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Sample records for cord palsy comparison

  1. Vocal cord palsy: An uncommon presenting feature of myasthenia gravis

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    Sethi Prahlad

    2011-01-01

    Full Text Available Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy. Viral neuronitis accounts for most idiopathic cases. Bilateral vocal cord palsy, on the other hand, is much less common and is a potentially life-threatening condition. Myasthenia gravis, an autoimmune disorder caused by antibodies targeting the post-synaptic acetylcholine receptor, has been infrequently implicated in its causation. We report here a case of bilateral vocal cord palsy developing in a 68-year-old man with no prior history of myasthenia gravis 2 months after he was operated on for diverticulitis of the large intestine. Delay in considering the diagnosis led to endotracheal intubation and prolonged mechanical ventilation with attendant complications. Our case adds to the existing literature implicating myasthenia gravis as an infrequent cause of bilateral vocal cord palsy. Our case is unusual as, in our patient, acute-onset respiratory distress and stridor due to bilateral vocal cord palsy was the first manifestation of a myasthenic syndrome.

  2. Causes of Acquired Vocal Cord Palsy in Indian Scenario.

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    Swapna Sebastian

    2012-10-01

    Full Text Available Vocal cord paresis or paralysis occurs due to lesion in the vagus nerve. Vocal cord paralysis can lead to dysphonia as well as dysphagia which lead the patient to frustration and emotional problems. The literature available on the etiology and the problems faced by them in Indian population is very scanty. Hence a prospective study was done on 41 Patients with vocal cord palsy who were referred to the Department of ENT for voice assessment and management from March 1st 2012 till 1st August 2012. The medical and surgical reports were examined. They were evaluated by an otorhinolaryngologist, and a Speech Language Pathologist. Diagnosis was made based on video stroboscopic findings. We also examined voice-related quality of life (V-RQOL outcomes in these patients. In this study, endo-tracheal intubation (15/41; 36.5% was the major cause of vocal cord palsy. The second major cause for vocal cord palsy in our study was surgical trauma (iatrogenic which constituted 26.8% (11/41, out of which thyroidectomy contributed to 81.81% (9/11 and cardiac surgery (Coronary Artery Bypass Grafting (CABG contributed to 18.18% (2/11. Neurological problems caused 14.63% (6/41 of the total cases. Non-surgical trauma constituted 9.75% (4/41 of the total patients. Left recurrent laryngeal nerve paralysis was found as a complication of heart disease in 7.3%(3/41. Tuberculosis of lungs and cancer of lungs accounted to be the rarest causes. Hoarseness of voice was the most common symptom with associated dysphagia in a few. The voice related quality of life of these patients was found to be poor. They were found to have problems in the social-emotional domain and physical functioning domain.

  3. Therapeutic Potential of Umbilical Cord Mesenchymal Stromal Cells Transplantation for Cerebral Palsy: A Case Report

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    Liming Wang; Haijie Ji; Jianjun Zhou,; Jiang Xie; Zhanqiang Zhong; Ming Li; Wen Bai; Na Li; Zijia Zhang; Xuejun Wang; Delin Zhu; Yongjun Liu; Mingyuan Wu

    2013-01-01

    Cerebral palsy is the most common motor disability in childhood. In current paper, we first report our clinical data regarding administration of umbilical cord mesenchymal stem cells (MSCs) transplantation in treatment of cerebral palsy. A 5-year-old girl with cerebral palsy was treated with multiple times of intravenous and intrathecal administration of MSCs derived from her young sister and was followed up for 28 months. The gross motor dysfunction was improved. Other benefits included enha...

  4. Multiple System Atrophy Manifested by Bilateral Vocal Cord Palsy as an Initial Sign

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    Yuri Seo

    2015-05-01

    Full Text Available A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA. After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Nighttime hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.

  5. FDG-PET/CT can rule out malignancy in patients with vocal cord palsy

    DEFF Research Database (Denmark)

    Thomassen, Anders; Nielsen, Anne Lerberg; Lauridsen, Jeppe Kiilerich

    2014-01-01

    vocal cords. PET/CT results were compared to clinical workup and histopathology. The study comprised 65 patients (32 females) with a mean age of 66±12 years (range 37-89). Eleven patients (17%) had antecedent cancer. Twenty-seven (42%) were diagnosed with cancer during follow-up. The palsy was right...

  6. FDG-PET/CT can rule out malignancy in patients with vocal cord palsy

    DEFF Research Database (Denmark)

    Thomassen, Anders; Nielsen, Anne Lerberg; Lauridsen, Jeppe Kiilerich;

    2014-01-01

    The aim was to investigate the performance of (18)F-fluorodeoxyglucose PET/CT to rule out malignancy in patients with confirmed vocal cord palsy (VCP). Between January 2011 and June 2013, we retrospectively included consecutive patients referred to PET/CT with paresis or paralysis of one or both...

  7. Therapeutic potential of umbilical cord mesenchymal stromal cells transplantation for cerebral palsy: a case report.

    Science.gov (United States)

    Wang, Liming; Ji, Haijie; Zhou, Jianjun; Xie, Jiang; Zhong, Zhanqiang; Li, Ming; Bai, Wen; Li, Na; Zhang, Zijia; Wang, Xuejun; Zhu, Delin; Liu, Yongjun; Wu, Mingyuan

    2013-01-01

    Cerebral palsy is the most common motor disability in childhood. In current paper, we first report our clinical data regarding administration of umbilical cord mesenchymal stem cells (MSCs) transplantation in treatment of cerebral palsy. A 5-year-old girl with cerebral palsy was treated with multiple times of intravenous and intrathecal administration of MSCs derived from her young sister and was followed up for 28 months. The gross motor dysfunction was improved. Other benefits included enhanced immunity, increased physical strength, and adjusted speech and comprehension. Temporary low-grade fever was the only side effect during the treatment. MSCs may be a safe and effective therapy to improve symptoms in children with cerebral palsy.

  8. Therapeutic Potential of Umbilical Cord Mesenchymal Stromal Cells Transplantation for Cerebral Palsy: A Case Report

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    Liming Wang

    2013-01-01

    Full Text Available Cerebral palsy is the most common motor disability in childhood. In current paper, we first report our clinical data regarding administration of umbilical cord mesenchymal stem cells (MSCs transplantation in treatment of cerebral palsy. A 5-year-old girl with cerebral palsy was treated with multiple times of intravenous and intrathecal administration of MSCs derived from her young sister and was followed up for 28 months. The gross motor dysfunction was improved. Other benefits included enhanced immunity, increased physical strength, and adjusted speech and comprehension. Temporary low-grade fever was the only side effect during the treatment. MSCs may be a safe and effective therapy to improve symptoms in children with cerebral palsy.

  9. Therapeutic Potential of Umbilical Cord Mesenchymal Stromal Cells Transplantation for Cerebral Palsy: A Case Report

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    Wang, Liming; Ji, Haijie; Zhou, Jianjun; Xie, Jiang; Zhong, Zhanqiang; Li, Ming; Bai, Wen; Li, Na; Zhang, Zijia; Wang, Xuejun; Zhu, Delin; Liu, Yongjun; Wu, Mingyuan

    2013-01-01

    Cerebral palsy is the most common motor disability in childhood. In current paper, we first report our clinical data regarding administration of umbilical cord mesenchymal stem cells (MSCs) transplantation in treatment of cerebral palsy. A 5-year-old girl with cerebral palsy was treated with multiple times of intravenous and intrathecal administration of MSCs derived from her young sister and was followed up for 28 months. The gross motor dysfunction was improved. Other benefits included enhanced immunity, increased physical strength, and adjusted speech and comprehension. Temporary low-grade fever was the only side effect during the treatment. MSCs may be a safe and effective therapy to improve symptoms in children with cerebral palsy. PMID:23533920

  10. Could autologous cord blood stem cell transplantation treat cerebral palsy?

    National Research Council Canada - National Science Library

    Chen, Aiqing; Clowry, Gavin J

    2011-01-01

    .... This is why initially in cerebral palsy only subtle changes in spontaneous movements are seen after the time of lesion, followed by a progressive evolution of a movement disorder over many months and years...

  11. A Case of Transient Local Anesthetic Induced Bilateral Vocal Cord Palsy

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    M. Rafiq

    2015-01-01

    Full Text Available We report a rare case of bilateral vocal cord palsy following total thyroidectomy with successful extubation within 12 hours. The patient is a 33-year-old lady who underwent uneventful total thyroidectomy for compressive symptoms. Thirty minutes after extubation, she developed stridor and the flexible laryngoscopy showed bilaterally adducted vocal cords. The patient, thus, was reintubated and after 12 hours she met the extubation parameters and so she was extubated successfully. The repeated flexible laryngoscopy showed normal vocal cords. A review of the literature revealed limited information on this transient condition.

  12. A Case of Transient Local Anesthetic Induced Bilateral Vocal Cord Palsy

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    Rafiq, M.; Al-Zoraigi, U.; Alzahrani, S.; Alabdulkarim, Y.

    2015-01-01

    We report a rare case of bilateral vocal cord palsy following total thyroidectomy with successful extubation within 12 hours. The patient is a 33-year-old lady who underwent uneventful total thyroidectomy for compressive symptoms. Thirty minutes after extubation, she developed stridor and the flexible laryngoscopy showed bilaterally adducted vocal cords. The patient, thus, was reintubated and after 12 hours she met the extubation parameters and so she was extubated successfully. The repeated flexible laryngoscopy showed normal vocal cords. A review of the literature revealed limited information on this transient condition. PMID:26167326

  13. Bilateral vocal cord palsy causing stridor as the only symptom of syringomyelia and Chiari I malformation, a case report

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    Saif Yousif

    2016-01-01

    Conclusion: Although uncommon, formation of a syrinx should be considered for patients who present with stridor and reiterates the importance of MRI as an important investigative tool of bilateral vocal cord palsy.

  14. Feasibility of trialling cord blood stem cell treatments for cerebral palsy in Australia.

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    Crompton, Kylie E; Elwood, Ngaire; Kirkland, Mark; Clark, Pamela; Novak, Iona; Reddihough, Dinah

    2014-07-01

    Umbilical cord blood may have therapeutic benefit in children with cerebral palsy (CP), but further studies are required. On first appearance it seems that Australia is well placed for such a trial because we have excellence in CP research backed by extensive CP registers, and both public and private cord blood banks. We aimed to examine the possibilities of conducting a trial of autologous umbilical cord blood cells (UCBCs) as a treatment for children with CP in Australia. Data linkages between CP registers and cord blood banks were used to estimate potential participant numbers for a trial of autologous UCBCs for children with CP. As of early 2013, one Victorian child with CP had cord blood stored in the public bank, and between 1 and 3 children had their cord blood stored at Cell Care Australia (private cord blood bank). In New South Wales, we counted two children on the CP register who had their stored cord blood available in early 2013. We estimate that there are between 10 and 24 children with CP of any type who have autologous cord blood available across Australia. In nations with small populations like Australia, combined with Australia's relatively low per capita cord blood storage to date, it is not currently feasible to conduct trials of autologous UCBCs for children with CP. Other options must be explored, such as allogeneic UCBCs or prospective trials for neonates at risk of CP. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. Bilateral Vocal Cord Palsy with Arnold Chiari Malformation: A Rare Case Series

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    Arora, Nikhil; Meher, Ravi; Bhargava, Eishaan K.

    2016-01-01

    Stridor in paediatric age group is not an uncommon presentation to the ENT emergency. The range of differential diagnosis is vast. The presentation may vary from noisy breathing to severe respiratory distress and apnea. Early and meticulous diagnosis is crucial for the management as the condition may be life threatening. We report a rare case series of 3 infants with Arnold Chiari Malformation who presented to the hospital with stridor and were diagnosed with bilateral vocal cord palsy. These 3 infants had similar underlying neurological condition with hydrocephalus and raised intracranial pressure. Chiari malformation is the one of the most common congenital central nervous system anomaly associated with bilateral vocal cord paralysis. However, the presentation is rare. This article, thus, emphasizes the significance of early diagnosis and immediate management of this condition. PMID:27790480

  16. Umbilical cord blood cells for treatment of cerebral palsy; timing and treatment options.

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    McDonald, Courtney A; Fahey, Michael C; Jenkin, Graham; Miller, Suzanne L

    2017-09-22

    Cerebral palsy is the most common cause of physical disability in children, and there is no cure. Umbilical cord blood (UCB) cell therapy for the treatment of children with cerebral palsy is currently being assessed in clinical trials. While there is much interest in the use of UCB stem cells for neuroprotection and neuroregeneration, the mechanisms of action are not fully understood. Further, UCB contains many stem and progenitor cells of interest, and we will point out that individual cell types within UCB may elicit specific effects. UCB is a clinically proven source of hemotopoietic stem cells (HSCs). It also contains mesenchymal stromal cells (MSCs), endothelial progenitor cells (EPCs) and immunosupressive cells such as regulatory T cells (Tregs) and monocyte-derived supressor cells. Each of these cell types may be individual candidates for the prevention of brain injury following hypoxic and inflammatory events in the perinatal period. We will discuss specific properties of cell types in UCB, with respect to their therapeutic potential and the importance of optimal timing of administration. We propose that tailored cell therapy and targeted timing of administration will optimise results for future clinical trials in the neuroprotective treatment of perinatal brain injury.Pediatric Research accepted article preview online, 22 September 2017. doi:10.1038/pr.2017.236.

  17. Umbilical cord blood biomarkers of neurologic injury and the risk of cerebral palsy or infant death.

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    Costantine, Maged M; Weiner, Steven J; Rouse, Dwight J; Hirtz, Deborah G; Varner, Michael W; Spong, Catherine Y; Mercer, Brian M; Iams, Jay D; Wapner, Ronald J; Sorokin, Yoram; Thorp, John M; Ramin, Susan M; O'Sullivan, Mary J; Peaceman, Alan M; Simhan, Hyagriv N

    2011-12-01

    To evaluate the association between cerebral palsy (CP) or infant death and putative cord blood biomarkers of neurologic injury, we performed a nested case-control secondary analysis of a multicenter randomized trial of magnesium sulfate (MgSO(4)) versus placebo to prevent CP or death among offspring of women with anticipated delivery from 24 to 31 weeks' gestation. Cases were infants who died by 1 year (n=25) or developed CP (n=16), and were matched 1:2 to a control group (n=82) that survived without developing CP. Umbilical cord sera concentrations of S100B, neuron-specific enolase (NSE) and the total soluble form of the receptor for advanced glycation end-products (sRAGE) were measured by ELISA in duplicates. Maternal characteristics were similar between the 2 groups. Cases were born at a lower gestational age (GA) and had lower birth weight compared with controls. There were no differences in concentrations of the three biomarkers and the composite outcome of CP or infant death. However, S100B was higher (median 847.3 vs. 495.7 pg/ml; P=0.03) in infants who had CP and total sRAGE was lower (median 1259.3 vs. 1813.1 pg/ml; P=0.02) in those who died compared with the control group. When corrected for delivery GA and treatment group, both differences lost statistical significance. In conclusion, cord blood S100B level may be associated with CP, but this association was not significant after controlling for GA and MgSO(4) treatment.

  18. Levodopa reverse stridor and prevent subsequent endotracheal intubation in Parkinson disease patients with bilateral vocal cord palsy: A case report.

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    Tsai, Chia-Chan; Wu, Meng-Ni; Liou, Li-Min; Chang, Yang-Pei

    2016-12-01

    Respiratory abnormalities are often overlooked; however, because of their potential comorbidity, they must be analyzed to determine the most effective treatment for patients with Parkinson disease (PD). Among various theories on respiratory abnormalities in PD, "upper airway obstruction" and "restrictive respiratory disorders" are 2 of the most accepted etiologies; both appear to be related to basal ganglia dysfunction. Complex vocal cord muscle dysfunction contributes to stridor, which can be a manifestation of nigrostriatal dopaminergic dysfunction. Stridor is a lethal form of upper airway obstruction in PD patients; its most frequent causes are bilateral vocal cord palsy, laryngeal spasms, and dystonia of the supra-laryngeal muscle. Several previous studies have suggested that levodopa administration induces a significant improvement of both lung function and symptoms of parkinsonian syndrome. We reported a 77-year-old gentleman PD patient admitted for acute levodopa-responsive stridor resulting from bilateral vocal cord palsy. Dopaminergic therapy prevented the need for subsequent endotracheal intubation and tracheostomy treatment. It is vital to understand that complex vocal cord muscle dysfunction may be related to nigrostriatal dopaminergic dysfunction in PD patients. The strategy of levodopa up-titration should be considered an option because it may be beneficial in relieving both stridor and parkinsonian syndrome, and in preventing respiratory failure.

  19. Levodopa reverse stridor and prevent subsequent endotracheal intubation in Parkinson disease patients with bilateral vocal cord palsy

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    Tsai, Chia-Chan; Wu, Meng-Ni; Liou, Li-Min; Chang, Yang-Pei

    2016-01-01

    Abstract Background: Respiratory abnormalities are often overlooked; however, because of their potential comorbidity, they must be analyzed to determine the most effective treatment for patients with Parkinson disease (PD). Among various theories on respiratory abnormalities in PD, “upper airway obstruction” and “restrictive respiratory disorders” are 2 of the most accepted etiologies; both appear to be related to basal ganglia dysfunction. Complex vocal cord muscle dysfunction contributes to stridor, which can be a manifestation of nigrostriatal dopaminergic dysfunction. Stridor is a lethal form of upper airway obstruction in PD patients; its most frequent causes are bilateral vocal cord palsy, laryngeal spasms, and dystonia of the supra-laryngeal muscle. Several previous studies have suggested that levodopa administration induces a significant improvement of both lung function and symptoms of parkinsonian syndrome. Case Summary: We reported a 77-year-old gentleman PD patient admitted for acute levodopa-responsive stridor resulting from bilateral vocal cord palsy. Dopaminergic therapy prevented the need for subsequent endotracheal intubation and tracheostomy treatment. Conclusion: It is vital to understand that complex vocal cord muscle dysfunction may be related to nigrostriatal dopaminergic dysfunction in PD patients. The strategy of levodopa up-titration should be considered an option because it may be beneficial in relieving both stridor and parkinsonian syndrome, and in preventing respiratory failure. PMID:27977587

  20. Human Umbilical Cord Blood Cells Ameliorate Motor Deficits in Rabbits in a Cerebral Palsy Model.

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    Drobyshevsky, Alexander; Cotten, C Michael; Shi, Zhongjie; Luo, Kehuan; Jiang, Rugang; Derrick, Matthew; Tracy, Elizabeth T; Gentry, Tracy; Goldberg, Ronald N; Kurtzberg, Joanne; Tan, Sidhartha

    2015-01-01

    Cerebral palsy (CP) has a significant impact on both patients and society, but therapy is limited. Human umbilical cord blood cells (HUCBC), containing various stem and progenitor cells, have been used to treat various brain genetic conditions. In small animal experiments, HUCBC have improved outcomes after hypoxic-ischemic (HI) injury. Clinical trials using HUCBC are underway, testing feasibility, safety and efficacy for neonatal injury as well as CP. We tested HUCBC therapy in a validated rabbit model of CP after acute changes secondary to HI injury had subsided. Following uterine ischemia at 70% gestation, we infused HUCBC into newborn rabbit kits with either mild or severe neurobehavioral changes. Infusion of high-dose HUCBC (5 × 10(6) cells) dramatically altered the natural history of the injury, alleviating the abnormal phenotype including posture, righting reflex, locomotion, tone, and dystonia. Half the high dose showed lesser but still significant improvement. The swimming test, however, showed that joint function did not restore to naïve control function in either group. Tracing HUCBC with either MRI biomarkers or PCR for human DNA found little penetration of HUCBC in the newborn brain in the immediate newborn period, suggesting that the beneficial effects were not due to cellular integration or direct proliferative effects but rather to paracrine signaling. This is the first study to show that HUCBC improve motor performance in a dose-dependent manner, perhaps by improving compensatory repair processes. © 2015 S. Karger AG, Basel.

  1. Involvement of Immune Responses in the Efficacy of Cord Blood Cell Therapy for Cerebral Palsy.

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    Kang, Mino; Min, Kyunghoon; Jang, Joonyoung; Kim, Seung Chan; Kang, Myung Seo; Jang, Su Jin; Lee, Ji Young; Kim, Sang Heum; Kim, Moon Kyu; An, SeongSoo A; Kim, MinYoung

    2015-10-01

    This study evaluated the efficacy of umbilical cord blood (UCB) cell for patients with cerebral palsy (CP) in a randomized, placebo-controlled, double-blind trial and also assessed factors and mechanisms related to the efficacy. Thirty-six children (ages 6 months to 20 years old) with CP were enrolled and treated with UCB or a placebo. Muscle strength and gross motor function were evaluated at baseline and 1, 3, and 6 months after treatment. Along with function measurements, each subject underwent (18)F-fluorodeoxyglucose positron emission tomography at baseline and 2 weeks after treatment. Cytokine and receptor levels were quantitated in serial blood samples. The UCB group showed greater improvements in muscle strength than the controls at 1 (0.94 vs. -0.35, respectively) and 3 months (2.71 vs. 0.65) after treatment (Pscells expressing Toll-like receptor 4 were noted at 1 day after treatment in the UCB group, and they were correlated with increased muscle strength at 3 months post-treatment. In this trial, treatment with UCB alone improved motor outcomes and induced systemic immune reactions and anti-inflammatory changes in the brain. Generally, motor outcomes were positively correlated with the number of UCB cells administered: a higher number of cells resulted in better outcomes. Nevertheless, future trials are needed to confirm the long-term efficacy of UCB therapy, as the follow-up duration of the present trial was short.

  2. Human allogeneic AB0/Rh-identical umbilical cord blood cells in the treatment of juvenile patients with cerebral palsy.

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    Romanov, Yury A; Tarakanov, Oleg P; Radaev, Sergey M; Dugina, Tamara N; Ryaskina, Svetlana S; Darevskaya, Anna N; Morozova, Yana V; Khachatryan, William A; Lebedev, Konstantin E; Zotova, Nelli S; Burkova, Anna S; Sukhikh, Gennady T; Smirnov, Vladimir N

    2015-07-01

    The term "cerebral palsy" (CP) encompasses many syndromes that emerge from brain damage at early stages of ontogenesis and manifest as the inability to retain a normal body position or perform controlled movements. Existing methods of CP treatment, including various rehabilitation strategies and surgical and pharmacological interventions, are mostly palliative, and there is no specific therapy focused on restoring injured brain function. During a post-registration clinical investigation, the safety and efficacy of intravenous infusion of allogeneic human leukocyte antigen (HLA)-unmatched umbilical cord blood (UCB) cells were studied in 80 pediatric patients with cerebral palsy and associated neurological complications. Patients received up to 6 intravenous infusions of AB0/Rh-identical, red blood cell-depleted UCB cells at an average dose of 250 × 10(6) viable cells per infusion. Patients were followed for 3-36 months, and multiple cell infusions did not cause any adverse effects. In contrast, in most patients who received four or more UCB cell infusions, positive dynamics related to significant improvements in neurological status and/or cognitive functions were observed. The results confirm that multiple intravenous infusions of allogeneic AB0/Rh-identical UCB cells may be a safe and effective procedure and could be included in treatment and rehabilitation programs for juvenile patients with cerebral palsy. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  3. First autologous cell therapy of cerebral palsy caused by hypoxic-ischemic brain damage in a child after cardiac arrest-individual treatment with cord blood.

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    Jensen, A; Hamelmann, E

    2013-01-01

    Each year, thousands of children incur brain damage that results in lifelong sequelae. Therefore, based on experimental evidence, we explored the therapeutic potential of human cord blood, known to contain stem cells, to examine the functional neuroregeneration in a child with cerebral palsy after cardiac arrest. The boy, whose cord blood was stored at birth, was 2.5 years old and normally developed when global ischemic brain damage occurred resulting in a persistent vegetative state. Nine weeks later, he received autologous cord blood (91.7 mL, cryopreserved, 5.75 × 10e8 mononuclear cells) intravenously. Active rehabilitation (physio- and ergotherapy) was provided daily, follow-up at 2, 5, 12, 24, 30, and 40 months. At 2-months follow-up the boy's motor control improved, spastic paresis was largely reduced, and eyesight was recovered, as did the electroencephalogram. He smiled when played with, was able to sit and to speak simple words. At 40 months, independent eating, walking in gait trainer, crawling, and moving from prone position to free sitting were possible, and there was significantly improved receptive and expressive speech competence (four-word sentences, 200 words). This remarkable functional neuroregeneration is difficult to explain by intense active rehabilitation alone and suggests that autologous cord blood transplantation may be an additional and causative treatment of pediatric cerebral palsy after brain damage.

  4. Beneficial effects of early environmental enrichment on motor development and spinal cord plasticity in a rat model of cerebral palsy.

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    Marques, Marília Rossato; Stigger, Felipe; Segabinazi, Ethiane; Augustin, Otávio Américo; Barbosa, Sílvia; Piazza, Francele Valente; Achaval, Matilde; Marcuzzo, Simone

    2014-04-15

    Cerebral palsy (CP) results from nonprogressive lesions in the immature brain generating changes on the neuromuscular system. Environmental enrichment (EE) is a combination of stimuli that provides greater motivation and interest in novel movement exploration through the provision of various devices associated to enhanced social stimulation that would mimic the physiotherapy approach. The aim of this study was to verify whether EE is able to prevent the establishment of motor impairment in a CP rat model. The animals were divided in two groups: control animals (healthy) and animals submitted to a CP model. After this, the pups were exposed to two environments: enriched or standard, totaling four groups: Control group (without CP in a standard environment), CP group (CP model in a standard environment), EE group (without CP in an enriched environment) and CP-EE (CP model in an enriched environment). The experimental model was induced in pregnant Wistar rats by the association of maternal exposure to bacterial endotoxin, perinatal anoxia and sensorimotor restriction of the pups. The assessment of motor skills was held using the following tests: open field, rotarod, horizontal ladder, narrow suspended bar and stride length. The histological analysis evaluated the mean cross-sectional area (CSA) of the soleus muscle fibers, the mean CSA of motoneuronal somata and expression of synaptophysin in the ventral horn of the spinal cord. EE was able to prevent the motor deficits, however, it did not reverse the muscle atrophy observed in CP animals. Furthermore, there was an average increase in the mean area of motoneurons and an increase in the expression of synaptophysin in the ventral horn of the spinal cord of the CP-EE group in relation to CP animals reared in a standard environment. Hereupon, the stimulus increment provided by EE can prevent the onset of motor deficits and histological changes in a CP rat model.

  5. Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Lee Young-Ho

    2012-03-01

    Full Text Available Abstract Backgrounds We conducted a pilot study of the infusion of intravenous autologous cord blood (CB in children with cerebral palsy (CP to assess the safety and feasibility of the procedure as well as its potential efficacy in countering neurological impairment. Methods Patients diagnosed with CP were enrolled in this study if their parents had elected to bank their CB at birth. Cryopreserved CB units were thawed and infused intravenously over 10~20 minutes. We assessed potential efficacy over 6 months by brain magnetic resonance imaging (MRI-diffusion tensor imaging (DTI, brain perfusion single-photon emission computed tomography (SPECT, and various evaluation tools for motor and cognitive functions. Results Twenty patients received autologous CB infusion and were evaluated. The types of CP were as follows: 11 quadriplegics, 6 hemiplegics, and 3 diplegics. Infusion was generally well-tolerated, although 5 patients experienced temporary nausea, hemoglobinuria, or urticaria during intravenous infusion. Diverse neurological domains improved in 5 patients (25% as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI. The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia. Conclusions Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.

  6. Safety of Allogeneic Umbilical Cord Blood Stem Cells Therapy in Patients with Severe Cerebral Palsy: A Retrospective Study.

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    Feng, Mei; Lu, Aili; Gao, Hongxia; Qian, Caiwen; Zhang, Jun; Lin, Tongxiang; Zhao, Yuanqi

    2015-01-01

    This retrospective study aimed to assess the safety of patients with severe cerebral palsy (CP), who received allogeneic umbilical cord blood stem cells (UCBSCs) treatment from August 2009 to December 2012 in Guangdong Provincial Hospital of Chinese Medicine. A total of 47 patients with average age of 5.85 ± 6.12 years were evaluated in this study. There was no significant association with allogeneic UCBSCs treatments found in the data of the laboratory index . No casualties occurred. Some adverse events during treatments were found in 26 (55.3%) patients, including fever (42.6%) and vomiting (21.2%). Intrathecal infusion and the ages at the initiation of treatment (≤10 years old) were risk factors for the occurrence of adverse events by logistic regression analysis. However, all adverse events disappeared after symptomatic treatment. No treatment related serious adverse events were found in follow-up visits within 6 months. In conclusion, allogeneic UCBSCs treatment was relatively safe for severe CP patients.

  7. Long-lasting paracrine effects of human cord blood cells on damaged neocortex in an animal model of cerebral palsy.

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    Bae, Sang-Hun; Kong, Tae-Ho; Lee, Hyun-Seob; Kim, Kyung-Sul; Hong, Kwan Soo; Chopp, Michael; Kang, Myung-Seo; Moon, Jisook

    2012-01-01

    Neonatal asphyxia is an important contributor to cerebral palsy (CP), for which there is no effective treatment to date. The administration of human cord blood cells (hUCBCs) is emerging as a therapeutic strategy for the treatment of neurological disorders. However, there are few studies on the application of hUCBCs to the treatment of neonatal ischemia as a model of CP. Experiments and behavioral tests (mainly motor tests) performed on neonatal hypoxia/ischemia have been limited to short-term effects of hUCBCs, but mechanisms of action have not been investigated. We performed a study on the use of hUCBCs in a rat model of neonatal hypoxia/ischemia and investigated the underlying mechanism for therapeutic benefits of hUCBC treatment. hUCBCs were intravenously transplanted into a rat model of neonatal hypoxia ischemia. hUCBCs increased microglia temporarily in the periventricular striatum in the early phase of disease, protected mature neurons in the neocortex from injury, paved the way for the near-normalization of brain damage in the subventricular zone (SVZ), and, in consequence, significantly improved performance in a battery of behavioral tests compared to the vehicle-treated group. Although the transplanted cells were rarely observed in the brain 3 weeks after transplantation, the effects of the improved behavioral functions persisted. Our preclinical findings suggest that the long-lasting positive influence of hUCBCs is derived from paracrine effects of hUCBCs that stimulate recovery in the injured brain and protect against further brain damage.

  8. Therapy for Cerebral Palsy by Human Umbilical Cord Blood Mesenchymal Stem Cells Transplantation Combined With Basic Rehabilitation Treatment

    Directory of Open Access Journals (Sweden)

    Che Zhang MD

    2015-03-01

    Full Text Available Background. Cerebral palsy (CP is the most common cause leading to childhood disability. Human umbilical cord blood mesenchymal stem cells (hUCB-MSCs transplantation is a promising alternative considering the safety and efficacy in current reports. This report represents a case of hUCB-MSCs transplantation combined with basic rehabilitation treatment beginning as early as age 6 months with follow-up as long as 5 years. Methods. A 6-year-old female patient was diagnosed with CP at age 6 months. The patient accepted 4 infusions of intravenous hUCB-MSCs in each course and received 4 courses of transplantation totally. A series of assessments were performed before the first transplantation, including laboratory tests, CDCC Infant Mental Development Scale, and Gross Motor Function Measure-88 (GMFM-88. Then annual assessments using the GMFM-88, Ashworth spasm assessment, and comprehensive function assessment scale were made in addition to the annual laboratory tests. In addition, electroencephalography and brain magnetic resonance imaging were conducted before transplantation and in the follow-up phase. Rehabilitation and safety follow-up have been ongoing for 5 years up to date. Results. There was no complaint about adverse effects during hospitalization or postoperative follow-up. Motor function recovered to normal level according to the evaluation of scales. Language function improved significantly. Linguistic rehabilitation therapy was enhanced for further improvement. Conclusions. The clinical application of hUC-MSCs combined with basic rehabilitation treatment was effective and safe for improving motor and comprehensive function in a patient with CP.

  9. Vocal cord palsy after vincristine treatment in a child and the inefficacy of glutamic acid in the prevention of relapse: a case report

    Directory of Open Access Journals (Sweden)

    Farruggia Piero

    2012-05-01

    Full Text Available Abstract Introduction Vincristine is an antineoplastic drug with a well known efficacy for the treatment of acute lymphoblastic leukemia and many solid tumors. No more than 20 pediatric patients with vincristine-induced vocal cord palsy have been reported, and to the best of our knowledge this is the first case where glutamic acid was administered with the aim of preventing a relapse of laryngeal dysfunction. Case presentation The larynx paralysis presented with hoarseness and stridor in a Caucasian 18-month-old girl and spontaneously resolved in about a month. In order to administer a subsequent full dose of vincristine, our patient received oral glutamic acid whose efficacy against vincristine neurological side effects has been previously reported. Conclusions Since in our patient the amino acid proved to be ineffective in the prevention of laryngeal paralysis relapse, we suggest that a dose reduction of vincristine should be preferred by oncologists as an initial approach after a case of drug-induced vocal cord palsy.

  10. First Autologous Cord Blood Therapy for Pediatric Ischemic Stroke and Cerebral Palsy Caused by Cephalic Molding during Birth: Individual Treatment with Mononuclear Cells

    Directory of Open Access Journals (Sweden)

    A. Jensen

    2016-01-01

    Full Text Available Intracranial laceration due to traumatic birth injury is an extremely rare event affecting approximately one newborn per a population of 4.5 million. However, depending on the mode of injury, the resulting brain damage may lead to lifelong sequelae, for example, cerebral palsy for which there is no cure at present. Here we report a rare case of neonatal arterial ischemic stroke and cerebral palsy caused by fetal traumatic molding and parietal depression of the head during delivery caused by functional cephalopelvic disproportion due to a “long pelvis.” This patient was treated by autologous cord blood mononuclear cells (45.8 mL, cryopreserved, TNC 2.53×10e8 with a remarkable recovery. Active rehabilitation was provided weekly. Follow-up examinations were at 3, 18, 34, and 57 months. Generous use of neonatal head MRI in case of molding, craniofacial deformity, and a sentinel event during parturition is advocated to enhance diagnosis of neonatal brain damage as a basis for fast and potentially causative treatment modalities including autologous cord blood transplantation in a timely manner.

  11. Characterization of a cerebral palsy-like model in rats: Analysis of gait pattern and of brain and spinal cord motor areas.

    Science.gov (United States)

    Dos Santos, Adriana Souza; de Almeida, Wellington; Popik, Bruno; Sbardelotto, Bruno Marques; Torrejais, Márcia Miranda; de Souza, Marcelo Alves; Centenaro, Lígia Aline

    2017-08-01

    In an attempt to propose an animal model that reproduces in rats the phenotype of cerebral palsy, this study evaluated the effects of maternal exposure to bacterial endotoxin associated with perinatal asphyxia and sensorimotor restriction on gait pattern, brain and spinal cord morphology. Two experimental groups were used: Control Group (CTG) - offspring of rats injected with saline during pregnancy and Cerebral Palsy Group (CPG) - offspring of rats injected with lipopolysaccharide during pregnancy, submitted to perinatal asphyxia and sensorimotor restriction for 30days. At 29days of age, the CPG exhibited coordination between limbs, weight-supported dorsal steps or weight-supported plantar steps with paw rotation. At 45days of age, CPG exhibited plantar stepping with the paw rotated in the balance phase. An increase in the number of glial cells in the primary somatosensory cortex and dorsal striatum were observed in the CPG, but the corpus callosum thickness and cross-sectional area of lateral ventricle were similar between studied groups. No changes were found in the number of motoneurons, glial cells and soma area of the motoneurons in the ventral horn of spinal cord. The combination of insults in the pre, peri and postnatal periods produced changes in hindlimbs gait pattern of animals similar to those observed in diplegic patients, but motor impairments were attenuated over time. Besides, the greater number of glial cells observed seems to be related to the formation of a glial scar in important sensorimotor brain areas. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

  12. Impact of chlorhexidine cleansing of the umbilical cord on cord separation time and neonatal mortality in comparison to dry cord care - a nursery-based randomized controlled trial.

    Science.gov (United States)

    Sharma, Deepak; Gathwala, Geeta

    2014-08-01

    To study the impact of chlorhexidine cleansing of the umbilical cord on cord separation time and neonatal mortality in comparison to dry cord care. This is the secondary analysis of the data of the study which was conducted in the NICU of a teaching hospital in north India between 2010 and 2011. Newborns (>32 weeks of gestation and weighing >1500 g) were randomized into chlorhexidine application and dry cord care groups. Here, we analyze the data regarding time of cord separation, umbilical sepsis and mortality in both the groups. One hundred and forty (dry care group 70, chlorhexidine group 70) were enrolled and finally analyzed. A significant difference was observed among groups in terms of time to cord separation (8.92 ± 2.77 days versus 10.31 ± 3.23 days; t = 2.20; p = 0.02, significant) and neonatal mortality (χ(2) = 4.11; p = 0.042, significant). Use of chlorhexidine for umbilical cord care shortens duration of cord separation and decreases neonatal mortality in NICU. This simple intervention can be used as mode for decreasing neonatal mortality.

  13. Comparison of Upright Gait with Supine Bungee-Cord Gait

    Science.gov (United States)

    Boda, Wanda L.; Hargens, Alan R.; Campbell, J. A.; Yang, C.; Holton, Emily M. (Technical Monitor)

    1998-01-01

    Running on a treadmill with bungee-cord resistance is currently used on the Russian space station MIR as a countermeasure for the loss of bone and muscular strength which occurs during spaceflight. However, it is unknown whether ground reaction force (GRF) at the feet using bungee-cord resistance is similar to that which occurs during upright walking and running on Earth. We hypothesized-that the DRAMs generated during upright walking and running are greater than the DRAMs generated during supine bungee-cord gait. Eleven healthy subjects walked (4.8 +/- 0.13 km/h, mean +/- SE) and ran (9.1 +/- 0.51 km/h) during upright and supine bungee-cord exercise on an active treadmill. Subjects exercised for 3 min in each condition using a resistance of 1 body weight calibrated during an initial, stationary standing position. Data were sampled at a frequency of 500Hz and the mean of 3 trials was analyzed for each condition. A repeated measures analysis of variance tested significance between the conditions. Peak DRAMs during upright walking were significantly greater (1084.9 +/- 111.4 N) than during supine bungee-cord walking (770.3 +/- 59.8 N; p less than 0.05). Peak GRFs were also significantly greater for upright running (1548.3 +/- 135.4 N) than for supine bungee-cord running (1099.5 +/- 158.46 N). Analysis of GRF curves indicated that forces decreased throughout the stance phase for bungee-cord gait but not during upright gait. These results indicate that bungee-cord exercise may not create sufficient loads at the feet to counteract the loss of bone and muscular strength that occurs during long-duration exposure to microgravity.

  14. COMPARISON OF MUSCLE STRENGTH, SPRINT POWER AND AEROBIC CAPACITY IN ADULTS WITH AND WITHOUT CEREBRAL PALSY

    NARCIS (Netherlands)

    de Groot, Sonja; Dallmeijer, Annet J.; Bessems, Paul J. C.; Lamberts, Marcel L.; van der Woude, Lucas H. V.; Janssen, Thomas W. J.

    2012-01-01

    Objective: To compare: (i) muscle strength, sprint power and maximal aerobic capacity; and (ii) the correlations between these variables in adults with and without cerebral palsy. Design: Cross-sectional study. Subjects: Twenty adults with and 24 without cerebral palsy. Methods: Isometric and isokin

  15. COMPARISON OF MUSCLE STRENGTH, SPRINT POWER AND AEROBIC CAPACITY IN ADULTS WITH AND WITHOUT CEREBRAL PALSY

    NARCIS (Netherlands)

    de Groot, Sonja; Dallmeijer, Annet J.; Bessems, Paul J. C.; Lamberts, Marcel L.; van der Woude, Lucas H. V.; Janssen, Thomas W. J.

    2012-01-01

    Objective: To compare: (i) muscle strength, sprint power and maximal aerobic capacity; and (ii) the correlations between these variables in adults with and without cerebral palsy. Design: Cross-sectional study. Subjects: Twenty adults with and 24 without cerebral palsy. Methods: Isometric and

  16. The Comparison of Malocclusion Prevalence Between Children with Cerebral Palsy and Healthy Children.

    Science.gov (United States)

    Bakarcić, Danko; Lajnert, Vlatka; Maricić, Barbara Mady; Jokić, Nataga Ivancić; Vrancić, Zlatka Roksandić; Grzić, Renata; Prpić, Igor

    2015-09-01

    This study sets out to examine the prevalence of malocclusion and habits in a group of children with cerebral palsy and to compare it with a control group of healthy children. The presence of an anterior open bite was statistically significantly higher in the cerebral palsied group. The presence of aposterior crossbite was not significantly different between the examined groups, as was the case for a lingual crossbite. The occurrence of visceral swallowing, incompetent lips and oral respiration was significantly higher in the cerebral palsied group. The current study cannot satisfactorily sustain the issue of a higher prevalence of posterior and lingual crossbite in children with cerebral palsy because of no significant differences between groups, but it certainly can for an anterior openbite. The present study also adds to the evidence that there is an increased prevalence of oral breathing, visceral swallowing and lip incompetence in children with cerebral palsy.

  17. Comparison of umbilical cord tissue and meconium for the confirmation of in utero drug exposure.

    Science.gov (United States)

    Colby, Jennifer M

    2017-09-01

    Drug screening in neonates is traditionally performed using meconium, but cord tissue has been proposed as an alternative specimen. This study compares the detection of drugs in a large number of paired meconium and umbilical cord tissue samples from subjects at risk of in utero drug exposure. Physician-ordered toxicology results and clinical information were collected in a retrospective review of subject medical records. All toxicology testing was performed by a national reference laboratory using a combination of immunoassays and chromatography-mass spectrometry. The comparison was limited to drugs present in both cord and meconium panels. Overall agreement between cord and meconium ranged from 76% (cannabinoids) to 100% (barbiturates), but Cohen's kappa was cord was less sensitive for the detection of 5 of the 6 drug classes, and for the detection of all 5 individual opioids. For 3 of the 5 individual opioids, the concentration of drug measured in meconium did not correlate well with qualitative detection in cord. This study reveals different sensitivities of drug detection in umbilical cord tissue and meconium. For the drugs studied here, meconium provides greater sensitivity, and is likely to remain the specimen of choice when sensitivity is of greatest importance. These results can help clinicians, laboratorians, and epidemiologists to (1) select the most appropriate test to confirm a suspected drug exposure and (2) interpret discordant results when testing is performed in multiple matrices. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates.

    Science.gov (United States)

    Jaiswal, Prateek; Upadhyay, Amit; Gothwal, Sunil; Chaudhary, Hema; Tandon, Ashutosh

    2015-10-01

    To compare the effect of umbilical cord milking (UCM) and delayed cord clamping (DCC) on cerebral blood flow in term neonates. This randomized controlled trial was conducted at a teaching hospital in India during 2012 to 2013. Two hundred newborns (>36wk) were randomized to UCM and DCC groups. UCM was done on 25cm of cord length. In DCC group, clamping was delayed by 60 to 90s. Resistive Index (RI), Pulsatility Index (PI) and cerebral blood flow velocities of middle cerebral artery (MCA) were measured at 24 to 48h of life. Baseline characteristics and hemodynamic parameters were comparable. Mean PI [1.18 (0.26)] and RI [0.65 (0.08)] in UCM group was comparable to mean PI [1.18 (0.25)] and RI [0.65 (0.08)] in DCC group. The peak systolic velocity and end diastolic velocity (cm/s) of blood flow in MCA for UCM group were 34.94 (11.82) and 11.71 (4.75) respectively, while in DCC group they were 37.24 (12.63) and 13.07 (4.78) (p 0.23 and 0.07) respectively. Indices among growth retarded babies were not different. DCC and UCM had similar effect on cerebral blood flow velocities and Doppler indices in MCA, in term neonates.

  19. Comparison of the Efficacy of Combination Therapy of Prednisolone - Acyclovir with Prednisolone Alone in Bell's Palsy

    National Research Council Canada - National Science Library

    Khajeh, Ali; Fayyazi, Afshin; Soleimani, Gholamreza; Miri-Aliabad, Ghasem; Shaykh Veisi, Sara; Khajeh, Behrouz

    2015-01-01

    Bell's palsy is a rapid onset, usually, unilateral paralysis of the facial nerve that causes significant changes in an individual's life such as a decline in personal, social, and educational performance...

  20. Therapy for Cerebral Palsy by Human Umbilical Cord Blood Mesenchymal Stem Cells Transplantation Combined With Basic Rehabilitation Treatment: A Case Report.

    Science.gov (United States)

    Zhang, Che; Huang, Li; Gu, Jiaowei; Zhou, Xihui

    2015-01-01

    Background. Cerebral palsy (CP) is the most common cause leading to childhood disability. Human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) transplantation is a promising alternative considering the safety and efficacy in current reports. This report represents a case of hUCB-MSCs transplantation combined with basic rehabilitation treatment beginning as early as age 6 months with follow-up as long as 5 years. Methods. A 6-year-old female patient was diagnosed with CP at age 6 months. The patient accepted 4 infusions of intravenous hUCB-MSCs in each course and received 4 courses of transplantation totally. A series of assessments were performed before the first transplantation, including laboratory tests, CDCC Infant Mental Development Scale, and Gross Motor Function Measure-88 (GMFM-88). Then annual assessments using the GMFM-88, Ashworth spasm assessment, and comprehensive function assessment scale were made in addition to the annual laboratory tests. In addition, electroencephalography and brain magnetic resonance imaging were conducted before transplantation and in the follow-up phase. Rehabilitation and safety follow-up have been ongoing for 5 years up to date. Results. There was no complaint about adverse effects during hospitalization or postoperative follow-up. Motor function recovered to normal level according to the evaluation of scales. Language function improved significantly. Linguistic rehabilitation therapy was enhanced for further improvement. Conclusions. The clinical application of hUC-MSCs combined with basic rehabilitation treatment was effective and safe for improving motor and comprehensive function in a patient with CP.

  1. Umbilical cord blood therapy potentiated with erythropoietin for children with cerebral palsy: a double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Min, Kyunghoon; Song, Junyoung; Kang, Jin Young; Ko, Jooyeon; Ryu, Ju Seok; Kang, Myung Seo; Jang, Su Jin; Kim, Sang Heum; Oh, Doyeun; Kim, Moon Kyu; Kim, Sung Soo; Kim, Minyoung

    2013-03-01

    Allogeneic umbilical cord blood (UCB) has therapeutic potential for cerebral palsy (CP). Concomitant administration of recombinant human erythropoietin (rhEPO) may boost the efficacy of UCB, as it has neurotrophic effects. The objectives of this study were to assess the safety and efficacy of allogeneic UCB potentiated with rhEPO in children with CP. Children with CP were randomly assigned to one of three parallel groups: the pUCB group, which received allogeneic UCB potentiated with rhEPO; the EPO group, which received rhEPO and placebo UCB; and the Control group, which received placebo UCB and placebo rhEPO. All participants received rehabilitation therapy. The main outcomes were changes in scores on the following measures during the 6 months treatment period: the gross motor performance measure (GMPM), gross motor function measure, and Bayley scales of infant development-II (BSID-II) Mental and Motor scales (18). F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET/CT) and diffusion tensor images (DTI) were acquired at baseline and followed up to detect changes in the brain. In total, 96 subjects completed the study. Compared with the EPO (n = 33) and Control (n = 32) groups, the pUCB (n = 31) group had significantly higher scores on the GMPM and BSID-II Mental and Motor scales at 6 months. DTI revealed significant correlations between the GMPM increment and changes in fractional anisotropy in the pUCB group. 18F-FDG-PET/CT showed differential activation and deactivation patterns between the three groups. The incidence of serious adverse events did not differ between groups. In conclusion, UCB treatment ameliorated motor and cognitive dysfunction in children with CP undergoing active rehabilitation, accompanied by structural and metabolic changes in the brain. Copyright © 2012 AlphaMed Press.

  2. Comparison of the Efficacy of Combination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy

    Directory of Open Access Journals (Sweden)

    Ali KHAJEH

    2015-06-01

    Full Text Available How to Cite This Article: Khajeh A, Fayyazi A, Soleimani Gh, Miri-Aliabad Gh, Shaykh Veisi S, Khajeh B. Comparison of the Efficacy ofCombination Therapy of Prednisolone-Acyclovir with Prednisolone Alone in Bell’s Palsy. Iran J Child Neurol. Spring 2015; 9(2:17-20.AbstractObjectiveBell’s palsy is a rapid onset, usually, unilateral paralysis of the facial nerve that causes significant changes in an individual’s life such as a decline in personal, social, and educational performance. This study compared efficacy of combined prednisolone and acyclovir therapy with prednisolone alone.Materials & MethodsThis study is a randomized controlled trial conducted on 43 Children (2–18 years old with Bell’s palsy. The first group of 23 patients was treated with prednisolone and the remaining patients were treated with a combination of prednisolone and acyclovir. The required data were extracted, using an informational form based on the House-Brackmann Scale, which grades facial nerve paralysis. The data were analyzed with Mann-Whitney test using SPSS version 16.ResultsThe mean age of the first and second group were 8.65 ± 5.07 and 8.35 ± 4.92 years, respectively, (p=0.84. Sixty one percent and 39% of patients in the first group, and 45% and 55% of patients in the second group were male and female, respectively. No significant differences exist between the groups in terms of age and gender. The rate of complete recovery was 65.2% in group I and 90% in the group II (p=0.04.ConclusionThe results of this study showed that the combined prednisolone and acyclovir therapy of patients with Bell’s palsy is far more effective than treatment with prednisolone alone. Actually, age and gender had no impact on the rate of recovery.

  3. Direct comparison between regional cerebral metabolism in progressive supranuclear palsy and Parkinson's disease

    NARCIS (Netherlands)

    Klein, RC; de Jong, BM; de Vries, JJ; Leenders, KL

    2005-01-01

    The differentiation between progressive supranuclear palsy (PSP) and Parkinson's disease (PD) may be difficult, especially in the early stages of disease. Positron emission tomography potentially provides a tool for making such a distinction. To identify key features in the spatial distributions of

  4. Gait Patterns in Hemiplegic Children with Cerebral Palsy: Comparison of Right and Left Hemiplegia

    Science.gov (United States)

    Galli, Manuela; Cimolin, Veronica; Rigoldi, Chiara; Tenore, Nunzio; Albertini, Giorgio

    2010-01-01

    The aims of this study are to compare quantitatively the gait strategy of the right and left hemiplegic children with Cerebral Palsy (CP) using gait analysis. The gait strategy of 28 right hemiparetic CP (RHG) and 23 left hemiparetic CP (LHG) was compared using gait analysis (spatio-temporal and kinematic parameters) and considering the hemiplegic…

  5. Motor imagery for walking: A comparison between cerebral palsy adolescents with hemiplegia and diplegia

    NARCIS (Netherlands)

    Molina, M.; Kudlinski, C.; Guilbert, J.; Spruijt, S.; Steenbergen, B.; Jouen, F.

    2014-01-01

    The goal of the study was to investigate whether motor imagery (MI) could be observed in cerebral palsy (CP) participants presenting a bilateral affected body side (diplegia) as it has been previously revealed in participants presenting a unilateral body affected sided (hemiplegia). MI capacity for

  6. Motor imagery for walking: A comparison between cerebral palsy adolescents with hemiplegia and diplegia

    NARCIS (Netherlands)

    Molina, M.; Kudlinski, C.; Guilbert, J.; Spruijt, S.; Steenbergen, B.; Jouen, F.

    2015-01-01

    The goal of the study was to investigate whether motor imagery (MI) could be observed in cerebral palsy (CP) participants presenting a bilateral affected body side (diplegia) as it has been previously revealed in participants presenting a unilateral body affected sided (hemiplegia). MI capacity for

  7. Measuring intellectual ability in cerebral palsy: The comparison of three tests and their neuroimaging correlates.

    Science.gov (United States)

    Ballester-Plané, Júlia; Laporta-Hoyos, Olga; Macaya, Alfons; Póo, Pilar; Meléndez-Plumed, Mar; Vázquez, Élida; Delgado, Ignacio; Zubiaurre-Elorza, Leire; Narberhaus, Ana; Toro-Tamargo, Esther; Russi, Maria Eugenia; Tenorio, Violeta; Segarra, Dolors; Pueyo, Roser

    2016-09-01

    Standard intelligence scales require both verbal and manipulative responses, making it difficult to use in cerebral palsy and leading to underestimate their actual performance. This study aims to compare three intelligence tests suitable for the heterogeneity of cerebral palsy in order to identify which one(s) could be more appropriate to use. Forty-four subjects with bilateral dyskinetic cerebral palsy (26 male, mean age 23 years) conducted the Raven's Coloured Progressive Matrices (RCPM), the Peabody Picture Vocabulary Test-3rd (PPVT-III) and the Wechsler Nonverbal Scale of Ability (WNV). Furthermore, a comprehensive neuropsychological battery and magnetic resonance imaging were assessed. The results show that PPVT-III gives limited information on cognitive performance and brain correlates, getting lower intelligence quotient scores. The WNV provides similar outcomes as RCPM, but cases with severe motor impairment were unable to perform it. Finally, the RCPM gives more comprehensive information on cognitive performance, comprising not only visual but also verbal functions. It is also sensitive to the structural state of the brain, being related to basal ganglia, thalamus and white matter areas such as superior longitudinal fasciculus. So, the RCPM may be considered a standardized easy-to-administer tool with great potential in both clinical and research fields of bilateral cerebral palsy.

