective surgery as one sitting procedure on static deformities and contractures in lower limbs with patients of spastic cerebral palsy at free disabled surgical camps at Chhattisgarh state. In our study 30 patients were included with sixty percent male and forty percent female , within 4 - 16 years age group. Almost all patients had diplegia and only few patients had quadriplegia with grade 3 power in both upper limbs. Improvement in functional ability and locomotion of all operated patients were asse ssed by gross motor functional classification scale and with physical examination. Almost all patients who were operated in our study showed significant improvement in functional abilities and locomotion after surgery. All patients were maintaining functional abilities at follow up duration of 2 years (24 months, with 70%. excellent cases gait of patient were normal or mild spastic but they were walking without support , with 20% good cases gait of patients were spastic but patients comfortably walk with short knee braces and with 10% fair cases gait of patients were scissors but patients walked comfortably with long knee braces . Our study shows that, promising results can be obtained in spastic cerebral palsy patients with static deformities and cont ractures of joints in lower limbs with multilevel soft tissue and bony corrective surgery. We believe that it’s a team effort of the surgeon , paramedical and rehabilitation staff in postoperative period for the achievement of better results.

  17. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients

    NARCIS (Netherlands)

    Niet, M. de; Latour, H.; Hendricks, H.T.; Geurts, A.C.H.; Weerdesteijn, V.G.M.

    2011-01-01

    de Niet M, Latour H, Hendricks H, Geurts AC, Weerdesteyn V. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients. OBJECTIVE: To identify whether a relationship exists between stretch and activity of the calf muscles du

  18. The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

  19. The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy

    NARCIS (Netherlands)

    Jelsma, Jennifer; Pronk, Marieke; Ferguson, Gillian; Jelsma-Smit, Dorothee

    2013-01-01

    Objective: To study the impact of training using the Nintendo Wii Fit in 14 children with spastic hemiplegic cerebral palsy. Methods: A single-subject single blinded design with multiple subjects and baselines was utilised. Interactive video gaming (IVG) in lieu of regular physiotherapy was given fo

  20. Data compression on the sphere

    CERN Document Server

    McEwen, J D; Eyers, D M; 10.1051/0004-6361/201015728

    2011-01-01

    Large data-sets defined on the sphere arise in many fields. In particular, recent and forthcoming observations of the anisotropies of the cosmic microwave background (CMB) made on the celestial sphere contain approximately three and fifty mega-pixels respectively. The compression of such data is therefore becoming increasingly important. We develop algorithms to compress data defined on the sphere. A Haar wavelet transform on the sphere is used as an energy compression stage to reduce the entropy of the data, followed by Huffman and run-length encoding stages. Lossless and lossy compression algorithms are developed. We evaluate compression performance on simulated CMB data, Earth topography data and environmental illumination maps used in computer graphics. The CMB data can be compressed to approximately 40% of its original size for essentially no loss to the cosmological information content of the data, and to approximately 20% if a small cosmological information loss is tolerated. For the topographic and il...