  8. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  9. Bell's Palsy

    Science.gov (United States)

    ... weakness or paralysis. Bell's palsy is named for Sir Charles Bell, a 19th century Scottish surgeon who ... facial nerve function and pain. In general, decompression surgery for Bell's palsy -- to relieve pressure on the ...

  10. MR-pathologic comparisons of wallerian degeneration in spinal cord injury.

    Science.gov (United States)

    Becerra, J L; Puckett, W R; Hiester, E D; Quencer, R M; Marcillo, A E; Post, M J; Bunge, R P

    1995-01-01

    To describe the MR manifestations and temporal course of wallerian degeneration that occurs above and below a spinal cord injury, and to compare the MR findings with postmortem histopathology. Twenty-four postmortem spinal cords from patients with cervical (n = 14), thoracic (n = 6), and lumbar (n = 4) cord injuries were studied with axial T1- and T2-weighted spin-echo MR imaging. Injury-to-death intervals varied from 8 days to 23 years. The images were examined for alteration of signal above and below the injury site. Histologic studies of these cords with axon, myelin, and connective tissue stains were performed at levels equivalent to the MR sections. Immunohistochemical analysis using antibodies to glial fibrillary acetic protein was also performed on 19 cords. Pathologic-imaging comparisons were made. MR images showed increased signal intensity in the dorsal columns above the injury level and in the lateral corticospinal tracts below the injury level in all cases in which cord injury had occurred 7 or more weeks before death. In early postinjury survival times (8 days and 12 days) MR findings were normal; histologically there was early wallerian degeneration in only the dorsal columns at 8 days and in both the lateral and dorsal columns at 12 days. MR showed wallerian degeneration in all cases examined at 7 weeks after injury and thereafter. Wallerian degeneration was demonstrated by histology and MR in all specimens in which the injury-to-death interval was greater than 7 weeks. Recognition of wallerian degeneration on MR allows complete analysis of the injury, explains abnormal MR signals at sites remote from the epicenter of the injury, and may be useful in the future in the timing and planning of therapeutic interventions.

  11. [Facial palsy].

    Science.gov (United States)

    Cavoy, R

    2013-09-01

    Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.

  12. MR findings of cerebral palsy: comparison between preterm patients and fullterm patients

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Yoon Joon; Kim, Dong Ik; Yoon, Pyeong Ho; Jeon, Pyoung; Ryu, Young Hoon; Hwang, Geum Ju; Kim, Eun Kyung [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Lee, Byung Hee [Pundang Cha General Hospital, Sungnam (Korea, Republic of)

    1997-09-01

    To observe the MR findings of cerebral palsy by evaluating cerebral damage resulting from hypoxic ischemic injury and other variable causes and to compare the findings between preterm and full-term patients. We reviewed the MR findings of 102 cerebral palsy patients (71 full-term and 31 preterm). These were analysed with regard to deep and peripheral white matter, gray matter, basal ganglia, the thalamus, brainstem, cerebellum, corpus callosum and ventricles, according to the pattern of injury such as hypoxic ischemic injury, migration anomaly and early intrauterine injury, the findings of full-term and preterm patients were then compared. MR findings of preterm patients(n=3D31) were as follows;hypoxic ischemic injury(n=3D26),normal(n=3D2), and migration anomaly(n=3D3), while those of full-term patients(n=3D71) were hypoxic ischemic injury(n=3D41), normal(n=3D24), migration anomaly(n=3D4), early uterine injury(n=3D2), and perirolandic ischemic injury(n=3D6);in 5 patients, this latter condition was combined with status marmoratus. Periventricular leukomalacia was the most common finding in both preterm patients and full-term patients;selective neuronal necrosis, parasagittal injury and perirolandic injury were observed only in full-term patients. On MRI, variable findings of cerebral palsy were clearly observed;periventricular leukomalacia was the most common finding in both preterm and full-term patients.=20.

  13. A COMPARISON BETWEEN CALLAHAN and KNAPP PROCEDURE for HYPOTROPIA in DOUBLE ELEVATOR PALSY

    Directory of Open Access Journals (Sweden)

    Ziaaddin Yazdian

    1994-06-01

    Full Text Available Twenty six patients with double elevator palsy (DEP (ranging from 25-90 PD, who had undergone either Callahan or Knapp-Modified-Kanpp Procedure from February, 1981 to February, 1994, were reviewed. We achieved acceptable results in correction of hypotropia in primary position. Three patients gained peripheral fusion and after reviewing the results we concluded that in patients having large-angle hypotropia with DEP, especially when it is accompanied by inferior rectus restriction. Callahan procedure is preferrable; however, in coexisting vertical-horizontal deviation, Modified-Knapp Procedure is recommended.

  14. Comparison of effects of lower extremity orthoses on energy expenditure in patients with cerebral palsy.

    Science.gov (United States)

    Caliskan Uckun, Asli; Celik, Canan; Ucan, Halil; Ordu Gokkaya, Nilufer Kutay

    2014-12-01

    The aim of the study was to compare the effects of lower extremity orthoses on energy expenditure in patients with cerebral palsy (CP). We included 48 children with CP using lower extremity orthosis. Energy expenditures determined based on heart rate, yielded an energy expenditure index (EEI) with and without orthosis during walking. RESULTS were compared statistically between orthosis groups (solid polyethylene ankle foot orthosis (PAFO), articulated PAFO, ground reaction foot orthosis (GRAFO), plastic and metallic knee-ankle-foot-orthosis (KAFO), and metallic AFO). It was found that an advancement in energy expenditure was seen with plastic orthoses which is more prominent by solid PAFO (p = 0.008). It was concluded that especially solid PAFO can be more beneficial in terms of energy consumption in CP patients. In rehabilitation phase, the EEI measurement was seen to be a useful and practical method for choosing the proper orthosis type.

  15. Infraclavicular brachial plexus block: Comparison of posterior cord stimulation with lateral or medial cord stimulation, a prospective double blinded study

    Directory of Open Access Journals (Sweden)

    Dushyant Sharma

    2013-01-01

    Full Text Available Background: Infraclavicular approach to the brachial plexus sheath provides anesthesia for surgery on the distal arm, elbow, forearm, wrist, and hand. It has been found that evoked distal motor response or radial nerve-type motor response has influenced the success rate of single-injection infraclavicular brachial plexus block. Aim: We conducted this study to compare the extent and effectiveness of infraclavicular brachial plexus block achieved by injecting a local anesthetic drug after finding specific muscle action due to neural stimulator guided posterior cord stimulation and lateral cord/medial cord stimulation. Methods: After ethical committee approval, patients were randomly assigned to one of the two study groups of 30 patients each. In group 1, posterior cord stimulation was used and in group 2 lateral/medial cord stimulation was used for infraclavicular brachial plexus block. The extent of motor block and effectiveness of sensory block were assessed. Results: All four motor nerves that were selected for the extent of block were blocked in 23 cases (76.7% in group 1 and in 15 cases (50.0% in group 2 (P:0.032. The two groups did not differ significantly in the number of cases in which 0, 1, 2, and 3 nerves were blocked (P>0.05. In group 1, significantly lesser number of patients had pain on surgical manipulation compared with patients of group 2 (P:0.037. Conclusion: Stimulating the posterior cord guided by a nerve stimulator before local anesthetic injection is associated with greater extent of block (in the number of motor nerves blocked and effectiveness of block (in reporting no pain during the surgery than stimulation of either the lateral or medial cord.

  16. MR imaging of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saginoya, Toshiyuki [Urasoe General Hospital, Okinawa (Japan); Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide [and others

    1996-06-01

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  17. Bell's Palsy

    Science.gov (United States)

    ... facial nerve, such as a tumor or skull fracture. Most people with Bell's palsy recover fully — with or without treatment. There's no one-size-fits-all treatment for Bell's palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely ...

  18. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Cerebral Palsy KidsHealth > For Teens > Cerebral Palsy Print A A ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  19. Motor imagery for walking: a comparison between cerebral palsy adolescents with hemiplegia and diplegia.

    Science.gov (United States)

    Molina, Michèle; Kudlinski, Cyril; Guilbert, Jessica; Spruijt, Steffie; Steenbergen, Bert; Jouen, François

    2015-02-01

    The goal of the study was to investigate whether motor imagery (MI) could be observed in cerebral palsy (CP) participants presenting a bilateral affected body side (diplegia) as it has been previously revealed in participants presenting a unilateral body affected sided (hemiplegia). MI capacity for walking was investigated in CP adolescents diagnosed with hemiplegia (n=10) or diplegia (n=10) and in adolescents with typical motor development (n=10). Participants were explicitly asked to imagine walking before and after actually walking toward a target located at 4 m and 8 m. Movement durations for executed and imagined trials were recorded. ANOVA and Pearson's correlation analyses revealed the existence of time invariance between executed and imagined movement durations for the control group and both groups of CP participants. However, results revealed that MI capacity in CP participants was observed for the short distance (4 m) but not for the long distance (8 m). Moreover, even for short distance, CP participants performed worse than typical adolescents. These results are discussed inline of recent researches suggesting that MI in CP participants may not depend on the side of the lesion.

  20. Kinematic gait parameters of a child with cerebral palsy: Comparison between different forms of support

    Directory of Open Access Journals (Sweden)

    Micheli Martinello

    2014-04-01

    Full Text Available The aim of this study was to evaluate the kinematic haracteristics of gait in children with spastic diplegia aided by different forms of support (one crutch, two crutches, and scapular girdle, and thus determine the most appropriate way to train gait in children with spastic diplegia based on biomechanical characteristics. The study subject was a female, nine-year-old child, diagnosed with cerebral palsy of spastic diplegia type. The following instruments were used for clinical evaluation of gross motor function: Gross Motor Function Classification System - GMFCS, Gross Motor Function Measure - GMFM 88, and Modified Ashworth Scale. The child performed five repetitions of gait with each type of support. By kinematic analysis, spatiotemporal and angular variables of hip and knee in the sagittal plane were obtained. The values closest to typical gait were obtained with 2 crutches, followed by support with scapular girdle and one crutch. It was possible to observe that gait with two crutches was the most appropriate form of support, considering the functionality and independence of the child assessed; however, gait supported by scapular girdle may be appropriate for gait training in clinical practice, because it stimulates different spatiotemporal and angular parameters.

  1. Sad and happy facial emotion recognition impairment in progressive supranuclear palsy in comparison with Parkinson's disease.

    Science.gov (United States)

    Pontieri, Francesco E; Assogna, Francesca; Stefani, Alessandro; Pierantozzi, Mariangela; Meco, Giuseppe; Benincasa, Dario; Colosimo, Carlo; Caltagirone, Carlo; Spalletta, Gianfranco

    2012-08-01

    The severity of motor and non-motor symptoms of progressive supranuclear palsy (PSP) has a profound impact on social interactions of affected individuals and may, consequently, contribute to alter emotion recognition. Here we investigated facial emotion recognition impairment in PSP with respect to Parkinson's disease (PD), with the primary aim of outlining the differences between the two disorders. Moreover, we applied an intensity-dependent paradigm to examine the different threshold of encoding emotional faces in PSP and PD. The Penn emotion recognition test (PERT) was used to assess facial emotion recognition ability in PSP and PD patients. The 2 groups were matched for age, disease duration, global cognition, depression, anxiety, and daily L-Dopa intake. PSP patients displayed significantly lower recognition of sad and happy emotional faces with respect to PD ones. This applied to global recognition, as well as to low-intensity and high-intensity facial emotion recognition. These results indicate specific impairment of recognition of sad and happy facial emotions in PSP with respect to PD patients. The differences may depend upon diverse involvement of cortical-subcortical loops integrating emotional states and cognition between the two conditions, and might represent a neuropsychological correlate of the apathetic syndrome frequently encountered in PSP.

  2. Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Snedecor SJ

    2013-07-01

    Full Text Available Sonya J Snedecor,1 Lavanya Sudharshan,1 Joseph C Cappelleri,2 Alesia Sadosky,3 Pooja Desai,4 Yash J Jalundhwala,5 Marc Botteman1 1Pharmerit International, Bethesda, MD, USA; 2Global Research and Development, Pfizer, Groton, CT, USA; 3Biostatistics, Pfizer, New York, NY, USA; 4College of Pharmacy, University of Texas at Austin, Austin, TX, USA; 5Pharmacy Administration, University of Illinois at Chicago, Chicago, IL, USA Background: Management of neuropathic pain (NeP associated with spinal cord injury (SCI is difficult. This report presents a systematic literature review and comparison of the efficacy and safety of pharmacologic therapies for treating SCI-associated NeP. Methods: Medline, Embase, Cochrane, and Database of Abstracts of Reviews of Effects were searched through December 2011 for randomized, blinded, and controlled clinical trials of SCI-associated NeP meeting predefined inclusion criteria. Efficacy outcomes of interest were pain reduction on the 11-point numeric rating scale (NRS or 100 mm visual analog scale and proportion of patients achieving ≥30% or ≥50% pain reduction. Discontinuations and adverse events (AEs were also assessed, for which Bayesian meta-analytic indirect comparisons were performed. Results: Of the nine studies included in the analysis, samples were <100 patients, except for one pregabalin study (n = 136. Standard errors for the NRS outcome were often not reported, precluding quantitative comparisons across treatments. Estimated 11-point NRS pain reduction relative to placebo was –1.72 for pregabalin, –1.65 for amitriptyline, –1.0 for duloxetine, –1 (median for levetiracetam, –0.27 for gabapentin, 1 (median for lamotrigine, and 2 for dronabinol. Risk ratios relative to placebo for 30% improvement were 0.71 for levetiracetam and 2.56 for pregabalin, and 0.94 and 2.91, respectively, for 50% improvement. Meta-analytic comparisons showed significantly more AEs with pregabalin and tramadol compared with

  3. Comparison of direct and indirect measures of walking energy expenditure in children with hemiplegic cerebral palsy.

    Science.gov (United States)

    Keefer, Daniel J; Tseh, Wayland; Caputo, Jennifer L; Apperson, Kathy; McGreal, Sheri; Morgan, Don W

    2004-05-01

    The purpose of this study was to investigate the use of the heartrate (HR) version of the energy expenditure index (EEIHR) as a proxy for measurement of walking oxygen consumption (VO2) in children with cerebral palsy (CP). Thirteen children (eight males, five females; mean age 11 years 2 months [SD 3 years], age range 6 to 15 years) with hemiplegic CP, participated in this study. The study was conducted over three sessions. During session 1, participants were familiarized with testing procedures and given 5 minutes of treadmill walking practice. In session 2, participants completed three 5-minute walking bouts on the treadmill at 0.67m x s(-1) to familiarize themselves with treadmill locomotion. During the final session participants walked at 0.67, 0.89, and 1.12m x s(-1) for 5 minutes while gross oxygen consumption (gross VO2; walking VO2/speed), net VO2 ([walking VO2-resting VO2]/speed), and EEIHR ([walking HR-resting HR]/speed) were measured during the last 2 minutes of each bout. Correlational analyses indicated no relationship (p>0.05) between measures of gross VO2 and EEIHR at each speed. Although no association was evident between net VO2 and EEIHR at 0.67 and 0.89m x s(-1), a moderate relationship (r=0.64; p<0.05) was present between these variables at 1.12m x s(-1). Examination of individual data revealed that most participants displayed an unmatched pattern of response between net VO2 and EEIHR. Our results suggest that caution should be applied when using EEIHR to estimate walking energy expenditure in children with CP.

  4. Quantitative comparison of cortical and deep grey matter in pathological subtypes of unilateral cerebral palsy.

    Science.gov (United States)

    Scheck, Simon M; Pannek, Kerstin; Fiori, Simona; Boyd, Roslyn N; Rose, Stephen E

    2014-10-01

    The aim of this study was to quantify grey matter changes in children with unilateral cerebral palsy (UCP), differentiating between cortical or deep grey matter (CDGM) lesions, periventricular white matter (PWM) lesions, and unilateral and bilateral lesions. In a cross-sectional study we obtained high resolution structural magnetic resonance images from 72 children (41 males, 31 females, mean age 10y 9mo [SD 3y 1mo], range 5y 1mo-17y 1mo) with UCP (33 left, 39 right hemiplegia; Manual Ability Classification System level I n=29, II n=43; Gross Motor Function Classification System level I n=46, II n=26), and 19 children with typical development (CTD; eight males, 11 females, mean age 11y 2mo [SD 2y 7mo], range 7y 8mo-16y 4mo). Images were classified by lesion type and analyzed using voxel-based morphometry (VBM) and subcortical volumetric analysis. Deep grey matter volumes were not significantly different between children with CDGM and PWM lesions, with the thalamus, putamen, and globus pallidus being reduced unilaterally in both groups compared with CTD (p≤0.001). Children with CDGM lesions additionally showed widespread cortical changes involving all lobes using VBM (p<0.01). Children with bilateral lesions had reduced thalamus and putamen volumes bilaterally (p<0.001). The thalamic volume was reduced bilaterally in children with unilateral lesions (p=0.004). Lesions to the PWM cause secondary changes to the deep grey matter structures similar to primary changes seen in CDGM lesions. Despite having a unilateral phenotype, grey matter changes are observed bilaterally, even in children with unilateral lesions. © 2014 Mac Keith Press.

  5. Comparison of efficacy of Adeli suit and neurodevelopmental treatments in children with cerebral palsy.

    Science.gov (United States)

    Bar-Haim, Simona; Harries, Netta; Belokopytov, Mark; Frank, Alexander; Copeliovitch, Leonel; Kaplanski, Jacob; Lahat, Eli

    2006-05-01

    This study compared the efficacy of Adeli suit treatment (AST) with neurodevelopmental treatment (NDT) in children with cerebral palsy (CP). Twenty-four children with CP, Levels II to IV according to the Gross Motor Function Classification System (GMFCS), were matched by age and functional status and randomly assigned to the AST or NDT treatment groups. In the AST group (n=12; eight males, four females; mean age 8.3 y [SD 2.0]), six children had spastic/ataxic diplegia, one triplegia and five spastic/mixed quadriplegia. In the NDT group (n=12; nine males, three females; mean age 8.1 y [SD 2.2]), five children had spastic diplegia and seven had spastic/mixed quadriplegia. Both groups were treated for 4 weeks (2 hours daily, 5 days per week, 20 sessions). To compare treatments, the Gross Motor Function Measure (GMFM-66) and the mechanical efficiency index (EIHB) during stair-climbing were measured at baseline, immediately after 1 month of treatment, and 10 months after baseline. The small but significant time effects for GMFM-66 and EIHB that were noted after 1 month of both intensive physiotherapy courses were greater than expected from natural maturation of children with CP at this age. Improvements in motor skills and their retention 9 months after treatment were not significantly different between the two treatment modes. Post hoc analysis indicated a greater increase in EIHB after 1 month (p=0.16) and 10 months (p=0.004) in AST than that in NDT, predominantly in the children with higher motor function (GMFCS Levels II and III). The results suggest that AST might improve mechanical efficiency without a corresponding gain in gross motor skills, especially in children with higher levels of motor function.

  6. Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison In 60 cases

    Institute of Scientific and Technical Information of China (English)

    Lixiong Wu; Haibo Yu; Yongfeng Liu

    2008-01-01

    BACKGROUND: The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE: To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure (GMFM) of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING: Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS: All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups: 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS: Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES: The comprehensive functional evaluation scale of cerebral palsy and

  7. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  8. Comparison of patterns of physical activity and sedentary behavior between children with cerebral palsy and children with typical development

    OpenAIRE

    Ryan, JM; Forde, C.; Hussey, JM; Gormley, J

    2015-01-01

    Background - Reduced participation in physical activity and increased time spent in sedentary behavior are associated with overweight, chronic disease, and disability. In order to optimize recommendations and interventions to increase physical activity and reduce sedentary behavior in children with cerebral palsy (CP), knowledge of their physical activity and sedentary behavior is needed.

  9. Comparison of Family and Therapist Perceptions of Physical and Occupational Therapy Services Provided to Young Children with Cerebral Palsy

    Science.gov (United States)

    LaForme Fiss, Alyssa C.; McCoy, Sarah Westcott; Chiarello, Lisa A.

    2012-01-01

    The purpose of this study was to determine whether parents and therapists have similar perceptions of therapy services provided to young children with cerebral palsy (CP), reflecting collaboration and provision of family-centered care. Forty-six parents of young children with CP and 40 therapists providing services for those children participated.…

  10. Comparison of the effect of topical application of human milk and dry cord care on the bacterial colonization of umbilical cord in newborn infants

    Directory of Open Access Journals (Sweden)

    Fatemeh Abbaszadeh

    2014-04-01

    Full Text Available Background: Breast milk contains significant amounts of compounds that act as natural antimicrobial agents. This study was conducted to compare the effect of topical application of human milk and dry cord care on bacterial colonization in the umbilical cord of newborn infants. Methods: This clinical trial study was carried out on 174 infants in Kashan. The newborns were randomized to mother's milk group and dry cord care group from the birth. In group 1, the mother rubbed her own milk on the cord stump every 12 hours from 3 hours after birth to 2 days after the umbilical cord separation. In group 2, the mother was recommended not to use any material on the cord. Then, the cord samples were taken four times; 3hours after birth, at days 3 and 7, and 2 days after the umbilical cord separation. Results: The findings of the culture two days after umbilical cord separation indicated that low percentage of neonates in the breast milk (23.1% and dry cord care (28.8% groups had bacterial colonization. Moreover, no significant difference was found between the two groups in terms of growth of pathogenic organisms and normal flora of the skin (P>0.05. Conclusion: Given the low prevalence of pathogenic microorganisms in the two groups, it seems using breast milk and dry cord care are equally effective methods of taking care of umbilical cord.

  11. Comparison of standard, prone and cine MRI in the evaluation of tethered cord

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sukhjinder [Cohen Children' s Medical Center, Department of Radiology, New Hyde Park, NY (United States); Kline-Fath, Beth; Racadio, Judy M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Bierbrauer, Karin [Cincinnati Children' s Hospital Medical Center, Department of Neurosurgery, Cincinnati, OH (United States); Salisbury, Shelia; Macaluso, Maurizio [Cincinnati Children' s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH (United States); Jackson, Elizabeth C. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Division of Nephrology, Cincinnati, OH (United States); Egelhoff, John C. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States)

    2012-06-15

    Tethered cord syndrome (TCS) is defined by abnormal traction on the spinal cord that confines its movement. Surgical cord release usually stops neurological deterioration; therefore, early and accurate neuroradiological diagnosis is important. Supine MRI is the imaging modality of choice, but prone MRI and cine MRI can demonstrate cord movement. We compared the diagnostic accuracies of standard MRI, prone MRI and cine MRI in patients with clinical suspicion of TCS and evaluated inter-reader reliability for MR imaging. Children who underwent MRI for suspicion of TCS were retrospectively identified. Supine, prone and cine MRI studies were re-read by two pediatric neuroradiologists. Conus level, filum appearance and cord movement were documented. Thirteen of 49 children had tethered cord documented at surgery. Conus level had the highest diagnostic accuracy (sensitivity 69-77%, specificity 94%, positive predictive value 82-83%, negative predictive value 89-92%, correct diagnosis 88-90%) and highest between-reader concordance (98%). Prone and cine MRI did not add to the accuracy of the supine imaging. Conus level provides the highest diagnostic accuracy and inter-reader reliability in TCS. Until a larger series is evaluated, it remains questionable whether prone or cine MRI provides enough additional diagnostic information to warrant routine use. (orig.)

  12. MR imaging of intramedullary tumors of the spinal cord: comparison with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Du Whan; Hwang, Hee Young; Lee, Hyeon Kyeong; Han, Moon Hee; Kim, In One; Kim, Hyen Jip; Chang, Kee Hyung [Seoul National University, College of Medicine, Seoul (Korea, Republic of)

    1991-09-15

    To evaluate the capability of MR imaging to localize intramedullary tumors of the spinal cord and to distinguish solid from cystic components. MR images of 12 patients with surgically-proven intramedullary spinal cord tumor were retrospectively reviewed and correlated with surgical findings. Histologic diagnosis consisted of 3 astrocytomas, 4 ependymomas, 2 gangliogliomas, and one case of lipoma, lymphoma, and glioblastoma multiform each. MR scans were obtained on a 2.0T or a 0.5T with T1-and T2-weighted spin-echo pulse sequences in sagittal and axial planes. Contrast enhancement was performed with Gd-DTPA in 9 patients. All tumors expanded the spinal cord and showed an extent of involvement ranging from 2 to 5 vertebral heights, except for the gangliogliomas which involved the spinal cord more extensively. Contrast enhancement was seen in all 9 patients. Intratumoral cavities were observed in 1 out of 3 astrocytomas and 2 gangliogliomas. Peritumoral syringomyelia was seen in 2 out of 4 ependymonas and 2 gangliogliomas. In most cases, the MR findings correlated well with the surgical findings with respect to the extent, distinctness of the tumor margin, intratumoral cavity, and associated syringomyelia. It is concluded that MR imaging is a very useful diagnostic tool in the evaluation of intramedullary spinal cord tumors.

  13. Comparison of Maternal and Umbilical Cord Blood Selenium Levels in Low and Normal Birth Weight Neonates

    Directory of Open Access Journals (Sweden)

    Lyly Nazemi

    2015-10-01

    Full Text Available Objective:To compare the maternal and umbilical cord serum selenium concentrations in Low and normal birth weight neonates.Materials and methods:A case-control study was carried out in Vali-Asr and Akbarabadi Hospitals (Jan. to Dec. 2013. Two groups; case group; 91 mothers who delivered a low birth weight (LBW neonate and control group; 86 subjects who delivered a normal birth weight neonate were selected. Immediately after birth, 5 ml of maternal blood and umbilical cord blood were collected, and sent to laboratory to assay Se concentrations. To compare both groups' blood Se concentration, data were analyzed in SPSS 16.0.Results:Eighty six (48.6% mothers with normal birth weight neonates and 91 (51.4% mothers with low birth weight infants entered the study. Mean maternal mothers' age and mean maternal blood Se were 28.55+5.90 years and 79.3756+26.46915. A significant association was seen between maternal blood and cord blood Se level in control and case group (P value<0.0001, r = 0.69 and(P value<0.001, r = 0.79. On the other hand no differences were seen between 2 groups' maternal blood Se level (P Value = 0.65. Umbilical Cord blood Se concentration was not also different between case and control group (P value = 0.46.Conclusion:We found that maternal and umbilical cord blood Se concentrations were not different in low and adequate birth weight infants, however; umbilical cord Se concentrations were positively correlated with maternal blood Se concentrations.

  14. COMPARISON BETWEEN THE EFFECT OF NEURODEVELOPMENTAL TREATMENT AND SENSORY INTEGRATION THERAPY ON GROSS MOTOR FUNCTION IN CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Alireza SHAMSODDINI

    2010-06-01

    Full Text Available ObjectiveThis study was planned to compare the effects of neurodevelopmental treatment and sensory integration therapy on gross motor function in children with cerebral palsyMaterials & MethodsTwenty two children with spastic CP were randomly divided into two groups. Sensory integrative therapy was given to the first group (n=11, and neurodevelopmental treatment was given to the second group (n=11. All children were evaluated with GMFM-88. Treatment was scheduled for three - one hour sessions per week for 3 months.ResultsTwenty two children with spastic CP (11 diplegia and 11 quadriplegia participated in this study. When two groups were compared, a significant difference was found in lying and rolling (P=0.003, sitting (0.009, crawling and kneeling (0.02 and standing ability (P=0.04. But there was no significant difference in walking, running, and jumping abilities between the two groups (0.417. Paired t-tests revealed a significant difference between pre and post test results, with increases in scores of lying and rolling, sitting, crawling and kneeling, standing in sensory integration therapy (SIT and neurodevelopmental treatment (NDT approaches.Conclusion Neurodevelopmental treatment and sensory integration therapy improved gross motor function in children with cerebral palsy in four dimensions (lying and rolling, sitting, crawling and kneeling, standing. However, walking, running and jumping did not significantly improve.

  15. Motor imagery training promotes motor learning in adolescents with cerebral palsy: comparison between left and right hemiparesis.

    Science.gov (United States)

    Cabral-Sequeira, Audrey Sartori; Coelho, Daniel Boari; Teixeira, Luis Augusto

    2016-06-01

    This experiment was designed to evaluate the effects of pure motor imagery training (MIT) and its combination with physical practice on learning an aiming task with the more affected arm in adolescents suffering from cerebral palsy. Effect of MIT was evaluated as a function of side of hemiparesis. The experiment was accomplished by 11- to 16-year-old participants (M = 13.58 years), who suffered left (n = 16) or right (n = 15) mild hemiparesis. They were exposed to pure MIT (day 1) followed by physical practice (day 2) on an aiming task demanding movement accuracy and speed. Posttraining movement kinematics of the group receiving MIT were compared with movement kinematics of the control group after receiving recreational activities (day 1) and physical practice (day 2). Kinematic analysis showed that MIT led to decreased movement time and straighter hand displacements to the target. Performance achievements from MIT were increased with further physical practice, leading to enhanced effects on motor learning. Retention evaluation indicated that performance improvement from pure MIT and its combination with physical practice were stable over time. Performance achievements were equivalent between adolescents with either right or left hemiparesis, suggesting similar capacity between these groups to achieve performance improvement from pure imagery training and from its association with physical practice. Our results suggest that motor imagery training is a procedure potentially useful to increase motor learning achievements in individuals suffering from cerebral palsy.

  16. Energy Expenditure in Adolescents With Cerebral Palsy: Comparison of the SenseWear Armband and Indirect Calorimetry.

    Science.gov (United States)

    Koehler, Karsten; Abel, Thomas; Wallmann-Sperlich, Birgit; Dreuscher, Annika; Anneken, Volker

    2015-04-01

    Inactivity and overweight are major health concerns in children and adolescents with disabilities. Methods for the assessment of activity and energy expenditure may be affected negatively by the underlying disability, especially when motor function is impaired. The purpose of this study was to assess the validity of the SenseWear Armband in adolescents with cerebral palsy and hemiparesis. Ten volunteers (age: 13.4 ± 1.6 years) were equipped with SenseWear Armbands on the hemiparetic and nonhemiparetic side of the body. Energy expenditure was measured at rest and during treadmill exercise (speed range: 0.85 to 2.35 m/s). Indirect calorimetry served as independent reference method. The mean error was between -0.6 and 0.8 kcal/min and there were no significant differences between SenseWear and indirect calorimetry at any speed. Differences between body sides in expenditure (mean: -0.2 to 0.0 kcal/min) and step count (mean: -3.4 to 9.7 steps/min) were not significant. The validity of the SenseWear Armband does not appear to be negatively affected by cerebral palsy during laboratory treadmill exercise. Future field studies are necessary to assess the validity and practicability energy expenditure and physical activity in children and adolescents with physical disabilities.

  17. Comparison of oral health status between children with cerebral palsy and normal children in India: A case–control study

    Science.gov (United States)

    Sinha, Nidhi; Singh, Bijay; Chhabra, Kumar Gaurav; Patil, Santosh

    2015-01-01

    Background: The aim of the present research was to describe and compare the oral health of children with cerebral palsy (CP) with the normal children in India. Materials and Methods: Fifty children with CP of the age range 7-17 years and fifty normal children were selected for the study. An oral examination was carried out and decayed, missing, and filled teeth (dmft/DMFT) index, oral hygiene index-simplified (OHI-S) index, Angles malocclusion were charted along with other significant dental findings. Data were analyzed using Student's t-test and Kruskal–Wallis one-way ANOVA test. Results: The mean dmft/DMFT of the CP group was 4.11 ± 2.62, while that of controls was 2.95 ± 2.75, which showed higher caries prevalence in the CP group. There was a significant association between the dmft/DMFT (P = 0.03), OHI-S (P = 0.001), and Angles Class 2 malocclusion and CP. Conclusions: Cerebral palsy group had higher caries, poor oral hygiene and Class 2 malocclusion when compared to controls primarily because of their compromised general health condition and also less dental awareness. Effort should be made for better organization of preventive dental care and promoting dental health of this challenged population. PMID:25810598

  18. Comparison of King Vision and Truview Laryngoscope for Postextubation Visualization of Vocal Cord Mobility in Patients Undergoing Thyroid and Major Neck Surgeries: A Randomized Clinical Trial

    Science.gov (United States)

    Priyanka, Anto Sahaya; Nag, Kusha; Hemanth Kumar, V. R.; Singh, Dewan Roshan; Kumar, Senthil; Sivashanmugam, T.

    2017-01-01

    Background: Visualization of vocal cords following extubation after thyroid and major neck surgeries is highly desirable for the surgeon as well as the anaesthesiologist to rule out vocal cord palsy or oedema. As the patient is emerging from general anaesthesia, it may be challenging for the anaesthesiologist to optimally visualise and grade vocal cord movement following extubation. Setting: Randomized clinical trial at a tertiary care centre. Methodology: After obtaining institutional ethics committee approval, 60 patients posted for thyroid and major neck surgeries under American Society of Anesthesiologists (ASA) grade I and II were recruited for the study. Written informed consent was obtained. Pre-operatively indirect laryngoscopy was performed in all the patients to assess baseline vocal cord function. All patients were premedicated and induced and maintained as per standardized anaesthesia protocol. Patients were randomized using a sealed envelope technique to either Group K where intubation was performed using Kings vision laryngoscope or Group T where intubation was performed using True view laryngoscope. Glottis visualization was graded in all patients and intubated. Ten minutes prior to extubation injection. dexmedetomidine 1 μg/kg was administered. Once patients satisfied extubation criteria, laryngoscopy was performed using respective video-laryngoscope in each group, patient extubated under vision and assessed for vocal cord visualization and mobility grade (VMG) and patient reactivity score (PRS). Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure was also noted. Total intraoperative morphine consumption was recorded. Vocal cord function was assessed again before the day of discharge by indirect laryngoscopy. Results: Age (P = 0.27), sex (P = 0.08), body mass index (P = 0.70), ASA (P = 0.39), mallampati class (P = 0.72) and morphine used (P = 0.39) were comparable in both groups. There was no statistically

  19. Comparison of Electric Stimulation Methods for Reduction of Triceps Surae Spasticity in Spinal Cord Injury

    NARCIS (Netherlands)

    Salm, van der Arjan; Veltink, Peter H.; IJzerman, Maarten J.; Groothuis-Oudshoorn, Karin C.; Nene, Anand V.; Hermens, Hermie J.

    2006-01-01

    Objectives: To compare the effect of 3 methods of electric stimulation to reduce spasticity of the triceps surae in patients with complete spinal cord injury (SCI) and to investigate the carryover effect. - Design: Placebo-controlled study with repeated measurements after the interventions. - Settin

  20. Paresthesia thresholds in spinal cord stimulation: a comparison of theoretical results with clinical data

    NARCIS (Netherlands)

    Struijk, Johannes J.; Holsheimer, Jan; Barolat, Giancarlo; He, Jiping; Boom, Herman B.K.

    1993-01-01

    The potential distributions produced in the spinal cord and surrounding tissues by dorsal epidural stimulation at the midcervical, midthoracic, and low thoracic levels were calculated with the use of a volume conductor model. Stimulus thresholds of myelinated dorsal column fibers and dorsal root fib

  1. COMPARISON OF EARLY AND DELAYED UMBILICAL CORD CLAMPING IN THE THIRD STAGE OF LABOUR

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    Tamara Serdinšek

    2015-09-01

    Full Text Available Background: Umbilical cord clamping in the third stage of labour is still controversial. Early cord clamping is defined as clamping at 10, 15, 30 or 60 seconds after delivery and delayed as clamping after 60 seconds or at 2-5 minutes after delivery, when the cord stops pulsating or when the placenta is visible within the birth canal. Early clamping is one of the three components of active management of the third stage of labour, which has been used widely in modern obstetrics during the last century. However, in some northern European countries, various parts of the USA and Canada and in developing countries physiological management is preferred.Conclusions: After publication of several trials describing advantages of delayed clamping, this has recently been progressively replacing early clamping. The most important advantages of delayed cord clamping are higher haemoglobin and ferritin levels, higher iron stores, lower incidence of iron deficiency anaemia, better cardiopulmonary adaptation, lower rate of respiratory distress syndrome, and longer duration of early breastfeeding in term neonates, while there is no increase in the incidence of postpartum haemorrhage. Delayed clamping seems to bring some advantages for preterm neonates as well. However, caution is still advised because of the potential adverse effects, especially polycythaemia with hyperviscosity, hyperbilirubinaemia and respiratory distress.

  2. Comparison of the effect of MIME therapy versus conventional therapy on the sunny brook facial grading system in patients with acute bell’s palsy

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    Mistry Gopi S, Sheth Megha S, Vyas Neeta J

    2014-03-01

    Full Text Available Background: Facial resting symmetry and expressions are determinants of facial attractiveness & being a marker of good health. Mime therapy is a combination of mime and physiotherapy and aims to promote symmetry of the face at rest and during movement. The objective of this study is to compare the effect of Mime therapy and conventional therapy on the facial functions in patients with acute Bell’s palsy. Method: The quasi-experimental study was conducted at SBB College of physiotherapy. A convenience sample was taken consisting of 30 participants, 10 in each group. Group A received Mime therapy. Group B, conventional therapy and Group C received home exercise program. Facial symmetry at rest and movement was assessed through Sunnybrook facial grading scale (FGS after completion of 10 sessions to each group. At the end of treatment, response to treatment was assessed by the Patient’s global impression of change scale (PGIC. Level of significance was kept at 5%. Result: Analysis of variance was used to compare all outcomes. At the end of 10 sessions, scores on Sunnybrook FGS (p<0.001 and PGIC (p<0.001 shows significant difference within and between groups. Post hoc Bonferroni test was used for multiple comparisons. FGS shows significant differences between groups A&B (p<0.001 and groups A&C (p<0.001. But no significant difference was seen between groups B&C(p=1.00. PGIC scale shows significant differences between groups A&B (p<0.001 and A&C (p<0.001 but no significant difference was seen between groupsB&C (p=1. 00. Conclusion: Mime therapy improves facial symmetry and functions more than conventional therapy and home exercises in people with acute Bells’ Palsy. No difference was found between conventional therapy and home exercise program.

  3. Comparison of the quality of life in cerebral palsy children with physical therapy more and less than 10 months

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    Dewi Anggreany

    2015-10-01

    Full Text Available Background Cerebral palsy (CP is the most common cause of severe physical disability in childhood. These limitations may cause lower level experience or quality of life (QoL. Physical therapy (PT plays a central role in managing CP. Objective To compare QoL in CP children with PT more and less than 10 months and to compare gross motoric level before and after PT. Methods A cross sectional study was performed from June 2012 to March 2013 in Medan. Eligible population were four to twelve year old CP children who received PT. Subjects were divided into 2 group, group I was CP children with PT more than 10 months, group II was CP children with PT less than 10 months. Parents were asked to fill CP QOL questionnaires. To evaluate motor impairment level we used gross motor function classification system (GMFCS that classified the motoric impairment into 5 levels. Data was analyzed by using independent T-test and MannWhitney U test with 95% confidence interval. Results There were 60 CP children divided into 2 groups of 30 children. The mean duration of PT in group I was 35.7 (SD 19.37 months and group II was 4.2 (SD 3.13 months. Gross motoric level in both group increased from GMFCS IV to GMFCS II in group I (P=0.0001 and from GMFCS IV to GMFCS III (P=0.002 in group II. The mean total CP QoL scores in group I and II were 79.63 (SD 5.73 and 47.71 (SD 6.85, respectively (P=0.0001. Conclusions Cerebral palsy children who received more than 10 months PT have higher QoL than children with less than 10 months PT. There was significant gross motor improvement after PT in both groups.

  4. Comparison of the quality of life in cerebral palsy children with physical therapy more and less than 10 months

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    Dewi Angreany

    2015-09-01

    Full Text Available Background Cerebral palsy (CP is the most common cause of severe physical disability in childhood. These limitations may cause lower level experience or quality of life (QoL. Physical therapy (PT plays a central role in managing CP. Objective To compare QoL in CP children with PT more and less than 10 months and to compare gross motoric level before and after PT. Methods A cross sectional study was performed from June 2012 to March 2013 in Medan. Eligible population were four to twelve year old CP children who received PT. Subjects were divided into 2 group, group I was CP children with PT more than 10 months, group II was CP children with PT less than 10 months. Parents were asked to fill CP QOL questionnaires. To evaluate motor impairment level we used gross motor function classification system (GMFCS that classified the motoric impairment into 5 levels. Data was analyzed by using independent T-test and Mann-Whitney U test with 95% confidence interval. Results There were 60 CP children divided into 2 groups of 30 children. The mean duration of PT in group I was 35.7 (SD 19.37 months and group II was 4.2 (SD 3.13 months. Gross motoric level in both group increased from GMFCS IV to GMFCS II in group I (P=0.0001 and from GMFCS IV to GMFCS III (P=0.002 in group II. The mean total CP QoL scores in group I and II were 79.63 (SD 5.73 and 47.71 (SD 6.85, respectively (P=0.0001. Conclusions Cerebral palsy children who received more than 10 months PT have higher QoL than children with less than 10 months PT. There was significant gross motor improvement after PT in both groups.

  5. United Cerebral Palsy

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    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  6. Bell's Palsy (For Kids)

    Science.gov (United States)

    ... Bell's palsy was named after a Scottish doctor, Sir Charles Bell, who studied the two facial nerves ... better. It's rare that a doctor would do surgery for Bell's palsy. Instead, he or she might ...

  7. Effect of topical application of chlorhexidine for umbilical cord care in comparison with conventional dry cord care on the risk of neonatal sepsis: a randomized controlled trial.

    Science.gov (United States)

    Gathwala, Geeta; Sharma, Deepak; Bhakhri, Bhanu kiran

    2013-06-01

    To compare topical application of chlorhexidine for umbilical cord care with conventional dry care for prevention of neonatal sepsis in neonatal intensive care unit (NICU). The study was conducted in the NICU of a teaching hospital in north India between 2010 and 2011. Newborns (≥ 32 weeks of gestation and weighing ≥ 1500 g) were randomized into chlorhexidine application and dry care groups. Data regarding time of cord separation, umbilical sepsis and neonatal sepsis were recorded. One hundred forty (dry care group 70, chlorhexidine group 70) were enrolled and finally analysed. A significant difference was observed among groups in terms of time to cord separation and incidence of blood culture-proven sepsis though there was no statistical difference noted among the groups with regards to umbilical infection, probable sepsis and meningitis. Use of chlorhexidine for umbilical cord care prevents sepsis in the NICU.

  8. Cerebral Palsy (For Kids)

    Science.gov (United States)

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Cerebral Palsy KidsHealth > For Kids > Cerebral Palsy Print A A A What's in this article? ... the first word you spoke? For kids with cerebral palsy, called CP for short, taking a first step ...

  9. Effect of Umbilical Cord Mesenchymal Stem Cell Transplantation Therapy for Cerebral Palsy on Motor Function%脐带间充质干细胞移植对脑瘫患儿运动功能的影响

    Institute of Scientific and Technical Information of China (English)

    杨华强; 张荣环; 杜玲; 李东升; 袁雅红; 刘瑜

    2012-01-01

    Objective: To observe the effect and application value of umbilical cord mesenchymal stem cells (UC-MSC) transplantation therapy for cerebral palsy (CP) on motor function. Methods: Twenty-five patients with CP were received UC-MSC transplantation by intravenous infusion and lumbar puncture intrathecal injections. All patients were followed up for more than six months after transplantation. The changes of motor function were comprehensive analysis by Gross Motor Function Measure (GMFM) and Berg Balance Scale(BBS (before treatment and post-treatment regularly. Results: After six months of transplantation, 22 of 25 cases with CP subjectively had improvement in motor function compared with prior treatment. All patients objectively had improvement in scores of GMFM and BSS post-treatment than pretherapy. Various biochemical indicators were normal and the patient had no severe complications and clear side effects after transplantation. All patients' condition was continously catabatic and no recurrence was found after six months was followed up. Conclusions: The UC-MSC transplantation can ameliorate sequelae and improve motor function and quality of life of CP. It is convenient, safe and effective in the treatment of CP.%目的:探讨脐带间充质干细胞移植治疗对脑瘫患儿运动功能的影响极其应用价值.方法:25例脑瘫患者给予脐带间充质干细胞移植治疗,移植方法采用静脉输注联合腰穿鞘内注射的方法.移植术前及移植术后定期采用粗大运动评估量表( Gross Motor Function Measure,GMFM)及Berg平衡量表(Berg Balance Scale,BBS)对运动功能的改善情况进行评估并进行综合分析.结果:移植术后6月25例脑瘫患儿中有22例患者主观上运动功能较前有明显好转,客观上25例患者GFMF与BSS与术前比较有明显改善(P<0.05),随访6月未发现与移植相关的副作用.结论:脐带间充质干细胞移植是一种安全有效的治疗方法,可在一定程度上改善脑

  10. [Peripheral facial nerve palsy].

    Science.gov (United States)

    Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M

    2013-06-01

    Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.

  11. Standardization of size, shape and internal structure of spinal cord images: comparison of three transformation methods.

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    Yasuhisa Fujiki

    Full Text Available Functional fluorescence imaging has been widely applied to analyze spatio-temporal patterns of cellular dynamics in the brain and spinal cord. However, it is difficult to integrate spatial information obtained from imaging data in specific regions of interest across multiple samples, due to large variability in the size, shape and internal structure of samples. To solve this problem, we attempted to standardize transversely sectioned spinal cord images focusing on the laminar structure in the gray matter. We employed three standardization methods, the affine transformation (AT, the angle-dependent transformation (ADT and the combination of these two methods (AT+ADT. The ADT is a novel non-linear transformation method developed in this study to adjust an individual image onto the template image in the polar coordinate system. We next compared the accuracy of these three standardization methods. We evaluated two indices, i.e., the spatial distribution of pixels that are not categorized to any layer and the error ratio by the leave-one-out cross validation method. In this study, we used neuron-specific marker (NeuN-stained histological images of transversely sectioned cervical spinal cord slices (21 images obtained from 4 rats to create the standard atlas and also to serve for benchmark tests. We found that the AT+ADT outperformed other two methods, though the accuracy of each method varied depending on the layer. This novel image standardization technique would be applicable to optical recording such as voltage-sensitive dye imaging, and will enable statistical evaluations of neural activation across multiple samples.

  12. Thorax and pelvis kinematics during walking, a comparison between children with and without cerebral palsy: A systematic review.

    Science.gov (United States)

    Swinnen, Eva; Goten, Laura Vander; De Koster, Berdien; Degelaen, Marc

    2016-01-01

    Dysfunctional postural control and pathological thorax and pelvis motions are often observed in children with cerebral palsy (CP) and can be considered as an indicator of diminished dynamic stability. The aim of this study was to identify the differences between children with CP and typically developing children in three-dimensional thorax and pelvis kinematics during walking. Three electronic databases were searched by using different combinations of keywords. The methodological quality of the studies was assessed by two researchers with the Strobe quality checklist. Ten studies (methodological quality: 32% to 74%) with in total 259 children with CP and 220 typically developing children (mean age: 7.6 to 13.6 year) were included. Compared to typically developing children, children with bilateral CP showed an increased range of motion of the thorax, pelvis and spine during walking. The results of the children with unilateral CP were less clear. In general, children with bilateral CP showed larger movement amplitudes of the trunk compared to children without CP. This increase in movement amplitudes could influence the dynamic stability of the body during walking. In children with unilateral CP, the results were less obvious and further research on this topic is required.

  13. A comparison of hip joint centre localisation techniques with 3-DUS for clinical gait analysis in children with cerebral palsy.

    Science.gov (United States)

    Peters, Alana; Baker, Richard; Morris, M E; Sangeux, Morgan

    2012-06-01

    Functional calibration techniques have been proposed as an alternative to regression equations for estimating the position of the hip within the pelvic co-ordinate system for clinical gait analysis. So far validation of such techniques has focussed on healthy adults. This study evaluated a range of techniques based on regression equations or functional calibration procedures techniques in 46 children representative of those attending a major clinical gait analysis service against previously validated 3-D ultrasound techniques for determining the hip joint centre. Best agreement with ultrasound for the position of the hip within the pelvic coordinate system was found for the Harrington equations (mean 14 mm, sd 8 mm). Sphere fitting (mean≈22 mm, sd 11 mm) performed better than transformational techniques applied locally (mean≈33 mm, sd 12 mm) or globally (mean=30 mm, sd 14 mm). The participants with cerebral palsy showed reduced range of movement compared with healthy adults. Differences between these results and studies modelling the effects of simulated noise on functional techniques can probably be attributed to differences between that noise and the soft tissue displacements that are actually occurring.

  14. Spinal cord decompression sickness: a comparison of recompression therapies in an animal model.

    Science.gov (United States)

    Sykes, J J; Hallenbeck, J M; Leitch, D R

    1986-06-01

    Somatosensory evoked potentials (SEP) were used in an animal model to measure spinal cord electrophysiological function. Animals were submitted to a dive profile resulting in spinal cord decompression sickness (DCS). The animals were treated after a delay allowing the lesion to consolidate. Serial measurements of SEP documented the onset, duration, and outcome of treatment. Physiological data were recorded throughout each experiment. Group A (n = 10) was recompressed to 60 fsw (feet of sea water) breathing 100% oxygen (2.8 ATA) and Group B (n = 8) was treated at 66 fsw breathing 66% oxygen (2.0 ATA). No differences were found between groups in the severity, surface interval before treatment, or the maximum effect of treatment. The maximum effect of treatment was seen by 25 min of treatment. Animals were regrouped into responders and nonresponders. The latter displayed a more rapid onset, a more severe insult, and more adverse physiological effects than the responders. The possibility of a different etiology was considered together with the failure to differentiate between the treatment groups. It was concluded that treatment B was safer but the problems of introducing a new therapeutic table outweighed the safety advantage.

  15. Comparison of ectopic bone formation of embryonic stem cells and cord blood stem cells in vivo.

    Science.gov (United States)

    Handschel, Jörg; Naujoks, Christian; Langenbach, Fabian; Berr, Karin; Depprich, Rita A; Ommerborn, Michelle A; Kübler, Norbert R; Brinkmann, Matthias; Kögler, Gesine; Meyer, Ulrich

    2010-08-01

    Cell-based reconstruction therapies promise new therapeutic opportunities for bone regeneration. Unrestricted somatic stem cells (USSC) from cord blood and embryonic stem cells (ESCs) can be differentiated into osteogenic cells. The purpose of this in vivo study was to compare their ability to induce ectopic bone formation in vivo. Human USSCs and murine ESCs were cultured as both monolayer cultures and micromasses and seeded on insoluble collagenous bone matrix (ICBM). One week and 1, 2, and 3 months after implanting the constructs in immune-deficient rats, computed tomography scans were performed to detect any calcification. Subsequently, the implanted constructs were examined histologically. The radiological examination showed a steep increase in the mineralized bone-like tissue in the USSC groups. This increase can be considered as statistically significant compared to the basic value. Moreover, the volume and the calcium portion measured by computed tomography scans were about 10 times higher than in the ESC group. The volume of mineralization in the ESC group increased to a much smaller extent over the course of time, and the control group (ICBM without cells) showed almost no alterations during the study. The histological examinations parallel the radiological findings. Cord blood stem cells in combination with ICBM-induced ectopic bone formation in vivo are stronger than ESCs.

  16. Comparison of Patterns of Physical Activity and Sedentary Behavior Between Children With Cerebral Palsy and Children With Typical Development.

    Science.gov (United States)

    Ryan, Jennifer M; Forde, Cuisle; Hussey, Juliette M; Gormley, John

    2015-12-01

    Reduced participation in physical activity and increased time spent in sedentary behavior are associated with overweight, chronic disease, and disability. In order to optimize recommendations and interventions to increase physical activity and reduce sedentary behavior in children with cerebral palsy (CP), knowledge of their physical activity and sedentary behavior is needed. The aim of this study was to describe light, moderate, and vigorous physical activity and sedentary behavior in preadolescent children with and without CP and compare physical activity and sedentary behavior between the 2 groups. This was a cross-sectional study of 33 children, aged 6 to 10 years, with CP (Gross Motor Function Classification System [GMFCS] levels I-III) and 33 age- and sex-matched children with typical development. Physical activity was measured using the RT3 accelerometer over 7 days. Children with CP spent more time in sedentary behavior and accumulated less total activity, moderate activity, vigorous activity, and sustained bouts of moderate-to-vigorous activity (MVPA). They also accumulated a fewer number of bouts of MVPA and vigorous activity, despite spending a similar amount of time in each bout. The small number of children in GMFCS levels II and III did not allow for adjustment for GMFCS level when comparing physical activity between children with and without CP. Preadolescent children with CP spent less time in moderate and vigorous activity and more time in sedentary behavior than children with typical development. Children with CP also accumulated less continuous MVPA and vigorous activity as a result of achieving fewer sustained bouts of MVPA and vigorous activity throughout the day. © 2015 American Physical Therapy Association.

  17. Current proceedings of cerebral palsy.

    Science.gov (United States)

    Fan, Hueng-Chuen; Ho, Li-Ing; Chi, Ching-Shiang; Cheng, Shin-Nan; Juan, Chun-Jung; Chiang, Kuo-Liang; Lin, Shinn-Zong; Harn, Horng-Jyh

    2015-01-01

    Cerebral palsy (CP) is a complicated disease with varying causes and outcomes. It has created significant burden to both affected families and societies, not to mention the quality of life of the patients themselves. There is no cure for the disease; therefore, development of effective therapeutic strategies is in great demand. Recent advances in regenerative medicine suggest that the transplantation of stem cells, including embryonic stem cells, neural stem cells, bone marrow mesenchymal stem cells, induced pluripotent stem cells, umbilical cord blood cells, and human embryonic germ cells, focusing on the root of the problem, may provide the possibility of developing a complete cure in treating CP. However, safety is the first factor to be considered because some stem cells may cause tumorigenesis. Additionally, more preclinical and clinical studies are needed to determine the type of cells, route of delivery, cell dose, timing of transplantation, and combinatorial strategies to achieve an optimal outcome.

  18. Comparison of iNOS inhibition by antisense and pharmacological inhibitors after spinal cord injury.

    Science.gov (United States)

    Pearse, D D; Chatzipanteli, K; Marcillo, A E; Bunge, M B; Dietrich, W D

    2003-11-01

    Inducible nitric oxide synthase (iNOS) is a key mediator of inflammation during pathological conditions. We examined, through the use of selective iNOS inhibitors, the role of iNOS in specific pathophysiological processes after spinal cord injury (SCI), including astrogliosis, blood-spinal cord barrier (BSCB) permeability, polymorphonuclear leukocyte infiltration, and neuronal cell death. Administration of iNOS antisense oligonucleotides (ASOs) (intraspinally at 3 h) or the pharmacological inhibitors, N-[3(Aminomethyl) benzyl] acetamidine (1400 W) (i.v./i.p. 3 and 9 h) or aminoguanidine (i.p. at 3 and 9 h) after moderate contusive injury decreased the number of iNOS immunoreactive cells at the injury site by 65.6% (iNOS ASOs), 62.1% (1400 W), or 59% (aminoguanidine) 24 h postinjury. iNOS activity was reduced 81.8% (iNOS ASOs), 56.7% (1400 W), or 67.9% (aminoguanidine) at this time. All iNOS inhibitors reduced the degree of BSCB disruption (plasma leakage of rat immunoglobulins), with iNOS ASO inhibition being more effective (reduced by 58%). Neutrophil accumulation within the injury site was significantly reduced by iNOS ASOs and 1400 W by 78.8% and 20.9%, respectively. Increased astrogliosis was diminished with iNOS ASOs but enhanced following aminoguanidine. Detection of necrotic and apoptotic neuronal cell death by propidium iodide and an FITC-conjugated Annexin V antibody showed that iNOS inhibition could significantly retard neuronal cell death rostral and caudal to the injury site. These novel findings indicate that acute inhibition of iNOS is beneficial in reducing several pathophysiological processes after SCI. Furthermore, we demonstrate that the antisense inhibition of iNOS is more efficacious than currently available pharmacological agents.

  19. Comparison of the Effects of Different Cryoprotectants on Stem Cells from Umbilical Cord Blood

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    Gecai Chen

    2016-01-01

    Full Text Available Purpose. Cryoprotectants (CPA for stem cells from umbilical cord blood (UCB have been widely developed based on empirical evidence, but there is no consensus on a standard protocol of preservation of the UCB cells. Methods. In this study, UCB from 115 donors was collected. Each unit of UCB was divided into four equal parts and frozen in different kinds of cryoprotectant as follows: group A, 10% ethylene glycol and 2.0% dimethyl sulfoxide (DMSO (v/v; group B, 10% DMSO and 2.0% dextran-40; group C, 2.5% DMSO (v/v + 30 mmol/L trehalose; and group D, without CPA. Results. CD34+, cell viability, colony forming units (CFUs, and cell apoptosis of pre- and postcryopreservation using three cryoprotectants were analyzed. After thawing, significant differences in CD34+ count, CFUs, cell apoptosis, and cell viability were observed among the four groups (P<0.05.  Conclusion. The low concentration of DMSO with the addition of trehalose might improve the cryopreservation outcome.

  20. Genetic Comparison of Stemness of Human Umbilical Cord and Dental Pulp

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    Chung-Min Kang

    2016-01-01

    Full Text Available This study focuses on gene expression patterns and functions in human umbilical cord (UC and dental pulp (DP containing mesenchymal stem cells (MSCs. DP tissues were collected from 25 permanent premolars. UC tissue samples were obtained from three newborns. Comparative gene profiles were obtained using cDNA microarray analysis and the expression of tooth development-associated and MSC-related genes was assessed by the quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR. Genes related to cell proliferation, angiogenesis, and immune responses were expressed at higher levels in UC, whereas genes related to growth factor and receptor activity and signal transduction were more highly expressed in DP. Although UC and DP tissues exhibited similar expression of surface markers for MSCs, UC showed higher expression of CD29, CD34, CD44, CD73, CD105, CD146, and CD166. qRT-PCR analysis showed that CD146, CD166, and MYC were expressed 18.3, 8.24, and 1.63 times more highly in UC, whereas the expression of CD34 was 2.15 times higher in DP. Immunohistochemical staining revealed significant differences in the expression of genes (DSPP, DMP1, and CALB1 related to odontogenesis and angiogenesis in DP. DP and UC tissue showed similar gene expression, with the usual MSC markers, while they clearly diverged in their differentiation capacity.

  1. Comparison of maternal and umbilical cord blood HIF-1α and nitric oxide levels in early and late onset preeclamptic pregnancies.

    Science.gov (United States)

    Demircan Sezer, Selda; Küçük, Mert; Nergiz Avcıoğlu, Sümeyra; Zafer, Emre; Altınkaya, Sunduz Özlem; Bıçakçı, Burcu; Yenisey, Çiğdem; Yüksel, Hasan; Kurt Ömürlü, İmran

    2015-01-01

    Despite the absence of a complete physiologic-pathologic understanding, common accepted theory for development of preeclampsia is incomplete trophoblastic invasion leading to failed uterine and spiral arteriolar remodeling, causing maternal vascular endothelial dysfunction by secreted molecules in response to decreased placental perfusion, placental hypoxia, and ischemia. Placental angiogenesis is especially ineffective in early onset preeclampsia and fetal morbidity/mortality rates are higher because of further decreased blood flow. In this study, we aim to compare the maternal and umbilical cord blood levels of hypoxia-inducible transcription factor-1α (HIF-1α), which is believed to regulate hypoxia-related transcriptional responses, to play role in activating genes for initial phases of placental development and angiogenesis and a physiologic vasodilator molecule nitric oxide (NO) in normal, early and late onset preeclamptic pregnant women. Pregnant women who were diagnosed with preeclampsia (early onset ≤34 weeks; late onset >34 weeks) and delivered in our clinic were enrolled for this prospective case-controlled study. Pregnant women without preeclampsia were recruited as control group. HIF-1α and NO levels in maternal and umbilical cord blood measured and compared among groups. A total of 46 cases were enrolled for this study, including 25 preeclamptic (13 in the early onset group and 12 in the late onset group) and 21 normal pregnant women in the control group. Comparison of preeclampsia group to controls revealed higher maternal blood HIF-1α levels in the control group, however higher umbilical cord NO levels in the preeclampsia group (p umbilical cord blood NO levels (p umbilical cord NO levels in preeclampsia group than controls. These findings suggest that umbilical cord blood NO levels in pregnant women with preeclampsia increase in response to hypoxia. However, lower HIF-1α levels in preeclampsia group can be due to our limited number of

  2. Comparison of Stored Umbilical Cord Blood and Adult Donor Blood: Transfusion Feasibility

    Directory of Open Access Journals (Sweden)

    Rola Sahyoun-tokan

    2012-09-01

    Full Text Available OBJECTIVE: This study aimed to compare the storage properties of red blood cell (RBC concentrates of umbilical cord blood (UCB and adult donor blood (ADB, and to evaluate the feasibility of UCB-RBC concentrate as an autologous source for blood transfusion in very low birth weight (VLBW preterm neonates. METHODS: In all, 30 newborn (10 preterm, 20 full term UCB and 31 ADB units were collected. RBC concentrates were stored and compared with regard to pH, potassium (K+, 2,3-biphosphoglycerate (2-3-BPG, adenosine tri-phosphate (ATP, plasma Hb, and bacterial contamination on d 1, 21, and 35 of storage. RESULTS: The K+ level increased with time and differed significantly between storage d 1 and 21, and between storage d 1 and 35 in both the UCB and ADB units. Initial and d 21 K+ levels were higher in the UCB units than in the ADB units. The 2,3-BPG level did not differ significantly between the UCB-PRC and ADB-PRC samples. After 35 d of storage both UCB-PRC and ADB-PRC samples exhibited significant differences from the initial free Hb, intracellular ATP, and pH values. Significant differences in intracellular ATP and pH were also observed between the UCB-PRC and ADB-PRC samples. CONCLUSION: The volume of harvested and prepared UCB-PRC can be used for some of the blood transfusions required during the neonatal period and thus may decrease the number of allogeneic transfusions, especially in preterm newborns. The hematological and biochemical changes that occurred in UCB during storage were comparable with those observed in ADB, and do not pose a risk to the immature metabolism of neonates. UCB-RPC prepared and stored under standard conditions can be a safe alternative RBC source for transfusions in VLBW newborns.

  3. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

    ... SSI file Error processing SSI file Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  4. Comparison of mental health between individuals with spinal cord injury and able-bodied controls in Neiva, Colombia

    Directory of Open Access Journals (Sweden)

    Leia A. Harper, BS

    2014-03-01

    Full Text Available Although research has investigated the mental health of individuals with spinal cord injury (SCI, an overwhelming majority of this research has been conducted in the United States, Western Europe, and other developed countries. The purpose of this study was to compare the mental health of individuals with SCI with able-bodied controls in Neiva, Colombia, South America. Subjects included 40 Colombians with SCI and 42 age- and sex-matched controls (N = 82. The groups did not differ based on age, sex, years of education, or socioeconomic status. However, controls were twice as likely to be married. Four measures assessed mental health, including satisfaction with life (Satisfaction with Life Scale, depressive symptoms (Patient Health Questionnaire-9, self-esteem (Rosenberg Self-Esteem Scale, and anxiety (State-Trait Anxiety Inventory. In comparison with able-bodied controls, individuals with SCI reported significantly lower mental health on both depressive symptoms and satisfaction with life. These effect sizes were medium and large, respectively. The groups did not differ significantly on measures of self-esteem or anxiety. Mental health of individuals with SCI should be considered a central part of SCI rehabilitation interventions, particularly in Latin America.

  5. Comparison of mental health between individuals with spinal cord injury and able-bodied controls in Neiva, Colombia.

    Science.gov (United States)

    Harper, Leia A; Coleman, Jennifer A; Perrin, Paul B; Olivera, Silvia Leonor; Perdomo, Jose Libardo; Arango, Jose Anselmo; Arango-Lasprilla, Juan Carlos

    2014-01-01

    Although research has investigated the mental health of individuals with spinal cord injury (SCI), an overwhelming majority of this research has been conducted in the United States, Western Europe, and other developed countries. The purpose of this study was to compare the mental health of individuals with SCI with able-bodied controls in Neiva, Colombia, South America. Subjects included 40 Colombians with SCI and 42 age- and sex-matched controls (N = 82). The groups did not differ based on age, sex, years of education, or socioeconomic status. However, controls were twice as likely to be married. Four measures assessed mental health, including satisfaction with life (Satisfaction with Life Scale), depressive symptoms (Patient Health Questionnaire-9), self-esteem (Rosenberg Self-Esteem Scale), and anxiety (State-Trait Anxiety Inventory). In comparison with able-bodied controls, individuals with SCI reported significantly lower mental health on both depressive symptoms and satisfaction with life. These effect sizes were medium and large, respectively. The groups did not differ significantly on measures of self-esteem or anxiety. Mental health of individuals with SCI should be considered a central part of SCI rehabilitation interventions, particularly in Latin America.

  6. GRIN: “GRoup versus INdividual physiotherapy following lower limb intra-muscular Botulinum Toxin-A injections for ambulant children with cerebral palsy: an assessor-masked randomised comparison trial”: study protocol

    Science.gov (United States)

    2014-01-01

    Background Cerebral palsy is the most common cause of physical disability in childhood. Spasticity is a significant contributor to the secondary impairments impacting functional performance and participation. The most common lower limb spasticity management is focal intramuscular injections of Botulinum Toxin-Type A accompanied by individually-delivered (one on one) physiotherapy rehabilitation. With increasing emphasis on improving goal-directed functional activity and participation within a family-centred framework, it is timely to explore whether physiotherapy provided in a group could achieve comparable outcomes, encouraging providers to offer flexible models of physiotherapy delivery. This study aims to compare individual to group-based physiotherapy following intramuscular Botulinum Toxin-A injections to the lower limbs for ambulant children with cerebral palsy aged four to fourteen years. Methods/Design An assessor-masked, block randomised comparison trial will be conducted with random allocation to either group-based or individual physiotherapy. A sample size of 30 (15 in each study arm) will be recruited. Both groups will receive six hours of direct therapy following Botulinum Toxin-A injections in either an individual or group format with additional home programme activities (three exercises to be performed three times a week). Study groups will be compared at baseline (T1), then at 10 weeks (T2, efficacy) and 26 weeks (T3, retention) post Botulinum Toxin-A injections. Primary outcomes will be caregiver/s perception of and satisfaction with their child’s occupational performance goals (Canadian Occupational Performance Measure) and quality of gait (Edinburgh Visual Gait Score) with a range of secondary outcomes across domains of the International Classification of Disability, Functioning and Health. Discussion This paper outlines the study protocol including theoretical basis, study hypotheses and outcome measures for this assessor-masked, randomised

  7. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  8. Comparison of the metabolic parameters and androgen level of umbilical cord blood in newborns of mothers with polycystic ovary syndrome and controls

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    Ferdous Mehrabian

    2012-01-01

    Full Text Available Background: This study aimed to assess the metabolic parameters and androgen concentration in the cord blood of newborns of mothers with polycystic ovary syndrome (PCOS in comparison with controls. Materials and Methods: This cross-sectional study was conducted in 2010-2011 in Isfahan, Iran. Biochemical tests were conducted on 40 infants, born from singleton pregnancies in women with PCOS and an equal number of controls. Results: The mean weight gain during pregnancy was higher in women with PCOS than in controls (16.02 ± 4.39 vs. 9.10 ± 2.20 kg, respectively, P < 0.0001. The mean birth weight was lower in newborns of mothers with PCOS than in controls (2905.25 ± 415.59 vs. 3223.25 ± 425.02 vs. grams, respectively, P = 0.001. The mean testosterone was higher in cord blood of newborns of PCOS women than in controls (5.58 ± 3.20 vs. 2.28 ± 0.62 pg/ml, P < 0.0001. Triglycerides and LDL-C were lower in cord blood of newborns, born from PCOS women than in controls (P = 0.001. The birth weight of the newborns of PCOS mothers was negatively correlated to free testosterone of cord blood (R = -0. 26, P = 0.04. Conclusion: The metabolic aberration in PCOS might influence fetal birth weight and cord blood lipid profile. These disorders may be caused by an exposure to elevated testosterone level during fetal life. The offspring of PCOS women may be at higher risk for chronic diseases in later life. The clinical impact of our findings should be confirmed in future longitudinal studies.

  9. Chiari malformation, syringomyelia and bulbar palsy in X linked hypophosphataemia.

    Science.gov (United States)

    Watts, Laura; Wordsworth, Paul

    2015-11-11

    X linked hypophosphataemia (XLH) is a rare condition with numerous musculoskeletal complications. It may mimic other more familiar conditions, such as vitamin D deficiency, ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis. We describe two cases with Chiari type 1 malformations and syringomyelia, neither of which is well recognised in XLH. The first presented late with the additional complications of spinal cord compression, pseudofracture, renal stones and gross femoroacetabular impingement requiring hip replacement. The second also had bulbar palsy; the first case to be described in this condition, to the best of our knowledge. We wish to raise awareness of the important neurological complications of syringomyelia, Chiari malformation, spinal cord compression and bulbar palsy when treating these patients. We also wish to draw attention to the utility of family history and genetic testing when making the diagnosis of this rare but potentially treatable condition.

  10. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia

    DEFF Research Database (Denmark)

    Ruggeri, A; Labopin, M; Sanz, G;

    2015-01-01

    Outcomes after unmanipulated haploidentical stem cell transplantation (Haplo) and after unrelated cord blood transplantation (UCBT) are encouraging and have become alternative options to treat patients with high-risk acute leukemia without human leukocyte antigen (HLA) matched donor. We compared ...

  11. Comparison of Dose Response Models for Predicting Normal Tissue Complications from Cancer Radiotherapy: Application in Rat Spinal Cord

    Energy Technology Data Exchange (ETDEWEB)

    Adamus-Górka, Magdalena; Mavroidis, Panayiotis, E-mail: panayiotis.mavroidis@ki.se; Lind, Bengt K.; Brahme, Anders [Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm S-17176 (Sweden)

    2011-05-18

    Seven different radiobiological dose-response models have been compared with regard to their ability to describe experimental data. The first four models, namely the critical volume, the relative seriality, the inverse tumor and the critical element models are mainly based on cell survival biology. The other three models: the Lyman (Gaussian distribution), the parallel architecture and the Weibull distribution models are semi-empirical and rather based on statistical distributions. The maximum likelihood estimation was used to fit the models to experimental data and the χ{sup 2}-distribution, AIC criterion and F-test were applied to compare the goodness-of-fit of the models. The comparison was performed using experimental data for rat spinal cord injury. Both the shape of the dose-response curve and the ability of handling the volume dependence were separately compared for each model. All the models were found to be acceptable in describing the present experimental dataset (p > 0.05). For the white matter necrosis dataset, the Weibull and Lyman models were clearly superior to the other models, whereas for the vascular damage case, the Relative Seriality model seems to have the best performance although the Critical volume, Inverse tumor, Critical element and Parallel architecture models gave similar results. Although the differences between many of the investigated models are rather small, they still may be of importance in indicating the advantages and limitations of each particular model. It appears that most of the models have favorable properties for describing dose-response data, which indicates that they may be suitable to be used in biologically optimized intensity modulated radiation therapy planning, provided a proper estimation of their radiobiological parameters had been performed for every tissue and clinical endpoint.

  12. Comparison of Dose Response Models for Predicting Normal Tissue Complications from Cancer Radiotherapy: Application in Rat Spinal Cord

    Directory of Open Access Journals (Sweden)

    Magdalena Adamus-Górka

    2011-05-01

    Full Text Available Seven different radiobiological dose-response models have been compared with regard to their ability to describe experimental data. The first four models, namely the critical volume, the relative seriality, the inverse tumor and the critical element models are mainly based on cell survival biology. The other three models: the Lyman (Gaussian distribution, the parallel architecture and the Weibull distribution models are semi-empirical and rather based on statistical distributions. The maximum likelihood estimation was used to fit the models to experimental data and the χ2-distribution, AIC criterion and F-test were applied to compare the goodness-of-fit of the models. The comparison was performed using experimental data for rat spinal cord injury. Both the shape of the dose-response curve and the ability of handling the volume dependence were separately compared for each model. All the models were found to be acceptable in describing the present experimental dataset (p > 0.05. For the white matter necrosis dataset, the Weibull and Lyman models were clearly superior to the other models, whereas for the vascular damage case, the Relative Seriality model seems to have the best performance although the Critical volume, Inverse tumor, Critical element and Parallel architecture models gave similar results. Although the differences between many of the investigated models are rather small, they still may be of importance in indicating the advantages and limitations of each particular model. It appears that most of the models have favorable properties for describing dose-response data, which indicates that they may be suitable to be used in biologically optimized intensity modulated radiation therapy planning, provided a proper estimation of their radiobiological parameters had been performed for every tissue and clinical endpoint.

  13. Employees with Cerebral Palsy

    Science.gov (United States)

    ... problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture (United Cerebral Palsy, 2010). "Cerebral" refers to the ...

  14. Stem cell transplantation for treating spinal cord injury A literature comparison between studies of stem cells obtained from various sources

    Institute of Scientific and Technical Information of China (English)

    Liangbi Xiang; Yu Chen

    2012-01-01

    OBJECTIVE: To identify global research trends of stem cell transplantation for treating spinal cord injury using a bibliometric analysis of the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for stem cell transplantation for treating spinal cord injury from 2002 to 2011 using the Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed articles on stem cell transplantation for treating spinal cord injury that were published and indexed in the Web of Science; (b) type of articles: original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) year of publication: 2002–2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles.MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to country; (3) distribution according to institution; (4) distribution according to journals; (5) distribution according to funding agencies; and (6) top cited articles over the last 10 years.RESULTS: Bone marrow mesenchymal stem cells and embryonic stem cells have been widely used for treating spinal cord injury. In total, 191 studies of bone marrow mesenchymal stem cell transplantation and 236 studies of embryonic stem cell transplantation for treating spinal cord injury appeared in the Web of Science from 2002 to 2011, and almost half of which were derived from American or Japanese authors and institutes. The number of studies of stem cell transplantation for treating spinal cord injury has gradually increased over the past 10 years. Most papers on stem cell transplantation for treating spinal cord injury appeared in journals with a particular focus on stem cell research, such as Stem Cells and Cell Transplantation. Although umbilical cord blood stem cells and adipose

  15. Comparisons of polybrominated diphenyl ethers levels in paired South Korean cord blood, maternal blood, and breast milk samples.

    Science.gov (United States)

    Kim, Tae Hyung; Bang, Du Yeon; Lim, Hyun Jung; Won, A Jin; Ahn, Mee Young; Patra, Nabanita; Chung, Ki Kyung; Kwack, Seung Jun; Park, Kui Lea; Han, Soon Young; Choi, Wahn Soo; Han, Jung Yeol; Lee, Byung Mu; Oh, Jeong-Eun; Yoon, Jeong-Hyun; Lee, Jaewon; Kim, Hyung Sik

    2012-03-01

    Polybrominated diphenyl ethers (PBDEs), commonly used flame retardants, have been reported as potential endocrine disruptor and neurodevelopmental toxicants, thus giving rise to the public health concern. The goal of this study was to investigate the relationship between umbilical cord blood, maternal blood, and breast milk concentrations of PBDEs in South Korean. We assessed PBDE levels in paired samples of umbilical cord blood, maternal blood, and breast milk. The levels of seven PBDE congeners were measured in 21 paired samples collected from the Cheil Woman's Hospital (Seoul, Korea) in 2008. We also measured thyroid hormones levels in maternal and cord blood to assess the association between PBDEs exposure and thyroid hormone levels. However, there was no correlation between serum thyroxin (T4) and total PBDEs concentrations. The total PBDEs concentrations in the umbilical cord blood, maternal blood, and breast milk were 10.7±5.1 ng g(-1) lipid, 7.7±4.2 ng g(-1) lipid, and 3.0±1.8 ng g(-1) lipid, respectively. The ranges of total PBDE concentrations observed were 2.28-30.94 ng g(-1) lipid in umbilical cord blood, 1.8-17.66 ng g(-1) lipid in maternal blood, and 1.08-8.66 ng g(-1) lipid in breast milk. BDE-47 (45-73% of total PBDEs) was observed to be present dominantly in all samples, followed by BDE-153. A strong correlation was found for major BDE-congeners between breast milk and cord blood or maternal blood and cord blood samples. The measurement of PBDEs concentrations in maternal blood or breast milk may help to determine the concentration of PBDEs in infant.

  16. Cord Blood

    Directory of Open Access Journals (Sweden)

    Saeed Abroun

    2014-05-01

    Full Text Available   Stem cells are naïve or master cells. This means they can transform into special 200 cell types as needed by body, and each of these cells has just one function. Stem cells are found in many parts of the human body, although some sources have richer concentrations than others. Some excellent sources of stem cells, such as bone marrow, peripheral blood, cord blood, other tissue stem cells and human embryos, which last one are controversial and their use can be illegal in some countries. Cord blood is a sample of blood taken from a newborn baby's umbilical cord. It is a rich source of stem cells, umbilical cord blood and tissue are collected from material that normally has no use following a child’s birth. Umbilical cord blood and tissue cells are rich sources of stem cells, which have been used in the treatment of over 80 diseases including leukemia, lymphoma and anemia as bone marrow stem cell potency.  The most common disease category has been leukemia. The next largest group is inherited diseases. Patients with lymphoma, myelodysplasia and severe aplastic anemia have also been successfully transplanted with cord blood. Cord blood is obtained by syringing out the placenta through the umbilical cord at the time of childbirth, after the cord has been detached from the newborn. Collecting stem cells from umbilical blood and tissue is ethical, pain-free, safe and simple. When they are needed to treat your child later in life, there will be no rejection or incompatibility issues, as the procedure will be using their own cells. In contrast, stem cells from donors do have these potential problems. By consider about cord blood potency, cord blood banks (familial or public were established. In IRAN, four cord blood banks has activity, Shariati BMT center cord blood bank, Royan familial cord blood banks, Royan public cord blood banks and Iranian Blood Transfusion Organ cord blood banks. Despite 50,000 sample which storage in these banks, but the

  17. Nanomedicine in cerebral palsy

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    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  18. Analysis of the adequate size of a cord blood bank and comparison of HLA haplotype distributions between four populations.

    Science.gov (United States)

    Haimila, Katri; Penttilä, Antti; Arvola, Anne; Auvinen, Marja-Kaisa; Korhonen, Matti

    2013-02-01

    The number of units and especially the number of different HLA haplotypes present in a cord blood (CB) bank is a crucial determinant of its usefulness. We generated data relevant to the development of our national CB in Finland. The HLA haplotype distribution was examined between specific populations. We developed graphical ways of data presentation that enable easy visualization of differences. First, we estimated the optimal size of a CB bank for Finland and found that approximately 1700 units are needed to provide a 5/6 HLA-matched donor for 80% of Finnish patients. Secondly, we evaluated HLA haplotype distributions between four locations, Finland, Japan, Sweden and Belgium. Our results showed that the Japanese Tokyo Cord Blood Bank differs in both the frequency and distribution of haplotypes from the European banks. The European banks (Finnish Cord Blood Registry, The Swedish National Cord Blood Bank, and Marrow Donor Program-Belgium) have similar frequencies of common haplotypes, but 26% of the haplotypes in the Finnish CB bank are unique, which justifies the existence of a national bank. The tendency to a homogenous HLA haplotype distribution in banks underlines the need for targeting recruitment at the poorly represented minority populations.

  19. Responses of subjects with spinal cord injuries to maximal wheelchair exercise : comparison of discontinuous and continuous protocols

    NARCIS (Netherlands)

    Rasche, W; Janssen, T W; Van Oers, C A; Hollander, A P; Van der Woude, L H

    1993-01-01

    Six male subjects with spinal cord injuries (SCI) participated in this investigation to compare peak values of oxygen uptake (VO2), heart rate (fc), ventilation (VE), respiratory exchange ratio (R) and power output (W) obtained using a discontinuous (DP) and a continuous jump max protocol (JMP) in a

  20. Comparison of Cord Blood Lipid Profile in Preterm Small for Gestational Age and Appropriate for Gestational Age Newborns

    Science.gov (United States)

    Katragadda, Tejasree; Shetty, Subodh; Baliga, Shantharam

    2017-01-01

    Introduction Coronary heart disease is one of the major causes of morbidity and mortality in current era. The roots of this epidemic have been traced to as early as foetal life by foetal origin hypothesis. There are a few studies which have compared the cord blood lipid profile of preterm and term babies and thereby leading a path to primordial prevention of chronic diseases. Aim To study cord blood lipid profile of preterm appropriate for gestational age and preterm small for gestational age neonates and compare atherogenic index of both groups. Materials and Methods This cross-sectional study was conducted in 109 preterm infants. Cord blood samples were collected from placental side of umbilical cord at birth and analyzed for lipid profile which includes serum cholesterol, triglycerides, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and apolipoproteins which include ApoA1, Apo B. Results Preterm Small for Gestational Age (SGA) neonates had statistically significant higher values of triglycerides, Apo B and atherogenic index compared to preterm Appropriate for Gestational Age (AGA) neonates. Other measured lipid levels were not statistically significant, though the values were higher than reference ranges for term babies. Conclusion Prematurity as a factor associated with a more atherogenic lipid profile is re-affirmed and SGA as an additional risk factor has been proven giving scope for future research and primordial prevention.

  1. COMPARISON OF STRESS LEVELS IN THE PARENTS OF CHILDREN WITH CEREBRAL PALSY AND PARENTS OF NORMAL CHILDREN IN VADODARA REGION OF GUJARAT

    Directory of Open Access Journals (Sweden)

    Dr. Vivek H. Ramanandi

    2015-04-01

    Full Text Available Background: Parenting is inherently stressful at times and several studies have shown that being a caregiver of a child who is disabled is even more stressful. A number of studies have identified the factors which exacerbate or mediate parenting stress in caregivers of children who are disabled. The aim of this study was to assess the parenting stress levels in parents of children who have cerebral palsy as compared to parents of normal children. Further objectives were to ascertain variables predictive of parenting stress levels. Methods: The Gujarati translated version of Parenting Stress Index/Short Form was first validated and was given to 49 parents of children with cerebral palsy (Group-A who were attending Varun Mahajan Apang Shishu Mandal, Vadodara and to the 50 parents of normal children(Group-B. Caregivers also completed a demographic questionnaire. 43 questionnaires from Group-A and 45 from Group-B were returned to the researcher. Means and frequencies were used to summarise the demographic data. T-tests were performed to establish whether there was any significant difference between the parenting stress levels in Group-A and Group-B. Results: The parents in Group-A showed clinically significant, and in many cases, pathological levels of parenting stress as compared to the parents in Group-B. Conclusions: The results of this study confirm that parenting stress is complex matter and it is important to predict the parenting stress levels of caregivers of disabled children. Therapists should evaluate the needs of each family individually and follow a family centred approach when managing children with cerebral palsy.

  2. Radiation induced femoral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Aranda, B.; Esnault, S.; Brunet, P. (Hopital de la Salpetriere, Paris (France))

    1982-01-01

    We report four cases of femoral palsy due to compressive fibrosis, after pelvic radiation therapy. Three patients had Hodgkin's disease, and one testicular seminoma. Prominent clinical features include major groin induration and underlying swelling. Unlike what is usually seen in tumoral relapse, little or no pain is associated with these neuropathies. The femoral post-radic palsy develops earlier and faster than brachial plexus palsy of same aetiology. In one case, progressive aggravation led to surgical neurolysis which resulted in dramatic and long lasting improvement. The principal preventive and therapeutic management methods are discussed: since compressive fibrosis is related to the use of isolated and massive electron beam therapy, various associations of cobalt and electron beam therapy are designed to best prevent the side effects of each of these methods. The early treatment of developing fibrosis by D. penicillamine is discussed.

  3. Pedaleo de brazos en personas con lesión medular, parálisis cerebral o ataxia cerebelosa: Parámetros fisiológicos. [Armcrank pedaling in persons with spinal cord injury, cerebral palsy or cerebellar ataxia: Physiological parameters].

    Directory of Open Access Journals (Sweden)

    Iris González-Carbonell

    2016-10-01

    cerebral palsy and 4 with Friedreich's ataxia were analyzed, comparing their physiological responses as well as their perceived effort, to a control group (16 participants. They performed a standardized armcrank pedaling exercise on an ergometer and heart rate, respiratory rate, tidal volume, expiratory volume, relative oxygen consumption, oxygen pulse and perceived exertion were measured. An ANOVA test was performed with these variables. For the group with spinal cord injury, stress and energy expenditure were the lowest, the group with cerebral palsy showed the highest levels of stress while perceived it as a moderate load. The group with Friedreich's ataxia showed medium high cardiorespiratory responses. In conclusion, it has been identified as different neurological disorders show very different physiological responses to exercise and the importance of their control.

  4. Acupuncture for Bell's palsy.

    Science.gov (United States)

    Chen, Ning; Zhou, Muke; He, Li; Zhou, Dong; Li, N

    2010-08-04

    Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. A number of studies published in China have suggested acupuncture is beneficial for facial palsy. The objective of this review was to examine the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell's palsy. We updated the searches of the Cochrane Neuromuscular Disease Group Trials Specialized Register (24 May 2010), The Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2010), MEDLINE (January 1966 to May 2010), EMBASE (January 1980 to May 2010), AMED (January 1985 to May 2010), LILACS (from January 1982 to May 2010) and the Chinese Biomedical Retrieval System (January 1978 to May 2010) for randomised controlled trials using 'Bell's palsy' and its synonyms, 'idiopathic facial paralysis' or 'facial palsy' as well as search terms including 'acupuncture'. Chinese journals in which we thought we might find randomised controlled trials relevant to our study were handsearched. We reviewed the bibliographies of the randomised trials and contacted the authors and known experts in the field to identify additional published or unpublished data. We included all randomised controlled trials involving acupuncture by needle insertion in the treatment of Bell's palsy irrespective of any language restrictions. Two review authors identified potential articles from the literature search, extracted data and assessed quality of each trial independently. All disagreements were resolved by discussion between the review authors. The literature search and handsearching identified 49 potentially relevant articles. Of these, six RCTs were included involving 537 participants with Bell's palsy. Two more possible trials were identified in the update than the previous version of this systematic review, but both were excluded because they were not real RCTs. Of the six included trials, five used acupuncture while the other one used

  5. Arrest—Individual Treatment with Cord Blood

    Directory of Open Access Journals (Sweden)

    A. Jensen

    2013-01-01

    Full Text Available Each year, thousands of children incur brain damage that results in lifelong sequelae. Therefore, based on experimental evidence, we explored the therapeutic potential of human cord blood, known to contain stem cells, to examine the functional neuroregeneration in a child with cerebral palsy after cardiac arrest. The boy, whose cord blood was stored at birth, was 2.5 years old and normally developed when global ischemic brain damage occurred resulting in a persistent vegetative state. Nine weeks later, he received autologous cord blood (91.7 mL, cryopreserved, 5.75×10e8 mononuclear cells intravenously. Active rehabilitation (physio- and ergotherapy was provided daily, follow-up at 2, 5, 12, 24, 30, and 40 months. At 2-months follow-up the boy’s motor control improved, spastic paresis was largely reduced, and eyesight was recovered, as did the electroencephalogram. He smiled when played with, was able to sit and to speak simple words. At 40 months, independent eating, walking in gait trainer, crawling, and moving from prone position to free sitting were possible, and there was significantly improved receptive and expressive speech competence (four-word sentences, 200 words. This remarkable functional neuroregeneration is difficult to explain by intense active rehabilitation alone and suggests that autologous cord blood transplantation may be an additional and causative treatment of pediatric cerebral palsy after brain damage.

  6. The cervical cord in amyotrophic lateral sclerosis. A comparison of the CT-myelography with pathological observation

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    Sugamiya, Hitoshi; Tokumaru, Yukio; Arai, Kimihito; Hirayama, Keizo [Chiba Univ. (Japan). School of Medicine

    1995-08-01

    The spinal cord with amyotrophic lateral sclerosis was macroscopically examined in five patients using CT-myelography (CTM) and autopsied specimens. The autopsied ages were from 48 to 75 years old (average: 64), and their clinical follow-up periods were from 0.8 to 4.0 years (average: 1.9). Muscular atrophy developed from an upper limb in three patients, whereas from a lower limb in one case and from bulbar muscles in another case. Cervical CTM was performed at C3 to C7 cervical vertebrae less than one year (four cases) and 1.9 years (one case) prior to autopsy. The macroscopical examination of the CTM and autopsied specimens showed the following characteristics: Two patients, whose clinical courses were less than one year from the onset, showed no abnormalities. Three patients, whose clinical courses were more than one year from the onset, showed a marked cervical flattening and concave of the posterolateral fissure, especially at the lower cervical level. It was supposed that this lower cervical abnormalities caused pronounced amyotrophy in the upper limbs and pyramidal tract sign of the lower limbs. Although muscular atrophy was asymmetric in one case, the spinal cord was symmetric in macroscopic appearance in both CTM and autopsied specimens. It was concluded that marked flattening and concave at the posterolateral fissure of the lower cervical spinal cord were revealed by CTM in patients whose clinical courses of amyotrophic lateral sclerosis were more than one year from the onset. (author).

  7. Mechanism of Forelimb Motor Function Restoration after Cervical Spinal Cord Hemisection in Rats: A Comparison of Juveniles and Adults

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    Atsushi Hasegawa

    2016-01-01

    Full Text Available The aim of this study was to investigate forelimb motor function after cervical spinal cord injury in juvenile and adult rats. Both rats received a left segmental hemisection of the spinal cord after C3-C4 laminectomy. Behavioral evaluation of motor function was monitored and assessed using the New Rating Scale (NRS and Forelimb Locomotor Scale (FLS and by measuring the range of motion (ROM of both the elbow and wrist. Complete left forelimb motor paralysis was observed in both rats. The NRS showed motor function recovery restored to 50.2±24.7% in juvenile rats and 34.0±19.8% in adult rats. FLS was 60.4±26.8% in juvenile rats and 46.5±26.9% in adult rats. ROM of the elbow and wrist were 88.9±20.6% and 44.4±24.1% in juvenile rats and 70.0±29.2% and 40.0±21.1% in adult rats. Thus, the NRS and ROM of the elbow showed a significant difference between age groups. These results indicate that left hemisection of the cervical spinal cord was not related to right-sided motor functions. Moreover, while motor paralysis of the left forelimb gradually recovered in both groups, the improvement was greater in juvenile rats.

  8. Suprascapular nerve palsy.

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    Moskowitz, E; Rashkoff, E S

    1989-11-01

    Isolated traumatic suprascapular nerve palsy without associated fracture is a rare occurrence. Localized segmental muscle atrophy limited to the supraspinatus and infraspinatus muscles associated with weakness in initiating abduction and in external rotation of the shoulder should suggest the diagnosis. Electromyography will confirm the diagnosis by excluding nerve root and brachial plexus involvement with denervation potentials limited to the supraspinatus and infraspinatus muscles.

  9. Extracellular Matrix Hydrogel Derived from Human Umbilical Cord as a Scaffold for Neural Tissue Repair and Its Comparison with Extracellular Matrix from Porcine Tissues.

    Science.gov (United States)

    Kočí, Zuzana; Výborný, Karel; Dubišová, Jana; Vacková, Irena; Jäger, Aleš; Lunov, Oleg; Jiráková, Klára; Kubinová, Šárka

    2017-06-01

    Extracellular matrix (ECM) hydrogels prepared by tissue decellularization have been reported as natural injectable materials suitable for neural tissue repair. In this study, we prepared ECM hydrogel derived from human umbilical cord (UC) and evaluated its composition and mechanical and biological properties in comparison with the previously described ECM hydrogels derived from porcine urinary bladder (UB), brain, and spinal cord. The ECM hydrogels did not differ from each other in the concentration of collagen, while the highest content of glycosaminoglycans as well as the shortest gelation time was found for UC-ECM. The elastic modulus was then found to be the highest for UB-ECM. In spite of a different origin, topography, and composition, all ECM hydrogels similarly promoted the migration of human mesenchymal stem cells (MSCs) and differentiation of neural stem cells, as well as axonal outgrowth in vitro. However, only UC-ECM significantly improved proliferation of tissue-specific UC-derived MSCs when compared with the other ECMs. Injection of UC-ECM hydrogels into a photothrombotic cortical ischemic lesion in rats proved its in vivo gelation and infiltration with host macrophages. In summary, this study proposes UC-ECM hydrogel as an easily accessible biomaterial of human origin, which has the potential for neural as well as other soft tissue reconstruction.

  10. Explicit and implicit motor learning in children with unilateral cerebral palsy.

    Science.gov (United States)

    van der Kamp, John; Steenbergen, Bert; Masters, Rich S W

    2017-07-30

    The current study aimed to investigate the capacity for explicit and implicit learning in children with unilateral cerebral palsy. Children with left and right unilateral cerebral palsy and typically developing children shuffled disks toward a target. A prism-adaptation design was implemented, consisting of pre-exposure, prism exposure, and post-exposure phases. Half of the participants were instructed about the function of the prism glasses, while the other half were not. For each trial, the distance between the target and the shuffled disk was determined. Explicit learning was indicated by the rate of adaptation during the prism exposure phase, whereas implicit learning was indicated by the magnitude of the negative after-effect at the start of the post-exposure phase. Results No significant effects were revealed between typically developing participants and participants with unilateral cerebral palsy. Comparison of participants with left and right unilateral cerebral palsy demonstrated that participants with right unilateral cerebral palsy had a significantly lower rate of adaptation than participants with left unilateral cerebral palsy, but only when no instructions were provided. The magnitude of the negative after-effects did not differ significantly between participants with right and left unilateral cerebral palsy. The capacity for explicit motor learning is reduced among individuals with right unilateral cerebral palsy when accumulation of declarative knowledge is unguided (i.e., discovery learning). In contrast, the capacity for implicit learning appears to remain intact among individuals with left as well as right unilateral cerebral palsy. Implications for rehabilitation Implicit motor learning interventions are recommended for individuals with cerebral palsy, particularly for individuals with right unilateral cerebral palsy Explicit motor learning interventions for individual with cerebral palsy - if used - best consist of singular verbal instruction.

  11. Comparison of human mesenchymal stromal cells from four neonatal tissues: Amniotic membrane, chorionic membrane, placental decidua and umbilical cord.

    Science.gov (United States)

    Araújo, Anelise Bergmann; Salton, Gabrielle Dias; Furlan, Juliana Monteiro; Schneider, Natália; Angeli, Melissa Helena; Laureano, Álvaro Macedo; Silla, Lúcia; Passos, Eduardo Pandolfi; Paz, Ana Helena

    2017-05-01

    Mesenchymal stromal cells (MSCs) are being investigated as a potential alternative for cellular therapy. This study was designed to compare the biological characteristics of MSCs isolated from amniotic membrane (A-MSCs), chorionic membrane (C-MSCs), placental decidua (D-MSCs) and umbilical cord (UC-MSCs) to ascertain whether any one of these sources is superior to the others for cellular therapy purposes. MSCs were isolated from amniotic membrane, chorionic membrane, umbilical cord and placental decidua. Immunophenotype, differentiation ability, cell size, cell complexity, polarity index and growth kinetics of MSCs isolated from these four sources were analyzed. MSCs were successfully isolated from all four sources. Surface marker profile and differentiation ability were consistent with human MSCs. C-MSCs in suspension were the smallest cells, whereas UC-MSCs presented the greatest length and least width. A-MSCs had the lowest polarity index and UC-MSCs, as more elongated cells, the highest. C-MSCs, D-MSCs and UC-MSCs exhibited similar growth capacity until passage 8 (P8); C-MSCs presented better lifespan, whereas insignificant proliferation was observed in A-MSCs. Neonatal and maternal tissues can serve as sources of multipotent stem cells. Some characteristics of MSCs obtained from four neonatal tissues were compared and differences were observed. Amniotic membrane was the least useful source of MSCs, whereas chorionic membrane and umbilical cord were considered good options for future use in cell therapy because of the known advantages of immature cells. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  12. Comparison of functional recovery of manual dexterity after unilateral spinal cord lesion or motor cortex lesion in adult macaque monkeys

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    Florence eHoogewoud

    2013-07-01

    Full Text Available In relation to mechanisms involved in functional recovery of manual dexterity from cervical cord injury or from motor cortical injury, our goal was to determine whether the movements that characterize post-lesion functional recovery are comparable to original movement patterns or do monkeys adopt distinct strategies to compensate the deficits depending on the type of lesion? To this aim, data derived from earlier studies, using a skilled finger task (the modified Brinkman board from which pellets are retrieved from vertical or horizontal slots, in spinal cord and motor cortex injured monkeys were analyzed and compared. Twelve adult macaque monkeys were subjected to a hemi-section of the cervical cord (n=6 or to a unilateral excitotoxic lesion of the hand representation in the primary motor cortex (n=6. In addition, in each subgroup, one half of monkeys (n=3 were treated for 30 days with a function blocking antibody against the neurite growth inhibitory protein Nogo-A, while the other half (n=3 represented control animals. The motor deficits, and the extent and time course of functional recovery were assessed.For some of the parameters investigated (wrist angle for horizontal slots and movement types distribution for vertical slots after cervical injury; movement types distribution for horizontal slots after motor cortex lesion, post-lesion restoration of the original movement patterns (true recovery led to a quantitatively better functional recovery. In the motor cortex lesion groups, pharmacological reversible inactivation experiments showed that the peri-lesion territory of the primary motor cortex or re-arranged, spared domain of the lesion zone, played a major role in the functional recovery, together with the ipsilesional intact premotor cortex.

  13. Comparison of the levels of the growth factors in umbilical cord serum and human milk and its clinical significance.

    Science.gov (United States)

    Patki, Satish; Patki, Ujjwala; Patil, Rajendra; Indumathi, S; Kaingade, Pankaj; Bulbule, Akshata; Nikam, Amar; Pishte, Amit

    2012-08-01

    The process of the growth of the fetus begins in the uterus and gets further accelerated following the birth, especially during initial few months. The role of the growth factors in the physiology of the cellular growth is already well established. Vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) seem to be imperative for angiogenesis, cell development and proliferation as well as maintenance of the tissues. The levels of these factors in the maternal serum during pregnancy as well as during postpartum period are insignificant. Consequently, we hypothesized that the fetus receives moderate supply of these growth factors from the placenta during its stay in the uterus. This supply gets further augmented during the postpartum period through the different source, i.e. mother's milk. To study this physiological transition of the source of the growth factors from the placenta to the breast milk, the concentrations of VEGF and HGF in the cord serum of full term neonates and that in the breast milk of the corresponding mothers were analyzed during ELISA. The human milk, especially the colostrum revealed significantly higher levels of VEGF and HGF (1541.759 ± 119.349 pg/ml and 7129.249 ± 273.472 pg/ml) than cord serum (16.632 ± 0.773 pg/ml and 2581.6 ± 108.275 pg/ml) respectively. The multifold higher levels of VEGF observed in colostrum probably correlates with its high neonatal requirement for the maturation of the gastrointestinal epithelium following birth. The higher levels of both the growth factors in the breast milk than those observed in the cord serum probably explain their higher needs by the neonates for immunological protection, protein synthesis and neurocognitive development. The observations of the present study strengthen the policy of the colostrum feeding, which is promoted by organizations like World Health Organization (WHO). This study further documents the fact that the commercial milk formulae cannot replace the human

  14. The Contact Activation System (CAS) in cord blood: Measurement of CAS components and comparison with mother's blood. A pilot study.

    Science.gov (United States)

    Uszyński, Mieczysław; Kuczyński, Jarosław; Żekanowska, Ewa; Uszyński, Waldemar

    2015-11-01

    Classical reference data concerning the coagulation system and fibrinolysis in fetuses and newborns date back to the 1990 s. Since that time a number of methodological or other improvements have been implemented, which may cast some doubt on timeliness of the data. The study objective was to measure the levels of Contact Activation System (CAS) components by antigen, i.e. factors XII and XI (FXII, FXI), prekallikrein (PK) and high molecular weight kininogen (HMWK) in cord blood and maternal blood. The study group consisted of 35 healthy parturient women with an uneventful pregnancy and birth. The samples of cord blood and maternal blood were obtained immediately after delivery, before clumping the umbilical cord. The CAS components were measured by immunoenzymatic method (ELISA). The median concentrations of CAS components in cord blood plasma and mother's plasma were as follow: FXII: 1.02 (0.60- 2.58) ng/mg protein vs. 0.94 (0.66-1.86) ng/mg protein (p>0.05); FXI: 2.71(0.03-8.0) ng/mg protein vs. 0.92 (0.03-10.44) ng/mg protein (p>0.05); PK: 168.78 (104.28-261.16) pg/mg protein vs. 113.44 (79.94-146.70) pg/mg protein (p>0.05); HMWK: 2169.45 (1530.64- 2539.83) ng/mg protein vs. 2857.96 (2541.52-3161.04) ng/mg protein (pblood of full-term and healthy fetuses were similar to those observed in mother's blood immediately after delivery. Only high molecular weight kininogen was found to be lower (accounting for 84% of the values noted in mothers). 2. Based on our measurements, we claim that the cited reference data concerning the contact factors in full-term and healthy newborns are underestimated; hence, new reference values need to be determined for each antigen and activity contact factor level. Copyright © 2015. Published by Elsevier Ltd.

  15. Cord-Blood Banking

    Science.gov (United States)

    ... to Be Smart About Social Media Cord-Blood Banking KidsHealth > For Parents > Cord-Blood Banking Print A ... for you and your family. About Cord-Blood Banking Cord-blood banking basically means collecting and storing ...

  16. Unilateral sixth nerve palsy.

    Science.gov (United States)

    Sotoodehnia, Mehran; Safaei, Arash; Rasooli, Fatemeh; Bahreini, Maryam

    2017-06-01

    The diagnosis of cerebral venous sinus thrombosis still remains a real challenge. Seizure, unusual headache with sudden onset, unexplained persistently unilateral vascular headache and neurologic deficit-which is difficult to be attributed to a vascular territory are some of the suggestive symptoms. An isolated sixth nerve palsy is discussed as a rare presentation for cerebral venous thrombosis. Following the extensive investigation to rule out other possible diagnoses, magnetic resonance venogram revealed the final etiology of sixth nerve palsy that was ipsilateral left transverse sinus thrombosis; therefore, anticoagulant treatment with low molecular weight heparin was administered. Rapid and accurate diagnosis and treatment cause to achieve excellent outcomes for most patients. Considering different clinical features, risk factors and high index of suspicion are helpful to reach the diagnosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. C5 Nerve root palsies following cervical spine surgery: A review

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    Nancy E Epstein

    2015-01-01

    Full Text Available Background: Cervical C5 nerve root palsies may occur in between 0% and 30% of routine anterior or posterior cervical spine operations. They are largely attributed to traction injuries/increased cord migration following anterior/posterior decompressions. Of interest, almost all studies cite spontaneous resolution of these deficits without surgery with 3-24 postoperative months. Methods: Different studies cite various frequencies for C5 root palsies following anterior or posterior cervical spine surgery. In their combined anterior/posterior series involving C4-C5 level  decompressions, Libelski et al. cited up to a 12% incidence of C5 palsies. In Gu et al. series, C5 root palsies occurred in 3.1% of double-door laminoplasty, 4.5% of open-door laminoplasty, and 11.3% of laminectomy. Miller et al. observed an intermediate 6.9% frequency of C5 palsies followed by posterior cervical decompressions and fusions (PCDF. Results: Gu et al. also identified multiple risk factors for developing C5 palsies following posterior surgery; male gender, ossification of the posterior longitudinal ligament (OPLL, narrower foramina, laminectomy, and marked dorsal spinal cord drift. Miller et al. also identified an average $1918 increased cost for physical/occupational therapy for patients with C5 palsies. Conclusions: The incidence of C5 root deficits for anterior/posterior cervical surgery at C4-C5 was 12% in one series, and ranged up to 11.3% for laminectomies, while others cited 0-30%. Although identification of preoperative risk factors for C5 root deficits may help educate patients regarding these risks, there is no clear method for their avoidance at this time.

  18. Sudden onset odontoid fracture caused by cervical instability in hypotonic cerebral palsy.

    Science.gov (United States)

    Shiohama, Tadashi; Fujii, Katsunori; Kitazawa, Katsuhiko; Takahashi, Akiko; Maemoto, Tatsuo; Honda, Akihito

    2013-11-01

    Fractures of the upper cervical spine rarely occur but carry a high rate of mortality and neurological disabilities in children. Although odontoid fractures are commonly caused by high-impact injuries, cerebral palsy children with cervical instability have a risk of developing spinal fractures even from mild trauma. We herein present the first case of an odontoid fracture in a 4-year-old boy with cerebral palsy. He exhibited prominent cervical instability due to hypotonic cerebral palsy from infancy. He suddenly developed acute respiratory failure, which subsequently required mechanical ventilation. Neuroimaging clearly revealed a type-III odontoid fracture accompanied by anterior displacement with compression of the cervical spinal cord. Bone mineral density was prominently decreased probably due to his long-term bedridden status and poor nutritional condition. We subsequently performed posterior internal fixation surgically using an onlay bone graft, resulting in a dramatic improvement in his respiratory failure. To our knowledge, this is the first report of an odontoid fracture caused by cervical instability in hypotonic cerebral palsy. Since cervical instability and decreased bone mineral density are frequently associated with cerebral palsy, odontoid fractures should be cautiously examined in cases of sudden onset respiratory failure and aggravated weakness, especially in hypotonic cerebral palsy patients.

  19. Clinical neurorestorative progresses in cerebral palsy

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    Sharma A

    2017-02-01

    Full Text Available Alok Sharma,1 Tongchao Geng,2 Hemangi Sane,3 Pooja Kulkarni3 1Department of Medical Services & Clinical Research, NeuroGen Brain and Spine Institute, Mumbai, India; 2Department of Neurology, Yuquan Hospital, Tsinghua University, Beijing, People’s Republic of China; 3Department of Research and Development, Neurogen Brain and Spine Institute, Mumbai, India Abstract: Cerebral palsy (CP, group of permanent nonprogressive clinical disorders in children, is caused by damage to the immature brain. Conventionally available treatments for CP are mainly targeted toward management of its symptoms. With the upcoming field of neurorestorative strategies, we are now able to repair the core brain damage in CP. There are various drugs, stem cells, etc, which have been implicated to have neurorestorative properties. Autologous bone marrow stem cells, umbilical cord stem cells, neural stem cells, and olfactory ensheathing cells have shown the safety and efficacy in preliminary studies. Here, we review the different medicines and cell types that have shown beneficial effects in clinical studies. We propose that combination strategies may be the future of neurorestoration. Keywords: stem cell therapy, bone marrow, umbilical cord, neural cells, regenerative medicine, brain

  20. Comparison of mobility device delivery within Department of Veterans Affairs for individuals with multiple sclerosis versus spinal cord injury.

    Science.gov (United States)

    Ambrosio, Fabrisia; Boninger, Michael L; Fitzgerald, Shirley G; Hubbard, Sandra L; Schwid, Steven R; Cooper, Rory A

    2007-01-01

    Individuals with multiple sclerosis (MS) report decreased satisfaction with their mobility devices compared with individuals with spinal cord injuries (SCIs). This study (1) investigated the demographic differences between veterans with MS (V-MS) and veterans with SCI (V-SCI) who were issued a wheelchair by the Veterans Health Administration (VHA) and (2) described differences in mobility device prescription. We merged two VHA databases to obtain demographic and wheelchair information for all V-MS and V-SCI in 2000 and 2001. Descriptive information for issued wheelchairs was available for 2,154 V-MS and V-SCI. We found that V-MS were significantly less likely to receive higher quality wheelchairs (manual or power) compared with V-SCI (p wheelchair prescription between these two groups indicates a need for further research regarding the assistive device prescription process in these populations.

  1. Comparison of CT and MR in 400 patients with suspected disease of the brain and cervical spinal cord

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    Bradley, W.G. Jr.; Waluch, V.; Yadley, R.A.; Wycoff, R.R.

    1984-09-01

    Magnetic resonance imaging (MR) (0.35T) and computed tomography (CT) were compared in 400 consecutive patients with suspected disease of the brain and cervical spinal cord. Of 325 positive diagnoses, MR detected abnormality while CT was normal in 93; MR was more specific in 68; MR and CT gave equivalent information in 129; CT was more specific in 32; and CT was positive while MR was normal in 3. MR was superior to CT in detection of multiple sclerosis, subcortical arteriosclerotic encephalopathy, posterior fossa infarcts and tumors, small extra-axial fluid collections, and cervical syringomyelia. CT was preferable in evaluation of meningiomas and separation of tumor from edema. CT takes less time and may be preferable in patients with acute trauma as well as very young or elderly individuals. Thus the two studies should be considered complementary.

  2. Comparison of dopamine kinetics in the larval Drosophila ventral nerve cord and protocerebrum with improved optogenetic stimulation.

    Science.gov (United States)

    Privman, Eve; Venton, B Jill

    2015-11-01

    Dopamine release and uptake have been studied in the Drosophila larval ventral nerve cord (VNC) using optogenetics to stimulate endogenous release. However, other areas of the central nervous system remain uncharacterized. Here, we compare dopamine release in the VNC and protocerebrum of larval Drosophila. Stimulations were performed with CsChrimson, a new, improved, red light-activated channelrhodopsin. In both regions, dopamine release was observed after only a single, 4 ms duration light pulse. Michaelis-Menten modeling was used to understand release and uptake parameters for dopamine. The amount of dopamine released ([DA]p ) on the first stimulation pulse is higher than the average [DA]p released from subsequent pulses. The initial and average amount of dopamine released per stimulation pulse is smaller in the protocerebrum than in the VNC. The average Vmax of 0.08 μM/s in the protocerebrum was significantly higher than the Vmax of 0.05 μM/s in the VNC. The average Km of 0.11 μM in the protocerebrum was not significantly different from the Km of 0.10 μM in the VNC. When the competitive dopamine transporter (DAT) inhibitor nisoxetine was applied, the Km increased significantly in both regions while Vmax stayed the same. This work demonstrates regional differences in dopamine release and uptake kinetics, indicating important variation in the amount of dopamine available for neurotransmission and neuromodulation. We use a new optogenetic tool, red light activated CsChrimson, to stimulate the release of dopamine in the ventral nerve cord and medial protocerebrum of the larval Drosophila central nervous system. We monitored extracellular dopamine by fast scan cyclic voltammetry and used Michaelis-Menten modeling to probe the regulation of extracellular dopamine, discovering important similarities and differences in these two regions.

  3. Pseudobulbar palsy associated with trismus.

    OpenAIRE

    Lai, M M; Howard, R S

    1994-01-01

    A 60 year old patient presented with an acute pseudobulbar palsy associated with trismus. A computed tomography scan revealed low attenuation areas consistent with infarction affecting the genu of the internal capsules bilaterally. Trismus has not previously been described as the presenting feature of a pseudobulbar palsy.

  4. Pseudobulbar palsy associated with trismus.

    Science.gov (United States)

    Lai, M. M.; Howard, R. S.

    1994-01-01

    A 60 year old patient presented with an acute pseudobulbar palsy associated with trismus. A computed tomography scan revealed low attenuation areas consistent with infarction affecting the genu of the internal capsules bilaterally. Trismus has not previously been described as the presenting feature of a pseudobulbar palsy. Images Figure 1 PMID:7824418

  5. Survey of methods of facial palsy documentation in use by members of the Sir Charles Bell Society

    NARCIS (Netherlands)

    Fattah, A.Y.; Gavilan, J.; Hadlock, T.A.; Marcus, J.R.; Marres, H.A.; Nduka, C.; Slattery, W.H.; Snyder-Warwick, A.K.

    2014-01-01

    OBJECTIVES/HYPOTHESIS: Facial palsy manifests a broad array of deficits affecting function, form, and psychological well-being. Assessment scales were introduced to standardize and document the features of facial palsy and to facilitate the exchange of information and comparison of outcomes. The aim

  6. The head-shaft angle of the hip in early childhood: a comparison of reference values for children with cerebral palsy and normally developing hips.

    Science.gov (United States)

    van der List, J P; Witbreuk, M M; Buizer, A I; van der Sluijs, J A

    2015-09-01

    The recognition of hips at risk of displacement in children with cerebral palsy (CP) is a difficult problem for the orthopaedic surgeon. The Gross Motor Function Classification System (GMFCS) and head-shaft angle (HSA) are prognostic factors for hip displacement. However, reference values for HSA are lacking. This study describes and compares the development of HSA in normal hips and children with CP. We selected 33 children from a retrospective cohort with unilateral developmental dysplasia of the hip (DDH) (five boys, 28 girls) and 50 children (35 boys, 15 girls) with CP with GMFCS levels II to V. HSA of normal developing hips was measured at the contralateral hip of unilateral DDH children (33 hips) and HSA of CP children was measured in both hips (100 hips). Measurements were taken from the radiographs of the children at age two, four and seven years. The normal hip HSA decreased by 2° per year (p GMFCS levels II and III HSA decreased by 0.6° (p = 0.046) and 0.9° (p = 0.049) per year, respectively. The HSA did not alter significantly in GMFCS levels IV and V. Between the ages of two and eight years, the HSA decreases in normal hips and CP children with GMFCS level, II to III but does not change in GMFCS levels IV to V. As HSA has a prognostic value for hip displacement, these reference values may help the orthopaedic surgeon to predict future hip displacement in children with CP.

  7. Volumetric Magnetic Resonance Imaging Study of Brain and Cerebellum in Children with Cerebral Palsy

    Science.gov (United States)

    Maciorkowska, Elżbieta; Gościk, Elżbieta

    2016-01-01

    Introduction. Quantitative magnetic resonance imaging (MRI) studies are rarely used in the diagnosis of patients with cerebral palsy. The aim of present study was to assess the relationships between the volumetric MRI and clinical findings in children with cerebral palsy compared to control subjects. Materials and Methods. Eighty-two children with cerebral palsy and 90 age- and sex-matched healthy controls were collected. Results. The dominant changes identified on MRI scans in children with cerebral palsy were periventricular leukomalacia (42%) and posthemorrhagic hydrocephalus (21%). The total brain and cerebellum volumes in children with cerebral palsy were significantly reduced in comparison to controls. Significant grey matter volume reduction was found in the total brain in children with cerebral palsy compared with the control subjects. Positive correlations between the age of the children of both groups and the grey matter volumes in the total brain were found. Negative relationship between width of third ventricle and speech development was found in the patients. Positive correlations were noted between the ventricles enlargement and motor dysfunction and mental retardation in children with cerebral palsy. Conclusions. By using the voxel-based morphometry, the total brain, cerebellum, and grey matter volumes were significantly reduced in children with cerebral palsy. PMID:27579318

  8. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cerebral palsy (CP is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cerebral palsy in the study group. MATERIA LS AND METHODS: Retrospective study was done to assess possible associated antenatal risk factors for cerebral palsy. Mothers of 100 cerebral palsy children were selected who are treated in Rani Chandramani Devi Hospital, a Government hospital in Visakhapa tn am, Andhra Pradesh State, India , from 2012 to 2014 and 100 controls, mothers of normal children were studied. Detailed antenatal history was obtained from the mothers of the children in both affected and control group. RESULTS: From the data, we conclude that the association of maternal anaemia with cerebral palsy is 7.3 times higher; association of maternal hypertension with cerebral palsy is 6.6 time higher, association with Pre - eclampsia is 6 times higher; association with Eclampsia is 8.6 times higher ; with antepartum haemorrhage, the association is 8.6 times higher and association of multiple pregnancy with cerebral palsy is 4.8 times higher than with controls. CONCLUSION: From this study of the role of antenatal risk factors, in the occurrence of cer ebral palsy in children it is concluded that the most common risk factor associated with cerebral palsy is the maternal anaemia and the other important risk factors associated being hypertension, pre eclampsia, eclampsia, antepartum haemorrhage and multipl e births.

  9. The Role of Information Systems to Manage Cerebral Palsy

    Science.gov (United States)

    AJAMI, Sima; MAGHSOUDLORAD, Ali Akbar

    2016-01-01

    Objective In healthcare system, it is necessary to have exact and accurate information in order to address health care needs and requirements of society members as well as expectations of policy makers, planners and decision makers. The aim of this narrative review article was to explain the role of information systems in cerebral palsy management and identify the advantages and barriers to the development of cerebral palsy registry system. Data were collected using databases such as of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). Overall, 65 sources were selected. One of the biggest challenges for children with physical and motor disabilities in rehabilitation center is access to a system, which provides a comprehensive data set reflecting all information on a patient’s care. Thus, data and information management in children with physical and motor disability such as cerebral palsy facilitates access to data and cerebral palsy data comparison as well as the monitoring incidence rate of cerebral palsy, enhancing health care quality; however, there are always numerous barriers to establish the system. One of the ways to overcome these problems is the establishment of a standard framework of minimum data sets and exact definition of its data components. Reliable standards in the use of applications as well as user-friendly software will ensure patients’ data extraction and registration. PMID:27247578

  10. Measuring wearing time of knee-ankle-foot orthoses in children with cerebral palsy: comparison of parent-report and objective measurement.

    Science.gov (United States)

    Maas, Josina C; Dallmeijer, Annet J; Oudshoorn, Bodil Y; Bolster, Eline A M; Huijing, Peter A; Jaspers, Richard T; Becher, Jules G

    2016-12-07

    Purpose state: Orthotic wearing time may be an important confounder in efficacy studies of treatment in children with spastic cerebral palsy (SCP). Most studies measure parent-reported wearing time (WTparent) with questionnaires, but it is questionable whether this yields valid results. This study aims to compare WTparent with objectively measured wearing time (WTobj) in children with SCP receiving orthotic treatment. Eight children with SCP participated in this observational study. For one year, they received knee-ankle-foot orthosis (KAFO) treatment. WTparent was measured using questionnaires. WTobj was measured using temperature sensor-data-loggers that were attached to the KAFOs. The 2.5th and 97.5th percentiles and median of differences between methods (per participant) were used to calculate limits of agreement and systematic differences. There was no systematic difference between WTparent and WTobj (0.1 h per week), but high inter-individual variation of the difference was found, as reflected by large limits of agreement (lower limit/2.5th percentile: -1.7 h/week; upper limit/97.5th percentile: 11.1 h/week). Parent-reported wearing time (WTparent) of a KAFO differs largely from objectively measured wearing time (WTobj) using temperature sensors. Therefore, parent-reported wearing time (WTparent) of KAFOs should be interpreted with utmost care. Implications for Rehabilitation Low wearing time of orthoses may be a cause of inefficacy of orthotic treatment and incorrect reported wearing time may bias results of efficacy studies. Results of this study show that parent-reported wearing time is not in agreement with objectively measured wearing time. Parent-reported wearing time of KAFOs should be interpreted with utmost care. Objective methods are recommended for measuring orthotic wearing time.

  11. COMPARISON BETWEEN PHYSIOLOGICAL COST INDEX IN HEALTHY NORMAL CHILDREN AS AGAINST AMBULATORY SPASTIC DIPLEGIC CEREBRAL PALSY (WITH AND WITHOUT ORTHOSIS IN THE AGE GROUP 6 TO 18 YEARS

    Directory of Open Access Journals (Sweden)

    Swatia Bhise

    2016-08-01

    Full Text Available Background: Efficacy of rehabilitation program for subjects with orthosis with objective measurement. The study aiming to objectively compare the PCI and walking speed of normal children with ambulatory spastic diaplegic. Also we aimed to analyze whether BMIhad impact on energy cost. Methods: 41 normal children and 41 community walking spastic diaplegic aged between 6 to 18 yrs. were assessed to compare the PCI. Speed of walking and heart rate were checked constantlyboth barefoot and in shoes in normal children and with and without conventional AFO in children with spastic diaplegic at their chosen velocities over four consecutive lengths of a 12.5m walkway i.e. total 50m.,Pre and Post readings are taken. Heart rate is affected by speed; PCI with speed of walking and heart rate was calculated for each child. Results: The mean PCI in shoes and barefoot was same in normal children i.e. 0.05 ±0.039beats/meter. The PCI for children with pathological gait i.e. spastic diaplegic without orthosis and with orthosis is 0.199 ±0.176 and 0.104± 0.093beats/meter appreciably greater than that for normal children(p less than 0.05. Conclusion: This study showed that walking with orthosis in spastic diplegic CP children showed higher costs of energy and slower walking speed compared normal children with age matched. The PCI of walking, with orthosis in children with spastic Diplegic cerebral palsy is less as compared to without orthosis i.e. gait is more energy efficient with orthosis. BMI doesn’t show any correlation with PCI further study may require.

  12. Identification by [{sup 99m}Tc]ECD SPECT of anterior cingulate hypoperfusion in progressive supranuclear palsy, in comparison with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Varrone, Andrea [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Karolinska Hospital, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden); Pagani, Marco; Salmaso, Dario [National Research Council, Institute of Cognitive Sciences and Technologies, Rome and Padua (Italy); Salvatore, Elena; Amboni, Marianna; De Michele, Giuseppe; Filla, Alessandro; Barone, Paolo [University Federico II, Department of Neurological Sciences, Napoli (Italy); Sansone, Valeria; Pappata, Sabina; Salvatore, Marco [University Federico II, Biostructure and Bioimaging Institute, National Research Council/Department of Biomorphological and Functional Sciences, Napoli (Italy); Nobili, Flavio [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Metabolic Sciences, Genoa (Italy)

    2007-07-15

    Progressive supranuclear palsy (PSP) is an akinetic-rigid syndrome that can be difficult to differentiate from Parkinson's disease (PD), particularly at an early stage. [{sup 99m}Tc]ethyl cysteinate dimer (ECD) SPECT could represent a widely available tool to assist in the differential diagnosis. In this study we used voxel-based analysis and Computerised Brain Atlas (CBA)-based principal component analysis (PCA) of [{sup 99m}Tc]ECD SPECT data to test whether: (1) specific patterns of rCBF abnormalities can differentiate PSP from controls and PD; (2) networks of dysfunctional brain regions can be found in PSP vs controls and PD. Nine PD patients, 16 PSP patients and ten controls were studied with [{sup 99m}Tc]ECD SPECT using a brain-dedicated device (Ceraspect). Voxel-based analysis was performed with statistical parametric mapping. PCA was applied to volume of interest data after spatial normalisation to CBA. The voxel-based analysis showed hypoperfusion of the anterior cingulate and medial frontal cortex in PSP compared with controls and PD. In PSP patients the rCBF impairment extended to the pre-supplementary motor area and prefrontal cortex, areas involved in executive function and motor networks. Compared with PSP patients, PD patients showed a mild rCBF decrease in associative visual areas which could be related to the known impairment of visuospatial function. The PCA identified three principal components differentiating PSP patients from controls and/or PD patients that included groups of cortical and subcortical brain regions with relatively decreased (cingulate cortex, prefrontal cortex and caudate) or increased (parietal cortex) rCBF, representing distinct functional networks in PSP. Anterior cingulate hypoperfusion seems to be an early, distinct brain abnormality in PSP as compared with PD. (orig.)

  13. Comparison between dopaminergic agents and physical exercise as treatment for periodic limb movements in patients with spinal cord injury.

    Science.gov (United States)

    De Mello, M T; Esteves, A M; Tufik, S

    2004-04-01

    Randomized controlled trial of physical exercise and dopaminergic agonist in persons with spinal cord injury and periodic leg movement (PLM). The objective of the present study was to compare the effectiveness of physical exercise and of a dopaminergic agonist in reducing the frequency of PLM. Centro de Estudos em Psicobiologia e Exercício. Universidade Federal de São Paulo, Brazil. A total of 13 volunteers (mean age: 31.6+/-8.3 years) received L-DOPA (200 mg) and benserazide (50 mg) 1 h before sleeping time for 30 days and were then submitted to a physical exercise program on a manual bicycle ergometer for 45 days (3 times a week). Both L-DOPA administration (35.11-19.87 PLM/h, P<0.03) and physical exercise (35.11-18.53 PLM/h, P<0.012) significantly reduced PLM; however, no significant difference was observed between the two types of treatment. The two types of treatment were found to be effective in the reduction of PLM; however, physical exercise is indicated as the first treatment approach, while dopaminergic agonists or other drugs should only be recommended for patients who do not respond to this type of treatment.

  14. A Temporary vs. Permanent Anchored Percutaneous Lead Trial of Spinal Cord Stimulation: A Comparison of Patient Outcomes and Adverse Events.

    Science.gov (United States)

    Simopoulos, Thomas; Sharma, Sanjiv; Aner, Moris; Gill, Jatinder S

    2017-09-13

    A trial of spinal cord stimulation (SCS) is a prerequisite to determine efficacy of the therapy prior to placement of a permanent implanted system. A trial may be conducted employing a percutaneously placed temporary cylindrical lead or via a permanently anchored cylindrical lead placed and subsequently secured via open surgical method. There has been little investigation comparing the two methods of trial. This study is a comparative analysis of the two methods both for prediction of success as well as associated morbidity. Retrospective chart review. SCS outcomes of percutaneous temporary lead trial or the temporary lead (TL) group and permanent anchored lead trial or permanent lead (PL) group were analyzed for lack of relief, poor paresthesia coverage, false positive trial phase, fading relief, and biological complications. Outcome data was analyzed for 148 patients in the TL group and 138 patients in the PL group. In comparing the two trial methods, false positive rate of trial was higher (p technical advantage of routinely anchoring the trial lead. © 2017 International Neuromodulation Society.

  15. Comparison of Lyophilized Glutaraldehyde-Preserved Bovine Pericardium with Different Vascular Prostheses for Use as Vocal Cords Implants: Experimental Study

    Science.gov (United States)

    Olmos-Zuñiga, J. Raúl; Jasso-Victoria, Rogelio; Gaxiola-Gaxiola, Miguel; Sotres-Vega, Avelina; Hernández-Jiménez, Claudia; Baltazares-Lipp, Matilde; Arredondo del Bosque, Fernando; Santillan-Doherty, Patricio

    2015-01-01

    This study compared the use of lyophilized glutaraldehyde-preserved bovine pericardium (LGPBP), polytetrafluoroethylene (PTFE), polyethylene terephthalate (PET), and Teflon felt (TF) as implants for vocal cords (VC) medialization and aimed to assess the endoscopic, macroscopic, and microscopic VC changes after medialization in a canine model. In 18 mongrel dogs, the right VC were medialized with LGPBP and the left were implanted as follows: Group I (n = 6): LGPBP and PTFE; Group II (n = 6): LGPBP and PET; Group III (n = 6): LGPBP and TF. Surgical handling of the implants was compared. Three months after surgery, macroscopic and microscopic changes of VC and implants were evaluated. LGPBP offered the best surgical handling (p = 0.005, Kruskal-Wallis). TF implants showed extrusion (p = 0.005, Kruskal-Wallis) and severe inflammation. All VC formed fibrous capsules around the implants; the ones developed by LGPBP implants were thinner (p = 0.001, ANOVA, Tukey). VC implanted with synthetic materials showed eosinophilic infiltration (p = 0.01, Kruskal-Wallis). We concluded that the LGPBP could be used as an implant for VC medialization because it is biocompatible, easy to handle and remove during surgical procedures, and nonabsorbable or extrudable and produces an inflammatory reaction similar to PTFE and PET. PMID:26075232

  16. Pressure ulcer prevalence and barriers to treatment after spinal cord injury: comparisons of four groups based on race-ethnicity.

    Science.gov (United States)

    Saladin, Lisa K; Krause, James S

    2009-01-01

    To compare the prevalence of pressure ulcer (PU) and barriers to treatment in the event of PU development as a function of race-ethnicity in persons with spinal cord injury (SCI). Interview data were collected from three rehabilitation hospitals each of which was designated as a model SCI system of care by the United States Department of Education. There were 475 participants with similar portions of each racial-ethnic group (African-American n = 121, American-Indian n = 105, Caucasians n = 127, Hispanics n = 122). The lowest prevalence rates for pressure ulcers were reported by Hispanics followed by Caucasians. Logistic regression revealed racial-ethnic differences in the odds of developing a PU within the past 12 months. Social support and injury severity were also associated with risk of PU while age, gender, years since injury, and education were not. Significant racial-ethnic differences were also observed in 5 of 9 barriers to the treatment of PUs. Results suggest that variability in social support and barriers to treatment may contribute to the racial-ethnic differences in prevalence rates for PU that were observed. Future research in this area could lead to the development of strategies to enhance prevention and treatment targeted at the elimination of any racial-ethnic disparities.

  17. Perceived Quality of Life With Spinal Cord Injury: A Comparison Between Emergency Medicine and Physical Medicine and Rehabilitation Physicians.

    Science.gov (United States)

    Cushman, Daniel M; Thomas, Katrina; Mukherjee, Debjani; Johnson, Reid; Spill, Gayle

    2015-09-01

    To explore the attitudes of health care providers who treat patients with spinal cord injury (SCI) and examine whether Emergency Medicine (EM) and Physical Medicine and Rehabilitation (PM&R) physicians differ in their judgments about quality of life (QOL) after SCI. Questionnaire survey of PM&R and EM physicians. Board-certified PM&R and EM physicians listed in the American Academy of Physical Medicine & Rehabilitation and the American College of Emergency Physicians and/or faculty from academic PM&R and EM departments in the United States and Canada. Evaluating various aspects of perceived QOL if the physician hypothetically sustained an SCI, including impact on leisure activities, social relationships, happiness, meaningful work, satisfying sexual relationships, and overall QOL. A total of 91 EM physicians and 89 PM&R physicians completed the surveys. PM&R physicians were more likely to agree that they would have a better QOL compared with EM physicians, regardless of the level of injury or aspect of life (P Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  18. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag L. STOSHLJEVIKJ

    2008-12-01

    Full Text Available Pupils with cerebral palsy attend elementary education accordind to a regular and special teaching plan and program. Regular school curriculum was reformed in 1992, while special plan and program has not been changed and adapted according to pupil’s needs and capacities. Music is one of the best means of expressing oneself and plays a very important role in the development of every child, the child with cerebral palsy in particular.In order to test the possibility of pupils with cerebral palsy, with and without mental retardation, to apprehend the actual program content, we have conducted research on musical achievement of children with cerebral palsy. During 2007 a research was carried out, on the sample of 27 pupils with cerebral palsy and mild mental retardation who attended classes in the school “Miodrag Matikj”, and a sample of16 students with cerebral palsy without mental retardation who attended the school “Dr. Dragan Hercog” in Belgrade.Results of the research, as well as analysis of music curriculum content, indicated that the capacities of students with cerebral palsy to carry out the curriculum tasks require special approach and methodology. Therefore, we introduced some proposals to overcome the difficulties in fulfilling music curriculum demands of those pupils. We made special emphasis on the use of computer based Assistive technology which facilitates the whole process to a large extent.

  19. [A case of Avellis' syndrome with ipsilateral central facial palsy due to a small medullary infarction].

    Science.gov (United States)

    Takahashi, K; Kitani, M; Fukuda, H

    2000-04-01

    We report a 51-year-old man with mild left central facial palsy and left Avellis' syndrome due to a small medullary infarction. On admission, neurological examination revealed hoarseness, dysphasia, absent left gag reflex, palsies of the left vocal cord and left soft palate, and hypalgesia and thermohypesthesia on the right side of the trunk and extremities. In addition, he had a mild left central facial palsy. He had no nausea, vomiting, vertigo, hiccups, nystagmus, Horner's sign, facial numbness, or paresis or ataxia of the limbs. A T2 weighted MRI showed a small, high signal intensity area in the left dorsal region of the medulla and this lesion was presumed to involve the nucleus ambiguus and a part of the spinothalamic tract. These findings suggest that an aberrant supranuclear pathway, looping around the nucleus ambiguus to the facial nucleus exists in our patient.

  20. Comparison of health related quality of life between two groups of veteran and non-veteran spinal cord injured patients

    Science.gov (United States)

    Salamati, Payman; Rostami, Reza; Saadat, Soheil; Taheri, Taher; Tajabadi, Maryam; Ranjbari, Ghazale; Naji, Zohrehsadat; Jafarpour, Saba; Rahimi-Movaghar, Vafa

    2015-01-01

    Background: Patients with spinal cord injury (SCI) have a lower health related quality of life (HRQOL) compared to both healthy controls and the normal population. The aim of this study was to compare HRQOL between two groups of veteran and non-veteran SCI patients. Methods: All male paraplegic non-veterans who had sustained complete SCI before 1988 and were residents of Tehran province (Iran), and a similar group of SCI veterans who consecutively participated in a health screening program were enrolled in this study. Patients fewer than 35 and older than 65 years of age were not included in this study. The participants were interviewed based on the Persian version of SF-36 questionnaire by two psychologists. Eight sub-scales and two physical and mental component summaries of the instrument were assessed. We used chi-square, odds ratio, Mann-Whitney U, independent t-test and linear regression for analysis. Results: Overall, 25 veterans and 22 non-veterans were enrolled in the study. The mean age, time since injury and the presence of comorbid illnesses were not significantly different between the two groups (P>0.05). A greater number of veterans were married (p= 0.003) and employed (p= 0.047). On average, veterans had more years of formal education than non-veterans (p= 0.001). The mean (SD) bodily pain sub-scale was 72.73(31.253) for non-veterans and 49.7 (28.287) for veterans (p=0.011). Absence of comorbid illnesses was associated with a better physical component summary (p< 0.001). Employment was associated with a better mental component summary (p= 0.022). Conclusion: We did not find any differences in HRQOL between the two groups except for the bodily pain sub-scale. Further studies with larger sample sizes are recommended. PMID:26157716

  1. Recurrent laryngeal nerve palsy complicating subclavian line insertion: a case report

    Directory of Open Access Journals (Sweden)

    Fishman Jonathan M

    2009-09-01

    Full Text Available Abstract Introduction Although recurrent laryngeal nerve injury has been described following central venous access via the jugular route, it has not previously been reported following access via the subclavian route. Case presentation A 63-year-old man presented with acute dysphonia immediately after insertion of a Hickman line via the subclavian route. Flexible laryngoscopy revealed a left vocal fold palsy. A computed tomography scan from the skull base to the thoracic inlet showed no obvious abnormality other than an abducted left vocal cord. The timing of the events and the computed tomography scan results strongly support the conclusion that the left recurrent laryngeal nerve was injured during insertion of the Hickman line, resulting in a left adductor vocal cord palsy. Conclusion This case illustrates an unusual example of iatrogenic injury to the recurrent laryngeal nerve. It is important to recognize the possibility that such injuries may occur in order to prevent them.

  2. Literature Review and Comparison of Two Statistical Methods to Evaluate the Effect of Botulinum Toxin Treatment on Gait in Children with Cerebral Palsy

    Science.gov (United States)

    Nieuwenhuys, Angela; Papageorgiou, Eirini; Pataky, Todd; De Laet, Tinne; Molenaers, Guy; Desloovere, Kaat

    2016-01-01

    Aim This study aimed at comparing two statistical approaches to analyze the effect of Botulinum Toxin A (BTX-A) treatment on gait in children with a diagnosis of spastic cerebral palsy (CP), based on three-dimensional gait analysis (3DGA) data. Through a literature review, the available expert knowledge on gait changes after BTX-A treatment in children with CP is summarized. Methods Part 1—Intervention studies on BTX-A treatment in children with CP between 4–18 years that used 3DGA data as an outcome measure and were written in English, were identified through a broad systematic literature search. Reported kinematic and kinetic gait features were extracted from the identified studies. Part 2—A retrospective sample of 53 children with CP (6.1 ± 2.3years, GMFCS I-III) received 3DGA before and after multilevel BTX-A injections. The effect of BTX-A on gait was interpreted by comparing the results of paired samples t-tests on the kinematic gait features that were identified from literature to the results of statistical parametric mapping analysis on the kinematic waveforms of the lower limb joints. Results Part 1–53 kinematic and 33 kinetic features were described in literature. Overall, there is no consensus on which features should be evaluated after BTX-A treatment as 49 features were reported only once or twice. Part 2—Post-BTX-A, both statistical approaches found increased ankle dorsiflexion throughout the gait cycle. Statistical parametric mapping analyses additionally found increased knee extension during terminal stance. In turn, feature analyses found increased outtoeing during stance after BTX-A. Conclusion This study confirms that BTX-A injections are a valuable treatment option to improve gait function in children with CP. However, different statistical approaches may lead to different interpretations of treatment outcome. We suggest that a clear, definite hypothesis should be stated a priori and a commensurate statistical approach should

  3. Literature Review and Comparison of Two Statistical Methods to Evaluate the Effect of Botulinum Toxin Treatment on Gait in Children with Cerebral Palsy.

    Directory of Open Access Journals (Sweden)

    Angela Nieuwenhuys

    Full Text Available This study aimed at comparing two statistical approaches to analyze the effect of Botulinum Toxin A (BTX-A treatment on gait in children with a diagnosis of spastic cerebral palsy (CP, based on three-dimensional gait analysis (3DGA data. Through a literature review, the available expert knowledge on gait changes after BTX-A treatment in children with CP is summarized.Part 1--Intervention studies on BTX-A treatment in children with CP between 4-18 years that used 3DGA data as an outcome measure and were written in English, were identified through a broad systematic literature search. Reported kinematic and kinetic gait features were extracted from the identified studies. Part 2--A retrospective sample of 53 children with CP (6.1 ± 2.3years, GMFCS I-III received 3DGA before and after multilevel BTX-A injections. The effect of BTX-A on gait was interpreted by comparing the results of paired samples t-tests on the kinematic gait features that were identified from literature to the results of statistical parametric mapping analysis on the kinematic waveforms of the lower limb joints.Part 1-53 kinematic and 33 kinetic features were described in literature. Overall, there is no consensus on which features should be evaluated after BTX-A treatment as 49 features were reported only once or twice. Part 2--Post-BTX-A, both statistical approaches found increased ankle dorsiflexion throughout the gait cycle. Statistical parametric mapping analyses additionally found increased knee extension during terminal stance. In turn, feature analyses found increased outtoeing during stance after BTX-A.This study confirms that BTX-A injections are a valuable treatment option to improve gait function in children with CP. However, different statistical approaches may lead to different interpretations of treatment outcome. We suggest that a clear, definite hypothesis should be stated a priori and a commensurate statistical approach should accompany this hypothesis.

  4. Immunophenotypic comparison of heterogenous non-sorted versus sorted mononuclear cells from human umbilical cord blood: a novel cell enrichment approach.

    Science.gov (United States)

    Indumathi, S; Harikrishnan, R; Rajkumar, J S; Dhanasekaran, M

    2015-01-01

    Human umbilical cord blood (hUCB) has been the preferred source of stem cells for the treatment of haematological malignancies and genetic disorders. This is primarily due to its non-invasiveness, high accessibility with relative ease of isolation. Still failures do prevail due to its heterogeneity and lesser frequency of MSC identified in UCB. This study, thus, employs a cell enrichment technology to improve its therapeutic efficacy. This was achieved by immunophenotypic comparison of stem cells isolated from the heterogenous non-sorted mononuclear cells (MNCs), linage depleted (Lin+ and Lin-) fractions obtained from magnetic activated cell sorter (MACS) and sorted MNCs obtained by fluorescent activated cell sorter (FACS). The markers under consideration were CD29, CD44, CD34, CD45, CD133, CD90 and CD117. FACS sorted MNCs were rich in naive stem cell population, whereas non-sorted MNCs and lineage depleted fractions were found to be rich in progenitors. Thus, we suggest that a combination therapy of both sorted population might serve as an alternative valuable tool in treating haematologic/genetic disorders. However, further research on cell enrichment technology might give a clue for improved cell based therapy in regenerative medicine.

  5. Peculiarities of somatic pathology in children with cerebral palsy (literature review

    Directory of Open Access Journals (Sweden)

    S.L. Nyankovsky

    2017-03-01

    Full Text Available Cerebral palsy remains one of the most topical problems of pediatric neurology and causes of childhood disability. This term includes group of syndromes that result from violations of or damage to the central nervous system. The incidence of cerebral palsy does not tend to decrease due to such factors, as the improvement of nursing methods and reduced mortality of prematurely born babies and infants with extremely low birth weight. The most common forms of cerebral palsy are spastic forms: spastic diplegia, spastic hemiparesis, double hemiplegia. Their share is 80–85 % of all cases of cerebral palsy. According to available data, children with cerebral palsy suffer from impairments of somatic health, physical development and regulatory mechanisms. The rehabilitation effectiveness of such children often depends on their rehabilitation potential, which depends on concomitant somatic pathology and functional disorders. It was found that anemia had a 3.6 times higher rate in children with spastic forms of cerebral palsy than in their healthy peers, rachitis — 2.9 times more higher, malnutrition — 12.8 times more higher. Among children with cerebral palsy, a group of frequently and chronically ill children included 5.6 times more children than comparison group. Chronic adenoiditis, rhinitis, otitis in children with cerebral palsy were diagnosed 6.5 times more often than in the comparison group. Cerebral palsy is a complicated, multicomponent problem, in the development of pathogenic mechanisms of which, somatic pathology plays a prominent role that suggests the need for multidisciplinary approach to the treatment, involving medical experts of different specialties.

  6. C-5 palsy after cerebrospinal fluid diversion in posttraumatic syringomyelia: case report.

    Science.gov (United States)

    Ghobrial, George M; Beygi, Sara; Viereck, Matthew J; Heller, Joshua E; Sharan, Ashwini; Jallo, Jack; Harrop, James S; Prasad, Srinivas

    2015-04-01

    Syringomyelia is a potentially debilitating disease that involves abnormal CSF flow mechanics; its incidence after traumatic spinal cord injury (SCI) is approximately 15%. Treatment consists of restoration of CSF flow, typically via arachnoidolysis and syrinx decompression. The authors present a case of pronounced syringomyelia in a patient with concomitant severe cervical myelomalacia to demonstrate unilateral C-5 palsy as a potential complication of aggressive syrinx decompression at a remote level. A 56-year-old man with a remote history of SCI at T-11 (ASIA [American Spinal Injury Association] Grade A) presented with complaints of ascending motor and sensory weakness into the bilateral upper extremities that had progressed over 1 year. MRI demonstrated severe distortion of the spinal cord at the prior injury level of T10-11, where an old anterior column injury and prior hook-rod construct was visualized. Of note, the patient had a holocord syrinx with demonstrable myelomalacia. To restore CSF flow and decompress the spinal cord, T-2 and T-3 laminectomies, followed by arachnoidolysis and syringopleural shunt placement, were performed. Postoperatively on Day 1, with the exception of a unilateral deltoid palsy, the patient had immediate improvement in upper-extremity strength and myelopathy. He was discharged from the hospital on postoperative Day 5; however, at his 2-week follow-up visit, a persistent unilateral deltoid palsy was noted. MRI demonstrated a significant reduction in the holocord syrinx, no neural foraminal stenosis, and a significant positional shift of the ventral spinal cord. Further motor recovery was noted at the 8-month follow-up. Syringomyelia is a debilitating disease arising most often as a result of traumatic SCI. In the setting of myelomalacia with a pronounced syrinx, C-5 palsy is a potential complication of syrinx decompression.

  7. Anesthetic management in a child with Arnold-Chiari malformation and bilateral vocal cord paralysis.

    NARCIS (Netherlands)

    Setz, A.C.W.; Boer, H.D. de; Driessen, J.J.; Scheffer, G.J.

    2005-01-01

    We report a case of a child who was scheduled for an emergency ventriculoperitoneal shunt procedure. The patient had a type II Arnold-Chiari malformation (ACM) and associated hydrocephalus and presented with near complete respiratory obstruction from bilateral abductor vocal cord palsy. Early diagno

  8. Cord blood testing

    Science.gov (United States)

    ... is born. The umbilical cord is the cord connecting the baby to the mother's womb. Cord blood ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  9. Neurocysticercosis presenting as pseudobulbar palsy

    Directory of Open Access Journals (Sweden)

    Arinaganahalli Subbanna Praveen Kumar

    2014-01-01

    Full Text Available Neurocysticercosis (NCC is the most common helminthic infestation of the central nervous system (CNS and a leading cause of acquired epilepsy worldwide. The common manifestations of NCC are seizures and headache. The NCC as a cause of pseudobulbar palsy is very unusual and not reported yet in the literature. A pseudobulbar palsy can occur in any disorder that causes bilateral corticobulbar disease. The common etiologies of pseudobulbar palsy are vascular, demyelinative, or motor neuron disease. We report a 38-year-old female patient who presented with partial seizures and pseudobulbar palsy. The MRI brain showed multiple small cysts with scolex in both the cerebral hemispheres and a giant intraparenchymal cyst. Our patient responded well to standard treatment of neurocysticercosis and antiepileptics.

  10. NEYROPSYCHOLOGICAL CONSECUENCES OF CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    ANA MARÍA NAVARRO MELENDRO

    2005-01-01

    Full Text Available Cerebral Palsy is defined as a movement alteration result of a non progressive damage witch is permanent in anencephalon that has not acquired its final maturation. Patients that suffer cerebral palsy present learning disabilities,that varies between being completely normal to severe as a consequence of memory, gnosis, praxis, perceptive andlanguage impairments. Nevertheless the consequences of this disease are not always predictable. This paper pretendsto make a description of the cognitive and behavioral deficits that overcomes along with the manifestation of thecerebral palsy and its possible treatment. We used a complete neuropsychological battery to evaluate a 7 years oldpatient who was diagnosed of cerebral palsy and spastic diplegia finding some cognitive impairment in fields such asmnesic, gnosic and attention processes.

  11. Learn More About Cerebral Palsy

    Centers for Disease Control (CDC) Podcasts

    2008-03-30

    This podcast describes the causes, preventions, types, and signs and symptoms of cerebral palsy.  Created: 3/30/2008 by National Center on Birth Defects and Developmental Disabilities.   Date Released: 3/21/2008.

  12. Comparison of molecular profiles of human mesenchymal stem cells derived from bone marrow, umbilical cord blood, placenta and adipose tissue.

    Science.gov (United States)

    Heo, June Seok; Choi, Youjeong; Kim, Han-Soo; Kim, Hyun Ok

    2016-01-01

    Mesenchymal stem cells (MSCs) are clinically useful due to their capacity for self-renewal, their immunomodulatory properties and tissue regenerative potential. These cells can be isolated from various tissues and exhibit different potential for clinical applications according to their origin, and thus comparative studies on MSCs from different tissues are essential. In this study, we investigated the immunophenotype, proliferative potential, multilineage differentiation and immunomodulatory capacity of MSCs derived from different tissue sources, namely bone marrow, adipose tissue, the placenta and umbilical cord blood. The gene expression profiles of stemness-related genes [octamer-binding transcription factor 4 (OCT4), sex determining region Y-box (SOX)2, MYC, Krüppel-like factor 4 (KLF4), NANOG, LIN28 and REX1] and lineage‑related and differentiation stage-related genes [B4GALNT1 (GM2/GS2 synthase), inhibin, beta A (INHBA), distal-less homeobox 5 (DLX5), runt-related transcription factor 2 (RUNX2), proliferator‑activated receptor gamma (PPARG), CCAAT/enhancer-binding protein alpha (C/EBPA), bone morphogenetic protein 7 (BMP7) and SOX9] were compared using RT-PCR. No significant differences in growth rate, colony-forming efficiency and immunophenotype were observed. Our results demonstrated that MSCs derived from bone marrow and adipose tissue shared not only in vitro tri-lineage differentiation potential, but also gene expression profiles. While there was considerable inter-donor variation in DLX5 expression between MSCs derived from different tissues, its expression appears to be associated with the osteogenic potential of MSCs. Bone marrow-derived MSCs (BM-MSCs) significantly inhibited allogeneic T cell proliferation possibly via the high levels of the immunosuppressive cytokines, IL10 and TGFB1. Although MSCs derived from different tissues and fibroblasts share many characteristics, some of the marker genes, such as B4GALNT1 and DLX5 may be useful for

  13. Spinal Cord Contusion

    Institute of Scientific and Technical Information of China (English)

    Gong Ju; Jian Wang; Yazhou Wang; Xianghui Zhao

    2014-01-01

    Spinal cord injury is a major cause of disability with devastating neurological outcomes and lim-ited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

  14. 11 Things to Know about Cerebral Palsy

    Science.gov (United States)

    ... processing SSI file 11 Things to Know about Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Cerebral palsy (CP) is the most common motor disability in ...

  15. Isolated trochlear nerve palsy with midbrain hemorrhage

    Directory of Open Access Journals (Sweden)

    Raghavendra S

    2010-01-01

    Full Text Available Midbrain hemorrhage causing isolated fourth nerve palsy is extremely rare. Idiopathic, traumatic and congenital abnormalities are the most common causes of fourth nerve palsy. We report acute isolated fourth nerve palsy in an 18-year-old lady due to a midbrain hemorrhage probably due to a midbrain cavernoma. The case highlights the need for neuroimaging in selected cases of isolated trochlear nerve palsy.

  16. [(18) F]AV-1451 tau positron emission tomography in progressive supranuclear palsy.

    Science.gov (United States)

    Whitwell, Jennifer L; Lowe, Val J; Tosakulwong, Nirubol; Weigand, Stephen D; Senjem, Matthew L; Schwarz, Christopher G; Spychalla, Anthony J; Petersen, Ronald C; Jack, Clifford R; Josephs, Keith A

    2017-01-01

    The [(18) F]AV-1451 positron emission tomography ligand allows the in vivo assessment of tau proteins in the brain. It shows strong binding in Alzheimer's dementia, but little is known about how it performs in progressive supranuclear palsy, a primary 4R tauopathy. The objectives of this study were to determine whether [(18) F]AV-1451 uptake can be observed in progressive supranuclear palsy and to characterize the regional distribution when compared with controls and Alzheimer's dementia. [(18) F]AV-1451 positron emission tomography was performed in 10 patients with probable progressive supranuclear palsy. These patients were age- and gender-matched to 50 controls and 10 Alzheimer's dementia patients who had undergone identical [(18) F]AV-1451 imaging. Regional comparisons of [(18) F]AV-1451 uptake were performed across the whole brain using region-of-interest and voxel-level analyses, and correlations between regional [(18) F]AV-1451 and the progressive supranuclear palsy rating scale were assessed. An elevated [(18) F]AV-1451 signal was observed in progressive supranuclear palsy when compared with controls in the pallidum, midbrain, dentate nucleus of the cerebellum, thalamus, caudate nucleus, and frontal regions. Signal in the cerebellar dentate and pallidum were also greater in progressive supranuclear palsy when compared with Alzheimer's dementia. Conversely, the [(18) F]AV-1451 signal across the cortex was higher in Alzheimer's dementia when compared with progressive supranuclear palsy. The [(18) F]AV-1451 signal in a number of regions correlated with the progressive supranuclear palsy rating scale. Progressive supranuclear palsy is associated with an elevated [(18) F]AV-1451 signal in a characteristic and distinct regional pattern that correlates with disease severity and differs from the patterns observed in Alzheimer's dementia. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  17. Neuroevolutional Approach to Cerebral Palsy and Speech.

    Science.gov (United States)

    Mysak, Edward D.

    Intended for cerebral palsy specialists, the book emphasizes the contribution that a neuroevolutional approach to therapy can make to habilitation goals of the child with cerebral palsy and applies the basic principles of the Bobath approach to therapy. The first section discusses cerebral palsy as a reflection of disturbed neuro-ontogenisis and…

  18. Facial Nerve Palsy In Secondary Syphilis

    Directory of Open Access Journals (Sweden)

    Masuria B.L

    1999-01-01

    Full Text Available A case of secondary syphilis with right facial nerve palsy is reported. A 28 year old unmarried male presented with diffuse maculopapular rash and facial nerve palsy. He had elevated while cells and protein in cerebrospinal fluid. Serum and cerebrospinal fluid were positive for VDRL and TPHA tests. Facial nerve palsy and maculopapular rash improved with penicillin therapy.

  19. Genetics Home Reference: progressive supranuclear palsy

    Science.gov (United States)

    ... affected individuals also experience changes in personality and behavior, such as a general loss of interest and ... supranuclear palsy MalaCards: supranuclear palsy, progressive Merck Manual Consumer ... X, Wiederholt W, Hansen L, Masliah E, Thal LJ, Katzman R, Xia Y, Saitoh T. Genetic evidence for the involvement of tau in progressive supranuclear palsy. Ann Neurol. ...

  20. Neuroevolutional Approach to Cerebral Palsy and Speech.

    Science.gov (United States)

    Mysak, Edward D.

    Intended for cerebral palsy specialists, the book emphasizes the contribution that a neuroevolutional approach to therapy can make to habilitation goals of the child with cerebral palsy and applies the basic principles of the Bobath approach to therapy. The first section discusses cerebral palsy as a reflection of disturbed neuro-ontogenisis and…

  1. Primary and secondary tethered cord syndrome. MRT diagnosis and comparison with operative findings in 40 patients. Das primaere und sekundaere Tethered Cord Syndrom. Kernspintomographische Diagnostik und Vergleich mit operativen Befunden bei 40 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Reichel, M.; Hamm, B.; Wolf, K.J. (Radiologische Klinik, Abt. fuer Radiologische Diagnostik und Nuklearmedizin, Freie Univ. Berlin (Germany)); Weigel, K. (Neurochirurgische Klinik, Universitaets-Klinikum Steglitz, Freie Univ. Berlin (Germany))

    1992-08-01

    The MRT findings in 40 patients with the tethered cord syndrome (TCS) have been compared with the operative findings. In cases of primary TCS (17 patients), MRT showed a low conus medullaris in 15 cases and this was confirmed surgically in 14. Other abnormal findings were lipomas (MRT 12/operatively 13), diastematomyelia (MRT 2/operatively 2) and thickened filum terminale (MRT 6/operatively 3). In secondary TCS (23 patients) postoperatively adhesions were prominent (MRT 16/operatively 23) while low position of the conus was found by MRT in 19 and surgically in 18 patients. Other findings were lipomas (MRT 5/operatively 6), epidermoids (MRT 2/operatively 2) and diastematomyelia (MRT 2/operatively 0). Agreement between MRT and operative findings regarding fixation of the spinal cord is closer in primary TCS (15/17, 88%) than in secondary TCS (16/23, 69%). (orig.).

  2. Role of Kabat physical rehabilitation in Bell's palsy: a randomized trial.

    Science.gov (United States)

    Barbara, Maurizio; Antonini, Giovanni; Vestri, Annarita; Volpini, Luigi; Monini, Simonetta

    2010-01-01

    When applied at an early stage, Kabat's rehabilitation was shown to provide a better and faster recovery rate in comparison with non-rehabilitated patients. To assess the validity of an early rehabilitative approach to Bell's palsy patients. A randomized study involved 20 consecutive patients (10 males, 10 females; aged 35-42 years) affected by Bell's palsy, classified according to the House-Brackmann (HB) grading system and grouped on the basis of undergoing or not early physical rehabilitation according to Kabat, i.e. a proprioceptive neuromuscular rehabilitation. The evaluation was carried out by measuring the amplitude of the compound motor action potential (CMAP), as well as by observing the initial and final HB grade, at days 4, 7 and 15 after onset of facial palsy. Patients belonging to the rehabilitation group clearly showed an overall improvement of clinical stage at the planned final observation, i.e. 15 days after onset of facial palsy, without presenting greater values of CMAP.

  3. Unrelated umbilical cord blood transplant for adult acute lymphoblastic leukemia in first and second complete remission: a comparison with allografts from adult unrelated donors

    Science.gov (United States)

    Marks, David I.; Woo, Kwang Ahn; Zhong, Xiaobo; Appelbaum, Frederick R.; Bachanova, Veronika; Barker, Juliet N.; Brunstein, Claudio G.; Gibson, John; Kebriaei, Partow; Lazarus, Hillard M.; Olsson, Richard; Perales, Miguel-Angel; Pidala, Joseph; Savani, Bipin; Rocha, Vanderson; Eapen, Mary

    2014-01-01

    Allogeneic hematopoietic cell transplantation has an established role in the treatment of adults with acute lymphoblastic leukemia whose survival when recipients of grafts from adult unrelated donors approaches that of recipients of grafts from sibling donors. Our aim was to determine the role of mismatched unrelated cord blood grafts in transplantation for 802 adults with acute lymphoblastic leukemia in first or second complete remission. Using Cox regression we compared outcomes after 116 mismatched single or double cord blood transplants, 546 peripheral blood progenitor cell transplants and 140 bone marrow transplants. The characteristics of the recipients and their diseases were similar except cord blood recipients were younger, more likely to be non-Caucasians and more likely to have a low white blood cell count at diagnosis. There were differences in donor-recipient human leukocyte antigen-match depending on the source of the graft. Most adult donor transplants were matched at the allele-level considering human leukocyte antigens-A, -B, -C and –DRB1. In contrast, most cord blood transplants were mismatched and considered antigen-level matching; 57% were mismatched at two loci and 29% at one locus whereas only 29% of adult donor transplants were mismatched at one locus and none at two loci. There were no differences in the 3-year probabilities of survival between recipients of cord blood (44%), matched adult donor (44%) and mismatched adult donor (43%) transplants. Cord blood transplants engrafted slower and were associated with less grade 2–4 acute but similar chronic graft-versus-host disease, relapse, and transplant-related mortality. The survival of cord blood graft recipients was similar to that of recipients of matched or mismatched unrelated adult donor grafts and so cord blood should be considered a valid alternative source of stem cells for adults with acute lymphoblastic leukemia in the absence of a matched unrelated adult donor. PMID:24056817

  4. Restoration of elbow extension after primary reconstruction in obstetric brachial plexus palsy.

    Science.gov (United States)

    Terzis, Julia K; Kokkalis, Zinon T

    2010-03-01

    Elbow extension is important for the elbow joint, and it is more difficult to restore with microsurgery than elbow flexion. The purpose of this article is to describe the experience of the authors with elbow extension reconstruction in obstetric brachial plexus palsy patients. The outcomes were analyzed in relation to the type of brachial plexus lesion, timing of surgery, and the type of nerve reconstruction. Fifty-five children with obstetric brachial plexus palsy who underwent nerve reconstruction for elbow extension restoration were studied. The mean follow-up period was 6.4 years (range, 2-22 y). Reinnervation of the triceps muscle was accomplished with indirect neurotization of the posterior cord from intraplexus donors or with direct neurotization from extraplexus donors, such as the contralateral C7 and the intercostal nerves. Thirty-seven (67%) of the 55 cases showed good or excellent results (>or=M3+). The average postoperative muscle grading for the triceps was 3.34+/-0.99 compared with 1.19+/-1.29 preoperatively (P<0.0001). Patients with C5 to C7 palsy achieved significantly stronger elbow extension than those with C5 to T1 palsy. In addition, the timing of surgery significantly influenced the final outcome. Elbow extension is one of big challenges to be restored, especially in obstetric brachial plexus palsy. In early cases (within 6 mo) intraplexus reconstruction of the posterior cord can give excellent results. In later cases, or in cases of multiple avulsions, extraplexus motor donors, which selectively targeted the triceps, can give variable results.

  5. Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients.

    Science.gov (United States)

    Neyroud, Daria; Armand, Stéphane; De Coulon, Geraldo; Sarah R Dias Da Silva; Maffiuletti, Nicola A; Kayser, Bengt; Place, Nicolas

    2017-02-01

    Patients with cerebral palsy develop an important muscle weakness which might affect the aetiology and extent of exercise-induced neuromuscular fatigue. This study evaluated the aetiology and extent of plantar flexor neuromuscular fatigue in patients with cerebral palsy. Ten patients with cerebral palsy and 10 age- and sex-matched healthy individuals (∼20 years old, 6 females) performed four 30-s maximal isometric plantar flexions interspaced by a resting period of 2-3s to elicit a resting twitch. Maximal voluntary contraction force, voluntary activation level and peak twitch were quantified before and immediately after the fatiguing task. Before fatigue, patients with cerebral palsy were weaker than healthy individuals (341±134N vs. 858±151N, pcerebral palsy following the fatiguing task (-10±23%, p>0.05), whereas it decreased by 30±12% (pcerebral palsy were weaker than their healthy peers but showed greater fatigue resistance. Cerebral palsy is a widely defined pathology that is known to result in muscle weakness. The extent and origin of muscle weakness were the topic of several previous investigations; however some discrepant results were reported in the literature regarding how it might affect the development of exercise-induced neuromuscular fatigue. Importantly, most of the studies interested in the assessment of fatigue in patients with cerebral palsy did so with general questionnaires and reported increased levels of fatigue. Yet, exercise-induced neuromuscular fatigue was quantified in just a few studies and it was found that young patients with cerebral palsy might be more fatigue resistant that their peers. Thus, it appears that (i) conflicting results exist regarding objectively-evaluated fatigue in patients with cerebral palsy and (ii) the mechanisms underlying this muscle fatigue - in comparison to those of healthy peers - remain poorly understood. The present study adds important knowledge to the field as it shows that when young adults with

  6. Gross motor function in children with spastic cerebral palsy and cerebral visual impairment: A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI)

    NARCIS (Netherlands)

    Salavati, M.; Rameckers, E.A.A.; Waninge, A.; Krijnen, W.P.; Steenbergen, B.; Schans, C.P. van der

    2017-01-01

    Purpose: To investigate whether the adapted version of the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result

  7. Gross motor function in children with spastic Cerebral Palsy and Cerebral Visual Impairment : A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI)

    NARCIS (Netherlands)

    Salavati, M.; Rameckers, E. A. A.; Waninge, A.; Krijnen, W. P.; Steenbergen, B.; van der Schans, C. P.

    2017-01-01

    Purpose: To investigate whether the adapted version of the Gross Motor Function Measure 88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result

  8. Gross motor function in children with spastic cerebral palsy and cerebral visual impairment: A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI)

    NARCIS (Netherlands)

    Salavati, M.; Rameckers, E.A.A.; Waninge, A.; Krijnen, W.P.; Steenbergen, B.; Schans, C.P. van der

    2017-01-01

    Purpose: To investigate whether the adapted version of the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result

  9. Cerebral palsy update.

    Science.gov (United States)

    Krägeloh-Mann, Ingeborg; Cans, Christine

    2009-08-01

    A common language on CP has been developed for the European registers by the SCPE (Surveillance of Cerebral Palsy in Europe) working group and the common database allows prevalence analyses on a larger basis. CP prevalence increases with lower birthweight and higher immaturity. Increase of survival after preterm birth has first also increased CP rates. But already in the 80s this trend was reversed for LBW infants, and in the 90 s also for VLBW or very immature infants. The outcome with respect to CP in the group of extremely LBW or immature infants remains a matter of specific concern, as prevalence seems to be rather stable on a high level. CP is caused in more than 80% by brain lesions or maldevelopments which can be attributed to different timing periods of the developing brain. Extent and topography determine the clinical subtype of CP and are related also to the presence and severity of associated disabilities. CP, thus, offers a model to study plasticity of the developing brain. Reorganisation following unilateral lesions is mainly interhemispheric and homotopic. In the motor system, it involves the recruitment of ipsilateral tracts; functionality seems to be limited and decreases already towards the end of gestation. There is no clear evidence for substantial reorganisation in the sensory system. The best compensatory potential is described concerning language function following left hemispheric lesions. Language function reorganized to the right hemisphere eventually seems not to be impaired, this occurs, however, on the expense of primary right hemispheric functions.

  10. [Advances in genetic research of cerebral palsy].

    Science.gov (United States)

    Wang, Fang-Fang; Luo, Rong; Qu, Yi; Mu, De-Zhi

    2017-09-01

    Cerebral palsy is a group of syndromes caused by non-progressive brain injury in the fetus or infant and can cause disabilities in childhood. Etiology of cerebral palsy has always been a hot topic for clinical scientists. More and more studies have shown that genetic factors are closely associated with the development of cerebral palsy. With the development and application of various molecular and biological techniques such as chromosome microarray analysis, genome-wide association study, and whole exome sequencing, new achievements have been made in the genetic research of cerebral palsy. Chromosome abnormalities, copy number variations, susceptibility genes, and single gene mutation associated with the development of cerebral palsy have been identified, which provides new opportunities for the research on the pathogenesis of cerebral palsy. This article reviews the advances in the genetic research on cerebral palsy in recent years.

  11. Lifetime costs of cerebral palsy

    DEFF Research Database (Denmark)

    Kruse, Marie; Michelsen, Susan Ishøy; Flachs, Esben Meulengracht

    2009-01-01

    This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs....... The population analyzed was retrieved from the Danish Cerebral Palsy Register, which covers the eastern part of the country and has registered about half of the Danish population of individuals with CP since 1950. For this study we analyzed 2367 individuals with CP, who were born in 1930 to 2000 and were alive...

  12. Hepatic myelopathy Morphology of the thoracic and lumbar cord in liver cirrhosis and non-cirrhosis corpses and comparison of neuron functional protein

    Institute of Scientific and Technical Information of China (English)

    Yu Lei; Zhen Liu; Huilong Huang; Suiliang Zhang; Yunheng Zhou; Shuai Wu; Xiaojun Hou; Jie Gong; Aiqun Wu

    2011-01-01

    The current study demonstrated that injury of the spinal cord lateral funiculus occurs in liver cirrhosis. This study sought to compare the morphology of the thoracic and lumbar cord, the expression of functional proteins, and changes in vessels between liver cirrhosis and non-cirrhosis corpses. Results showed that in the liver cirrhosis group, the hepatic vein expanded, the gastrointestinal tract was full of coagulated blood, blood-stasis was easily seen in the veniplex of the vertebral canal and the lumbar spinal cord, and the cell bodies of the anterior horn in the thoracic and lumbar cord were smaller than those in non-cirrhosis corpses. In addition, nerve cells shrank, Nissl bodies were concentrated with obscured nuclei, and neurofilament and synapsin containing cell bodies of the anterior horn and white matter decreased in the liver cirrhosis group. These experimental findings indicate that abnormal circulation of the spinal cord, resulting from hemodynamic change of cirrhotic portal hypertension, may be the most significant cause of hepatic myelopathy.

  13. [Palsy of the upper limb: Obstetrical brachial plexus palsy, arthrogryposis, cerebral palsy].

    Science.gov (United States)

    Salazard, B; Philandrianos, C; Tekpa, B

    2016-10-01

    "Palsy of the upper limb" in children includes various diseases which leads to hypomobility of the member: cerebral palsy, arthrogryposis and obstetrical brachial plexus palsy. These pathologies which differ on brain damage or not, have the same consequences due to the early achievement: negligence, stiffness and deformities. Regular entire clinical examination of the member, an assessment of needs in daily life, knowledge of the social and family environment, are key points for management. In these pathologies, the rehabilitation is an emergency, which began at birth and intensively. Splints and physiotherapy are part of the treatment. Surgery may have a functional goal, hygienic or aesthetic in different situations. The main goals of surgery are to treat: joints stiffness, bones deformities, muscles contractures and spasticity, paresis, ligamentous laxity. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Ocular defects in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Katoch Sabita

    2007-01-01

    Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.

  15. Embodying Investigations of Cerebral Palsy

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke

    The main question of Kristian Martiny’s dissertation is: how do we help persons living with the brain damage, cerebral palsy (CP)? This question is as complex and difficult to answer as any healthcare question. Martiny argues that we need to ‘open up’ how we do ( cognitive ) science in order...

  16. Antiviral treatment for Bell's palsy (idiopathic facial paralysis

    Directory of Open Access Journals (Sweden)

    Ildiko Gagyor

    Full Text Available ABSTRACTBACKGROUND: Corticosteroids are widely used in the treatment of idiopathic facial paralysis (Bell's palsy, but the effectiveness of additional treatment with an antiviral agent is uncertain. Significant morbidity can be associated with severe cases of Bell's palsy.OBJECTIVES: To assess the effects of antiviral treatments alone or in combination with any other therapy for Bell's palsy.METHODS:Search methods:On 7 October 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, DARE, NHS EED, and HTA. We also reviewed the bibliographies of the identified trials and contacted trial authors and known experts in the field and relevant drug companies to identify additional published or unpublished data. We searched clinical trials registries for ongoing studies.Selection criteria:We considered randomised controlled trials or quasi-randomised controlled trials of antivirals with and without corticosteroids versus control therapies for the treatment of Bell's palsy.We excluded trials that had a high risk of bias in several domains.Data collection and analysis:Pairs of authors independently assessed trials for relevance, eligibility, and risk of bias, using standard Cochrane procedures.MAIN RESULTS: Eleven trials, including 2883 participants, met the inclusion criteria and are included in the final analysis. We added four studies to the previous review for this update. Some of the trials were small, and a number were at high or unclear risk of bias. Other trials did not meet current best standards in allocation concealment and blinding. Incomplete recovery:We found no significant benefit from adding antivirals to corticosteroids in comparison with corticosteroids alone for people with Bell's palsy (risk ratio (RR 0.69, 95% confidence interval (CI 0.47 to 1.02, n = 1715. For people with severe Bell's palsy (House Brackmann scores of 5 and 6 or the equivalent in other scales, we found a

  17. Tethered Spinal Cord Syndrome

    Science.gov (United States)

    ... roots may be cut to relieve pain. In adults, surgery to free (detether) the spinal cord can reduce the size ... is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord ...

  18. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  19. Comparison of Heart Rate Response to Tennis Activity between Persons with and without Spinal Cord Injuries: Implications for a Training Threshold

    Science.gov (United States)

    Barfield, J. P.; Malone, Laurie A.; Coleman, Tristica A.

    2009-01-01

    The purpose of this study was to evaluate the ability of individuals with spinal cord injury (SCI) to reach a training threshold during on-court sport activity. Monitors collected heart rate (HR) data every 5 s for 11 wheelchair tennis players (WCT) with low paraplegia and 11 able-bodied controls matched on experience and skill level (ABT).…

  20. In-vivo spinal cord deformation in flexion

    Science.gov (United States)

    Yuan, Qing; Dougherty, Lawrence; Margulies, Susan S.

    1997-05-01

    Traumatic mechanical loading of the head-neck complex results cervical spinal cord injury when the distortion of the cord is sufficient to produce functional or structural failure of the cord's neural and/or vascular components. Characterizing cervical spinal cord deformation during physiological loading conditions is an important step to defining a comprehensive injury threshold associated with acute spinal cord injury. In this study, in vivo quasi- static deformation of the cervical spinal cord during flexion of the neck in human volunteers was measured using magnetic resonance (MR) imaging of motion with spatial modulation of magnetization (SPAMM). A custom-designed device was built to guide the motion of the neck and enhance more reproducibility. the SPAMM pulse sequence labeled the tissue with a series of parallel tagging lines. A single- shot gradient-recalled-echo sequence was used to acquire the mid-sagittal image of the cervical spine. A comparison of the tagged line pattern in each MR reference and deformed image pair revealed the distortion of the spinal cord. The results showed the cervical spinal cord elongates during head flexion. The elongation experienced by the spinal cord varies linearly with head flexion, with the posterior surface of the cord stretching more than the anterior surface. The maximal elongation of the cord is about 12 percent of its original length.

  1. Spinal Cord Injuries

    Science.gov (United States)

    ... your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... bone disks that make up your spine. Most injuries don't cut through your spinal cord. Instead, ...

  2. Intrathecal baclofen withdrawal resembling serotonin syndrome in an adolescent boy with cerebral palsy.

    Science.gov (United States)

    Salazar, Maria L; Eiland, Lea S

    2008-10-01

    Intrathecal baclofen (ITB) is increasingly being used to reduce spasticity among children with cerebral palsy, dystonia, and spinal cord injuries. However, complications such as withdrawal, which is a potentially life-threatening condition, can occur. Intrathecal baclofen withdrawal should be differentiated with autonomic dysreflexia, malignant hyperthermia, neuroleptic malignant syndrome, and serotonin syndrome. We report a case of ITB withdrawal secondary to low residual volume in the pump reservoir and resembling serotonin syndrome in an adolescent with cerebral palsy. He presented with agitation, diaphoresis, increasing spasticity, rigidity, jitteriness, hyperreflexia, clonus, tachycardia, hypertension, and rhabdomyolysis. Treatment consisted of emergent refilling of the pump, intravenous diazepam, and oral cyproheptadine. We also emphasize the importance of prompt recognition of ITB withdrawal among high-risk patients.

  3. Bell Palsy and Acupuncture Treatment

    Directory of Open Access Journals (Sweden)

    Betul Battaloglu Ižnanc

    2013-08-01

    A 22-year-old female patient, a midwifery student, had treatment with corticosteroid and antiviral agents as soon as Bell Palsy (BP was diagnosed (House-Breckman stage 6. Six weeks later, patient didn’t recover, while in House-Breckman stage 3, acupuncture was perfomed and local and distal acupoints were used with ears, body and face. Ear acupuncture point was used two times with detection. In the course of six sessions body and face points were stimulated by electroacupuncture. After ten acupuncture treatments, the subjective symptoms and the facial motion on the affected side improved. There was an spotting ecchymosis the ST2 points on. The symmetry of the face is a determinant of facial charm and influences interpersonal attraction for adults, children and pregnant women. Medical options for the sequelae of BP are limited. Acupuncture’s effectively in Bell palsy patients’ should be shown with more clinical and electrophysiological studies.

  4. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  5. In vivo differentiation of human amniotic epithelial cells into cardiomyocyte-like cells and cell transplantation effect on myocardial infarction in rats: comparison with cord blood and adipose tissue-derived mesenchymal stem cells.

    Science.gov (United States)

    Fang, Cheng-Hu; Jin, Jiyong; Joe, Jun-Ho; Song, Yi-Sun; So, Byung-Im; Lim, Sang Moo; Cheon, Gi Jeong; Woo, Sang-Keun; Ra, Jeong-Chan; Lee, Young-Yiul; Kim, Kyung-Soo

    2012-01-01

    Human amniotic epithelial cells (h-AECs), which have various merits as a cell source for cell therapy, are known to differentiate into cardiomyocytes in vitro. However, the ability of h-AECs to differentiate into cardiomyocytes in vivo and their cell transplantation effects on myocardial infarction are still unknown. In this study, we assessed whether h-AECs could differentiate into cardiomyocytes in vivo and whether h-AECs transplantation can decrease infarct size and improve cardiac function, in comparison to transplantation of cord blood-derived mesenchymal stem cells (MSCs) or adipose tissue-derived MSCs. For our study, we injected h-AECs, cord blood-derived MSCs, adipose tissue-derived MSCs, and saline into areas of myocardial infarction in athymic nude rats. After 4 weeks, 3% of the surviving h-AECs expressed myosin heavy chain, a marker specific to the myocardium. Compared with the saline group, all cell-implanted groups showed a higher ejection fraction, lower infarct area by positron emission tomography and histology, and more abundant myocardial gene and protein expression in the infarct area. We showed that h-AECs can differentiate into cardiomyocyte-like cells, decrease infarct size, and improve cardiac function in vivo. The beneficial effects of h-AECs were comparable to those of cord blood and adipose tissue-derived MSCs. These results support the need for further studies of h-AECs as a cell source for myocardial regeneration due to their plentiful availability, low immunity, and lack of ethical issues related to their use.

  6. Peripheral facial weakness (Bell's palsy).

    Science.gov (United States)

    Basić-Kes, Vanja; Dobrota, Vesna Dermanović; Cesarik, Marijan; Matovina, Lucija Zadro; Madzar, Zrinko; Zavoreo, Iris; Demarin, Vida

    2013-06-01

    Peripheral facial weakness is a facial nerve damage that results in muscle weakness on one side of the face. It may be idiopathic (Bell's palsy) or may have a detectable cause. Almost 80% of peripheral facial weakness cases are primary and the rest of them are secondary. The most frequent causes of secondary peripheral facial weakness are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immune disorders, drugs, degenerative diseases of the central nervous system, etc. The diagnosis relies upon the presence of typical signs and symptoms, blood chemistry tests, cerebrospinal fluid investigations, nerve conduction studies and neuroimaging methods (cerebral MRI, x-ray of the skull and mastoid). Treatment of secondary peripheral facial weakness is based on therapy for the underlying disorder, unlike the treatment of Bell's palsy that is controversial due to the lack of large, randomized, controlled, prospective studies. There are some indications that steroids or antiviral agents are beneficial but there are also studies that show no beneficial effect. Additional treatments include eye protection, physiotherapy, acupuncture, botulinum toxin, or surgery. Bell's palsy has a benign prognosis with complete recovery in about 80% of patients, 15% experience some mode of permanent nerve damage and severe consequences remain in 5% of patients.

  7. Common questions about Bell palsy.

    Science.gov (United States)

    Albers, Janet R; Tamang, Stephen

    2014-02-01

    Bell palsy is an acute affliction of the facial nerve, resulting in sudden paralysis or weakness of the muscles on one side of the face. Testing patients with unilateral facial paralysis for diabetes mellitus or Lyme disease is not routinely recommended. Patients with Lyme disease typically present with additional manifestations, such as arthritis, rash, or facial swelling. Diabetes may be a comorbidity of Bell palsy, but testing is not needed in the absence of other indications, such as hypertension. In patients with atypical symptoms, magnetic resonance imaging with contrast enhancement can be used to rule out cranial mass effect and to add prognostic value. Steroids improve resolution of symptoms in patients with Bell palsy and remain the preferred treatment. Antiviral agents have a limited role, and may improve outcomes when combined with steroids in patients with severe symptoms. When facial paralysis is prolonged, surgery may be indicated to prevent ocular desiccation secondary to incomplete eyelid closure. Facial nerve decompression is rarely indicated or performed. Physical therapy modalities, including electrostimulation, exercise, and massage, are neither beneficial nor harmful.

  8. [Assessment of motor and sensory pathways of the brain using diffusion-tensor tractography in children with cerebral palsy].

    Science.gov (United States)

    Memedyarov, A M; Namazova-Baranova, L S; Ermolina, Y V; Anikin, A V; Maslova, O I; Karkashadze, M Z; Klochkova, O A

    2014-01-01

    Diffusion tensor tractography--a new method of magnetic resonance imaging, that allows to visualize the pathways of the brain and to study their structural-functional state. The authors investigated the changes in motor and sensory pathways of brain in children with cerebral palsy using routine magnetic resonance imaging and diffusion-tensor tractography. The main group consisted of 26 patients with various forms of cerebral palsy and the comparison group was 25 people with normal psychomotor development (aged 2 to 6 years) and MR-picture of the brain. Magnetic resonance imaging was performed on the scanner with the induction of a magnetic field of 1,5 Tesla. Coefficients of fractional anisotropy and average diffusion coefficient estimated in regions of the brain containing the motor and sensory pathways: precentral gyrus, posterior limb of the internal capsule, thalamus, posterior thalamic radiation and corpus callosum. Statistically significant differences (p cerebral palsy in relation to the comparison group. All investigated regions, the coefficients of fractional anisotropy in children with cerebral palsy were significantly lower, and the average diffusion coefficient, respectively, higher. These changes indicate a lower degree of ordering of the white matter tracts associated with damage and subsequent development of gliosis of varying severity in children with cerebral palsy. It is shown that microstructural damage localized in both motor and sensory tracts that plays a leading role in the development of the clinical picture of cerebral palsy.

  9. Mobility Experiences of Adolescents with Cerebral Palsy

    Science.gov (United States)

    Palisano, Robert J.; Shimmell, Lorie J.; Stewart, Debra; Lawless, John J.; Rosenbaum, Peter L.; Russell, Dianne J.

    2009-01-01

    The purpose of this study was to describe how youth with cerebral palsy experience mobility in their daily lives using a phenomenological approach. The participants were 10 youth with cerebral palsy, 17 to 20 years of age, selected using purposeful sampling with maximum variation strategies. A total of 14 interviews were completed. Transcripts…

  10. Mobility Experiences of Adolescents with Cerebral Palsy

    Science.gov (United States)

    Palisano, Robert J.; Shimmell, Lorie J.; Stewart, Debra; Lawless, John J.; Rosenbaum, Peter L.; Russell, Dianne J.

    2009-01-01

    The purpose of this study was to describe how youth with cerebral palsy experience mobility in their daily lives using a phenomenological approach. The participants were 10 youth with cerebral palsy, 17 to 20 years of age, selected using purposeful sampling with maximum variation strategies. A total of 14 interviews were completed. Transcripts…

  11. Clinical practice guideline: Bell's Palsy executive summary.

    Science.gov (United States)

    Baugh, Reginald F; Basura, Gregory J; Ishii, Lisa E; Schwartz, Seth R; Drumheller, Caitlin Murray; Burkholder, Rebecca; Deckard, Nathan A; Dawson, Cindy; Driscoll, Colin; Gillespie, M Boyd; Gurgel, Richard K; Halperin, John; Khalid, Ayesha N; Kumar, Kaparaboyna Ashok; Micco, Alan; Munsell, Debra; Rosenbaum, Steven; Vaughan, William

    2013-11-01

    The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the new Clinical Practice Guideline: Bell's Palsy. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations developed encourage accurate and efficient diagnosis and treatment and, when applicable, facilitate patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell's palsy. There are myriad treatment options for Bell's palsy; some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, there are numerous diagnostic tests available that are used in the evaluation of patients with Bell's palsy. Many of these tests are of questionable benefit in Bell's palsy. Furthermore, while patients with Bell's palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell's palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have an unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell's palsy.

  12. Facial electroneurography in Bell's palsy: variability in the early stage and comparison between interpretation methods Eletroneurografia do nervo facial na paralisia de Bell: variabilidade na fase aguda e comparação entre técnicas

    Directory of Open Access Journals (Sweden)

    Jovany Luis Alves de Medeiros

    1996-09-01

    Full Text Available To determine the variability of the abnormalities found in the electroneurography (ENG of the facial nerve in cases of Bell's palsy during the initial two week period was one of the objectives of the authors. A second one was to investigate the value of ENG as a tool to determine an early prognosis of recovery utilizing two different methods. In the first one the amplitude of the compound muscular action potential (CMAP obtained on the paralyzed side was compared to this potential on the opposite (normal side. The second method compared the CMAP on the paralyzed side to normal standardized data from normal individuals. A group of 33 patients with Bell's palsy was followed until total recovery or for at least 4 months, if the recovery was not achieved earlier. It was observed that amplitude of the CMAP become stable towards the sixth day of palsy and this is a good time to establish the prognosis. Another conclusion is that both methods were equivalent to determine the prognosis in Bell's palsy.O objetivo deste trabalho é determinar a variabilidade da eletroneurografia (ENG do nervo facial na paralisia de Bell durante as primeiras duas semanas e investigar o valor da ENG na determinação de um prognóstico precoce utilizando-se dois métodos diferentes. O primeiro método compara a amplitude do potencial de ação muscular composto obtido no lado paralisado com o lado normal e o segundo método compara o potencial de ação muscular composto obtido no lado paralisado com valores normativos. Um grupo de 33 pacientes com paralisia de Bell foi seguido até a recuperação total ou pelo menos por quatro meses nos casos em que não houve recuperação. Observou-se que a amplitude do potencial de ação muscular composto estabiliza-se em torno do sexto dia e que este é um bom momento para se realizar o exame e se estabelecer um prognóstico. Outra conclusão é que ambos os métodos são equivalentes para determinação prognóstica.

  13. Using image processing technology and mathematical algorithm in the automatic selection of vocal cord opening and closing images from the larynx endoscopy video.

    Science.gov (United States)

    Kuo, Chung-Feng Jeffrey; Chu, Yueng-Hsiang; Wang, Po-Chun; Lai, Chun-Yu; Chu, Wen-Lin; Leu, Yi-Shing; Wang, Hsing-Won

    2013-12-01

    The human larynx is an important organ for voice production and respiratory mechanisms. The vocal cord is approximated for voice production and open for breathing. The videolaryngoscope is widely used for vocal cord examination. At present, physicians usually diagnose vocal cord diseases by manually selecting the image of the vocal cord opening to the largest extent (abduction), thus maximally exposing the vocal cord lesion. On the other hand, the severity of diseases such as vocal palsy, atrophic vocal cord is largely dependent on the vocal cord closing to the smallest extent (adduction). Therefore, diseases can be assessed by the image of the vocal cord opening to the largest extent, and the seriousness of breathy voice is closely correlated to the gap between vocal cords when closing to the smallest extent. The aim of the study was to design an automatic vocal cord image selection system to improve the conventional selection process by physicians and enhance diagnosis efficiency. Also, due to the unwanted fuzzy images resulting from examination process caused by human factors as well as the non-vocal cord images, texture analysis is added in this study to measure image entropy to establish a screening and elimination system to effectively enhance the accuracy of selecting the image of the vocal cord closing to the smallest extent.

  14. Umbilical cord and preeclampsia.

    Science.gov (United States)

    Olaya-C, M; Salcedo-Betancourt, J; Galvis, S H; Ortiz, A M; Gutierrez, S; Bernal, J E

    2016-01-01

    Preeclampsia is associated with abnormalities in the umbilical cord in several ways: morphological, biochemical and functional. Alteration in blood vessels of the placenta, decidua and circulatory system of the fetus might be related to factors that cause preeclampsia and may be associated with alterations of the umbilical cord. This study aimed to analyze the relationship between each type of umbilical cord abnormality and the different subtypes of hypertensive gestational disorders. We conducted a prospective study on consecutive autopsies and its placentas, looking for abnormalities in the umbilical cord's features and their clinical associations. Umbilical cord abnormalities including length, diameter, insertion, entanglements, knots and coils were associated with maternal gestational hypertension. In women with gestational hypertension, umbilical cord abnormalities are associated with fetal and neonatal consequences.

  15. Manifestations of undifferetiated connective tissue dysplasia in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    V. A. Tupikov

    2013-01-01

    Full Text Available Objective - to reveal the phenotypic features of undifferentiated connective tissue dysplasia in the form of dysplastic syndrome. Material and methods. The study included 477 children (240 boys and 237 girls with cerebral palsy (CP aged from 1 year to 17. The control group consisted of 134 healthy children (70 boys and 64 girls aged from 2 to 16. For verification of undifferentiated connective tissue dysplasia international phenotypic Glesby scale, Abakumova scale and Kadurina and Gorbunova scale were applied. Results. Depending on used criteria, the clinical signs of dysplastic syndrome were found in 77,3-80,9% of children with cerebral palsy compared with 14,2-15,7% in the control group. There were statistically highly significant (p <0,001 difference in the number of markers and the severity of the dysplastic syndrome in children with cerebral palsy compared with healthy children and children with double hemiplegia in comparison with other forms of cerebral palsy. It was concluded that the CP should be seen as a manifestation of systemic organ dysplasia (dysplastic syndrome. This should be considered during the examination, choosing the tactics of conservative treatment with the principle of "control ripening," The timing and methods of surgical repair of motor disorders in children with cerebral palsy.

  16. Prognostic study of acute cervical cord injury by plain and enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Eiji; Shiba, Keiichiro; Ueda, Takayoshi [Spinal Injuries Center, Iizuka, Fukuoka (Japan)] [and others

    1995-09-01

    Ninety-six patients with cervical cord injury underwent MR imaging 10 days (early phase) and 2 weeks after injury to predict the pathophysiology of injury at 2 weeks. The subjects were divided into the following 3 groups based on the findings of T2-weighted images at the early phase: Group I, patients showing a low signal intensity area in the injured spinal cord; Group II, patients showing only a high intensity area; Group III, patients showing no changes in the signal intensity. The images taken at 2 weeks after injury were classified into the following 3 types: type R, images with a rim-enhanced site in the periphery of the injured spinal cord; type NR, images with no rim-enhanced site; type N, images with no enhanced area. Most of the Group I patients (more than 80%) had palsy, and all Group III patients had paresis. All type R patients had palsy, and all type N patients had paresis. The difference in the morphology of contrast site was useful in differentiating palsy and paresis in type NR cases in the Group II. Although it is possible to predict the pathophysiology of injury based on the findings of T2-weighted images taken at early phase, images taken at 2 weeks after injury provided more accurate prognosis. (S.Y.).

  17. Comparison of the Blood Level OF Leptin in Umbilical Cord of Newborns of Mothers With Gestational Diabetes and Normal Mothers and Its Relationship With Growth Indices of Newborns

    Directory of Open Access Journals (Sweden)

    Aramesh

    2015-09-01

    Full Text Available Background Diabetes is defined as an abnormal increase in blood glucose levels and is the most common disease that can complicate pregnancy. Leptin, a hormone produced mainly in adipose tissue, plays an important role in preventing fat accumulation in tissues such as skeletal muscle and myocardium and can be used to evaluate changes in lipid levels effectively. Leptin cannot cross the placental barrier, and its level in the umbilical cord is of fetal origin. Objectives Due to the lack of similar studies in Ahvaz, we aimed to determine the relationship between umbilical blood levels of this hormone with growth indices of newborns with normal mothers and mothers with gestational diabetes mellitus (GDM. Materials and Methods After delivery and using the aseptic method, 5 mL of blood from the umbilical vein was taken immediately by staffs to separate serum and was then stored at −20°C. Serum level of leptin was measured using the Elisa method in two groups: “case” and “control.” All information collected in the questionnaires was analyzed using SPSS-19 software as well as other statistical methods. Results Serum leptin levels in the cord blood of mothers with GDM were significantly higher than in normal mothers. There was a significant relationship between serum leptin levels and birth weight in infants with diabetic mothers. In this study, no significant correlation was observed between cord leptin levels and other growth indices. Conclusions Changes in neonatal leptin levels can reflect changes in the body fat tissue and neonatal birth weight and could be effective in predicting weight gain in newborns with mothers who have gestational diabetes and may reduce birth trauma or future complications.

  18. Parental Stress and Related Factors in Parents of Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Hui-Yi Wang

    2004-07-01

    Full Text Available Children with cerebral palsy display prominent motor dysfunction associated with other developmental disorders. Parenting a child with cerebral palsy presents a number of challenges and stresses. The first purpose of this study was to compare parental stress in parents of children with cerebral palsy to that in parents of children with typical development. The second purpose was to analyze the correlations between parental stress and parents' characteristics, the child's characteristics, the child's earliest age when rehabilitation was first commenced, and weekly frequency of rehabilitation for the child. A convenience sample of 63 parents of children with cerebral palsy (mean age of children, 4.3 ± 1.8 years was recruited. Forty parents of children with typical development were recruited as a comparison group. All parents filled out the Chinese version of the Parenting Stress Index (PSI, which consists of child domain and parent domain scales. The scores reported by parents of children with cerebral palsy in the child domain, parent domain, and PSI total scale were significantly higher than those for parents in the comparison group. The child domain score was significantly correlated to the child's age and severity of motor disability. A significant correlation was also found between the parent domain score and the child's earliest age of commencing rehabilitation. The PSI total scale score was significantly associated with both the child's severity of motor disability and age of commencing rehabilitation. Clinical professionals should be concerned about parental stress in parents of children with cerebral palsy and provide resources to support such parents. We suggest some strategies to reduce parental stress by strengthening parents' child-care skills.

  19. FLEXIBLE FIBREOPTIC LARYNGOSCOPY VERSUS SIMPLE VOICE ASSESSMENT IN A ROUTINE CLINICAL SETTING TO PREDICT VOCAL CORD PARALYSIS AFTER THYROID SURGERY

    Directory of Open Access Journals (Sweden)

    BP Sah

    2014-06-01

    Full Text Available Backgrounds: Thyroid disease has a high prevalence in the general population, with a female predominance. Thyroidectomy is a very frequently performed surgical procedure for the treatment of benign and malignant nodules. The intricate and delicate anatomical structures for voice production lie in proximity to the thyroid gland and are vulnerable during operations on the thyroid. Aims and objectives: To find predictive value of vocal cord palsy as observed by simple voice assessment following thyroid surgery using flexible fibreoptic laryngoscopy as gold standard. Materials and Method: This was a prospective observational study. 42 diagnosed cases of thyroid swelling that were undergone different modalities of thyroidectomy from February 2009 to January 2010were enrolled in study. Age, sex, geographical distribution, vocal cord status and post operative voice changes at 5th and 30th days were recorded and analyzed. Results: Age range was 15 to 63 yrs. Female to male ratio was 5:1. Sensitivity, specificity, positive predictive value, negative predictive value of subjective and objective voice change to predict vocal cord palsy at 5 th postoperative day were 70% and 80%, 75% and 81.3%, 46.67% and 57.14%, 88.89% and 92.85% respectively, at 30 th postoperative day were 71.42% and 85.71%, 88. 57% and 85.71%, 55% and 54.54%, 93.93% and 96.77% respectively. Conclusions: Prediction of postoperative vocal cord palsy could not be done with simple voice assessment.

  20. Early Observations on Facial Palsy.

    Science.gov (United States)

    Pearce, J M S

    2015-01-01

    Before Charles Bell's eponymous account of facial palsy, physicians of the Graeco-Roman era had chronicled the condition. The later neglected accounts of the Persian physicians Abu al-Hasan Ali ibn Sahl Rabban al-Tabari and Abu Bakr Muhammad ibn Zakarīya Rāzi ("Rhazes") and Avicenna in the first millennium are presented here as major descriptive works preceding the later description by Stalpart van der Wiel in the seventeenth century and those of Friedreich and Bell at the end of the eighteenth and the beginning of the nineteenth centuries.

  1. Aerobic training in children with cerebral palsy.

    Science.gov (United States)

    Nsenga, A L; Shephard, R J; Ahmaidi, S; Ahmadi, S

    2013-06-01

    Rehabilitation is a major goal for children with cerebral palsy, although the potential to enhance cardio-respiratory fitness in such individuals remains unclear. This study thus compared current cardio-respiratory status between children with cerebral palsy and able-bodied children, and examined the ability to enhance the cardio-respiratory fitness of children with cerebral palsy by cycle ergometer training. 10 children with cerebral palsy (Gross Motor Function Classification System levels I and II) participated in thrice-weekly 30 min cycle ergometer training sessions for 8 weeks (mean age: 14.2±1.9 yrs). 10 additional subjects with cerebral palsy (mean age: 14.2±1.8 yrs) and 10 able-bodied subjects (mean age: 14.1±2.1 yrs) served as controls, undertaking no training. All subjects undertook a progressive cycle ergometer test of cardio-respiratory fitness at the beginning and end of the 8-week period. Cardio-respiratory parameters [oxygen intake V˙O2), ventilation V ˙ E) and heart rate (HR)] during testing were measured by Cosmed K4 b gas analyzer. The children with cerebral palsy who engaged in aerobic training improved their peak oxygen consumption, heart rate and ventilation significantly (pchildren with cerebral palsy can benefit significantly from cardio-respiratory training, and such training should be included in rehabilitation programs.

  2. Potential Mechanism for Some Post-operative C5 Palsies - an Anatomical Study.

    Science.gov (United States)

    Alonso, Fernando; Voin, Vlad; Iwanaga, Joe; Hanscom, David; Chapman, Jens R; Oskouian, Rod J; Loukas, Marios; Tubbs, R Shane

    2017-06-09

    Anatomical Study. Determine if shoulder depression (e.g., taping the shoulders) might result in C5 nerve traction and subsequent injury. Postoperative C5 nerve palsy is a recognized entity that is still often enigmatic. Inferior shoulder depression is usually employed to assist with surgical visualization during cervical spine procedures. In the supine position, ten adult fresh frozen human cadavers underwent dissection of the spinal cord and its adjacent dorsal, ventral roots and spinal nerves from C4 to T1. In the supine position, the head was rotated ipsilaterally, contralaterally and in lateral flexion. The shoulder was elevated, retracted, protracted and depressed all with direct observation of nerve roots, intradural ventral/dorsal rootlets, or the spinal cord. The effects of these movements upon the cervical nerve rootlets were measured. The greatest displacement of nervous tissue was generated by shoulder depression and occurred primarily at the intradural rootlet level. The nerve rootlets that underwent the greatest average displacement were found at C5, with a decreasing gradient to C7 and no gross motion at C8 or T1. With maximal shoulder depression, C5-C7 rootlet tension produced cord movement to the ipsilateral side, touching the dura mater covering the lateral vertebral column with the C5 nerve root moving farthest. Shoulder depression is often used during cervical spine surgery. In cadavers, shoulder depression causes significant tension and displacement of the C5 nerve rootlets, and in the extreme, cord displacement to the ipsilateral side. This could be a mechanism for injury, putting patients at greater risk for postoperative C5 palsy. 5.

  3. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

    OpenAIRE

    Saluja Paramveer; Manandhar Lochana; Agarwal Rishi; Grandhi Bala

    2011-01-01

    Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred...

  4. [How to deal with cerebral palsy in 21st century--a new epoch in clinic treatment].

    Science.gov (United States)

    Tian, Chun-Yu; Leng, Li-Ge; Tian, Zeng-Min

    2014-11-01

    The aims of this paper were to define (1) criteria of cerebral palsy; (2) classification of cerebral palsy; (3) etiology, neuroimaging, and epidemiology of cerebral palsy; (4) different kinds of treatments of cerebral palsy. Data were drawn from an international survey of PUBMED (1994-2014) and CNKI (1994-2014). An expert panel used a consensus building technique. The10-point Jadad scale was used to assess the quality of the trials based on the following items, including allocation sequence generation, randomization concealment, methods of blinding, and descriptions of withdrawals and dropouts. Our clinical experience was also summarized. Below is a summary. (1) Further work is warranted to reach agreement for the classification of cerebral palsy. (2) A worldwide prevalence of 1.5-4.0 per 1 000 live births, with an average lifetime cost of 1 million dollars per person in the United States, while it is 1.8-6.0 per 1000 live births in China. (3) Comparison of clinical efficacy of different treatments. In this review, the current advances in different kind of treatments of brain injury are discussed with specific relevance to cerebral palsy.

  5. Spinal Cord Diseases

    Science.gov (United States)

    ... damages the vertebrae or other parts of the spine, this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such as meningitis and polio Inflammatory diseases Autoimmune diseases Degenerative diseases such as amyotrophic lateral sclerosis and spinal ...

  6. Comparison of administration of single dose ceftriaxone for elective caesarean section before skin incision and after cord clamping in preventing post-operative infectious morbidity.

    Science.gov (United States)

    Kalaranjini, S; Veena, P; Rani, Reddi

    2013-12-01

    To compare the efficacy of ceftriaxone before skin incision and after cord clamping in preventing post-operative infectious morbidity and neonatal outcome in elective caesarean section and to determine the effect of antibiotic prophylaxis before skin incision on neonatal outcome. Our study was a randomised controlled trial conducted among 874 women undergoing elective caesarean section from October 2010 to July 2012. These women were randomly categorised into two groups with 437 women in each group. Group 1 received single dose of ceftriaxone 1 g intravenously 15-45 min before skin incision. Group 2 received the antibiotic after cord clamping. Primary outcome measures were maternal post-operative infectious morbidities like surgical site wound infection, febrile morbidity, endometritis, urinary tract infections and neonatal sepsis. Results were analysed using Chi-square test and unpaired t test. Surgical site wound infection occurred in 3 women in group 1 (0.7%) and 6 women in group 2 (1.4%). Fever occurred in 9 women in group 1 (2.1%) and 5 in group 2 (1.1%) with the p value of 0.419, not statistically significant. Urinary tract infection occurred in 9 women in group 1 (2.1%) and 7 women in group 2 (1.6%) with the p value of 0.801. None of the women in either group developed endometritis. About 20 neonates [10 neonates (2.3%) in group 1 and 10 neonates (2.3%) in group 2] required NICU admission after caesarean delivery. The reasons for admission were respiratory distress, prematurity and congenital anomaly. About 0.9% of neonates in group 1 and 1.8% in group 2 developed neonatal sepsis with positive blood culture (p = 0.388). Timing of administration of prophylactic antibiotics for elective caesarean section either before skin incision or after cord clamping did not have significant difference in the occurrence of post-operative infectious morbidity. No adverse neonatal outcome was observed in women who received the antibiotic before skin incision.

  7. A comparison of umbilical cord blood-derived endothelial progenitor and mononuclear cell transplantation for the treatment of acute hindlimb ischemia

    Directory of Open Access Journals (Sweden)

    Phuc Van Pham

    2014-01-01

    Full Text Available Acute lower limb ischemia is a common peripheral artery disease whose treatment presents many difficulties. Stem cell transplantation is considered a novel and promising method of treating this disease. Umbilical cord blood (UCB is rich in stem cells, including hematopoietic stem cells (HSCs, mesenchymal stem cells (MSCs and endothelial progenitor cells (EPCs. However, historically, banked umbilical cord blood has been used mainly to treat blood-related diseases. Therefore, this study compared the efficacy of umbilical cord bloodderived mononuclear cells (UCB-MNCs with EPC transplantation for the treatment of acute hindlimb ischemia (ALI in mouse models. MNCs were isolated from UCB by Ficoll gradient centrifugation, after which the EPCs were sorted based on CD34+ and CD133+ markers and cultured according to a previously published protocol. To induce ALI, mice were immuno-suppressed using busulfan (BU and cyclophosphamide (CY, after which the femoral arteries were burned. Induction of ALI in the immune suppressed mice was confirmed by the grade of tissue damage, pedal frequency in water, tissue edema, changes in histology, total white blood cell count, and white blood cell composition. Model mice were injected with a dose of MNCs or EPCs and un-treated control mice were injected with phosphate buffered saline. The efficiency of treatment was evaluated by comparing the grade of tissue damage between the three groups of mice. Mice aged 6 and ndash;12 months were suitable for ALI, with 100% of mice exhibiting ischemia from grade I 10%, grade III 50%, grade IV 40%. For all ALI mice, a gradual increase in pedal frequency in water, increased tissue edema, necrosis of muscle tissue, and loss of hindlimb function were observed after 20 days. Transplanted MNCs and EPCs significantly improved hindlimb ischemia compared with control treatment. Moreover, EPC transplantation significantly improved hindlimb ischemia compared with MNC transplantation. Following

  8. Comparison of human amniotic fluid-derived and umbilical cord Wharton's Jelly-derived mesenchymal stromal cells: Characterization and myocardial differentiation capacity

    Institute of Scientific and Technical Information of China (English)

    Jing Bai; Yuan Hu; Yi-Ru Wang; Li-Feng Liu; Jie Chen; Shao-Ping Su; Yu Wang

    2012-01-01

    Objective To compare the characterization and myocardial differentiation capacity of amniotic fluid-derived mesenchymal stromal cells (AF MSCs) and umbilical cord Wharton's Jelly-derived mesenchymal stromal cells (WJ MSCs). Methods The human AF MSCs were cultured from amniotic fluid samples obtained by amniocentesis. The umbilical cord WJ MSCs were obtained from Wharton's Jelly of umbilical cords of infants delivered full-term by normal labor. The morphology, growth curves, and analyses by flow cytometry of cell surface markers were compared between the two types of cells. Myocardial genes (GATA-4, c-TnT, α-actin, and Cx43) were detected by real-time PCR and the corresponding protein expressions were detected by Western blot analysis after myocardial induced in AF MSCs and WJ MSCs. Results Our findings revealed AF MSCs and WJ MSCs shared similar morphological characteristics of the fibroblastoid shape. The AF MSCs were easily obtained than the WJ MSCs and had a shorter time to reach adherence of 2.7 ± 1.6 days to WJ MSCs of 6.5 ± 1.8 days. The growth curves by MTT cytotoxic assay showed the AF MSCs had a similar proliferative capacity at passage 5 and passage 10. However, the proliferative capacities of WJ MSCs were decreased at 5 passage relative to 10 passage. Both AF stem cells and WJ stem cells had the characteristics of mesenchymal stromal cells with some characteristics of embryonic stem cells. They express CD29 and CD105, but not CD34. They were positive for Class I major histocompatibility (MHC I) antigens (HLA-ABC), and were negative, or mildly positive, for MHC Class II (HLA-DR) antigen. Oct-4 was positive in all the two cells types. Both AF MSCs and WJ MSCs could differentiate along myocardium. The differentiation capacities were detected by the expression of GATA-4, c-TnT, α-actin, Cx43 after myocardial induction. Conclusions Both AF MSCs and WJ MSCs have the potential clinical application for myogenesis in cardiac regenerative therapy.

  9. Validation of a cerebral palsy register

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  10. Validation of a cerebral palsy register

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  11. A randomized controlled trial of acupuncture and moxibustion to treat Bell's palsy according to different stages: design and protocol.

    Science.gov (United States)

    Chen, Xiaoqin; Li, Ying; Zheng, Hui; Hu, Kaming; Zhang, Hongxing; Zhao, Ling; Li, Yan; Liu, Lian; Mang, Lingling; Yu, Shuyuan

    2009-07-01

    Acupuncture to treat Bell's palsy is one of the most commonly used methods in China. There are a variety of acupuncture treatment options to treat Bell's palsy in clinical practice. Since Bell's palsy has three different path-stages (acute stage, resting stage and restoration stage), so whether acupuncture is effective in the different path-stages and which acupuncture treatment is the best method are major issues in acupuncture clinical trials about Bell's palsy. In this article, we report the design and protocol of a large sample multi-center randomized controlled trial to treat Bell's palsy with acupuncture. There are five acupuncture groups, with four according to different path-stages and one not. In total, 900 patients with Bell's palsy are enrolled in this study. These patients are randomly assigned to receive one of the following four treatment groups according to different path-stages, i.e. 1) staging acupuncture group, 2) staging acupuncture and moxibustion group, 3) staging electro-acupuncture group, 4) staging acupuncture along yangming musculature group or non-staging acupuncture control group. The outcome measurements in this trial are the effect comparison achieved among these five groups in terms of House-Brackmann scale (Global Score and Regional Score), Facial Disability Index scale, Classification scale of Facial Paralysis, and WHOQOL-BREF scale before randomization (baseline phase) and after randomization. The result of this trial will certify the efficacy of using staging acupuncture and moxibustion to treat Bell's palsy, and to approach a best acupuncture treatment among these five different methods for treating Bell's palsy.

  12. Split Cord Malformations

    Directory of Open Access Journals (Sweden)

    Yurdal Gezercan

    2015-06-01

    Full Text Available Split cord malformations are rare form of occult spinal dysraphism in children. Split cord malformations are characterized by septum that cleaves the spinal canal in sagittal plane within the single or duplicated thecal sac. Although their precise incidence is unknown, split cord malformations are exceedingly rare and represent %3.8-5 of all congenital spinal anomalies. Characteristic neurological, urological, orthopedic clinical manifestations are variable and asymptomatic course is possible. Earlier diagnosis and surgical intervention for split cord malformations is associated with better long-term fuctional outcome. For this reason, diagnostic imaging is indicated for children with associated cutaneous and orthopedic signs. Additional congenital anomalies usually to accompany the split cord malformations. Earlier diagnosis, meticuolus surgical therapy and interdisciplinary careful evaluation and follow-up should be made for good prognosis. [Cukurova Med J 2015; 40(2.000: 199-207

  13. [Spontaneous spinal cord herniation].

    Science.gov (United States)

    Rivas, J J; de la Lama, A; Gonza Lez, P; Ramos, A; Zurdo, M; Alday, R

    2004-10-01

    Spontaneous spinal cord herniation through a dural defect is an unusual condition. This entity has been probably underestimated before the introduction of MRI. We report a case of a 49-year-old man with a progressive Brown-Sequard syndrome. MRI and CT myelogram showed a ventrally displaced spinal cord at level T6-T7 and expansion of the posterior subarachnoid space. Through a laminectomy, a spinal cord herniation was identified and reduced. The anterior dural defect was repaired with a patch of lyophilized dura. The patient recovered muscle power but there was no improvement of the sensory disturbance. The diagnosis of spontaneous spinal cord herniation must be considered when progressive myelopathy occurs in middle-aged patients, without signs of spinal cord compression and typical radiological findings. Surgical treatment may halt the progressive deficits and even yield improvement in many cases.

  14. Associations between Manual Abilities, Gross Motor Function, Epilepsy, and Mental Capacity in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Ewa GAJEWSKA*

    2014-04-01

    children with cerebral palsy. A population-based study of 359 children. BMC Musculoskeletal Disorders 2007;21:50.Bax MC, Keith Brown J. The spectrum of disorders known as CP. In: Scrutton D, Damiano D, Mayston M, editors. Management of the Motor Disorders of Children with CP. Clinics in Developmental Medicine London: Mac Keith Press; 2004. p. 83-140.Kwong KL, Wong SN, So KT. Epilepsy in children with cerebral palsy. Pediatr Neurol 1998 ;19:31-6.Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil 2006;28(4:183-91.Sugiura C, Shiota M, Ieshima A, Ohno K. [Epilepsy in patients with cerebral palsy--analysis of frequency and clinical prognosis]. No To Hattatsu 2003;35(6:478-83.McLellan A. Epilepsy – an additional risk factor for psychological problems in cerebral palsy. Dev Med Child Neurology 2008;50(10:727.Kulak W, Sobaniec W, Smigielska-Kuzia J, Kubas B, Walecki J. A comparison of spastic diplegic and tetraplegic cerebral palsy. Pediatr Neurol 2005;32(5:311-7.Rossman BS, Ashwal S. Evaluation of the child with cerebral palsy. Seminars in Pediatr Neurol 2004;11(1:47-57. 

  15. Ocular microtremor in oculomotor palsy.

    Science.gov (United States)

    Bolger, C; Bojanic, S; Sheahan, N F; Coakley, D; Malone, J F

    1999-03-01

    Ocular microtremor (OMT) is a high frequency tremor of the eyes present in all individuals. Recent reports suggest that OMT may be a useful indicator of brainstem function. However, the actual origin of ocular microtremor remains controversial. This study aims to provide evidence that OMT has a neurogenic origin. The OMT activity of five subjects with unilateral oculomotor nerve palsy and one subject with complete unilateral internal and external ophthalmoplegia were recorded from both eyes of each subject using the piezoelectric strain gauge technique, with the normal eye acting as a control. Five parameters of OMT activity were studied in each subject: the peak count, the power of the high frequency peak, the percentage power between 60 and 100 Hz, the percentage power between 70 and 80 Hz, and the 10 dB cut-off point. In the five subjects with oculomotor nerve palsy, the mean peak count in the normal eye was 88.4 Hz (SD+/-16.9) and in the affected eye was 59 Hz (SD+/-8.6), P < 0.0096. There was also a fall in the peak power, the power between 60 and 100 Hz, and the power between 70 and 80 Hz. In subject six, who had complete opthalmoplegia, there was no evidence of OMT activity in the denervated eye. These results suggest that innervation of the extraocular muscles is necessary for normal OMT activity, and OMT therefore has a neurogenic origin.

  16. MR findings of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1994-11-15

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.

  17. Comparison of efficacies of vegetable oil based and polyethylene glycol based bisacodyl suppositories in treating patients with neurogenic bowel dysfunction after spinal cord injury: a meta-analysis.

    Science.gov (United States)

    Yi, Zhu; Jie, Cheng; Wenyi, Zhang; Bin, Xie; Hongzhu, Jin

    2014-10-01

    We performed a meta-analysis to compare the efficacies of vegetable oil based bisacodyl (VOB) and polyethylene glycol based bisacodyl (PGB) suppositories in treating patients with neurogenic bowel dysfunction (NBD) after spinal cord injury (SCI). Relevant clinical studies (up to February 2014) were retrieved through the following databases: PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CCTR), Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang, and VIP database for Chinese Technical Periodicals. Data were analyzed using the standardized weighted mean difference (SMD) and its 95% confidence interval (CI). P-values 0.05) between patients in the PGB and VOB groups. Based on the results, we conclude that the PGB suppository could act faster than the VOB suppository in the treatment of NBD in patients with SCI.

  18. Comparison of transplant outcomes from matched sibling bone marrow or peripheral blood stem cell and unrelated cord blood in patients 50 years or older.

    Science.gov (United States)

    Konuma, Takaaki; Tsukada, Nobuhiro; Kanda, Junya; Uchida, Naoyuki; Ohno, Yuju; Miyakoshi, Shigesaburo; Kanamori, Heiwa; Hidaka, Michihiro; Sakura, Toru; Onizuka, Makoto; Kobayashi, Naoki; Sawa, Masashi; Eto, Tetsuya; Matsuhashi, Yoshiko; Kato, Koji; Ichinohe, Tatsuo; Atsuta, Yoshiko; Miyamura, Koichi

    2016-05-01

    Older recipient and donor age were associated with higher incidences of severe graft-versus-host disease (GVHD) and mortality after allogeneic hematopoietic stem cell transplantation from matched sibling donors (MSDs) and matched unrelated donors. Since a lower incidence of severe GVHD is advantageous in unrelated cord blood transplantation (CBT), a higher incidence of GVHD using older MSDs could be overcome using cord blood for older patients. We retrospectively analyzed Japanese registration data of 2,091 patients with acute myeloid leukemia, acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome aged 50 years or older who underwent MSD bone marrow transplantation (BMT) (n = 319), MSD peripheral blood stem cell transplantation (PBSCT) (n = 462), or unrelated CBT (n = 1,310) between 2007 and 2012. Median age of MSD was 56 (range, 38-74) years. Compared with CBT, the risk of developing extensive chronic GVHD was higher after BMT (hazard ratio [HR], 2.00; P = 0.001) or PBSCT (HR, 2.38; P transplant-related mortality was lower after BMT (HR, 0.61; P < 0.001) or PBSCT (HR, 0.63; P < 0.001). Relapse rates were not significant difference between three groups. Although overall mortality was lower after BMT (HR, 0.67; P < 0.001) or PBSCT (HR, 0.75; P = 0.002) compared with CBT, the rates of a composite endpoint of GVHD-free, relapse-free survival (GRFS) were not significant difference between three groups. These data showed that MSDs remain the best donor source for older patients, but CBT led to similar GRFS to BMT and PBSCT.

  19. [A case presenting with trochlear nerve palsy and segmental sensory disturbance due to circumscribed midbrain and upper pontine hemorrhage].

    Science.gov (United States)

    Ishihara, Kenji; Furutani, Rikiya; Shiota, Jun-ichi; Kawamura, Mitsuru

    2003-07-01

    We describe a patient presenting with trochlear nerve palsy and segmental sensory disturbance due to circumscribed mesencephalic hemorrhage. A 36-year-old man with no past illness visited our hospital complaining of sudden onset of diplopia, dysesthesia of the left face and upper extremity, and acuphenes of the left ear. Neurological examination revealed left trochlear nerve palsy and segmental sensory disturbance of the left side almost above T11 level. Pain and temperature sensation were disturbed, but vibration, joint position, graphesthesia, kinesthesia, and discrimination sensation were spared. Magnetic resonance imaging of the head, performed 7 days after onset, revealed acute to subacute phase hemorrhage at the right inferior colliculus. No abnormalities were identified on cerebral angiography. Symptoms gradually improved with conservative therapy. After about ten weeks, diplopia disappeared and area of sensory disturbance was reduced (disturbance of pain sensation reduced to about T4 level, temperature sensation to about T9). Segmental sensory disturbance usually accompanies spinal cord lesion. However, several cases of similar symptoms following cerebrovascular disease of the brainstem have been reported. Conversely, some reports have indicated that trochlear nerve palsy due to midbrain hemorrhage accompanies sensory disturbance contralateral to the lesion. The nature of sensory disturbance is thus variable. The present case suggests that segmental sensory disturbance might accompany trochlear nerve palsy caused by hemorrhage of the inferior colliculus, as intramedullary fibers of the trochlear nerve and spinothalamic tract are located nearby and somatotopy of the spinothalamic tract is preserved even at the level of the midbrain.

  20. The effect of a multidisciplinary obstetric emergency team training program, the In Time course, on diagnosis to delivery interval following umbilical cord prolapse - A retrospective cohort study.

    Science.gov (United States)

    Copson, Sean; Calvert, Katrina; Raman, Puvaneswary; Nathan, Elizabeth; Epee, Mathias

    2017-06-01

    Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval. We also aimed to investigate if an improvement in perinatal outcomes could be demonstrated. A retrospective cohort study was performed. All cases of cord prolapse in the designated time period were identified and reviewed and a comparison of outcome measures pre- and post-training was undertaken. Thirty-one cases were identified in the pre-training period, and compared to 64 cases post-training. Documentation improved significantly post-training. There were non-significant improvements in use of spinal anaesthetic, and in the length of stay in the special care neonatal unit. There was a significant increase in the number of babies with Apgar scores less than seven at 5 min. There were no differences in the diagnosis to delivery interval, or in perinatal mortality rates. Obstetric emergency training was associated with improved teamwork, as evidenced by the improved documentation post-training in this study, but not with improved diagnosis to delivery interval. Long-term follow-up studies are required to ascertain whether training has an impact on longer-term paediatric outcomes, such as cerebral palsy rates. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  1. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

    Directory of Open Access Journals (Sweden)

    Saluja Paramveer

    2011-07-01

    Full Text Available Abstract Introduction Isolated facial nerve palsy usually manifests as Bell's palsy. Lacunar infarct involving the lower pons is a rare cause of solitary infranuclear facial paralysis. The present unusual case is one in which the patient appeared to have Bell's palsy but turned out to have a pontine infarct. Case presentation A 47-year-old Asian Indian man with a medical history of hypertension presented to our institution with nausea, vomiting, generalized weakness, facial droop, and slurred speech of 14 hours' duration. His physical examination revealed that he was conscious, lethargic, and had mildly slurred speech. His blood pressure was 216/142 mmHg. His neurologic examination showed that he had loss of left-sided forehead creases, inability to close his left eye, left facial muscle weakness, rightward deviation of the angle of the mouth on smiling, and loss of the left nasolabial fold. Afferent corneal reflexes were present bilaterally. MRI of the head was initially read as negative for acute stroke. Bell's palsy appeared less likely because of the acuity of his presentation, encephalopathy-like imaging, and hypertension. The MRI was re-evaluated with a neurologist's assistance, which revealed a tiny 4 mm infarct involving the left dorsal aspect of the pons. The final diagnosis was isolated facial nerve palsy due to lacunar infarct of dorsal pons and hypertensive encephalopathy. Conclusion The facial nerve has a predominant motor component which supplies all muscles concerned with unilateral facial expression. Anatomic knowledge is crucial for clinical localization. Bell's palsy accounts for around 72% of facial palsies. Other causes such as tumors and pontine infarcts can also present as facial palsy. Isolated dorsal infarct presenting as isolated facial palsy is very rare. Our case emphasizes that isolated facial palsy should not always be attributed to Bell's palsy. It can be a presentation of a rare dorsal pontine infarct as observed

  2. Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy

    Science.gov (United States)

    Kane, Kyra J; Lanovaz, Joel; Bisaro, Derek; Oates, Alison; Musselman, Kristin E

    2016-01-01

    Objective: Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function—the Obstacles and Curb tests—relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy. Methods: A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test–retest reliability. Results: At fast speeds, all tests showed discriminative validity (p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81–0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73–0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test–retest reliability for tests performed at fast speeds rather than self-selected speeds. Conclusion: The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test–retest reliability for children with spina bifida/cerebral palsy. PMID:27493754

  3. Progressive Supranuclear Palsy (PSP): Frequently Asked Questions

    Science.gov (United States)

    ... in this section for the benefit of others. PSP What does the name "supranuclear palsy" mean? In ... CurePSP. What are the common early symptoms of PSP? The most common first symptom, occurring on average ...

  4. Botulinum A toxin utilizations in obstetric palsy

    Directory of Open Access Journals (Sweden)

    Atakan Aydin

    2012-12-01

    Conclusion: We conclude that with the help of botulinum A toxin and physyotherapy, obstetrical palsy patient with cocontractions can significantly improve movements and may have less surgery. [Hand Microsurg 2012; 1(3.000: 89-94

  5. [Functional electric stimulation (FES) in cerebral palsy].

    Science.gov (United States)

    Miyazaki, M H; Lourenção, M I; Ribeiro Sobrinho, J B; Battistella, L R

    1992-01-01

    Our study concerns a patient with cerebral palsy, submitted to conventional occupational therapy and functional electrical stimulation. The results as to manual ability, spasticity, sensibility and synkinesis were satisfactory.

  6. Magnetic resonance imaging of spinal cord syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Einsiedel, H. von; Stepan, R.

    1985-05-01

    Thirty-four patients with intramedullary space-occupying lesions or cord compression syndromes were examined with a resistive and two different superconductive magnetic resonance (MR) imaging units. Studies were done primarily by the spin-echo (SE) technique and in the majority of patients different pulse sequences were used. Images with short echo-time (TE) and short recovery-time (TR) were best for demonstration of spinal cord anatomy, for depicting cystic portions in intramedullary tumours and for showing syringomyelia. Solid intramedullary tumours showed normal cord signal intensity. Images with prolonged TE and TR predominantly enhanced CSF signal intensity and, to a more considerable extent, solid intramedullary tumours. Thus, the diameter of the subarachnoid space and the presence of a solid intramedullary tumour, not concomittant with a significant enlargement of the spinal cord, could only be recognized on these prolonged SE images. Major advantages of MR in comparison to CT are that the spinal cord can be imaged in the sagittal plane and that beam hardening artifacts do not occur; in comparison to myelography the cord can be imaged directly by MR. Partial volume is a major limitation of MR, not only in the preferably applied sagittal plane. The choice of slice thickness adequate to the diameter of the lesion and straight positioning of the patient for sagittal single slice midline images are fundamental for reliable MR investigations. Another limitation to MR is that cortical bone gives no signal. The actual diameter of the spinal canal therefore cannot be correctly appreciated and consequently it was difficult or impossible to assess spinal stenosis.

  7. Cord Wood Testing in a Non-Catalytic Wood Stove

    Energy Technology Data Exchange (ETDEWEB)

    Butcher, T. [Brookhaven National Lab. (BNL), Upton, NY (United States); Trojanowski, R. [Brookhaven National Lab. (BNL), Upton, NY (United States); Wei, G. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2014-06-30

    EPA Method 28 and the current wood stove regulations have been in-place since 1988. Recently, EPA proposed an update to the existing NSPS for wood stove regulations which includes a plan to transition from the current crib wood fuel to cord wood fuel for certification testing. Cord wood is seen as generally more representative of field conditions while the crib wood is seen as more repeatable. In any change of certification test fuel, there are questions about the impact on measured results and the correlation between tests with the two different fuels. The purpose of the work reported here is to provide data on the performance of a noncatalytic stove with cord wood. The stove selected has previously been certified with crib wood which provides a basis for comparison with cord wood. Overall, particulate emissions were found to be considerably higher with cord wood.

  8. Modeling spinal cord biomechanics

    Science.gov (United States)

    Luna, Carlos; Shah, Sameer; Cohen, Avis; Aranda-Espinoza, Helim

    2012-02-01

    Regeneration after spinal cord injury is a serious health issue and there is no treatment for ailing patients. To understand regeneration of the spinal cord we used a system where regeneration occurs naturally, such as the lamprey. In this work, we analyzed the stress response of the spinal cord to tensile loading and obtained the mechanical properties of the cord both in vitro and in vivo. Physiological measurements showed that the spinal cord is pre-stressed to a strain of 10%, and during sinusoidal swimming, there is a local strain of 5% concentrated evenly at the mid-body and caudal sections. We found that the mechanical properties are homogeneous along the body and independent of the meninges. The mechanical behavior of the spinal cord can be characterized by a non-linear viscoelastic model, described by a modulus of 20 KPa for strains up to 15% and a modulus of 0.5 MPa for strains above 15%, in agreement with experimental data. However, this model does not offer a full understanding of the behavior of the spinal cord fibers. Using polymer physics we developed a model that relates the stress response as a function of the number of fibers.

  9. Ocular problems in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Esra Ayhan Tuzcu

    2012-09-01

    Full Text Available The aim of this study is to evaluate eye problemsin children with cerebral palsy in our region.Materials and Methods: 90 patients which was diagnosedas cerebral palsy, treated and followed up in PediatricNeurology Department of Mustafa Kemal University,were included to this study. The history was taken, anda physical examination was performed to determine theetiology of the disease and type of SP. All of the patientswere underwent a detailed ophthalmological examinationincluding visual acuity, refractive error, amblyopia, strabismus,nystagmus and fundus examination.Results: Totally 90 patients, 51 male and 39 female,were included to the study. When the etiologic factorswere evaluated, the asphyxia was seen in 33.3% of thepatients. The most common type of cerebral palsy wasspastic quadriplegia at the rate of 43.3%. Eye problemswere detected in 60% of our cases. Of this, 54.4% wererefractive errors, 35.6% were strabismus, and 22.2%were optic nerve pathologies. Amblyopia was found in11.1% of cases. Although strabismus is more common inspastic diplegia type of cerebral palsy, there was no statisticallysignificant differenceConclusions: In conclusion, eye problems are commonin children with cerebral palsy. Therefore, we recommendroutine eye examination in these patients due to be beneficialin reducing the detection and communication difficulties.Key words: Cerebral palsy, refractive error, strabismus,optic atrophy

  10. Surgical management of third nerve palsy

    Directory of Open Access Journals (Sweden)

    Anupam Singh

    2016-01-01

    Full Text Available Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell′s phenomenon, superior oblique (SO overaction, and lateral rectus (LR contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%, trauma (20%, inflammation (13%, aneurysm (7%, and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension, aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles.

  11. Management of peripheral facial nerve palsy.

    Science.gov (United States)

    Finsterer, Josef

    2008-07-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell's palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell's palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell's palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell's palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell's palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae.

  12. Tumors Presenting as Multiple Cranial Nerve Palsies

    Directory of Open Access Journals (Sweden)

    Kishore Kumar

    2017-04-01

    Full Text Available Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor.

  13. 鼠神经生长因子治疗婴幼儿痉挛型脑瘫与非痉挛型脑瘫的临床疗效比较%Comparison of Clinical Outcome with Mouse Nerve Growth Factor(NGF) Treatment of Spastic Cerebral Palsy and Non-Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    卢凤玲; 陈继栋; 李伟明

    2015-01-01

    目的:探讨鼠神经生长因子对治疗痉挛性脑瘫和非痉挛型型脑瘫的疗效比较。方法将60例符合诊断标准及条件的脑瘫患儿按痉挛型及非痉挛型脑瘫分成两组。其中痉挛型脑瘫组35例,包含年龄≤36个月23例和>36个月12例,非痉挛型脑瘫组25例,包含年龄≤36个月15例和>36个月10例。两组均进行常规的综合康复治疗,采用运动治疗为主,配合推拿、按摩、针灸等,同时应用鼠神经生长因子(NGF)20μg(≥9000 AU/支)加注射用水2 mL,肌内注射,每日1次,20次为1个疗程。第1个疗程结束后停药1周再进行第2个疗程,共使用2个疗程。分别观察治疗前和2个疗程结束后,两组粗大运动功能测试量表(GMFM-88)变化情况。结果①两个疗程结束后两组GMFM-88评分均较治疗前明显提高,差异有统计学意义(P36个月的患儿,通过治疗粗大运动得分上均有显著性提高,差异有统计学意义(P<0.01),提示治疗对不同年龄段患儿普遍显效;③两组临床疗效比较差异无统计学意义(P>0.05),提示二者均疗效显著。结论 NGF能安全治疗婴幼儿脑性瘫痪,并对于痉挛型脑瘫和非痉挛型脑瘫均能取得满意疗效。%ObjectiveTo compare NGF treatment outcome in Pediatric spastic and non spastic cerebral palsy.MethodsTotal 60 cases of pediatric cerebal palsy into two groups: spastic and non spastic. Spastic group has 35 cases of age equal or younger than 36 month old; 12 cases of age older than 36 month old. Non -spastic group has 15 cases of age equal or younger than 36 month old; 10 cases age older than 36 month.Both group reveived NGF treatment along with standard physiotherapy : primarily exercise, massage, acupuncture. NGF treatment regimen is 20 times. Total two cycles and one -week break between cycles. The observation of pre and post treatments' GMFM 88 scores.Result①After two treatment regimens, both GMFM

  14. The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy

    NARCIS (Netherlands)

    Einspieler, C; Cioni, G; Paolicelli, PB; Bos, AF; Dressler, A; Ferrari, F; Roversi, MF; Prechtl, HFR

    2002-01-01

    Qualitative abnormalities of spontaneous motor activity in new-borns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed lon

  15. The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy

    NARCIS (Netherlands)

    Einspieler, C; Cioni, G; Paolicelli, PB; Bos, AF; Dressler, A; Ferrari, F; Roversi, MF; Prechtl, HFR

    Qualitative abnormalities of spontaneous motor activity in new-borns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed

  16. Comparison of cellular architecture, axonal growth, and blood vessel formation through cell-loaded polymer scaffolds in the transected rat spinal cord.

    Science.gov (United States)

    Madigan, Nicolas N; Chen, Bingkun K; Knight, Andrew M; Rooney, Gemma E; Sweeney, Eva; Kinnavane, Lisa; Yaszemski, Michael J; Dockery, Peter; O'Brien, Timothy; McMahon, Siobhan S; Windebank, Anthony J

    2014-11-01

    The use of multichannel polymer scaffolds in a complete spinal cord transection injury serves as a deconstructed model that allows for control of individual variables and direct observation of their effects on regeneration. In this study, scaffolds fabricated from positively charged oligo[poly(ethylene glycol)fumarate] (OPF(+)) hydrogel were implanted into rat spinal cords following T9 complete transection. OPF(+) scaffold channels were loaded with either syngeneic Schwann cells or mesenchymal stem cells derived from enhanced green fluorescent protein transgenic rats (eGFP-MSCs). Control scaffolds contained extracellular matrix only. The capacity of each scaffold type to influence the architecture of regenerated tissue after 4 weeks was examined by detailed immunohistochemistry and stereology. Astrocytosis was observed in a circumferential peripheral channel compartment. A structurally separate channel core contained scattered astrocytes, eGFP-MSCs, blood vessels, and regenerating axons. Cells double-staining with glial fibrillary acid protein (GFAP) and S-100 antibodies populated each scaffold type, demonstrating migration of an immature cell phenotype into the scaffold from the animal. eGFP-MSCs were distributed in close association with blood vessels. Axon regeneration was augmented by Schwann cell implantation, while eGFP-MSCs did not support axon growth. Methods of unbiased stereology provided physiologic estimates of blood vessel volume, length and surface area, mean vessel diameter, and cross-sectional area in each scaffold type. Schwann cell scaffolds had high numbers of small, densely packed vessels within the channels. eGFP-MSC scaffolds contained fewer, larger vessels. There was a positive linear correlation between axon counts and vessel length density, surface density, and volume fraction. Increased axon number also correlated with decreasing vessel diameter, implicating the importance of blood flow rate. Radial diffusion distances in vessels

  17. Bell's palsy before Bell: Cornelis Stalpart van der Wiel's observation of Bell's palsy in 1683.

    Science.gov (United States)

    van de Graaf, Robert C; Nicolai, Jean-Philippe A

    2005-11-01

    Bell's palsy is named after Sir Charles Bell (1774-1842), who has long been considered to be the first to describe idiopathic facial paralysis in the early 19th century. However, it was discovered that Nicolaus Anton Friedreich (1761-1836) and James Douglas (1675-1742) preceded him in the 18th century. Recently, an even earlier account of Bell's palsy was found, as observed by Cornelis Stalpart van der Wiel (1620-1702) from The Hague, The Netherlands in 1683. Because our current knowledge of the history of Bell's palsy before Bell is limited to a few documents, it is interesting to discuss Stalpart van der Wiel's description and determine its additional value for the history of Bell's palsy. It is concluded that Cornelis Stalpart van der Wiel was the first to record Bell's palsy in 1683. His manuscript provides clues for future historical research.

  18. Cerebral palsy in preterm infants

    Directory of Open Access Journals (Sweden)

    Demeši-Drljan Čila

    2016-01-01

    Full Text Available Background/Aim. Cerebral palsy (CP is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS. Results. More than half of the children with CP were born prematurely (54.4%. Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001. In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049, children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0% affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032. Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike

  19. [Progressive supranuclear palsy: what's new?].

    Science.gov (United States)

    Levy, Richard

    2011-06-01

    Progressive supranuclear palsy (PSP) has been described as a clinical syndrome characterized by an impairment of voluntary control of gaze (supranuclear palsy), postural and gait instability, and behavioral and cognitive deficits including a frontal syndrome and psychic retardation. However, in the recent years, at least four other clinical forms of PSP have been recognized: PSP-Parkinsonism, "pure akinesia with gait freezing", PSP with cortico-basal syndrome, and PSP with speech apraxia. PSP-Parkinsonism mimics the signs and symptoms of idiopathic Parkinson's disease, including a significant reactivity to levodopa. "Pure akinesia with gait freezing" is characterized by a difficulty of self-initiation of motor programs, usually walking program. PSP with cortico-basal syndrome mimics cortico-basal degeneration (CBD) in that unilateral or asymmetric limb dystonia and apraxia are prominent signs. PSP with speech apraxia is an isolated syndrome of progressive anarthria. All these clinical syndromes are due to brain accumulation of phosphorylated tau protein. The differences in clinical expression within the framework of PSP can be explained by the differences in the topographical distribution of the lesions. PSP is considered as a primary tau disease ("tauopathy") such as CBD and some forms of fronto-temporal lobar degeneration. At the level of neuropathology, the pattern of tau abnormal inclusions differentiates PSP from other tau diseases, but some overlaps are reported. Moreover, several of the clinical forms of PSP partially or fully overlap with the other tauopathies. As a whole, the emergence of new clinical forms of PSP challenges the nosology of tauopathies and our understanding of these diseases.

  20. Genetics of Progressive Supranuclear Palsy

    Directory of Open Access Journals (Sweden)

    Sun Young Im

    2015-09-01

    Full Text Available Progressive supranuclear palsy (PSP is a neurodegenerative syndrome that is clinically characterized by progressive postural instability, supranuclear gaze palsy, parkinsonism and cognitive decline. Pathologically, diagnosis of PSP is based on characteristic features, such as neurofibrillary tangles, neutrophil threads, tau-positive astrocytes and their processes in basal ganglia and brainstem, and the accumulation of 4 repeat tau protein. PSP is generally recognized as a sporadic disorder; however, understanding of genetic background of PSP has been expanding rapidly. Here we review relevant publications to outline the genetics of PSP. Although only small number of familial PSP cases have been reported, the recognition of familial PSP has been increasing. In some familial cases of clinically probable PSP, PSP pathologies were confirmed based on NINDS neuropathological diagnostic criteria. Several mutations in MAPT, the gene that causes a form of familial frontotemporal lobar degeneration with tauopathy, have been identified in both sporadic and familial PSP cases. The H1 haplotype of MAPT is a risk haplotype for PSP, and within H1, a sub-haplotype (H1c is associated with PSP. A recent genome-wide association study on autopsyproven PSP revealed additional PSP risk alleles in STX6 and EIF2AK3. Several heredodegenerative parkinsonian disorders are referred to as PSP-look-alikes because their clinical phenotype, but not their pathology, mimics PSP. Due to the fast development of genomics and bioinformatics, more genetic factors related to PSP are expected to be discovered. Undoubtedly, these studies will provide a better understanding of the pathogenesis of PSP and clues for developing therapeutic strategies.

  1. Human Umbilical Cord Perivascular Cells Exhibited Enhanced Migration Capacity towards Hepatocellular Carcinoma in Comparison with Bone Marrow Mesenchymal Stromal Cells: A Role for Autocrine Motility Factor Receptor

    Directory of Open Access Journals (Sweden)

    Juan Bayo

    2014-01-01

    Full Text Available Hepatocellular carcinoma (HCC is the third cause of cancer-related death worldwide. Unfortunately, the incidence and mortality associated with HCC are increasing. Therefore, new therapeutic strategies are urgently needed and the use of mesenchymal stromal cells (MSCs as carrier of therapeutic genes is emerging as a promising option. Different sources of MSCs are being studied for cell therapy and bone marrow-derived cells are the most extensively explored; however, birth associated-tissues represent a very promising source. The aim of this work was to compare the in vitro and in vivo migration capacity between bone marrow MSCs (BM-MSCs and human umbilical cord perivascular cells (HUCPVCs towards HCC. We observed that HUCPVCs presented higher in vitro and in vivo migration towards factors released by HCC. The expression of autocrine motility factor (AMF receptor, genes related with the availability of the receptor on the cell surface (caveolin-1 and -2 and metalloproteinase 3, induced by the receptor activation and important for cell migration, was increased in HUCPVCs. The chemotactic response towards recombinant AMF was increased in HUCPVCs compared to BM-MSCs, and its inhibition in the conditioned medium from HCC induced higher decrease in HUCPVC migration than in BM-MSC. Our results indicate that HUCPVCs could be a useful cellular source to deliver therapeutic genes to HCC.

  2. Bell's Palsy: Treatment with Steroids and Antiviral Drugs

    Science.gov (United States)

    ... PATIENTS and their FAMILIES BELL’S PALSY: TREATMENT WITH STEROIDS AND ANTIVIRAL DRUGS This information sheet is provided to help you understand the role of steroids and antiviral drugs for treating Bell’s palsy. Neurologists ...

  3. Robotic Device May Help Gait in Kids with Cerebral Palsy

    Science.gov (United States)

    ... Robotic Device May Help Gait in Kids With Cerebral Palsy Those with condition known as 'crouch gait' had ... helped improve the walking ability of children with cerebral palsy who suffer from a condition known as "crouch ...

  4. Gastrostomy tube feeding of children with cerebral palsy

    DEFF Research Database (Denmark)

    Dahlseng, Magnus O; Andersen, Guro L; DA Graca Andrada, Maria

    2012-01-01

    To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries.......To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries....

  5. Genetics Home Reference: horizontal gaze palsy with progressive scoliosis

    Science.gov (United States)

    ... Health Conditions HGPPS horizontal gaze palsy with progressive scoliosis Printable PDF Open All Close All Enable Javascript ... collapse boxes. Description Horizontal gaze palsy with progressive scoliosis ( HGPPS ) is a disorder that affects vision and ...

  6. Association between type of cerebral palsy and the cognitive levels

    Directory of Open Access Journals (Sweden)

    Ratna Dewi Kusumaningrum

    2009-07-01

    Conclusion Our data showed that most patients with cerebral palsy had mental retardation of several cognitive level but there was no significant association between each type of cerebral palsy with cognitive levels.

  7. Spinal Cord Injury

    Science.gov (United States)

    ... indicated by a total lack of sensory and motor function below the level of injury. People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel ...

  8. Spinal cord abscess

    Science.gov (United States)

    ... drugs The infection often begins in the bone ( osteomyelitis ). The bone infection may cause an epidural abscess ... Boils Cerebral spinal fluid (CSF) collection Epidural abscess Osteomyelitis Pulmonary tuberculosis Sepsis Spinal cord trauma Swelling Review ...

  9. Clinical Practice Guideline of Acupuncture for Bell's Palsy

    Directory of Open Access Journals (Sweden)

    Xi Wu

    2016-10-01

    Full Text Available Backgroud: Acupuncture is common used for Bell's palsy in clinic, however, recent systematic reviews all shows that there is no sufficient evidence to support the effectiveness of acupuncture for Bell's palsy because ofthe poor quality and heterogeneity. It's urgently necessary to develop a guideline of acupuncture for Bell's palsy based on principles of evidence-based medicine to optimize acupuncture treating, standardize outcomes evaluating and to improve the quality of acupuncture for patients with Bell's palsy under general circumstances.

  10. Lineage specification of neuronal precursors in the mouse spinal cord.

    OpenAIRE

    L.J. Richards; Murphy, M.; Dutton, R; Kilpatrick, T J; Puche, A. C.; Key, B; Tan, S S; Talman, P S; Bartlett, P. F.

    1995-01-01

    We have investigated the differentiation potential of precursor cells within the developing spinal cord of mice and have shown that spinal cord cells from embryonic day 10 specifically give rise to neurons when plated onto an astrocytic monolayer, Ast-1. These neurons had the morphology of motor neurons and > 83% expressed the motor neuron markers choline acetyltransferase, peripherin, calcitonin gene-related peptide, and L-14. By comparison, < 10% of the neurons arising on monolayers of othe...

  11. Diagnosis, treatment, and prevention of cerebral palsy.

    Science.gov (United States)

    O'Shea, Thomas Michael

    2008-12-01

    Cerebral palsy is the most prevalent cause of persisting motor function impairment with a frequency of about 1/500 births. In developed countries, the prevalence rose after introduction of neonatal intensive care, but in the past decade, this trend has reversed. A recent international workshop defined cerebral palsy as "a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain." In a majority of cases, the predominant motor abnormality is spasticity; other forms of cerebral palsy include dyskinetic (dystonia or choreo-athetosis) and ataxic cerebral palsy. In preterm infants, about one-half of the cases have neuroimaging abnormalities, such as echolucency in the periventricular white matter or ventricular enlargement on cranial ultrasound. Among children born at or near term, about two-thirds have neuroimaging abnormalities, including focal infarction, brain malformations, and periventricular leukomalacia. In addition to the motor impairment, individuals with cerebral palsy may have sensory impairments, cognitive impairment, and epilepsy. Ambulation status, intelligence quotient, quality of speech, and hand function together are predictive of employment status. Mortality risk increases incrementally with increasing number of impairments, including intellectual, limb function, hearing, and vision. The care of individuals with cerebral palsy should include the provision of a primary care medical home for care coordination and support; diagnostic evaluations to identify brain abnormalities, severity of neurologic and functional abnormalities, and associated impairments; management of spasticity; and care for associated problems such as nutritional deficiencies, pain, dental care, bowel and bladder continence, and orthopedic complications. Current strategies to decrease the risk of cerebral palsy include interventions to

  12. Magnetic Resonance Parkinsonism Index: diagnostic accuracy of a fully automated algorithm in comparison with the manual measurement in a large Italian multicentre study in patients with progressive supranuclear palsy

    Energy Technology Data Exchange (ETDEWEB)

    Nigro, Salvatore [National Research Council, Institute of Bioimaging and Molecular Physiology, Catanzaro (Italy); Arabia, Gennarina [University ' ' Magna Graecia' ' , Institute of Neurology, Department of Medical and Surgical Sciences, Catanzaro (Italy); Antonini, Angelo; Weis, Luca; Marcante, Andrea [' ' Fondazione Ospedale San Camillo' ' - I.R.C.C.S, Parkinson' s Disease and Movement Disorders Unit, Venice-Lido (Italy); Tessitore, Alessandro; Cirillo, Mario; Tedeschi, Gioacchino [Second University of Naples, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Naples (Italy); Second University of Naples, MRI Research Center SUN-FISM, Naples (Italy); Zanigni, Stefano; Tonon, Caterina [Policlinico S. Orsola - Malpighi, Functional MR Unit, Bologna (Italy); University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna (Italy); Calandra-Buonaura, Giovanna [University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna (Italy); IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna (Italy); Pezzoli, Gianni; Cilia, Roberto [ASST G.Pini - CTO, ex ICP, Parkinson Institute, Milano (Italy); Zappia, Mario; Nicoletti, Alessandra; Cicero, Calogero Edoardo [University of Catania, Department ' ' G.F. Ingrassia' ' , Section of Neurosciences, Catania (Italy); Tinazzi, Michele; Tocco, Pierluigi [University Hospital of Verona, Department of Neurological and Movement Sciences, Verona (Italy); Cardobi, Nicolo [University Hospital of Verona, Institute of Radiology, Verona (Italy); Quattrone, Aldo [National Research Council, Institute of Bioimaging and Molecular Physiology, Catanzaro (Italy); University ' ' Magna Graecia' ' , Institute of Neurology, Department of Medical and Surgical Sciences, Catanzaro (Italy)

    2017-06-15

    To investigate the reliability of a new in-house automatic algorithm for calculating the Magnetic Resonance Parkinsonism Index (MRPI), in a large multicentre study population of patients affected by progressive supranuclear palsy (PSP) or Parkinson's disease (PD), and healthy controls (HC), and to compare the diagnostic accuracy of the automatic and manual MRPI values. The study included 88 PSP patients, 234 PD patients and 117 controls. MRI was performed using both 3T and 1.5T scanners. Automatic and manual MRPI values were evaluated, and accuracy of both methods in distinguishing PSP from PD and controls was calculated. No statistical differences were found between automated and manual MRPI values in all groups. The automatic MRPI values differentiated PSP from PD with an accuracy of 95 % (manual MRPI accuracy 96 %) and 97 % (manual MRPI accuracy 100 %) for 1.5T and 3T scanners, respectively. Our study showed that the new in-house automated method for MRPI calculation was highly accurate in distinguishing PSP from PD. Our automatic approach allows a widespread use of MRPI in clinical practice and in longitudinal research studies. (orig.)

  13. Gross motor function in children with spastic Cerebral Palsy and Cerebral Visual Impairment: A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI).

    Science.gov (United States)

    Salavati, M; Rameckers, E A A; Waninge, A; Krijnen, W P; Steenbergen, B; van der Schans, C P

    2017-01-01

    To investigate whether the adapted version of the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result of a better comprehension of the instruction of the adapted version. The scores of the original and adapted GMFM-88 were compared in the same group of children (n=21 boys and n=16 girls), mean (SD) age 113 (30) months with CP and CVI, within a time span of two weeks. A paediatric physical therapist familiar with the child assessed both tests in random order. The GMFCS level, mental development and age at testing were also collected. The Wilcoxon signed-rank test was used to compare two different measurements (the original and adapted GMFM-88) on a single sample, (the same child with CP and CVI; pvisual problems. On the basis of these findings, we recommend using the adapted GMFM-88 to measure gross motor functioning in children with CP and CVI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Importance of speech production for phonological awareness and word decoding: the case of children with cerebral palsy.

    NARCIS (Netherlands)

    Peeters, M.; Verhoeven, L.; Moor, J.M.H. de; Balkom, H. van

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness,

  15. Importance of Speech Production for Phonological Awareness and Word Decoding: The Case of Children with Cerebral Palsy

    Science.gov (United States)

    Peeters, Marieke; Verhoeven, Ludo; de Moor, Jan; van Balkom, Hans

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness, Phonological Short-term Memory (STM), Speech…

  16. Controlled Study of the Effects of Continuous Intrathecal Baclofen Infusion in Non-Ambulant Children with Cerebral Palsy

    Science.gov (United States)

    Morton, Richard E.; Gray, Natalie; Vloeberghs, Michael

    2011-01-01

    Aim: To measure changes in children with severe spastic cerebral palsy (CP) after continuous intrathecal baclofen (ITB) infusion over 18 months and to compare the results with those of a comparison group awaiting treatment. Method: Thirty-eight children with severe spastic CP considered suitable for ITB were assessed when first seen, just before…

  17. Foundations of phonological awareness in pre-school children with cerebral palsy : the impact of intellectual disability

    NARCIS (Netherlands)

    Peeters, M.H.J.; Verhoeven, L.T.W.; Balkom, A.J.L.M. van; Moor, J.M.H. de

    2008-01-01

    Background Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception

  18. Foundations of phonological awareness in pre-school children with cerebral palsy: the impact of intellectual disability.

    NARCIS (Netherlands)

    Peeters, M.; Verhoeven, L.; Balkom, H. van; Moor, J. de

    2008-01-01

    BACKGROUND: Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception

  19. Importance of speech production for phonological awareness and word decoding: the case of children with cerebral palsy.

    NARCIS (Netherlands)

    Peeters, M.; Verhoeven, L.; Moor, J.M.H. de; Balkom, H. van

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness,

  20. Foundations of phonological awareness in pre-school children with cerebral palsy : the impact of intellectual disability

    NARCIS (Netherlands)

    Peeters, M.H.J.; Verhoeven, L.T.W.; Balkom, A.J.L.M. van; Moor, J.M.H. de

    2008-01-01

    Background Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception

  1. Foundations of phonological awareness in pre-school children with cerebral palsy: the impact of intellectual disability.

    NARCIS (Netherlands)

    Peeters, M.; Verhoeven, L.; Balkom, H. van; Moor, J. de

    2008-01-01

    BACKGROUND: Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception

  2. Importance of Speech Production for Phonological Awareness and Word Decoding: The Case of Children with Cerebral Palsy

    Science.gov (United States)

    Peeters, Marieke; Verhoeven, Ludo; de Moor, Jan; van Balkom, Hans

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness, Phonological Short-term Memory (STM), Speech…

  3. Comparison of cyclosporine and tacrolimus combined with mycophenolate mofetil in prophylaxis for graft-versus-host disease after reduced-intensity umbilical cord blood transplantation.

    Science.gov (United States)

    Miyamoto, Toshihiro; Takashima, Shuichiro; Kato, Koji; Takase, Ken; Yoshimoto, Goichi; Yoshida, Shuro; Henzan, Hideho; Osaki, Koichi; Kamimura, Tomohiko; Iwasaki, Hiromi; Eto, Tetsuya; Teshima, Takanori; Nagafuji, Koji; Akashi, Koichi

    2017-01-01

    Umbilical cord blood transplantation with a reduced-intensity conditioning regimen (RIC-UCBT) is used increasingly in patients who have comorbid organ functions and lack human leukocyte antigen-identical donors. We compared the outcomes in 35 patients who received mycophenolate mofetil plus cyclosporine (MMF/CSP, n = 17) or MMF plus tacrolimus (MMF/TAC, n = 18) for graft-versus-host disease (GVHD) prophylaxis after RIC-UCBT. Cumulative incidence of neutrophil engraftment was 94 and 89 % in MMF/CSP and MMF/TAC groups, respectively (p = 0.34). The incidence of pre-engraftment immune reaction did not differ between the MMF/CSP (41 %) and MMF/TAC (39 %, p = 1.00) groups; however, patients in the MMF/TAC group tended to have a lower incidence of grade II-IV acute GVHD than those in MMF/CSP group (28 vs 53 %, p = 0.11). Overall survival (OS) at 1 year was 43 and 60 % in MMF/CSP and MMF/TAC groups, respectively (p = 0.39). Progression-free survival, non-relapse mortality, and relapse rate were comparable between the two groups (p = 0.76, 0.59, and 0.88, respectively). In multivariate analyses, MMF/TAC GVHD prophylaxis was closely associated with improved OS, but not with incidence of engraftment and acute GVHD. These results suggest that more intensive GVHD prophylaxis with MMF/TAC decreased acute GVHD without affecting other clinical outcomes, resulting in improved OS after RIC-UCBT.

  4. Comparison of the metabolic demands of dance performance using three mobility devices for a dancer with spinal cord injury and an able-bodied dancer.

    Science.gov (United States)

    Mengelkoch, Larry J; Highsmith, M Jason; Morris, Merry L

    2014-09-01

    Mobility devices for dancers with physical mobility impairments have previously been limited to traditional manual or power wheelchairs. The hands-free torso-controlled mobility chair is a unique powered mobility device which allows greater freedom and expression of movement of the trunk and upper extremities. This study compared differences in energy expenditure during a standardized dance activity using three mobility devices: the hands-free torso-controlled mobility chair, a manual sports wheelchair with hand-arm control, and an electric power chair with hand-joystick control. An experienced dancer with C7 incomplete spinal cord injury (SCI) and an experienced able-bodied dancer were recruited for testing. Three measurement trials were obtained for each chair per subject. Oxygen uptake (VO2) and heart rate (HR) were measured continuously during the dance activity. Immediately following the dance activity, subjects rated perceived exertion. Significant differences (p ≤ 0.05) and similar linear patterns in VO2 and HR responses were observed between chairs for both dancers. When the hands-free mobility chair was used, the dance activity required a moderate level of energy expenditure compared to the manual sports chair or electric power chair for both dancers. Higher ratings of perceived exertion were observed in the manual chair compared to the other chairs for the dancer with SCI, but were similar between chairs for the able-bodied dancer. These results suggest that for a dancer with high-level SCI, the hands-free torso-controlled mobility chair may offer improved freedom and expressive movement possibilities and is an energy-efficient mobility device.

  5. Pressure changes under the ischial tuberosities during gluteal neuromuscular stimulation in spinal cord injury: a comparison of sacral nerve root stimulation with surface functional electrical stimulation.

    Science.gov (United States)

    Liu, Liang Qin; Ferguson-Pell, Martin

    2015-04-01

    To compare the magnitude of interface pressure changes during gluteal maximus contraction by stimulating sacral nerve roots with surface electrical stimulations in patients with spinal cord injuries (SCIs). Pilot interventional study. Spinal injury research laboratory. Adults (N=18) with suprasacral complete SCI. Sacral nerve root stimulation (SNRS) via a functional magnetic stimulator (FMS) or a sacral anterior root stimulator (SARS) implant; and surface functional electrical stimulation (FES). Interface pressure under the ischial tuberosity (IT) defined as peak pressure, gradient at peak pressure, and average pressure. With optimal FMS, a 29% average reduction of IT peak pressure was achieved during FMS (mean ± SD: 160.1±24.3mmHg at rest vs 114.7±18.0mmHg during FMS, t5=6.3, P=.002). A 30% average reduction of peak pressure during stimulation via an SARS implant (143.2±31.7mmHg at rest vs 98.5±21.5mmHg during SARS, t5=4.4, P=.007) and a 22% average decrease of IT peak pressure during FES stimulation (153.7±34.8mmHg at rest vs 120.5±26.1mmHg during FES, t5=5.3, P=.003) were obtained. In 4 participants who completed both the FMS and FES studies, the percentage of peak pressure reduction with FMS was slightly greater than with FES (mean difference, 7.8%; 95% confidence interval, 1.6%-14.0; P=.04). SNRS or surface FES can induce sufficient gluteus maximus contraction and significantly reduce ischial pressure. SNRS via an SARS implant may be more convenient and efficient for frequently activating the gluteus maximus. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Direct Comparison of Wharton's Jelly and Bone Marrow-Derived Mesenchymal Stromal Cells to Enhance Engraftment of Cord Blood CD34+ Transplants

    Science.gov (United States)

    van der Garde, Mark; van Pel, Melissa; Millán Rivero, Jose Eduardo; de Graaf-Dijkstra, Alice; Slot, Manon C.; Kleinveld, Yoshiko; Watt, Suzanne M.; Roelofs, Helene

    2015-01-01

    Cotransplantation of CD34+ hematopoietic stem and progenitor cells (HSPCs) with mesenchymal stromal cells (MSCs) enhances HSPC engraftment. For these applications, MSCs are mostly obtained from bone marrow (BM). However, MSCs can also be isolated from the Wharton's jelly (WJ) of the human umbilical cord. This source, regarded to be a waste product, enables a relatively low-cost MSC acquisition without any burden to the donor. In this study, we evaluated the ability of WJ MSCs to enhance HSPC engraftment. First, we compared cultured human WJ MSCs with human BM-derived MSCs (BM MSCs) for in vitro marker expression, immunomodulatory capacity, and differentiation into three mesenchymal lineages. Although we confirmed that WJ MSCs have a more restricted differentiation capacity, both WJ MSCs and BM MSCs expressed similar levels of surface markers and exhibited similar immune inhibitory capacities. Most importantly, cotransplantation of either WJ MSCs or BM MSCs with CB CD34+ cells into NOD SCID mice showed similar enhanced recovery of human platelets and CD45+ cells in the peripheral blood and a 3-fold higher engraftment in the BM, blood, and spleen 6 weeks after transplantation when compared to transplantation of CD34+ cells alone. Upon coincubation, both MSC sources increased the expression of adhesion molecules on CD34+ cells, although stromal cell-derived factor-1 (SDF-1)-induced migration of CD34+ cells remained unaltered. Interestingly, there was an increase in CFU-GEMM when CB CD34+ cells were cultured on monolayers of WJ MSCs in the presence of exogenous thrombopoietin, and an increase in BFU-E when BM MSCs replaced WJ MSCs in such cultures. Our results suggest that WJ MSC is likely to be a practical alternative for BM MSC to enhance CB CD34+ cell engraftment. PMID:26414086

  7. Comparison of FcRγ-Deficient and CD57+ Natural Killer Cells Between Cord Blood and Adult Blood in the Cytomegalovirus-Endemic Korean Population.

    Science.gov (United States)

    Baek, Hee Jo; Kim, Da-Woon; Phan, Minh-Trang Thi; Kim, Ju-Sun; Yang, Ji-Hoon; Choi, Jeong Il; Lee, Je-Jung; Shin, Myung-Geun; Ryang, Dong-Wook; Kim, Sang-Ki; Lee, Seung-Hwan; Kook, Hoon; Cho, Duck

    2015-07-01

    FcRγ-deficient natural killer (NK) cells (g(-)NK cells) have been associated with cytomegalovirus (CMV) infection. However, the frequency of g(-)NK cells in a CMV-endemic area (i.e., Korea) has not yet been studied. We examined the frequency of g(-)NK cells and expression of CD57 on NK cells in cord blood (CB) and adult blood (AB). Of the 24 AB samples collected, 95.8% (23/24) were CMV IgG(+)/IgM(-), while 100% of the 13 healthy CB samples were CMV IgG(+)/IgM(-). We performed whole-blood flow cytometry assays to analyze intracellular FcRγ and CD3ζ expression of CD3(-)/CD56(dim) NK cells from 13 CB and 24 AB samples, and surface CD57 expression on CD3(-)/CD56(dim)/CD16(+) NK cells from 13 CB and 19 AB samples. All CMV seropositive AB samples contained g(-)NK cells (23/23), and the median proportion of g(-)NK cells in the CD3(-)/CD56(dim) NK cell pool was 35.0% (range: 11-77%). CD57(+) NK cells in the CD3(-)/CD56(dim)/CD16(+) NK cell population were detected in all 19 AB samples tested, but not in any CB samples. Our data suggest that g(-)NK cells and CD57(+) NK cells are present at a very high frequency in CMV-seropositive AB, but rare in CMV-naïve CB.

  8. Ultrasound, color - normal umbilical cord (image)

    Science.gov (United States)

    ... is a normal color Doppler ultrasound of the umbilical cord performed at 30 weeks gestation. The cord is ... the cord, two arteries and one vein. The umbilical cord is connected to the placenta, located in the ...

  9. "All that palsies is not Bell's" - The need to define Bell's palsy as an adverse event following immunization

    NARCIS (Netherlands)

    Rath, Barbara; Linder, Thomas; Cornblath, David; Hudson, Michael; Fernandopulle, Rohini; Hartmann, Katharina; Heininger, Ulrich; Izurieta, Hector; Killion, Leslie; Kokotis, Pangiotis; Oleske, James; Vajdy, Michael; Wong, Virginia

    2007-01-01

    Bell's palsy has been reported as an adverse event following immunization (AEFI). Review of the published literature reveals that several characteristics have been used to describe Bell's palsy, which differ significantly from author to author. Evidently, the definition of "Bell's palsy" remains

  10. Therapeutic results in sixth nerve palsy

    Directory of Open Access Journals (Sweden)

    Pruna Violeta-Ioana

    2015-03-01

    Full Text Available Authors aim to assess through a retrospective study the efficiency of different therapeutic methods used in VIth nerve palsy. 60 patients with VIth nerve palsy, admitted and treated in Oftapro Clinic, were divided into two groups: a group with partial dysfunction (paresis of sixth nerve and a group with the complete abolition of neuromuscular function (VIth nerve palsy. Initial examination included assessment of neuromuscular function, binocular vision and existence of medial rectus muscle contracture (ipsi- and contralateral and contralateral lateral rectus inhibitory palsy. Neuromuscular dysfunction was graded from - 8 (paralysis to 0 (normal abduction. Therapeutic modalities ranged from conservative treatment (occlusion, prism correction, botulinum toxin chemodenervation and surgical treatment: medial rectus recession + lateral rectus resection, in cases of paresis, and transposition procedures (Hummelscheim and full tendon transfer in cases of sixth nerve palsy. Functional therapeutic success was defined as absence of diplopia in primary position, with or without prism correction, and surgical success was considered obtaining orthoptic alignment in primary position or a small residual deviation (under 10 PD. 51 patients had unilateral dysfunction, and 9 patients had bilateral VI-th nerve dysfunction. 8 patients had associated fourth or seventh cranial nerves palsy. The most common etiology was traumatic, followed by tumor and vascular causes. There were 18 cases of spontaneous remission, partial or complete (4-8 months after the onset, and 6 cases enhanced by botulinum toxin chemodenervation. 17 paretic eyes underwent surgery, showing a very good outcome, with restoration of binocular single vision. The procedure of choice was recession of medial rectus muscle, combined with resection of lateral rectus muscle. All patients with sixth nerve palsy underwent surgery, except one old female patient, who refused surgery. Hummelscheim procedure was

  11. A comparison of FES with KAFO for providing ambulation and upright mobility in a child with a complete thoracic spinal cord injury.

    Science.gov (United States)

    Bonaroti, D; Akers, J; Smith, B T; Mulcahey, M J; Betz, R R

    1999-01-01

    This study compared functional and physiologic measures of ambulation and upright mobility with functional electrical stimulation (FES) versus knee-ankle-foot-orthoses (KAFO) in an 11-year-old boy with a T-10 level spinal cord injury. The child was a limited community ambulator with bilateral KAFO and loftstrand crutches. The FES system consisted of percutaneous intramuscular electrodes controlled by a portable stimulator and thumbswitch, an AFO for ankle and foot support, and loftstrand crutches. The subject used a swing-through gait pattern with both modes of mobility. The Functional Independence Measure scoring system and time to completion were used to compare performance in 6 standardized activities: donning, high transfer, inaccessible toilet transfer, ascend/descend stairs, and floor-to-standing transfer. Ten repeated measures were performed for each mode. Physiologic measures included energy expenditure, postural stability using forceplates, and a Functional Standing Test (FST). The subject performed all 6 mobility activities independently with FES and KAFO. In 4 of 6 activities, there was a trend toward faster times with FES, but this was not statistically significant. Toilet transfers and stair descent were performed significantly faster with KAFO. There was no difference in completion times on the activities of the FST. Measures of postural sway suggested that the subject was more stable with KAFO during quiet standing, while the modes were equal during a dynamic activity (raising arm for functional use). Energy expenditure results revealed no significant difference in oxygen cost per meter but a significantly higher oxygen consumption rate per minute for FES. Ambulation with both modes was performed at levels consistent with strenuous exercise. Maximum ambulation distances were relatively equal while the subject's velocity was significantly faster with FES. Of note, the subject reported ceasing ambulation during maximum distance trials due to general

  12. Sixth Nerve Palsy from Cholesterol Granuloma of the Petrous Apex

    Science.gov (United States)

    Roemer, Ségolène; Maeder, Philippe; Daniel, Roy Thomas; Kawasaki, Aki

    2017-01-01

    Herein, we report a patient who had an isolated sixth nerve palsy due to a petrous apex cholesterol granuloma. The sixth nerve palsy appeared acutely and then spontaneously resolved over several months, initially suggesting a microvascular origin of the palsy. Subsequent recurrences of the palsy indicated a different pathophysiologic etiology and MRI revealed the lesion at the petrous apex. Surgical resection improved the compressive effect of the lesion at Dorello’s canal and clinical improvement was observed. A relapsing–remitting sixth nerve palsy is an unusual presentation of this rare lesion. PMID:28261154

  13. Effectiveness of low cost adapted school furniture on the functional performance of a child with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Teixeira Piovezanni

    2014-06-01

    Full Text Available Individuals with cerebral palsy present an atypical motor function, characteristic altered postures in movement coordination and muscle tone. This causes limitations in their ability to perform functional activities. In this context, the introduction of assistive technology is vital to the objective of augmenting their ability to function productively and be included in society. It is common for individuals with cerebral palsy to have difficulty maintaining body dynamics, especially with seated posture. The objective of this study is to produce an adapted school desk and adapted school chair with low cost materials and to study their efficacy in adjusting the writing motor skills of a child with cerebral palsy. This stydi’s case is a boy who has been diagnosed with diplegic cerebral palsy. The collection and registration of data was done in three stages, with the child positioned in adapted furniture, regular school furniture and again in the furniture adapted to establish a comparison. Data analysis was through nonparametrical statistical tests. There was no statistical significance and was verified inconsistency in the data presented, because cannot be said for sure wich furniture was more effective in carrying while performing a proposed task and even if there was learning motor with its repetition. This fact does not invalidate the adequacy of school furniture to the student with cerebral palsy, because is an important factor facilitate control and postural stability to the individual, which interferes with fine motor skills of these individuals, influencing their performance in school activities.

  14. Importance of speech production for phonological awareness and word decoding: the case of children with cerebral palsy.

    Science.gov (United States)

    Peeters, Marieke; Verhoeven, Ludo; de Moor, Jan; van Balkom, Hans

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness, Phonological Short-term Memory (STM), Speech Perception, Speech Production and Nonverbal Reasoning were considered reading precursors. Children with cerebral palsy lag behind on all reading precursors at the beginning of the second year of kindergarten. For the children without disabilities, early reading skills in Grade 1 were best predicted by Phonological Awareness and Phonological STM while Speech Production was the most important predictor of early reading success for the children with cerebral palsy, followed by Phonological Awareness and Speech Perception. Furthermore, for children with cerebral palsy, Speech Production appears to dominate reading development, as Speech Production measured at the beginning of the second year of kindergarten was strongly predictive of all other reading precursors measured at the end of the second year of kindergarten. The results of this study reveal that children with cerebral palsy with additional speech impairments are at risk for limited literacy development. Clinical implications are discussed.

  15. An unusual cause of radial nerve palsy

    Directory of Open Access Journals (Sweden)

    Agrawal Hemendra Kumar

    2014-06-01

    Full Text Available Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed theliterature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure. Key words: Radial nerve; Humeral fractures; Paralysis; Diaphyses

  16. An unusual cause of radial nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Hemendra Kumar Agrawal; Vipin Khatkar; Mohit Garg; Balvinder Singh; Ashish Jaiman; Vinod Kumar Sharma

    2014-01-01

    Neurapraxia frequently occurs following traction injury to the nerve intraoperatively,leading to radial nerve palsy which usually recovers in 5-30 weeks.In our case,we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate.The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal.On the second postoperative day,following the suction drain removal and dressing,patient developed immediate radial nerve palsy along with wrist drop.We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.

  17. [Spinal cord infarction].

    Science.gov (United States)

    Naumann, N; Shariat, K; Ulmer, S; Stippich, C; Ahlhelm, F J

    2012-05-01

    Infarction of the spinal cord can cause a variety of symptoms and neurological deficits because of the complex vascular supply of the myelon. The most common leading symptom is distal paresis ranging from paraparesis to tetraplegia caused by arterial ischemia or infarction of the myelon. Venous infarction, however, cannot always be distinguished from arterial infarction based on the symptoms alone.Modern imaging techniques, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) assist in preoperative planning of aortic operations to reliably identify not only the most important vascular structure supplying the spinal cord, the artery of Adamkiewicz, but also other pathologies such as tumors or infectious disorders. In contrast to CT, MRI can reliably depict infarction of the spinal cord.

  18. Development of The Viking Speech Scale to classify the speech of children with cerebral palsy.

    Science.gov (United States)

    Pennington, Lindsay; Virella, Daniel; Mjøen, Tone; da Graça Andrada, Maria; Murray, Janice; Colver, Allan; Himmelmann, Kate; Rackauskaite, Gija; Greitane, Andra; Prasauskiene, Audrone; Andersen, Guro; de la Cruz, Javier

    2013-10-01

    Surveillance registers monitor the prevalence of cerebral palsy and the severity of resulting impairments across time and place. The motor disorders of cerebral palsy can affect children's speech production and limit their intelligibility. We describe the development of a scale to classify children's speech performance for use in cerebral palsy surveillance registers, and its reliability across raters and across time. Speech and language therapists, other healthcare professionals and parents classified the speech of 139 children with cerebral palsy (85 boys, 54 girls; mean age 6.03 years, SD 1.09) from observation and previous knowledge of the children. Another group of health professionals rated children's speech from information in their medical notes. With the exception of parents, raters reclassified children's speech at least four weeks after their initial classification. Raters were asked to rate how easy the scale was to use and how well the scale described the child's speech production using Likert scales. Inter-rater reliability was moderate to substantial (k>.58 for all comparisons). Test-retest reliability was substantial to almost perfect for all groups (k>.68). Over 74% of raters found the scale easy or very easy to use; 66% of parents and over 70% of health care professionals judged the scale to describe children's speech well or very well. We conclude that the Viking Speech Scale is a reliable tool to describe the speech performance of children with cerebral palsy, which can be applied through direct observation of children or through case note review. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Pathophysiology of muscle contractures in cerebral palsy.

    Science.gov (United States)

    Mathewson, Margie A; Lieber, Richard L

    2015-02-01

    Patients with cerebral palsy present with a variety of adaptations to muscle structure and function. These pathophysiologic symptoms include functional deficits such as decreased force production and range of motion, in addition to changes in muscle structure such as decreased muscle belly size, increased sarcomere length, and altered extracellular matrix structure and composition. On a cellular level, patients with cerebral palsy have fewer muscle stem cells, termed satellite cells, and altered gene expression. Understanding the nature of these changes may present opportunities for the development of new muscle treatment therapies.

  20. Education and employment prospects in cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Kejs, Anne Mette T

    2005-01-01

    Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819...... participants with CP born between 1965 and 1978 (471 males; mean age 28y 10 mo, SD 4y, range 21 to 35y) in the Danish Cerebral Palsy Registry were compared with 4406 controls without CP born between 1965 and 1978 (2546 males; mean age 28y 10 mo, SD 4y, range 21 to 35y). Diagnostic subtypes of the 819...

  1. Epidemiology of cerebral palsy in Southern Denmark

    DEFF Research Database (Denmark)

    Frøslev-Friis, Christina; Dunkhase-Heinl, Ulrike; Andersen, Johnny Dohn Holmgren

    2015-01-01

    INTRODUCTION: The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered. METHODS: A population-based cohort study covering 17...... prevention of CP is possible if the numbers of preterm births and multiple pregnancies can be reduced. FUNDING: The Danish Cerebral Palsy Follow-up Programme is supported by the foundation "Ludvig og Sara Elsass Fond". TRIAL REGISTRATION: 2008-58-0034....

  2. Epidemiology of cerebral palsy in Southern Denmark

    DEFF Research Database (Denmark)

    Frøslev-Friis, Christina; Dunkhase-Heinl, Ulrike; Andersen, Johnny Dohn Holmgren;

    2015-01-01

    INTRODUCTION: The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered. METHODS: A population-based cohort study covering 17...... prevention of CP is possible if the numbers of preterm births and multiple pregnancies can be reduced. FUNDING: The Danish Cerebral Palsy Follow-up Programme is supported by the foundation "Ludvig og Sara Elsass Fond". TRIAL REGISTRATION: 2008-58-0034....

  3. Feeding difficulties in children with cerebral palsy.

    Science.gov (United States)

    Andrew, Morag J; Parr, Jeremy R; Sullivan, Peter B

    2012-12-01

    Feeding difficulties are common in children with cerebral palsy and have an effect on growth, nutritional state, general health, social interaction and behaviour and developmental outcomes. Many factors have an effect on feeding ability. Identification of these factors and amelioration of their impact on feeding difficulties is essential to promote adequate growth and nutrition. Appropriate assessment and management is best achieved by a multiprofessional team skilled in the care of children with cerebral palsy and feeding impairments. Feeding difficulties must be considered within the wider context of family and social circumstance.

  4. Spinal cord swelling and candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Ho, K.; Gronseth, G.; Aldrich, M.; Williams, A.

    1982-11-01

    Fusiform swelling of the spinal cord was noted myelographically in a patient with Hodgkin's disease. Autopsy revealed that the swelling was caused by Candida infection of the spinal cord. It is suggested that fungal infection be included in the differential diagnosis of spinal cord swelling in the immunosuppressed cancer patient.

  5. Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell's palsy)

    OpenAIRE

    Hagberg Lars; Bremell Daniel

    2011-01-01

    Abstract Background Bell's palsy and Lyme neuroborreliosis are the two most common diagnoses in patients with peripheral facial palsy in areas endemic for Borrelia burgdorferi. Bell's palsy is treated with corticosteroids, while Lyme neuroborreliosis is treated with antibiotics. The diagnosis of Lyme neuroborreliosis relies on the detection of Borrelia antibodies in blood and/or cerebrospinal fluid, which is time consuming. In this study, we retrospectively analysed clinical and cerebrospinal...

  6. Spinal Cord Stimulation

    DEFF Research Database (Denmark)

    Meier, Kaare

    2014-01-01

    pain after failed back surgery syndrome (FBSS)(4), pain due to peripheral nerve injury, stump pain(5), peripheral vascular disease(6) and diabetic neuropathy(7,8); whereas phantom pain(9), postherpetic neuralgia(10), chronic visceral pain(11), and pain after partial spinal cord injury(12) remain more......Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain that is refractory to other treatment. Originally described by Shealy et al. in 1967(1), it is used to treat a range of conditions such as complex regional pain syndrome (CRPS I)(2), angina pectoris(3), radicular...

  7. Delayed cord clamping and cord gas analysis at birth.

    Science.gov (United States)

    Xodo, Serena; Xodo, Luigi; Berghella, Vincenzo

    2017-09-16

    Delayed cord clamping for at least 60 seconds in both term and preterm babies is a major recent change in clinical care. Delayed cord clamping has several effects on other possible interventions. One of these is the effect of delayed cord clamping on umbilical artery gas analysis. When indicated, umbilical artery gas analysis can safely be done either with early cord clamping, or, probably most of the times it is necessary, during delayed cord clamping with the cord still unclamped. Paired blood samples (one from the umbilical artery and one from the umbilical vein) can be taken from the pulsating and unclamped cord, immediately after birth, during delayed cord clamping, without any effect on either the accuracy of umbilical artery gas analysis or on the transfusion of blood through delayed cord clamping. Umbilical artery gas analysis should instead not be done after delayed cord clamping, since delayed cord clamping alters several acid-based parameters and lactate values. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society.

    Science.gov (United States)

    Santosa, Katherine B; Fattah, Adel; Gavilán, Javier; Hadlock, Tessa A; Snyder-Warwick, Alison K

    2017-07-01

    There is no widely accepted assessment tool or common language used by clinicians caring for patients with facial palsy, making exchange of information challenging. Standardized photography may represent such a language and is imperative for precise exchange of information and comparison of outcomes in this special patient population. To review the literature to evaluate the use of facial photography in the management of patients with facial palsy and to examine the use of photography in documenting facial nerve function among members of the Sir Charles Bell Society-a group of medical professionals dedicated to care of patients with facial palsy. A literature search was performed to review photographic standards in patients with facial palsy. In addition, a cross-sectional survey of members of the Sir Charles Bell Society was conducted to examine use of medical photography in documenting facial nerve function. The literature search and analysis was performed in August and September 2015, and the survey was conducted in August and September 2013. The literature review searched EMBASE, CINAHL, and MEDLINE databases from inception of each database through September 2015. Additional studies were identified by scanning references from relevant studies. Only English-language articles were eligible for inclusion. Articles that discussed patients with facial palsy and outlined photographic guidelines for this patient population were included in the study. The survey was disseminated to the Sir Charles Bell Society members in electronic form. It consisted of 10 questions related to facial grading scales, patient-reported outcome measures, other psychological assessment tools, and photographic and videographic recordings. In total, 393 articles were identified in the literature search, 7 of which fit the inclusion criteria. Six of the 7 articles discussed or proposed views specific to patients with facial palsy. However, none of the articles specifically focused on

  9. Spinal Cord Stimulation

    DEFF Research Database (Denmark)

    Meier, Kaare

    2014-01-01

    pain after failed back surgery syndrome (FBSS)(4), pain due to peripheral nerve injury, stump pain(5), peripheral vascular disease(6) and diabetic neuropathy(7,8); whereas phantom pain(9), postherpetic neuralgia(10), chronic visceral pain(11), and pain after partial spinal cord injury(12) remain more...

  10. Use of Actuator-Driven Pulsed Water Jet in Brain and Spinal Cord Cavernous Malformations Resection.

    Science.gov (United States)

    Endo, Toshiki; Takahashi, Yoko; Nakagawa, Atsuhiro; Niizuma, Kuniyasu; Fujimura, Miki; Tominaga, Teiji

    2015-09-01

    A piezo actuator-driven pulsed water jet (ADPJ) system is a novel surgical instrument that enables dissection of tissue without thermal damage. It can potentially resect intra-axial lesions while preserving neurological function. To report our first experience of applying an ADPJ system to brain and spinal cord cavernous malformations. Four patients (2 women and 2 men, mean age 44.5 years) with brain (n = 3) and spinal cord (n = 1) cavernous malformations were enrolled in the study. All surgeries were performed with the aid of the ADPJ system. Postoperative neurological function and radiological findings were evaluated. The ADPJ system was useful in dissecting boundaries between the lesion and surrounding brain/spinal cord tissues. The pulsed water jet provided a clear surgical view and helped surgeons follow the margins. Water jet dissection peeled off the brain and spinal cord tissues from the lesion wall. Surrounding gliotic tissue was preserved. As a consequence, the cavernous malformations were successfully removed. Postoperative magnetic resonance imaging confirmed total removal of lesions in all cases. Preoperative neurological symptoms completely resolved in 2 patients. The others experienced partial recovery. No patients developed new postoperative neurological deficits; facial palsy temporarily worsened in 1 patient who underwent a suprafacial colliculus approach for the brainstem lesion. The ADPJ provided a clear surgical field and enabled surgeons to dissect boundaries between lesions and surrounding brain and spinal cord gliotic tissue. The ADPJ system is a feasible option for cavernous malformation surgery, enabling successful tumor removal and preservation of neurological function.

  11. Gait Stability in Children with Cerebral Palsy

    Science.gov (United States)

    Bruijn, Sjoerd M.; Millard, Matthew; van Gestel, Leen; Meyns, Pieter; Jonkers, Ilse; Desloovere, Kaat

    2013-01-01

    Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as…

  12. VII NERVE PALSY — EVALUATION AND MANAGEMENT

    African Journals Online (AJOL)

    Enrique

    Facial nerve palsy is a devastating and readily visible nerve injury. Loss of tone ... Bell's occurs at any age, with a slight ... Surgery at the Nelson Mandela School of. Medicine, King Edward ..... cosmetic surgery (muscle transfer/ facial slings) is ...

  13. Peripheral nerve involvement in Bell's palsy

    Directory of Open Access Journals (Sweden)

    J. A. Bueri

    1984-12-01

    Full Text Available A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.

  14. Pretend Play of Children with Cerebral Palsy

    Science.gov (United States)

    Pfeifer, Luzia Iara; Pacciulio, Amanda Mota; dos Santos, Camila Abrao; dos Santos, Jair Licio; Stagnitti, Karen Ellen

    2011-01-01

    Background and Purpose: Evaluate self-initiated pretend play of children with cerebral palsy. Method: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. Results: There were significant negative correlations between the children's…

  15. Clinical practice: swallowing problems in cerebral palsy.

    NARCIS (Netherlands)

    Erasmus, C.E.; Hulst, K. van; Rotteveel, J.J.; Willemsen, M.A.A.P.; Jongerius, P.H.

    2012-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the

  16. Epidemiology of cerebral palsy in Southern Denmark

    DEFF Research Database (Denmark)

    Frøslev-Friis, Christina; Dunkhase-Heinl, Ulrike; Andersen, Johnny Dohn Holmgren;

    2015-01-01

    INTRODUCTION: The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered. METHODS: A population-based cohort study covering 17,580 l...

  17. Early identification and intervention in cerebral palsy

    DEFF Research Database (Denmark)

    Herskind, Anna; Greisen, Gorm; Nielsen, Jens Bo

    2015-01-01

    Infants with possible cerebral palsy (CP) are commonly assumed to benefit from early diagnosis and early intervention, but substantial evidence for this is lacking. There is no consensus in the literature on a definition of 'early', but this review focuses on interventions initiated within the fi...

  18. Social integration of adults with cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Hansen, Thomas

    2006-01-01

    Social integration and independence is the ultimate goal of habilitation and social support for patients with cerebral palsy (CP). Having a partner and having children provide support for social integration of adults with or without a disability. We studied 416 participants with CP born between...

  19. Gait Stability in Children with Cerebral Palsy

    Science.gov (United States)

    Bruijn, Sjoerd M.; Millard, Matthew; van Gestel, Leen; Meyns, Pieter; Jonkers, Ilse; Desloovere, Kaat

    2013-01-01

    Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as…

  20. Cerebral Palsy. NICHCY Disability Fact Sheet #2

    Science.gov (United States)

    National Dissemination Center for Children with Disabilities, 2010

    2010-01-01

    Cerebral palsy--also known as CP--is a condition caused by injury to the parts of the brain that control the body's ability to use muscles effectively. Often the injury happens before birth, sometimes during delivery or soon after birth. The symptoms will differ from person to person and change as children and their nervous systems mature. This…

  1. Educational Solutions for Children with Cerebral Palsy

    Science.gov (United States)

    Driver, Lynn; Omichinski, Donna Riccio; Miller, Nicole; Sandella, Danielle; Warschausky, Seth

    2010-01-01

    This paper characterizes educational strengths and needs of children with cerebral palsy (CP) and connects research findings from the University of Michigan's Adapted Cognitive Assessment Lab (ACAL) to current special educational requirements. It acknowledges the uniqueness of educating a child with significant motor and communication disabilities…

  2. Pretend Play of Children with Cerebral Palsy

    Science.gov (United States)

    Pfeifer, Luzia Iara; Pacciulio, Amanda Mota; dos Santos, Camila Abrao; dos Santos, Jair Licio; Stagnitti, Karen Ellen

    2011-01-01

    Background and Purpose: Evaluate self-initiated pretend play of children with cerebral palsy. Method: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. Results: There were significant negative correlations between the children's…

  3. Cerebral Palsy: Still A Social Problem

    Directory of Open Access Journals (Sweden)

    Angom Bisharda

    1997-08-01

    Full Text Available Research Problem: What arc the social aspects of cerebral palsy?Objective: To determine the extent and severity of neuromuscular involvement in cases of cerebral palsy and to find out the associated defects among these children.Study Design: Cross sectional study.Setting: Tertiary care hospital, outdoor patients.Participants: Children in the age group of 0 - 12 years.Sample Size: 120 children suffering from cerebral palsy.Study Variables: Social factors, neuromuscular involvement.Statistical Analysis: By proportionsResult: Out of 120 cases, maximum number of cases (66.6% were in the age group of 1- 4 years. 83 cases ( 69.16% were males. Among the various types, spastic type was the commonest (87.5%. Of these spastic cases, 52 (49.52% had quadriplegia. No case of tremor and rigidity was seen. Delayed milestones was the commonest associated disorder, seen in 107 (89.16% cases, followed by speech defect in 58(48.3% cases, visual defect in 34(28.3% cases and convulsions in 24 (20.0% cases. Hearing defect was seen in 5 cases (4.16% only.Conclusion: More concerted efforts arc required to identify children with cerebral palsy and rehabilitate them for the betterment of society.

  4. Clinical practice: swallowing problems in cerebral palsy.

    NARCIS (Netherlands)

    Erasmus, C.E.; Hulst, K. van; Rotteveel, J.J.; Willemsen, M.A.A.P.; Jongerius, P.H.

    2012-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the

  5. Thyroxine Level of Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    Zhang Jie

    2000-01-01

    Objective:To investigate the thyroxine level of Children with cerebral palsy so as to understand thd changes of their nevous endocrine. Methods:Radioimmunoassay was applied to 57 Children with cerebral palsy and 108 normal children.The serum level of tridothyronine(T3), thyroxine(T4)free tridothyronine(FT3),free thyroxin(FT4),and thyroid stimulating hormone(TSH) were measured for those children in the moming and and in condition without any food Rsults: (1)Chiidren with cerebral palsy all showed low T3 values.The difference of T3 value between CP children and norrmal children was significant (P<0.001). (2)Results from groups with difference ages:the CP toddler′s age group also showed low T4 and FT4 values The difference of T4 and FT4 values between the toddler′s age CP childrengroup and the toddler′s age normal children group tegted was significant (CP<0.01 for T4, P <0. 05 for FT4): Conclusion:The tlyroxine level of children with cerebral palsy showed lower values compared to normal children, especisly, the low T3 values were significant.

  6. Cerebral Palsy--A Continuing Battle.

    Science.gov (United States)

    Gullerud, Ruth A.

    1979-01-01

    A review of the changes in the treatment of and attitudes toward cerebral palsy in the last 30 years is presented. The author stresses the need for early diagnosis and evaluation, day care (especially respite care), counseling, transportation, special living arrangements, and integration of this population. (PHR)

  7. Facial nerve palsy and hemifacial spasm.

    Science.gov (United States)

    Valls-Solé, Josep

    2013-01-01

    Facial nerve lesions are usually benign conditions even though patients may present with emotional distress. Facial palsy usually resolves in 3-6 weeks, but if axonal degeneration takes place, it is likely that the patient will end up with a postparalytic facial syndrome featuring synkinesis, myokymic discharges, and hemifacial mass contractions after abnormal reinnervation. Essential hemifacial spasm is one form of facial hyperactivity that must be distinguished from synkinesis after facial palsy and also from other forms of facial dyskinesias. In this condition, there can be ectopic discharges, ephaptic transmission, and lateral spread of excitation among nerve fibers, giving rise to involuntary muscle twitching and spasms. Electrodiagnostic assessment is of relevance for the diagnosis and prognosis of peripheral facial palsy and hemifacial spasm. In this chapter the most relevant clinical and electrodiagnostic aspects of the two disorders are reviewed, with emphasis on the various stages of facial palsy after axonal degeneration, the pathophysiological mechanisms underlying the various features of hemifacial spasm, and the cues for differential diagnosis between the two entities.

  8. Cerebral palsy: the first three years.

    Science.gov (United States)

    Hoffer, M M; Koffman, M

    1980-09-01

    The orthopedic surgeion should be an integral part of a medical team for evaluation and treatment of young children with cerebral palsy. Surgical procedures in this first three years of life are usually limited to the adductor releases about the hip. Stretching and plastic splints about the ankle and knee followed by ankle-foot orthoses are frequently effective in correction of deformity.

  9. Precise control of miR-125b levels is required to create a regeneration-permissive environment after spinal cord injury: a cross-species comparison between salamander and rat

    OpenAIRE

    Juan Felipe Diaz Quiroz; Eve Tsai; Matthew Coyle; Tina Sehm; Karen Echeverri

    2014-01-01

    Most spinal cord injuries lead to permanent paralysis in mammals. By contrast, the remarkable regenerative abilities of salamanders enable full functional recovery even from complete spinal cord transections. The molecular differences underlying this evolutionary divergence between mammals and amphibians are poorly understood. We focused on upstream regulators of gene expression as primary entry points into this question. We identified a group of microRNAs (miRNAs) that are conserved between ...

  10. Sleep disordered breathing following spinal cord injury

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Jennum, Poul; Laub, Michael

    2009-01-01

    Individuals with spinal cord injury (SCI) commonly complain about difficulty in sleeping. Although various sleep disordered breathing definitions and indices are used that make comparisons between studies difficult, it seems evident that the frequency of sleep disorders is higher in individuals...... with SCI, especially with regard to obstructive sleep apnea. In addition, there is a correlation between the incidence of sleep disturbances and the spinal cord level injured, age, body mass index, neck circumference, abdominal girth, and use of sedating medications. Regulation of respiration is dependent...... on wakefulness and sleep. Thus, it is important to be aware of basic mechanisms in the regulation and control of sleep and awake states. Supine position decreases the vital capacity in tetraplegic individuals, and diminished responsiveness to Pa(CO)(2) may further decrease ventilatory reserve. There also may...

  11. Stem cells for cerebral palsy%干细胞在脑性瘫痪治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    王金刚; 尹忠民; 闻华

    2011-01-01

    BACKGROUND: Stem cells under appropriate conditions can differentiate into neurons, astrocytes and oligodendrocytes, which may radically improve neurons loss and glial cell degeneration in cerebral palsy children, thus to improve brain function in children.OBJECTIVE: To retrospectively analyze the effects of stem cells from different sources on cerebral palsy children. METHODS: The first author searched PubMed and Wanfang databases (1992/2011) for articles concerning therapies for cerebral palsy and stem cells from different sources for cerebral palsy. RESULTS AND CONCLUSION: Neural stem cells for animal nerve injury repair have been a reported, but the clinical application of neural stem cells is still in clinical trials. Although embryonic, bone marrow blood, fetal cord blood, umbilical cord-derived stem cells have been applied to child cerebral palsy in some hospitals and a preliminary efficacy has been obtained, the specific evaluation criteria and long-term effects remain to be further studied.%背景:干细胞在适当条件下可以分化为神经元细胞、星形胶质细胞与少突胶质细胞,可能从根本上改善脑性瘫痪患儿神经元缺失及神经胶质细胞变性,进而改善患儿脑功能障碍,从理论上达到根治目的.目的:回顾性分析不同来源干细胞经不同途径治疗脑性瘫痪患儿的疗效.方法:由第一作者检索1992/2011 PubMed数据及万方数据库有关脑性瘫痪的治疗及不同来源干细胞在治疗脑性瘫痪等方面的文献.结果与结论:神经干细胞在动物神经功能损伤中的修复作用已有很多国内外报道,但目前其在人体的临床应用仍处于临床试验阶段.虽然胚胎、骨髓血、胎儿脐带血、脐带来源的干细胞已在部分医院应用到脑性瘫痪患儿中,并取得了初步的疗效,其具体评定标准及长期疗效仍有待进一步随访、观察.

  12. Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Luanda A. C. Grecco

    2013-02-01

    Full Text Available BACKGROUND: Treadmill gait training as a therapeutic resource in the rehabilitation of children with cerebral palsy has recently been the focus of many studies; however, little is still known regarding its effect on static and functional balance in children. OBJECTIVE: The aim of the present study was to compare the effects of treadmill training and over ground gait training in children with cerebral palsy. METHOD: A randomized controlled trial with blinded evaluator was conducted with children with cerebral palsy between three and 12 years of age categorized in Levels I to III of the Gross Motor Function Classification System. Assessments were performed before and after the intervention and involved the Berg balance scale as well as the determination of oscillations from the center of pressure in the anteroposterior and mediolateral directions with eyes open and closed. The experimental group was submitted to treadmill training and the control group performed gait training over the ground. The intervention consisted of two 30-minute sessions per week for seven weeks. RESULTS: Both groups exhibited better functional balance after the protocol. The experimental group had higher Berg balance scale scores and exhibited lesser mediolateral oscillation with eyes open in comparison to the control group. CONCLUSIONS: Treadmill training had a greater effect on functional balance and mediolateral oscillation in comparison to over ground gait training in children with cerebral palsy. Trial registration: RBR-5v3kg9.(Brazilian Registry of Clinical Trials.

  13. A Case of Successful Foraminotomy for Severe Bilateral C5 Palsy following Posterior Decompression and Fusion Surgery for Cervical Ossification of Posterior Longitudinal Ligament

    Directory of Open Access Journals (Sweden)

    Yoshifumi Kudo

    2016-01-01

    Full Text Available We report a very rare (5~7% case of bilateral C5 palsy after cervical surgery. A 71-year-old male patient with cervical ossification of posterior longitudinal ligament (OPLL with foraminal stenosis at bilateral C4/5 underwent posterior decompression and fusion surgery. After surgery, muscle weakness in his both deltoid and biceps was detected and gradually deteriorated to complete paralysis. Postoperative MRI showed sufficient decompression of the spinal cord and posterior shifting. Subsequently, an additional bilateral foraminotomy at C4/5 was performed, with a suspicion that bilateral foraminal stenosis at C4/5 may have been the cause of the paresis. After foraminotomy, muscular contraction was seen in both deltoid and biceps. Finally, complete motor recovery was achieved in a year. Although the gold standard procedure for the prevention and treatment of postoperative C5 palsy has not yet been established, an additional foraminotomy may be recommended for severe C5 palsy in cases of foraminal stenosis even after the occurrence of palsy.

  14. The diagnostic yield of neuroimaging in sixth nerve palsy - Sankara Nethralaya Abducens Palsy Study (SNAPS: Report 1

    Directory of Open Access Journals (Sweden)

    Akshay Gopinathan Nair

    2014-01-01

    Full Text Available Aims: The aim was to assess the etiology of sixth nerve palsy and on the basis of our data, to formulate a diagnostic algorithm for the management in sixth nerve palsy. Design: Retrospective chart review. Results: Of the 104 neurologically isolated cases, 9 cases were attributable to trauma, and 95 (86.36% cases were classified as nontraumatic, neurologically isolated cases. Of the 95 nontraumatic, isolated cases of sixth nerve palsy, 52 cases were associated with vasculopathic risk factors, namely diabetes and hypertension and were classified as vasculopathic sixth nerve palsy (54.7%, and those with a history of sixth nerve palsy from birth (6 cases were classified as congenital sixth nerve palsy (6.3%. Of the rest, neuroimaging alone yielded a cause in 18 of the 37 cases (48.64%. Of the other 19 cases where neuroimaging did not yield a cause, 6 cases were attributed to preceding history of infection (3 upper respiratory tract infection and 3 viral illnesses, 2 cases of sixth nerve palsy were found to be a false localizing sign in idiopathic intracranial hypertension and in 11 cases, the cause was undetermined. In these idiopathic cases of isolated sixth nerve palsy, neuroimaging yielded no positive findings. Conclusions: In the absence of risk factors, a suggestive history, or positive laboratory and clinical findings, neuroimaging can serve as a useful diagnostic tool in identifying the exact cause of sixth nerve palsy. Furthermore, we recommend an algorithm to assess the need for neuroimaging in sixth nerve palsy.

  15. The diagnostic yield of neuroimaging in sixth nerve palsy--Sankara Nethralaya Abducens Palsy Study (SNAPS): Report 1.

    Science.gov (United States)

    Nair, Akshay Gopinathan; Ambika, Selvakumar; Noronha, Veena Olma; Gandhi, Rashmin Anilkumar

    2014-10-01

    The aim was to assess the etiology of sixth nerve palsy and on the basis of our data, to formulate a diagnostic algorithm for the management in sixth nerve palsy. Retrospective chart review. Of the 104 neurologically isolated cases, 9 cases were attributable to trauma, and 95 (86.36%) cases were classified as nontraumatic, neurologically isolated cases. Of the 95 nontraumatic, isolated cases of sixth nerve palsy, 52 cases were associated with vasculopathic risk factors, namely diabetes and hypertension and were classified as vasculopathic sixth nerve palsy (54.7%), and those with a history of sixth nerve palsy from birth (6 cases) were classified as congenital sixth nerve palsy (6.3%). Of the rest, neuroimaging alone yielded a cause in 18 of the 37 cases (48.64%). Of the other 19 cases where neuroimaging did not yield a cause, 6 cases were attributed to preceding history of infection (3 upper respiratory tract infection and 3 viral illnesses), 2 cases of sixth nerve palsy were found to be a false localizing sign in idiopathic intracranial hypertension and in 11 cases, the cause was undetermined. In these idiopathic cases of isolated sixth nerve palsy, neuroimaging yielded no positive findings. In the absence of risk factors, a suggestive history, or positive laboratory and clinical findings, neuroimaging can serve as a useful diagnostic tool in identifying the exact cause of sixth nerve palsy. Furthermore, we recommend an algorithm to assess the need for neuroimaging in sixth nerve palsy.

  16. A preliminary report on the use of laser-Doppler flowmetry during tethered spinal cord release.

    Science.gov (United States)

    Schneider, S J; Rosenthal, A D; Greenberg, B M; Danto, J

    1993-02-01

    Neurological deterioration in the tethered cord syndrome has been postulated to result from a compromise of blood flow in the distal spinal cord. In order to evaluate vascular perfusion in human subjects, a new technique of laser-Doppler flowmetry was used to monitor continuously the microcirculation of the distal spinal cord during surgery for tethered cord release in 10 children. For further comparison, five children undergoing selective dorsal rhizotomy were also monitored. In the tethered cord syndrome group, spinal cord blood flow before untethering was a mean of 12.6 ml/min per 100 g of tissue and increased in all cases after release to a mean of 29.4 ml/min per 100 g of tissue. All patients improved neurologically. The selective dorsal rhizotomy group had a preoperative mean spinal cord blood flow of 30.8 ml/min per 100 g of tissue, which was not altered by the operative procedure. Significant improvement occurs in distal spinal cord blood flow after tethered cord release, which may be representative of an important mechanism in the pathophysiology of the tethered cord syndrome.

  17. The relation of breech presentation at term to cerebral palsy

    DEFF Research Database (Denmark)

    Krebs, L; Topp, M; Langhoff-Roos, J

    1999-01-01

    OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...... palsy, severity of handicap. RESULTS: Breech presentation at term was associated with a borderline significantly higher risk of cerebral palsy than vertex presentation (OR 1.56; 95% CI 0.9-2.4). Breech presentation infants more often had a lower Apgar score (

  18. Comparison of different orthosis for improving gait in patients with spinal cord injury%脊髓损伤患者E-MAG和落环锁式膝踝足矫形器的应用对比◆

    Institute of Scientific and Technical Information of China (English)

    吴强; 马宗浩; 何成奇

    2013-01-01

    BACKGROUND: Drop ring lock knee-ankle-foot orthosis has been widely used in patients with higher level spinal cord injury, with one primary limitation in ambulation being attributable to the absence of knee flexion in swing phase. As a result, an individual is forced to use compensatory upper body motions to advance the legs. At present, the research on the comparison between different knee-ankle-foot orthoses is rare. OBJECTIVE: To investigate and compare the clinical effect of E-MAG and drop ring lock knee-ankle-foot orthosis in the treatment of the patients with spinal cord injury. METHODS: With the approach of case crossover study, the application effect of drop ring lock knee-ankle-foot orthosis in combination with an E-MAG on a patient with a T10 spinal cord injury was observed. With the measurement of three-dimensional gait data, a comparison was made between the scenarios of having the knees locked during the entire gait cycle to that of al owing the knees to flex freely during the swing phase, yet stil be locked for stability during stance. RESULTS AND CONCLUSION: Qualitative observation and kinematic three-dimensional gait data demonstrated that this patient ambulated with a faster, more efficient gait pattern when using E-MAG. Despite having no voluntary control of knees, this orthotic option afforded the ability to walk safely and smoothly with both knees flexing during swing and knee lock in stance phase, and with less upper body compensation. Compared with drop ring lock knee-ankle-foot orthosis, E-MAG active orthosis contains stance phase control, so it has higher degree of acceptance and practicality%  背景:落环锁式膝踝足矫形器在较高位脊髓损伤患者中被广泛应用,但该矫形器在行走时有一个主要限制即摆动期膝关节锁定,导致患者在行走时需要通过上肢活动来补偿。目前有关不同矫形器治疗效果的对比鲜有研究。目的:探究并对比E-MAG活跃型矫形器和落环

  19. Combination of Citicoline and Physiotherapy in Children with Cerebral Palsy

    OpenAIRE

    Jafar Nasiri; Mehran Kargar

    2014-01-01

    Background: The most common cause of physical disability in children is cerebral palsy. This study was aimed to evaluate the effect of citicoline in combination to physiotherapy versus physiotherapy alone, to improve the functional outcome in pediatric cerebral palsy. Methods: The clinical trial was performed on 50 pediatric patients aged 18-75 months with spastic diplegia or quadriplegic cerebral palsy. Patients were assessed in two groups: case group, under treatment, using injection of...

  20. Benign recurrent abducens (6th) nerve palsy in two children.

    Science.gov (United States)

    Knapp, Christopher M; Gottlob, Irene

    2004-03-01

    Benign recurrent abducens (6th) nerve palsy is rare. We found 23 cases in children reported in the literature; however, many of these cases followed immunization or were associated with viral illness. Here we report two cases of recurrent abducens nerve palsy with no obvious etiology. The diagnosis should be considered in any child who experiences abducens nerve palsy in the absence of any underlying pathology or precipitating factors.

  1. Treadmill training with partial body weight support compared with conventional gait training for low-functioning children and adolescents with nonspastic cerebral palsy: a two-period crossover study.

    Science.gov (United States)

    Su, Ivan Y W; Chung, Kenny K Y; Chow, Daniel H K

    2013-12-01

    Partial body weight-supported treadmill training has been shown to be effective in gait training for patients with neurological disorders such as spinal cord injuries and stroke. Recent applications on children with cerebral palsy were reported, mostly on spastic cerebral palsy with single subject design. There is lack of evidence on the effectiveness of such training for nonspastic cerebral palsy, particularly those who are low functioning with limited intellectual capacity. This study evaluated the effectiveness of partial body weight-supported treadmill training for improving gross motor skills among these clients. A two-period randomized crossover design with repeated measures. A crossover design following an A-B versus a B-A pattern was adopted. The two training periods consisted of 12-week partial body weight-supported treadmill training (Training A) and 12-week conventional gait training (Training B) with a 10-week washout in between. Ten school-age participants with nonspastic cerebral palsy and severe mental retardation were recruited. The Gross Motor Function Measure-66 was administered immediately before and after each training period. Significant improvements in dimensions D and E of the Gross Motor Function Measure-66 and the Gross Motor Ability Estimator were obtained. Our findings revealed that the partial body weight-supported treadmill training was effective in improving gross motor skills for low-functioning children and adolescents with nonspastic cerebral palsy. .

  2. Isolated abducens nerve palsy with hyperhomocysteinemia: Association and outcomes

    Directory of Open Access Journals (Sweden)

    Virender Sachdeva

    2013-01-01

    Full Text Available Ischemic abducens nerve palsy usually presents as isolated cranial nerve palsy in the middle aged and elderly patients with known risk factors such as diabetes mellitus, hypertension, dyslipidemia, carotid artery disease, etc., In this report, we describe four patients with isolated abducens nerve palsy who presented with an acute onset diplopia whose detailed history and examination were suggestive of an ischemic etiology. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge this is the first report of association of hyperhomocysteinemia and isolated abducens nerve palsy.

  3. Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell's palsy

    Directory of Open Access Journals (Sweden)

    Hagberg Lars

    2011-08-01

    Full Text Available Abstract Background Bell's palsy and Lyme neuroborreliosis are the two most common diagnoses in patients with peripheral facial palsy in areas endemic for Borrelia burgdorferi. Bell's palsy is treated with corticosteroids, while Lyme neuroborreliosis is treated with antibiotics. The diagnosis of Lyme neuroborreliosis relies on the detection of Borrelia antibodies in blood and/or cerebrospinal fluid, which is time consuming. In this study, we retrospectively analysed clinical and cerebrospinal fluid parameters in well-characterised patient material with peripheral facial palsy caused by Lyme neuroborreliosis or Bell's palsy, in order to obtain a working diagnosis and basis for treatment decisions in the acute stage. Methods Hospital records from the Department of Infectious Diseases, Sahlgrenska University Hospital, for patients with peripheral facial palsy that had undergone lumbar puncture, were reviewed. Patients were classified as Bell's palsy, definite Lyme neuroborreliosis, or possible Lyme neuroborreliosis, on the basis of the presence of Borrelia antibodies in serum and cerebrospinal fluid and preceding erythema migrans. Results One hundred and two patients were analysed; 51 were classified as Bell's palsy, 34 as definite Lyme neuroborreliosis and 17 as possible Lyme neuroborreliosis. Patients with definite Lyme neuroborreliosis fell ill during the second half of the year, with a peak in August, whereas patients with Bell's palsy fell ill in a more evenly distributed manner over the year. Patients with definite Lyme neuroborreliosis had significantly more neurological symptoms outside the paretic area of the face and significantly higher levels of mononuclear cells and albumin in their cerebrospinal fluid. A reported history of tick bite was uncommon in both groups. Conclusions We found that the time of the year, associated neurological symptoms and mononuclear pleocytosis were strong predictive factors for Lyme neuroborreliosis as a

  4. Immature spinal locomotor output in children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Germana Cappellini

    2016-10-01

    Full Text Available Detailed descriptions of gait impairments have been reported in cerebral palsy (CP, but it is still unclear how maturation of the spinal motoneuron output is affected. Spatiotemporal alpha-motoneuron activation during walking can be assessed by mapping the electromyographic activity profiles from several, simultaneously recorded muscles onto the anatomical rostrocaudal location of the motoneuron pools in the spinal cord, and by means of factor analysis of the muscle activity profiles. Here, we analysed gait kinematics and EMG activity of 11 pairs of bilateral muscles with lumbosacral innervation in 35 children with CP (19 diplegic, 16 hemiplegic, 2-12 years and 33 typically developing (TD children (1-12 years. TD children showed a progressive reduction of EMG burst durations and a gradual reorganization of the spatiotemporal motoneuron output with increasing age. By contrast, children with CP showed very limited age-related changes of EMG durations and motoneuron output, as well as of limb intersegmental coordination and foot trajectory control (on both sides for diplegic children and the affected side for hemiplegic children. Factorization of the EMG signals revealed a comparable structure of the motor output in children with CP and TD children, but significantly wider temporal activation patterns in children with CP, resembling the patterns of much younger TD infants. A similar picture emerged when considering the spatiotemporal maps of alpha-motoneuron activation. Overall, the results are consistent with the idea that early injuries to developing motor regions of the brain substantially affect the maturation of the spinal locomotor output and consequently the future locomotor behaviour.

  5. Is early cord clamping, delayed cord clamping or cord milking best?

    Science.gov (United States)

    Vatansever, Binay; Demirel, Gamze; Ciler Eren, Elif; Erel, Ozcan; Neselioglu, Salim; Karavar, Hande Nur; Gundogdu, Semra; Ulfer, Gozde; Bahadir, Selcen; Tastekin, Ayhan

    2017-03-20

    To compare the antioxidant status of three cord clamping procedures (early clamping, delayed clamping and milking) by analyzing the thiol-disulfide balance. This randomized controlled study enrolled 189 term infants who were divided into three groups according to the cord clamping procedure: early clamping, delayed clamping and milking. Blood samples were collected from the umbilical arteries immediately after clamping, and the thiol/disulfide homeostasis was analyzed. The native and total thiol levels were significantly (p cord clamping group compared with the other two groups. The disulfide/total thiol ratio was significantly (p = .026) lower in the delayed cord clamping and milking groups compared with the early clamping groups. Early cord clamping causes the production of more disulfide bonds and lower thiol levels, indicating that oxidation reactions are increased in the early cord clamping procedure compared with the delayed cord clamping and milking procedures. The oxidant capacity is greater with early cord clamping than with delayed clamping or cord milking. Delayed cord clamping or milking are beneficial in neonatal care, and we suggest that they be performed routinely in all deliveries.

  6. Precise control of miR-125b levels is required to create a regeneration-permissive environment after spinal cord injury: a cross-species comparison between salamander and rat.

    Science.gov (United States)

    Diaz Quiroz, Juan Felipe; Tsai, Eve; Coyle, Matthew; Sehm, Tina; Echeverri, Karen

    2014-06-01

    Most spinal cord injuries lead to permanent paralysis in mammals. By contrast, the remarkable regenerative abilities of salamanders enable full functional recovery even from complete spinal cord transections. The molecular differences underlying this evolutionary divergence between mammals and amphibians are poorly understood. We focused on upstream regulators of gene expression as primary entry points into this question. We identified a group of microRNAs (miRNAs) that are conserved between the Mexican axolotl salamander (Ambystoma mexicanum) and mammals but show marked cross-species differences in regulation patterns following spinal cord injury. We found that precise post-injury levels of one of these miRNAs (miR-125b) is essential for functional recovery, and guides correct regeneration of axons through the lesion site in a process involving the direct downstream target Sema4D in axolotls. Translating these results to a mammalian model, we increased miR-125b levels in the rat through mimic treatments following spinal cord transection. These treatments downregulated Sema4D and other glial-scar-related genes, and enhanced the animal's functional recovery. Our study identifies a key regulatory molecule conserved between salamander and mammal, and shows that the expression of miR-125b and Sema4D must be carefully controlled in the right cells at the correct level to promote regeneration. We also show that these molecular components of the salamander's regeneration-permissive environment can be experimentally harnessed to improve treatment outcomes for mammalian spinal cord injuries.

  7. Sonography of the umbilical cord.

    Science.gov (United States)

    Dudiak, C M; Salomon, C G; Posniak, H V; Olson, M C; Flisak, M E

    1995-09-01

    Knowledge of the development, normal sonographic appearance, and potential abnormalities of the umbilical cord is important in fetal assessment. The umbilical cord can be visualized throughout most of gestation and is detectable sonographically soon after visualization of the fetal pole. The normal umbilical cord is 50-60 cm long and may coil as many as 40 times, usually to the left. Abnormalities in umbilical cord size, degree of coiling, attachment, and position can have important implications for the outcome of the pregnancy. Structural abnormalities of the umbilical cord such as single umbilical artery, knots, cysts, and tumors may be associated with fetal distress or malformations. Color Doppler ultrasound (US) is useful in the identification and evaluation of structural abnormalities of the cord. By allowing measurement of blood flow velocity in the umbilical artery, duplex Doppler US may provide additional information in the evaluation of intrauterine growth retardation and twin-twin transfusion syndrome.

  8. Surgical Outcomes of High-Grade Spinal Cord Gliomas

    Science.gov (United States)

    Hida, Kazutoshi; Yano, Syunsuke; Aoyama, Takeshi; Koyanagi, Izumi; Houkin, Kiyohiro

    2015-01-01

    Study Design A retrospective study. Purpose The purpose of this study was to obtain useful information for establishing the guidelines for treating high-grade spinal cord gliomas. Overview of Literature The optimal management of high-grade spinal cord gliomas remains controversial. We report the outcomes of the surgical management of 14 high-grade spinal glioma. Methods We analyzed the outcomes of 14 patients with high-grade spinal cord gliomas who were surgically treated between 1989 and 2012. Survival was charted with the Kaplan-Meier plots and comparisons were made with the log-rank test. Results None of the patients with high-grade spinal cord gliomas underwent total resection. Subtotal resection was performed in two patients, partial resection was performed in nine patients, and open biopsy was performed in three patients. All patients underwent postoperative radiotherapy and six patients further underwent radiation cordotomy. The median survival time for patients with high-grade spinal cord gliomas was 15 months, with a 5-year survival rate of 22.2%. The median survival time for patients with World Health Organization grade III tumors was 25.5 months, whereas the median survival time for patients with glioblastoma multiforme was 12.5 months. Both univariate and multivariate Cox proportional hazards models demonstrated a significant effect only in the group that did not include cervical cord lesion as a factor associated with survival (p=0.04 and 0.03). Conclusions The surgical outcome of patients diagnosed with high-grade spinal cord gliomas remains poor. Notably, only the model which excluded cervical cord lesions as a factor significantly predicted survival. PMID:26713128

  9. Pain following spinal cord injury

    OpenAIRE

    2004-01-01

    The aims of this thesis were to assess and characterise nociceptive and neuropathic pain, the use of pharmacological and non-pharmacological pain treatment, and the influence of pain on the quality of sleep in a population following spinal cord injury (SCI). This thesis is divided into five separate studies: I. Pain in a Swedish spinal cord injury population. II. Gender related differences in pain in spinal cord injured individuals. III. Use of analgesic drugs in indi...

  10. The Cerebral Palsy Demonstration Project: a multidimensional research approach to cerebral palsy.

    Science.gov (United States)

    Shevell, Michael; Miller, Steven P; Scherer, Stephen W; Yager, Jerome Y; Fehlings, Michael G

    2011-03-01

    Cerebral palsy is the most common cause of physical impairment in pediatrics. As a heterogeneous disorder in all its disparate aspects it defies a simplistic research approach that seeks to further our understanding of its mechanisms, outcomes and treatments. Within NeuroDevNet, with its focus on abnormal brain development, cerebral palsy was selected as one of the three neurodevelopmental disabilities to be the focus of a dedicated demonstration project. The Cerebral Palsy Demonstration Project will feature a multi-dimensional approach utilizing epidemiologic, imaging, genetics, animal models and stem cell modalities that will at all times emphasize clinical relevance, translation into practice, and potential synergies between investigators now segregated by both academic disciplines and geographic distance. The objective is to create a national platform of varied complementary and inter-digitated efforts. The specific research plan to enable this will be outlined in detail. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Clinical practice: swallowing problems in cerebral palsy.

    Science.gov (United States)

    Erasmus, Corrie E; van Hulst, Karen; Rotteveel, Jan J; Willemsen, Michel A A P; Jongerius, Peter H

    2012-03-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy.

  12. CT findings in patients with cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Konno, K. (Akita Univ. (Japan))

    1982-01-01

    Clinical findings and CT findings in 73 cases of cerebral palsy were studied. The causes of cerebral palsy were presumed to be as follows: abnormal cerebral development (36%), asphyxial delivery (34%), and immature delivery (19%), etc. CT findings were abnormal in 58% of the 73 cases, 83% of the spastic tetraplegia patients and all of the spastic hemiplegia patients showed abnormal CT findings. All the patients with spastic monoplegia presented normal CT findings. In 75% of the spastic hemiplegia cases, the CT abnormalities were due to cerebral parenchymal abnormality such as porencephaly and regional low absorption. In cases of spastic tetraplegia, cerebral parenchymal abnormality was found only in 10%. Cortical atrophy was found only in 15 of the 73 cases, whereas central atrophy was found in 36 cases.

  13. Assessment of the hand in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Praveen Bhardwaj

    2011-01-01

    Full Text Available Cerebral palsy is the musculoskeletal manifestation of a nonprogressive central nervous system lesion that usually occurs due to a perinatal insult to the brain. Though the cerebral insult is static the musculoskeletal pathology is progressive. Some patients with cerebral palsy whose hands are affected can be made better by surgery. The surgical procedures as such are not very technically demanding but the assessment, decision-making, and selecting the procedures for the given patient make this field challenging. When done well, the results are rewarding not only in terms of improvement in hand function but also in appearance and personal hygiene, which leads to better self-image and permits better acceptance in the society. This article focuses on the clinical examination, patient selection, and decision-making while managing these patients.

  14. Lagophthalmos after facial palsy: current therapeutic options.

    Science.gov (United States)

    Vásquez, Luz María; Medel, Ramón

    2014-01-01

    As the facial nerve carries sensory, motor and parasympathetic fibres involved in facial muscle innervation, facial palsy results in functional and cosmetic impairment. It can result from a wide variety of causes like infectious processes, trauma, neoplasms, autoimmune diseases, and most commonly Bell's palsy, but it can also be of iatrogenic origin. The main ophthalmic sequel is lagophthalmos. The increased surface exposure increases the risk of keratitis, corneal ulceration, and potentially loss of vision. Treatment options are wide; some are temporary, some permanent. In addition to gold standard and traditional therapies and procedures, new options are being proposed aiming to improve not only lagophthalmos but also the quality of life of these patients. © 2014 S. Karger AG, Basel.

  15. Herpes zoster ophthalmicus associated with abducens palsy

    Directory of Open Access Journals (Sweden)

    Nibrass Chaker

    2014-01-01

    Full Text Available The extraocular muscle palsies associated with herpes zoster ophthalmicus (HZO are transient, self-limiting conditions, usually seen in elderly patients. There are different treatment recommendations for paralytic complications, but prognosis has generally reported to be favorable. A 75-year-old male patient presented with diplopia. Clinical history revealed left facial vesicular eruptions and pain treated by oral aciclovir 1 week following symptom onset. On examination, we observed cicatricial lesions with crusts involving left hemiface, a limitation in abduction of the left eye, and a superficial punctuate keratitis (SPK with decreased visual acuity (4/10. Examination of the right eye was unremarkable. Hess screen test confirmed left six nerve palsy.

  16. Concise Review: Stem Cell Interventions for People With Cerebral Palsy: Systematic Review With Meta-Analysis.

    Science.gov (United States)

    Novak, Iona; Walker, Karen; Hunt, Rod W; Wallace, Euan M; Fahey, Michael; Badawi, Nadia

    2016-08-01

    : Evidence for stem cells as a potential intervention for cerebral palsy is emerging. Our objective was to determine the efficacy and safety of stem cells for improving motor and cognitive function of people with cerebral palsy. Searches were conducted in October 2015 in CENTRAL, EMBASE, MEDLINE, and Cochrane Libraries. Randomized controlled trials and controlled clinical trials of stem cells for cerebral palsy were included. Two authors independently decided upon included trials, extracted data, quality, and risk of bias. The primary outcome was gross motor function. Secondary outcomes were cognitive function and adverse events (AEs). Effects were expressed as standardized mean differences (SMD) with 95% confidence intervals (CI), using a random-effects model. Five trials comprising 328 participants met inclusion criteria. Four cell types were studied: olfactory ensheathing, neural, neural progenitors, and allogeneic umbilical cord blood (UCBs). Transplantation procedures differed from central nervous system neurosurgical transplantation to intravenous/arterial infusion. Participants were followed short-term for only 6 months. Evidence of variable quality indicated a small statistically significant intervention effect from stem cells on gross motor skills (SMD 1.27; 95% CI 0.22, 2.33), with UCBs most effective. There were insufficient and heterogeneous data to compare cognitive effects. Serious AEs were rare (n = 4/135 [3%] stem cells; n = 3/139 [2%] controls). Stem cells appeared to induce short-term improvements in motor skills. Different types of stem cell interventions were compared, meaning the data were heterogeneous and are a study limitation. Further randomized controlled trials are warranted, using rigorous methodologies. Stem cells are emerging as a scientifically plausible treatment and possible cure for cerebral palsy, but are not yet proven. The lack of valid animal models has significantly hampered the scope of clinical trials. Despite the state of

  17. Systematic review of the effects of mirror therapy in children with cerebral palsy.

    Science.gov (United States)

    Park, Eom-Ji; Baek, Soon-Hyung; Park, Soohee

    2016-11-01

    [Purpose] To provide data for systematic intervention plans in occupational therapy practice by objectivity showing the value of mirror therapy interventions in children with cerebral palsy. [Subjects and Methods] Medline and EMBASE databases were searched for the key words "cerebral palsy," "mirror movement," "mirror therapy," and "mirror visual feedback." Nine studies that met the inclusion and exclusion criteria were identified. The qualitatively determined level of evidence, period of research, comparisons and interventions, tools used to measure the intervention, and the effects were analyzed. [Results] According to the results analyzed, one (1/9, 11.1%) study showed the same result as the control group, one (1/9, 11.1%) showed a negative effect, and seven (7/9, 77.8%) showed positive effects of mirror-mediated therapy, with meaningful improvement in function, such as hand strength, movement speed, muscle activity, and accuracy of hand matching. [Conclusion] Through this study, the value of mirror-mediated therapeutic interventions in occupational therapy practice targeting cerebral palsy was confirmed. It is expected that this result will be useful in establishing mirror therapy as an interventional program.

  18. The effects of forward and backward walking according to treadmill inclination in children with cerebral palsy

    Science.gov (United States)

    Kim, Won-hyo; Kim, Won-bok; Yun, Chang-kyo

    2016-01-01

    [Purpose] This study investigated the effects of forward and backward walking using different treadmill incline positions on lower muscle activity in children with cerebral palsy, to provide baseline data for gait training intensity. [Subjects and Methods] Nineteen subjects with cerebral palsy walked forward and backward at a self-selected pace on a treadmill with inclines of 0%, 5%, 10%, and 15%. Activation of the rectus femoris, biceps femoris, tibialisanterior, and lateral gastrocnemius was measured using surface electromyography during the stance phase. [Results] As treadmill incline increased during forward walking, muscle activation of the paralyzed lower limbs did not significantly change. However, as treadmill incline increased during backward walking, rectus femoris activation significantly increased and a significant difference was found between treadmill inclines of 0% and 10%. A comparison of backward and forward walking showed a significant difference in rectus femoris activation at treadmill inclines of 0%, 5%, and 10%. Activation of the tibialis anterior was only significantly higher for backward walking at the 10% gradient. [Conclusion] Backward walking may strengthen the rectus femoris and tibialis anterior in walking training for cerebral palsy. Gradient adjustment of the treadmill can be used to select the intensity of walking training. PMID:27313373

  19. Research on pattern reversal visual evoked potential of children with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Lu Li

    2015-07-01

    Full Text Available AIM: To explore the judgment of pattern reversal visual evoked potential on visual function and injured part of children with spastic cerebral palsy.METHODS: There were two groups in this study. 30 children with spastic cerebral palsy(quadriplegia: 15, diplegia: 15were selected as observation group, while 30 normal children were selected as control group with randomized controlled trial. The changes of half-view and full-view incubation period and amplitude were observed by pattern reversal visual evoked potential.RESULTS: Full-view pattern reversal visual evoked potential: the P100 incubation period of the observation group was 113.55±8.14ms, and the P100 amplitude was 23.08±15.41μV. The P100 incubation period of the control group was 105.05±5.58ms, and the P100 amplitude was 31.65±7.37μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference was statistically significant(PP>0.05. Compared to the control group, each eye and each view latency of observation group were higher, the difference was statistically significant(PCONCLUSION: Pattern reversal visual evoked potential can help people to understand the visual impairment and injury of children with spastic cerebral palsy in order to identify the abnormal children and early intervention.

  20. Acupuncture Combined with Music Therapy for Treatment of 30 Cases of Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    YU Hai-bo; LIU Yong-feng; WU Li-xiong; CHEN Zheng-qiu

    2009-01-01

    Objective: To observe clinical therapeutic effects of acupuncture combined with music therapy for treatment of cerebral palsy. Methods: Sixty children with cerebral palsy were randomly divided into an acupuncture group (Group Acup.) and an acupuncture plus music group (Group Acup.+ M). Simple acupuncture was applied in Group Acup., and acupuncture at 5 groups of points plus music were applied in Group Acup. +M. The treatment was given once every two days with 3 treatments weekly, and 36 treatments constituted a therapeutic course. Therapeutic effects including movement improvement were observed for comparison after 3 courses of treatments. Results: The comprehensive functions were elevated in both groups, and the total effective rate in Group Acup. + M was obviously better than that in Group Acup (P<0.05). Movement functions were also improved in both groups, but the differences in improvement of creeping and kneeling, standing, and walking were significant between the two groups (P<0.01), showing the effect in Group Acup. +M was better than that in Group Acup.. Conclusion: The therapy of acupuncture plus music gained better therapeutic effect on cerebral palsy than simple acupuncture, which provided new thoughts for treating the disease by comprehensive therapies.

  1. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  2. Dietary Practices in Saudi Cerebral Palsy Children

    OpenAIRE

    Al-Hammad, Nouf S.

    2015-01-01

    Objectives: To determine the dietary practices of Saudi cerebral palsy (CP) children. Methods: A self-administered questionnaire was used to collect the following information from parents of CP children: demographics, main source of dietary information, frequency of main meals, foods/drinks used for main meals and in-between-meals. Results: Parents of 157 CP children participated. Parents were divided into three, while children were divided into two age groups. The main sources of dietary inf...

  3. Parental infertility and cerebral palsy in children

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hvidtjørn, Dorte; Basso, Olga

    2010-01-01

    Children born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have been reported to have a higher risk of cerebral palsy (CP), perhaps due to the higher frequency of preterm birth, multiple births or vanishing embryo in the pregnancies. However, it has been suggested...... that the underlying infertility may be part of the pathway. In this study, we examined whether untreated subfecundity (measured by time to pregnancy) or infertility treatment was associated with an increased risk of CP in the offspring....

  4. NEONATAL NERVE PALSIES: A CONTEMPORARY OBSTETRIC PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Daren J. Roberts

    2014-05-01

    Full Text Available Background:Birth trauma and its often incorrect inference of iatrogenic causation has led to unfortunate implications for the affected child, the parents, the obstetrician and the midwife due to unwarranted medico-legal attention in our current litigious society.A more discerning evaluation of neonatal nerve palsies following labour and delivery has led to a better understanding of their aetiology with potentially more appropriate outcomes for all parties involved.

  5. Neonatal brachial plexus palsy: a permanent challenge

    Directory of Open Access Journals (Sweden)

    Carlos Otto Heise

    2015-09-01

    Full Text Available Neonatal brachial plexus palsy (NBPP has an incidence of 1.5 cases per 1000 live births and it has not declined despite recent advances in obstetrics. Most patients will recover spontaneously, but some will remain severely handicapped. Rehabilitation is important in most cases and brachial plexus surgery can improve the functional outcome of selected patients. This review highlights the current management of infants with NBPP, including conservative and operative approaches.

  6. Gross motor function, functional skills and caregiver assistance in children with spastic cerebral palsy (CP) with and without cerebral visual impairment (CVI)

    NARCIS (Netherlands)

    Salavati, M.; Rameckers, E.A.A.; Steenbergen, B.; Schans, C.P. van der

    2014-01-01

    Aim: To determine whether the level of gross motor function and functional skills in children with cerebral palsy (CP) and cerebral visual impairment (CVI) as well as caregiver assistance are lower in comparison with the corresponding group of children experiencing CP without CVI. Method: Data aggre

  7. Gross motor function, functional skills and caregiver assistance in children with spastic cerebral palsy (CP) with and without cerebral visual impairment (CVI)

    NARCIS (Netherlands)

    Salavati, M.; Rameckers, E.A.A.; Steenbergen, B.; Schans, C.P. van der

    2014-01-01

    Aim: To determine whether the level of gross motor function and functional skills in children with cerebral palsy (CP) and cerebral visual impairment (CVI) as well as caregiver assistance are lower in comparison with the corresponding group of children experiencing CP without CVI. Method: Data

  8. The Collaborative Construction of Non-Serious Episodes of Interaction by Non-Speaking Children with Cerebral Palsy and Their Peers

    Science.gov (United States)

    Clarke, Michael; Wilkinson, Ray

    2009-01-01

    Inequality in communicative resources available to non-speaking children with cerebral palsy in comparison with their "naturally" speaking co-participants has material consequences for the ways in which face-to-face interaction is organized. Analyses of interaction involving non-speaking children with physical disability and speaking adults has…

  9. Co-Activity during Maximum Voluntary Contraction: A Study of Four Lower-Extremity Muscles in Children with and without Cerebral Palsy

    Science.gov (United States)

    Tedroff, Kristina; Knutson, Loretta M.; Soderberg, Gary L.

    2008-01-01

    This study was designed to determine whether children with cerebral palsy (CP) showed more co-activity than comparison children in non-prime mover muscles with regard to the prime mover during maximum voluntary isometric contraction (MVIC) of four lower-extremity muscles. Fourteen children with spastic diplegic CP (10 males, four females; age…

  10. Energy requirements of children with cerebral palsy.

    Science.gov (United States)

    Hogan, S Eileen

    2004-01-01

    Energy requirements of children and adolescents with cerebral palsy appear to be disease-specific and different from the current recommendations for healthy children, varying depending upon functional capacity, degree of mobility, severity of disease, and level of altered metabolism. Feeding problems are prevalent in many of these children, and can result in inadequate energy intake. Wasting of voluntary muscles, a common symptom of cerebral palsy, contributes to reduced resting energy needs; nevertheless, the location of the central nervous system lesion may also influence energy requirements. To guarantee individualized, accurate, and optimal energy recommendations for this population, resting energy expenditure should preferentially be measured by indirect calorimetry. Equations and formulae to predict healthy people's resting energy expenditure are available, but tend to overestimate these children's energy needs. Future studies should address the role of the central nervous system in regulating energy metabolism in this population. When adequately nourished, children and adolescents with cerebral palsy appear more tranquil and require decreased feeding time, which gives caregivers time to develop the child's functional independence and character. Understanding energy requirements of this population will provide caregivers and health professionals with guidelines for providing optimal nutritional status.

  11. PHYSIOTHERAPY MANAGEMENT FOR PROGRESSIVE SUPRA NUCLEAR PALSY

    Directory of Open Access Journals (Sweden)

    P. Keerthi Chandra Shekhar.

    2013-06-01

    Full Text Available Background:An elderly patient with disturbances in gait, impaired balance, difficulty moving the eyes andhistory of frequent falls are not commonly seen in physiotherapy referral cases. Progressive supranuclear palsy(PSP is relatively uncommon and is the most frequently occurring form of Atypical Parkinsonism withcardinalfeatures of vertical gaze palsy, gait instability with frequent falls. However, because the initialclinical featuresoften resemble Parkinson’s disease (PD many patients are referred for rehabilitation services withthe wrongdiagnosis as PD. The progression of the symptoms in PSP is much faster than in PD and there is no cure oreffective medication to manage PSP. We describe a case of 59 years old male, patient who was referred tophysiotherapy department for asymmetric limb apraxia, markedly impaired balance and frequent falls duringtransitional movements. Two years before the patient was diagnosis as PD and later the patient was re-diag-nosed as PSP based on the progression of the disease. The patient was rehabilitated using coordination exer-cises and reciprocal rhythmic movements to reduce rigidity, transfer training exercises for balance,gait trainingusing weights strapped to ankles in parallel bar and visual tracking exercises. The exercises wereprogrammedfor 1 ½ hours a day, 5 days a week, for 8 weeks. After 15 weeks there was improvement in gait and balance ofthe patient with decrease in fall incidence on a Progressive Supranuclear Palsy Rating Scale (PSPRS.

  12. Hypopituitarism in children with cerebral palsy.

    Science.gov (United States)

    Uday, Suma; Shaw, Nick; Krone, Ruth; Kirk, Jeremy

    2017-06-01

    Poor growth and delayed puberty in children with cerebral palsy is frequently felt to be related to malnutrition. Although growth hormone deficiency is commonly described in these children, multiple pituitary hormone deficiency (MPHD) has not been previously reported. We present a series of four children with cerebral palsy who were born before 29 weeks gestation who were referred to the regional endocrinology service, three for delayed puberty and one for short stature, in whom investigations identified MPHD. All patients had a height well below -2 standard deviation score (2nd centile) at presentation and three who had MRI scans had an ectopic posterior pituitary gland. We therefore recommend that the possibility of MPHD should be considered in all children with cerebral palsy and poor growth or delayed puberty. Early diagnosis and treatment is essential to maximise growth and prevent associated morbidity and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. [New developments in spastic unilateral cerebral palsy].

    Science.gov (United States)

    Chabrier, S; Roubertie, A; Allard, D; Bonhomme, C; Gautheron, V

    2010-01-01

    Hemiplegic (or spastic unilateral) cerebral palsy accounts for about 30% of all cases of cerebral palsy. With a population prevalence of 0.6 per 1000 live births, it is the most common type of cerebral palsy among term-born children and the second most common type after diplegia among preterm infants. Many types of prenatal and perinatal brain injury can lead to congenital hemiplegia and brain MRI is the most useful tool to classify them with accuracy and to provide early prognostic information. Perinatal arterial ischemic stroke thus appears as the leading cause in term infants, whereas encephalopathy of prematurity is the most common cause in premature babies. Other causes include brain malformations, neonatal sinovenous thrombosis, parenchymal hemorrhage (for example due to coagulopathy or alloimmune thrombocytopenia) and the more recently described familial forms of porencephaly associated with mutations in the COL4A1 gene. In adjunction with pharmacologic treatment (botulinium neurotoxin injection), new evidence-based rehabilitational interventions, such as constraint-induced movement therapy and mirror therapy, are increasingly being used.

  14. 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.

  15. SOMATOTYPE PROFILES AND CHANGES DEPENDING ON TREADMILL EXERCISE IN CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Nazmi

    2014-08-01

    Full Text Available Objective. The postponement of the brain development as a result of brain lesion causes some functional inabilities affecting the whole body of the children with cerebral palsy compared to their peers. In this study, it was aimed to investigate the effects of the treadmill exercise on somatotype profiles and some variables in disabled children diagnosed with cerebral palsy. Methods. The subjects of the study were 37 children with cerebral palsy whose ages range from 7 to 15 and they were taking regular physical therapy in a private education and rehabilitation center. The experimental group and the control group consists of 20 children (8 girls and 12 boys and 17 children (10 girls and 7 boys, respectively. The subjects of the experimental group were performed treadmill exercise under the supervision of a physical therapist twice a week for three months (totally 24 walking exercises while their treatments in the center were continuing. The initial and final speeds, duration of the exercise, the distance covered and the calories burnt were recorded and the somatotypical characteristics of the subjects were evaluated before and after the study. Results. It was encountered that the initial and final pace of the exercise, the duration of the use of the treadmill, the distance covered and the calories burnt increased significantly. No remarkable changes in the pulse rates were determined before and after the exercise. During the comparison of the experimental and control groups before and after the exercise, some noteworthy variations in ectomorphy and ponderal index were confirmed after the exercise even though no considerable differences in mesomorphy, endomorphy and body fat percentage were determined. Conclusion. We are of the opinion that the treadmill exercise will positively affect the pace of the exercise, the distance covered, the calories burnt by the children with cerebral palsy, moving more freely, controlled walking and body type.

  16. Manual muscle test at C5 palsy onset predicts the likelihood of and time to C5 palsy resolution.

    Science.gov (United States)

    Macki, Mohamed; Alam, Ridwan; Kerezoudis, Panagiotis; Gokaslan, Ziya; Bydon, Ali; Bydon, Mohamad

    2016-02-01

    The primary objective of this study was to identify time to and prognostic factors of C5 palsy resolution. All patients over a 7 year period who experienced C5 palsy following a posterior decompression and instrumented fusion surgery were retrospectively reviewed. C5 palsy resolution was defined as a recovery of deltoid muscle function equal to or greater than the preoperative condition as defined by the manual muscle test (MMT). Of the 511 patients who met the selection criteria, 8.6% (n=44) experienced C5 palsy. MMT information was available for 43 patients; 81.4% (n=35) had full resolution from their condition. Of the 35 patients who resolved, the median MMT score at onset was 3-. Following a discrete-time proportional hazards model, the hazards of C5 palsy resolution increased by 19% for every one-grade increase in MMT score at symptom onset (hazard ratio [HR]=1.19, p=0.005). Moreover, males displayed a 71% lower hazard of resolution than females (HR=0.29, p=0.003). Following an adjusted Kaplan-Meier analysis, the median time to C5 palsy resolution was between 6 months and 1 year. In a multiple linear regression, a lower MMT score at the onset of C5 palsy predicted a longer time to C5 palsy resolution (coefficient=-0.19, p=0.003). Time to C5 palsy onset was not statistically associated with hazards of palsy resolution (p=0.381) or time to resolution (p=0.121). A higher MMT score at the onset of C5 palsy statistically significantly predicted a higher chance of resolution and a shorter recovery time. Female sex was also associated with a higher hazard of resolution.

  17. The relationship between fetal biophysical profile and cord blood PH

    Directory of Open Access Journals (Sweden)

    Valadan M

    2009-02-01

    Full Text Available "nBackground: The Biophysical Profile (BPP is a noninvasive test that predicts the presence or absence of fetal asphyxia and, ultimately, the risk of fetal death in the antenatal period. Intervention on the basis of an abnormal biophysical profile result has been reported to yield a significant reduction in prenatal mortality, and an association exists between biophysical profile scoring and a decreased cerebral palsy rate in a given population. The BPP evaluates five characteristics: fetal movement, tone, breathing, heart reactivity, and amniotic fluid (AF volume estimation. The purpose of study was to determine whether there are different degree of acidosis at which the biophysical activity (acute marker are affected. "nMethods: In a prospective study of 140 patients undergoing cesarean section before onset of labor, the fetal biophysical profile was performed 24h before the time of cesarean and was matched with cord arterial PH that was obtained from a cord segment (10-20cm that was double clamped after delivery of newborn. (using cord arterial PH less than 7.20 for the diagnosis of acidosis. "nResults: The fetal biophysical profile was found to have a significant relationship with umbilical blood PH. The sensitivity, specificity, positive predictive value, negative predictive value of fetal biophysical profile score were: 88.9%, 88.6%, 50%, 98.1%. "nConclusion: The first manifestations of fetal acidosis are nonreactive nonstress testing and fetal breathing loss; in advanced acidemia fetal movements and fetal tone are compromised. A protocol of antepartum fetal evaluation is suggested based upon the individual biophysical components rather than the score alone.

  18. Cerebral Palsy Checklist: Teens & Young Adult (13 to 21)

    Science.gov (United States)

    ... Affects Your Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to Getting Involved Teaching Kids to Be Smart About Social Media Cerebral Palsy Checklist: Teens & Young Adults KidsHealth > For Parents > Cerebral Palsy Checklist: ...

  19. Quality of Arithmetic Education for Children with Cerebral Palsy

    Science.gov (United States)

    Jenks, Kathleen M.; de Moor, Jan; van Lieshout, Ernest C. D. M.; Withagen, Floortje

    2010-01-01

    The aim of this exploratory study was to investigate the quality of arithmetic education for children with cerebral palsy. The use of individual educational plans, amount of arithmetic instruction time, arithmetic instructional grouping, and type of arithmetic teaching method were explored in three groups: children with cerebral palsy (CP) in…

  20. [Analysis of risk factors for perinatal brachial plexus palsy].

    Science.gov (United States)

    Gosk, Jerzy; Rutowski, Roman

    2005-04-01

    Risk factors of obstetrical brachial plexus palsy include: (1) large birth weight, (2) shoulder dystocia and prolonged second stage of labour, (3) instrumental vaginal delivery (forceps delivery, vacuum extraction), (4) diabetes mellitus and mother's obesity, (5) breech presentation, (6) delivery and infant with obstetrical brachial plexus palsy in antecedent delivery. The purpose was analysis of the classical risk factors for brachial plexus palsy based on our own clinical material. Clinical material consists of 83 children with obstetrical brachial plexus palsy treated at the Department of Trauma and Hand Surgery (surgically--54, conservatively--29). Control group consists of 56 healthy newborns. Data recorded included: birth weight, body length, head and chest circumference, Apgar test at 1 min., type of brachial palsy and side affected, type of birth, presentation, duration of delivery (II stage), age of mother, mother's diseases, parity. The infants treated surgically have had a significantly higher birth weight, body height, head and chest circumference, in compression with control group and group treated conservatively. The differences were statistically important. Shoulder dystocia occurred in 32.9% of all vaginal delivery. Instrumental vaginal delivery was observed in 11.3% and breech presentation in 4.9% cases. There were no incidences of obstetrical brachial plexus palsy recurrence. Diabetes mellitus and mother's obesity was found in 3 cases. (1) Fetal macrosomia is the important risk factor of the obstetrical brachial plexus palsy. (2) Obstetrical brachial plexus palsy may occur also in the absence of the classical risk factors.

  1. Quality of Arithmetic Education for Children with Cerebral Palsy

    Science.gov (United States)

    Jenks, Kathleen M.; de Moor, Jan; van Lieshout, Ernest C. D. M.; Withagen, Floortje

    2010-01-01

    The aim of this exploratory study was to investigate the quality of arithmetic education for children with cerebral palsy. The use of individual educational plans, amount of arithmetic instruction time, arithmetic instructional grouping, and type of arithmetic teaching method were explored in three groups: children with cerebral palsy (CP) in…

  2. An Unusual Case of Neuralgic Amyotrophy Presenting with Bilateral Phrenic Nerve and Vocal Cord Paresis

    Directory of Open Access Journals (Sweden)

    F. Holtbernd

    2011-02-01

    Full Text Available Background: Neuralgic amyotrophy (brachial plexus neuropathy, brachial plexus neuritis, or Parsonage-Turner syndrome is an uncommon inflammatory condition typically characterized by acute and severe shoulder pain followed by paresis with muscle weakness and atrophy of the upper limb or shoulder girdle. We report an unusual clinical manifestation of neuralgic amyotrophy, namely bilateral phrenic nerve palsy with concomitant laryngeal paresis. Case Report: A 55-year-old male presented with orthopnea and aphonia after an episode of bilateral shoulder pain preceded by an upper respiratory tract infection. Spirometry, chest X-ray and videolaryngoscopy revealed bilateral and simultaneous paresis of the diaphragm and the vocal cords. Clinical examination at admission and at the 2-month follow-up did not show upper limb weakness or atrophy, except for a mild atrophy of the right supraspinatus muscle. An electromyography of the upper limb muscles and nerve conduction studies did not reveal signs of denervation. Analysis of the cerebrospinal fluid and an MRI of the neuraxis were unremarkable. After treatment with prednisolone, vocal cord function markedly improved within 8 weeks, whereas paresis of the diaphragm persisted. Conclusion: Shoulder pain followed by diaphragmatic paralysis with dyspnea and hoarseness may be a manifestation of neuralgic amyotrophy even if upper limb or shoulder girdle palsies are absent.

  3. Biomarkers in spinal cord injury.

    NARCIS (Netherlands)

    Pouw, M.H.; Hosman, A.J.F.; Middendorp, J.J. van; Verbeek, M.M.; Vos, P.E.; Meent, H. van de

    2009-01-01

    STUDY DESIGN: Literature review. OBJECTIVES: In traumatic spinal cord injury (SCI), much effort has been put into the evaluation of SCI severity and the prediction of recovery potential. An accurate prediction of the initial damage of the spinal cord that differentiates between the severities of SCI

  4. Cutting the Cord-2

    Science.gov (United States)

    2004-01-01

    This animation shows the view from the rear hazard avoidance cameras on the Mars Exploration Rover Spirit as the rover turns 45 degrees clockwise. This maneuver is the first step in a 3-point turn that will rotate the rover 115 degrees to face west. The rover must make this turn before rolling off the lander because airbags are blocking it from exiting from the front lander petal. Before this crucial turn took place, engineers instructed the rover to cut the final cord linking it to the lander. The turn took around 30 minutes to complete.

  5. Cutting the Cord

    Science.gov (United States)

    2004-01-01

    This animation shows the view from the front hazard avoidance cameras on the Mars Exploration Rover Spirit as the rover turns 45 degrees clockwise. This maneuver is the first step in a 3-point turn that will rotate the rover 115 degrees to face west. The rover must make this turn before rolling off the lander because airbags are blocking it from exiting off the front lander petal. Before this crucial turn could take place, engineers instructed the rover to cut the final cord linking it to the lander. The turn took around 30 minutes to complete.

  6. Cranial nerves palsy as an initial feature of an early onset distal hereditary motor neuropathy--a new distal hereditary motor neuropathy phenotype.

    Science.gov (United States)

    Haberlová, J; Claeys, K G; De Jonghe, P; Seeman, P

    2009-06-01

    Distal hereditary motor neuropathy is a heterogeneous group of disorders characterised by a pure motor axonal neuropathy. It is occasionally associated with additional signs such as facial weakness, vocal cord paralysis, weakness of the diaphragm, and pyramidal signs. Although predominantly the inheritance is autosomal dominant, all types of inheritance have been described. Here we report a Czech family with cranial nerves palsy as an initial feature of a non progressive infantile onset dominant distal hereditary motor neuropathy. This family may represent a new subtype of distal hereditary motor neuropathy.

  7. Comparison of cytotoxicity among three gingival retraction cords on human gingival fibroblasts in vitro%三种排龈线对体外培养人牙龈成纤维细胞毒性的比较

    Institute of Scientific and Technical Information of China (English)

    倪莹; 张晓明; 惠敏; 刘健

    2012-01-01

    BACKGROUND: In recent years, the gingival retraction effect of gingival retraction drugs is a hot topic for domestic and foreign scholars, while the biocompatibility of the commercial gingival retraction cord is less involved. OBJECTIVE: To evaluate the cytotoxicity effect of three kinds of gingival retraction cords on human gingival fibroblasts, and to provide theoretical basis for choosing proper gingival retraction cords in clinic. METHODS: Three kinds of gingival retraction cords (epinephrine-impregnated cord, aluminium sulphate-impregnated cord and non-drug-impregnated cord) were incubated in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum for 24 hours, according to 1:1 and 1:4 dilution, and then the cords acted on gingival fibroblasts cultured in vitro. Dulbecco's modified Eagle's medium containing 10% fetal bovine serum was used as negative control group. RESULTS AND CONCLUSION: The results of MTT assay demonstrated that the three kinds of gingival retraction cords all could inhibit human gingival fibroblasts growth and proliferation. The cytotoxicity of the three kinds of gingival retraction cords in the leaching liquor with 1:1 dilution was significantly higher than that of 1:4 dilution and control groups (P< 0.05). The cytotoxicity of epinephrine-impregnated cord in the leaching liquor with 1:4 dilution was significantly higher than that of the control group (P < 0.05). The results of transmission electron microscope showed that some cells in the epinephrine-impregnated cord group were found apoptosis. These findings suggest that the three kinds of gingival retraction cords all have certain cytotoxicity to gingival fibroblasts. The cytotoxicity of epinephrine-impregnated cord is the biggest, followed by aluminium sulphate-impregnated cord, and the cytotoxicity of the non-drug-impregnated cord is the smallest.%背景:近年来,国内外学者研究热点主要集中在排龈药物的排龈效果,而对商品化排龈线的生物相

  8. Dynamic touch is affected in children with cerebral palsy.

    Science.gov (United States)

    Ocarino, Juliana M; Fonseca, Sergio T; Silva, Paula L P; Gonçalves, Gabriela G P; Souza, Thales R; Mancini, Marisa C

    2014-02-01

    Children with developmental disorders such as cerebral palsy have limited opportunities for effortful interactions with objects and tools. The goal of the study was to investigate whether children with cerebral palsy have deficits in their ability to perceive object length by dynamic touch when compared to typically developing children. Fourteen children with typical development and 12 children with cerebral palsy were asked to report the length of hand-held rods after wielding them out of sight. Multilevel regression models indicated that I1 (maximum principal moment of inertia) was a significant predictor of perceived length - LP (pcerebral palsy (group factor) partially explained such variance (p=.002). In addition, accuracy and reliability of the length judgments made by children with cerebral palsy were significantly lower than the typically developing children (p<.05). Theoretical and clinical implications of these results were identified and discussed.

  9. From recurrent peripheral facial palsy to multiple sclerosis.

    Science.gov (United States)

    Ivanković, Mira; Demarin, Vida

    2011-09-01

    Peripheral facial palsy is a clinical entity, which may be presented as the first symptom of multiple sclerosis (MS). Although MS is mostly a multifocal chronic inflammation of the central nervous system, peripheral nervous system can also be involved. Isolated cranial nerve palsies are rare and occur in 1.6% of MS patients. In this report, a case is presented of a 35-year-old woman who developed isolated seventh nerve palsy that was misdiagnosed as Bell's palsy. Despite recurrent peripheral facial palsy, positive cerebrospinal fluid finding and magnetic resonance imaging, the diagnosis of MS could only be confirmed when the patient developed other neurologic symptoms and when the criteria for dissemination in space were satisfied. In clinical presentation, the patient had only cranial nerve involvement, with complete recovery.

  10. Vocal cord dysfunction in children.

    Science.gov (United States)

    Noyes, Blakeslee E; Kemp, James S

    2007-06-01

    Vocal cord dysfunction is characterised by paradoxical vocal cord adduction that occurs during inspiration, resulting in symptoms of dyspnoea, wheeze, chest or throat tightness and cough. Although the condition is well described in children and adults, confusion with asthma often triggers the use of an aggressive treatment regimen directed against asthma. The laryngoscopic demonstration of vocal cord adduction during inspiration has been considered the gold standard for the diagnosis of vocal cord dysfunction, but historical factors and pulmonary function findings may provide adequate clues to the correct diagnosis. Speech therapy, and in some cases psychological counselling, is often beneficial in this disorder. The natural course and prognosis of vocal cord dysfunction are still not well described in adults or children.

  11. Recombinant adeno-associated virus-mediated global anterograde delivery of glial cell line-derived neurotrophic factor to the spinal cord: comparison of rubrospinal and corticospinal tracts in the rat.

    Science.gov (United States)

    Foust, Kevin D; Flotte, Terence R; Reier, Paul J; Mandel, Ronald J

    2008-01-01

    Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of spinal lower motoneurons. Gene delivery is a promising strategy to deliver therapeutic molecules to these vulnerable cells. However, definition of an optimal route of delivery capable of accessing neurons over a considerable extent of the neuraxis represents a significant logistical problem. Intramuscular vector injections are not ideal as this approach would involve hundreds of injections to completely treat an ALS patient and also would be dependent on retrograde transport of the viral platform of choice. Alternatively, upper motoneurons could deliver trophic factors over considerable distances by anterograde transport after a relatively localized intracerebral injection. To test this approach, the present study was designed to compare the corticospinal (CST) and rubrospinal (RST) tracts for their ability to transport recombinant adeno-associated virus serotype 5 (rAAV5)-derived green fluorescent protein (GFP) or glial cell line-derived neurotrophic factor (GDNF) to the spinal cord. Unilateral injections of rAAV5-GFP into the red nucleus (RN) or motor cortex of normal rats produced GFP-positive fibers in the appropriate descending tracts extending to the lumbar spinal cord. For both tracts, GFP-positive axonal projections into the spinal gray matter were consistently observed. GDNF immunohistochemistry demonstrated that confirmed RN injections resulted in GDNF-positive fibers projecting into spinal gray matter as seen in the GFP group. In contrast, confirmed cortical rAAV5-GDNF injections resulted in less evident staining in spinal cord. Spinal cord GDNF levels were elevated at distances up to 72 mm from the injection sites, and confirmed that RST-related GDNF transport to spinal cord surpassed CST-associated delivery.

  12. Precise control of miR-125b levels is required to create a regeneration-permissive environment after spinal cord injury: a cross-species comparison between salamander and rat

    Directory of Open Access Journals (Sweden)

    Juan Felipe Diaz Quiroz

    2014-06-01

    Full Text Available Most spinal cord injuries lead to permanent paralysis in mammals. By contrast, the remarkable regenerative abilities of salamanders enable full functional recovery even from complete spinal cord transections. The molecular differences underlying this evolutionary divergence between mammals and amphibians are poorly understood. We focused on upstream regulators of gene expression as primary entry points into this question. We identified a group of microRNAs (miRNAs that are conserved between the Mexican axolotl salamander (Ambystoma mexicanum and mammals but show marked cross-species differences in regulation patterns following spinal cord injury. We found that precise post-injury levels of one of these miRNAs (miR-125b is essential for functional recovery, and guides correct regeneration of axons through the lesion site in a process involving the direct downstream target Sema4D in axolotls. Translating these results to a mammalian model, we increased miR-125b levels in the rat through mimic treatments following spinal cord transection. These treatments downregulated Sema4D and other glial-scar-related genes, and enhanced the animal’s functional recovery. Our study identifies a key regulatory molecule conserved between salamander and mammal, and shows that the expression of miR-125b and Sema4D must be carefully controlled in the right cells at the correct level to promote regeneration. We also show that these molecular components of the salamander’s regeneration-permissive environment can be experimentally harnessed to improve treatment outcomes for mammalian spinal cord injuries.

  13. Retraining the injured spinal cord

    Science.gov (United States)

    Edgerton, V. R.; Leon, R. D.; Harkema, S. J.; Hodgson, J. A.; London, N.; Reinkensmeyer, D. J.; Roy, R. R.; Talmadge, R. J.; Tillakaratne, N. J.; Timoszyk, W.; Tobin, A.

    2001-01-01

    The present review presents a series of concepts that may be useful in developing rehabilitative strategies to enhance recovery of posture and locomotion following spinal cord injury. First, the loss of supraspinal input results in a marked change in the functional efficacy of the remaining synapses and neurons of intraspinal and peripheral afferent (dorsal root ganglion) origin. Second, following a complete transection the lumbrosacral spinal cord can recover greater levels of motor performance if it has been exposed to the afferent and intraspinal activation patterns that are associated with standing and stepping. Third, the spinal cord can more readily reacquire the ability to stand and step following spinal cord transection with repetitive exposure to standing and stepping. Fourth, robotic assistive devices can be used to guide the kinematics of the limbs and thus expose the spinal cord to the new normal activity patterns associated with a particular motor task following spinal cord injury. In addition, such robotic assistive devices can provide immediate quantification of the limb kinematics. Fifth, the behavioural and physiological effects of spinal cord transection are reflected in adaptations in most, if not all, neurotransmitter systems in the lumbosacral spinal cord. Evidence is presented that both the GABAergic and glycinergic inhibitory systems are up-regulated following complete spinal cord transection and that step training results in some aspects of these transmitter systems being down-regulated towards control levels. These concepts and observations demonstrate that (a) the spinal cord can interpret complex afferent information and generate the appropriate motor task; and (b) motor ability can be defined to a large degree by training.

  14. Bell's palsy before Bell : Cornelis Stalpart van der Wiel's observation of Bell's palsy in 1683

    NARCIS (Netherlands)

    van de Graaf, RC; Nicolai, JPA

    2005-01-01

    Bell's palsy is named after Sir Charles Bell (1774-1842), who has long been considered to be the first to describe idiopathic facial paralysis in the early 19th century. However, it was discovered that Nicolaus Anton Friedreich (1761-1836) and James Douglas (1675-1742) preceded him in the 18th centu

  15. Umbilical cord blood transplantation.

    Science.gov (United States)

    Koo, Hong Hoe; Ahn, Hyo Seop

    2012-07-01

    Since the first umbilical cord blood transplantation (CBT) in 1998, cord blood (CB) has now become one of the most commonly used sources of hematopoietic stem cells for transplantation. CBT has advantages of easy procurement, no risk to donor, low risk of transmitting infections, immediate availability and immune tolerance allowing successful transplantation despite human leukocyte antigen disparity. Several studies have shown that the number of cells transplanted is the most important factor for engraftment in CBT, and it limits the wide use of CB in adult patients. New strategies for facilitating engraftment and reducing transplantation-related mortality are ongoing in the field of CBT and include the use of a reduced-intensity conditioning regimen, double-unit CBT, ex vivo expansion of CB, and co-transplantation of CB and mesenchymal stem cells. Recently, the results of two international studies with large sample sizes showed that CB is an acceptable alternative source of hematopoietic stem cells for adult recipients who lack human leukocyte antigen-matched adult donors. Along with the intensive researches, development in banking process of CB will amplify the use of CB and offer the chance for cure in more patients.

  16. Umbilical cord blood transplantation

    Directory of Open Access Journals (Sweden)

    Hong Hoe Koo

    2012-07-01

    Full Text Available Since the first umbilical cord blood transplantation (CBT in 1998, cord blood (CB has now become one of the most commonly used sources of hematopoietic stem cells for transplantation. CBT has advantages of easy procurement, no risk to donor, low risk of transmitting infections, immediate availability and immune tolerance allowing successful transplantation despite human leukocyte antigen disparity. Several studies have shown that the number of cells transplanted is the most important factor for engraftment in CBT, and it limits the wide use of CB in adult patients. New strategies for facilitating engraftment and reducing transplantation-related mortality are ongoing in the field of CBT and include the use of a reduced-intensity conditioning regimen, double-unit CBT, ex vivo expansion of CB, and co-transplantation of CB and mesenchymal stem cells. Recently, the results of two international studies with large sample sizes showed that CB is an acceptable alternative source of hematopoietic stem cells for adult recipients who lack human leukocyte antigen-matched adult donors. Along with the intensive researches, development in banking process of CB will amplify the use of CB and offer the chance for cure in more patients.

  17. Physical therapy for Bell's palsy (idiopathic facial paralysis).

    Science.gov (United States)

    Teixeira, Lázaro J; Valbuza, Juliana S; Prado, Gilmar F

    2011-12-07

    with acupuncture (360 participants). For most outcomes we were unable to perform meta-analysis because the interventions and outcomes were not comparable.For the primary outcome of incomplete recovery after six months, electrostimulation produced no benefit over placebo (moderate quality evidence from one study with 86 participants). Low quality comparisons of electrostimulation with prednisolone (an active treatment)(149 participants), or the addition of electrostimulation to hot packs, massage and facial exercises (22 participants), reported no significant differences. Similarly a meta-analysis from two studies, one of three months and the other of six months duration, (142 participants) found no statistically significant difference in synkinesis, a complication of Bell's palsy, between participants receiving electrostimulation and controls. A single low quality study (56 participants), which reported at three months, found worse functional recovery with electrostimulation (mean difference (MD) 12.00 points (scale of 0 to 100) 95% confidence interval (CI) 1.26 to 22.74).Two trials of facial exercises, both at high risk of bias, found no difference in incomplete recovery at six months when exercises were compared to waiting list controls or conventional therapy. There is evidence from a single small study (34 participants) of moderate quality that exercises are beneficial on measures of facial disability to people with chronic facial palsy when compared with controls (MD 20.40 points (scale of 0 to 100), 95% CI 8.76 to 32.04) and from another single low quality study with 145 people with acute cases treated for three months where significantly fewer participants developed facial motor synkinesis after exercise (risk ratio 0.24, 95% CI 0.08 to 0.69). The same study showed statistically significant reduction in time for complete recovery, mainly in more severe cases (47 participants, MD -2.10 weeks, 95% CI -3.15 to -1.05) but this was not a prespecified outcome in this

  18. Neuron-specific enolase: reference values in cord blood.

    Science.gov (United States)

    Kintzel, K; Sonntag, J; Strauss, E; Obladen, M

    1998-04-01

    With foetal sonography prenatal detection of tumours has become more frequent. To evaluate and treat these infants it is necessary to identify the tumour postnatally. Elevated neuron-specific enolase is a biochemical marker of neuroblastoma. Since conditions during birth may influence neuron-specific enolase concentration in foetal serum, specific reference values in cord blood are required. Cord blood samples were taken from 192 healthy term newborns and concentration of neuron-specific enolase was measured by enzyme immunoassay (EIA). Median neuron-specific enolase concentration in the reference group was 8.0 micrograms/l and the 5th-95th percentiles were 4.8-19.4 micrograms/l. No differences between male and female newborns were detected (p = 0.13). Measurement of neuron-specific enolase in cord blood, in comparison with our reference values, offers an early postnatal possibility of confirming the diagnosis of neuroblastoma.

  19. Exercise interventions for cerebral palsy.

    Science.gov (United States)

    Ryan, Jennifer M; Cassidy, Elizabeth E; Noorduyn, Stephen G; O'Connell, Neil E

    2017-06-11

    Cerebral palsy (CP) is a neurodevelopmental disorder resulting from an injury to the developing brain. It is the most common form of childhood disability with prevalence rates of between 1.5 and 3.8 per 1000 births reported worldwide. The primary impairments associated with CP include reduced muscle strength and reduced cardiorespiratory fitness, resulting in difficulties performing activities such as dressing, walking and negotiating stairs.Exercise is defined as a planned, structured and repetitive activity that aims to improve fitness, and it is a commonly used intervention for people with CP. Aerobic and resistance training may improve activity (i.e. the ability to execute a task) and participation (i.e. involvement in a life situation) through their impact on the primary impairments of CP. However, to date, there has been no comprehensive review of exercise interventions for people with CP. To assess the effects of exercise interventions in people with CP, primarily in terms of activity, participation and quality of life. Secondary outcomes assessed body functions and body structures. Comparators of interest were no treatment, usual care or an alternative type of exercise intervention. In June 2016 we searched CENTRAL, MEDLINE, Embase, nine other databases and four trials registers. We included randomised controlled trials (RCTs) and quasi-RCTs of children, adolescents and adults with CP. We included studies of aerobic exercise, resistance training, and 'mixed training' (a combination of at least two of aerobic exercise, resistance training and anaerobic training). Two review authors independently screened titles, abstracts and potentially relevant full-text reports for eligibility; extracted all relevant data and conducted 'Risk of bias' and GRADE assessments. We included 29 trials (926 participants); 27 included children and adolescents up to the age of 19 years, three included adolescents and young adults (10 to 22 years), and one included adults over 20

  20. Attitudes Towards Individuals with Spinal Cord Injuries

    Science.gov (United States)

    Conway, Cassandra Sligh D.; Gooden, Randy; Nowell, Jennifer; Wilson, Navodda

    2010-01-01

    This paper will shed light on the lives of persons with spinal cord injuries by revealing the literature on spinal cord injuries that focuses on research that can shed light on attitudes towards persons with spinal cord injuries. The background literature related to incidences, the definition of spinal cord injury, and vocational opportunities are…

  1. EFFECTS OF AN EXERCISE-ORIENTED REHABILITATION PROGRAM ON MECHANICAL EFFICIENCIY AND AEROBIC CAPACITY IN CHILDREN WITH SPASTIC CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    M. Izadi

    2008-10-01

    Full Text Available AbstractObjectiveChildren suffering from Cerebral Palsy (CP, exhibit movement limitations and physiological abnormalities as compared to normal individuals.The objective of this study was to assess mechanical efficiency and certain cardiovascular indices before and after an exercise-rehabilitation program in children with dipelegia spastic cerebral palsy (experimental group in comparison with able-bodied children(controls. Material and MethodsIn this study, 15 spastic cerebral palsy (dipelegic children participated in an exercise-rehabilitation program, three days a week for three months with an average 144bpm of heart rate. The mechanical efficiency (net, gross, rest and submaximal heart rate and maximal oxygen consumption(VO2max weremeasured before (pretest and after (posttest exercise program on the cycle ergometer according to the Macmaster ergometer protocol. Then control group, of 18 normal children underwent the exercise program and were assessed, following which results of the 2 groups were compared using SPSS for statistical analysis (P ResultsMechanical efficiency (net, gross increased significantly in CP patients after the exercise-rehabilitation program; reults did not alter significantly for the controls.Rest and submaximal heart rate in CP patients decreased significantly after exercise program. Maximal oxygen consumption, which remained unchanged in patients following the exercise program, was similar in patients and controls after the program. ConclusionCerebral palsy patients, because of their high muscle tone, severe degree of spasticity, and involuntary movements are physically more incapacitated and need more energy than normal able-bodied individuals.Rehabilitation and aerobic exercise can be effective in improving their cardiovascular fitness and muscle function and increasing their mechanical efficiency.Keywords: spastic cerebral palsy, maximal oxygen consumption, heart rate, mechanical efficiency, rehabilitation.

  2. Education and employment prospects in cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Kejs, Anne Mette T

    2005-01-01

    information was obtained from Denmark's unique registries. Of the participants with CP, 33% vs 77% of controls, had education beyond lower secondary school (i.e. after age 15-16y), 29% were competitively employed (vs 82% of controls), 5% were studying, and 5% had specially created jobs. Excluding participants......Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819...

  3. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  4. REHABILITATION OF PERSONS WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Natasa CICEVSKA-JOVANOVA

    2000-06-01

    Full Text Available The persons with cerebral palsy with motoric impairments as a primary demmages, they have other following disables: visual impairments, hearing impairments, speech disables and very often they have intellectual difficulties.This persons in school have problems with writing, they couldn’t oriented in the books, they have difficulties with manipulation with school’s supplies and didactic materials, they couldn’t follow the order of the words in the line during the reading and the writing and etc.Using the exercises of psycho-motor reeducation, all before mentioned difficulties and problems can be mitigate or disappear.

  5. International Spinal Cord Injury

    DEFF Research Database (Denmark)

    Dvorak, M F; Itshayek, E; Fehlings, M G

    2015-01-01

    the final version. RESULTS: The data set consists of nine variables: (1) Intervention/Procedure Date and start time (2) Non-surgical bed rest and external immobilization, (3) Spinal intervention-closed manipulation and/or reduction of spinal elements, (4) Surgical procedure-approach, (5) Date and time......STUDY DESIGN: Survey of expert opinion, feedback and final consensus. OBJECTIVE: To describe the development and the variables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set. SETTING: International working group. METHODS...... of the completion of the intervention or surgical closure; (6) Surgical procedure-open reduction, (7) Surgical procedure-direct decompression of neural elements, and (8 and 9) Surgical procedure-stabilization and fusion (spinal segment number and level). All variables are coded using numbers or characters. Each...

  6. Etiopathogenesis of lower motor neuron facial palsy: Our experience

    Directory of Open Access Journals (Sweden)

    M Venugopal

    2011-01-01

    Full Text Available Introduction : Facial nerve is the seventh cranial nerve having important functions, and hence its paralysis can lead to a great deal of mechanical impairment and emotional embarrassment. Etiopathogenisis of lower motor neuron facial palsy is still a diagnostic challenge and the literature has shown varying results pertaining to the same. This study was designed to sketch out the prevalence of disease causation and the profile of peripheral facial palsy patients presenting to the ENT department at Government Medical College, Kozhikode. Materials and Methods : A prospective study involving 60 patients with facial nerve palsy, presented during the period November 2006 to October 2008, was undertaken. Detailed analysis of etiopathogenesis, age and sex distribution, severity of palsy, anatomical levels and follow up for 1 year was done. Results : Trauma, both iatrogenic and non-iatrogenic, was the most widespread etiology in our study, followed by Bell′s palsy which is described as the commonest cause in world literature. Majority of the patients belonged to the age group of 31-40 years and there was slight male preponderance Non-iatrogenic facial palsy following road traffic accident was common in young males, while females dominated in infectious palsies. Majority of cases reported with grade III palsy, followed by grade IV. High-resolution computed tomography of temporal bone is exceedingly sensitive in delineating facial canal. Conclusions : Data analysis shows similarity with the existing literature except a novel trend towards amplified incidence of trauma surpassing Bell′s palsy. The need for comprehensive history taking, meticulous clinical examination, judicious investigations and appropriate intervention is substantiated by the study.

  7. [Aquatic exercise in the treatment of children with cerebral palsy].

    Science.gov (United States)

    Dimitrijević, Lidija; Bjelaković, Bojko; Lazović, Milica; Stanković, Ivona; Čolović, Hristina; Kocić, Mirjana; Zlatanović, Dragan

    2012-01-01

    Aquatic exercise is one of the most popular supplementary treatments for children with neuro-motor impairment, especially for cerebral palsy (CP). As water reduces gravity force which increases postural stability, a child with CP exercises more easily in water than on land. The aim of the study was to examine aquatic exercise effects on gross motor functioning, muscle tone and cardiorespiratory endurance in children with spastic CP. The study included 19 children of both sexes, aged 6 to 12 years, with spastic CP. They were included in a 12-week aquatic exercise program, twice a week. Measurements of GMFM (gross motor function measurement), spasticity (MAS-Modified Ashworth Scale), heart rate (HR) and maximal oxygen consumption (VO2max) were carried out before and after treatment. The measurement results were compared before and after treatment. GMFM mean value before therapy was 80.2% and statistically it was significantly lower in comparison to the same value after therapy, which was 86.2% (p therapy; the mean value before treatment was 3.21 according to MAS, and after treatment it was 1.95 (p Aquatic exercise program can be useful in improving gross motor functioning, reducing spasticity and increasing cardiorespiratory endurance in children with spastic CP.

  8. The history of facial palsy and spasm: Hippocrates to Razi.

    Science.gov (United States)

    Sajadi, Mohammad M; Sajadi, Mohamad-Reza M; Tabatabaie, Seyed Mahmoud

    2011-07-12

    Although Sir Charles Bell was the first to provide the anatomic basis for the condition that bears his name, in recent years researchers have shown that other European physicians provided earlier clinical descriptions of peripheral cranial nerve 7 palsy. In this article, we describe the history of facial distortion by Greek, Roman, and Persian physicians, culminating in Razi's detailed description in al-Hawi. Razi distinguished facial muscle spasm from paralysis, distinguished central from peripheral lesions, gave the earliest description of loss of forehead wrinkling, and gave the earliest known description of bilateral facial palsy. In doing so, he accurately described the clinical hallmarks of a condition that we recognize as Bell palsy.

  9. Macrophage activation and its role in repair and pathology after spinal cord injury.

    Science.gov (United States)

    Gensel, John C; Zhang, Bei

    2015-09-04

    The injured spinal cord does not heal properly. In contrast, tissue repair and functional recovery occur after skin or muscle injuries. The reason for this dichotomy in wound repair is unclear but inflammation, and specifically macrophage activation, likely plays a key role. Macrophages have the ability to promote the repair of injured tissue by regulating transitions through different phase of the healing response. In the current review we compare and contrast the healing and inflammatory responses between spinal cord injuries and tissues that undergo complete wound resolution. Through this comparison, we identify key macrophage phenotypes that are inaptly triggered or absent after spinal cord injury and discuss spinal cord stimuli that contribute to this maladaptive response. Sequential activation of classic, pro-inflammatory, M1 macrophages and alternatively activated, M2a, M2b, and M2c macrophages occurs during normal healing and facilitates transitions through the inflammatory, proliferative, and remodeling phases of repair. In contrast, in the injured spinal cord, pro-inflammatory macrophages potentiate a prolonged inflammatory phase and remodeling is not properly initiated. The desynchronized macrophage activation after spinal cord injury is reminiscent of the inflammation present in chronic, non-healing wounds. By refining the role macrophages play in spinal cord injury repair we bring to light important areas for future neuroinflammation and neurotrauma research. This article is part of a Special Issue entitled SI: Spinal cord injury. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Education and employment prospects in cerebral palsy

    DEFF Research Database (Denmark)

    Michelsen, Susan Ishøy; Uldall, Peter; Kejs, Anne Mette T

    2005-01-01

    Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819 participa......Parents and paediatric neurologists need information on the long-term social prognosis of children with cerebral palsy (CP). No large population-based study has been performed on this topic. On 31 December 1999, to find predictors in childhood of subsequent education and employment, 819...... participants with CP were: 31% hemiplegia, 43% diplegia, 18% tetraplegia, and 8% other types. Level of motor impairment with respect to walking ability was: 62% able to walk without assistance, 21% with assistance, and 16% not able to walk (for 1% of study children walking ability was not known). Relevant...... information was obtained from Denmark's unique registries. Of the participants with CP, 33% vs 77% of controls, had education beyond lower secondary school (i.e. after age 15-16y), 29% were competitively employed (vs 82% of controls), 5% were studying, and 5% had specially created jobs. Excluding participants...

  11. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S. [Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Han; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-03-15

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  12. Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan.

    Directory of Open Access Journals (Sweden)

    Junichi Hasegawa

    Full Text Available The aim of this study was to identify the relevant obstetric factors for cerebral palsy (CP after 33 weeks' gestation in Japan.This retrospective case cohort study (1:100 cases and controls used a Japanese national CP registry. Obstetric characteristics and clinical course were compared between CP cases in the Japan Obstetric Compensation System for Cerebral Palsy database and controls in the perinatal database of the Japan Society of Obstetrics and Gynecology born as live singleton infants between 2009 and 2011 with a birth weight ≥ 2,000 g and gestation ≥ 33 weeks.One hundred and seventy-five CP cases and 17,475 controls were assessed. Major relevant single factors for CP were placental abnormalities (31%, umbilical cord abnormalities (15%, maternal complications (10%, and neonatal complications (1%. A multivariate regression model demonstrated that obstetric variables associated with CP were acute delivery due to non-reassuring fetal status (relative risk [RR]: 37.182, 95% confidence interval [CI]: 20.028-69.032, uterine rupture (RR: 24.770, 95% CI: 6.006-102.160, placental abruption (RR: 20.891, 95% CI: 11.817-36.934, and preterm labor (RR: 3.153, 95% CI: 2.024-4.911, whereas protective factors were head presentation (RR: 0.199, 95% CI: 0.088-0.450 and elective cesarean section (RR: 0.236, 95% CI: 0.067-0.828.CP after 33 weeks' gestation in the recently reported cases in Japan was strongly associated with acute delivery due to non-reassuring fetal status, uterine rupture, and placental abruption.

  13. Neurophysiological changes induced by the botulinum toxin type A injection in children with cerebral palsy.

    Science.gov (United States)

    Frascarelli, Flaminia; Di Rosa, Giuseppe; Bisozzi, Eleonora; Castelli, Enrico; Santilli, Valter

    2011-01-01

    In the last few years botulinum toxin type A (BTX-A) has been widely used in the management of spasticity in children with cerebral palsy in order to reduce hypertonicity and improve functional outcomes enhancing motor skill development. The botulinum toxin injection seems to interact with intrafusal and extrafusal fibers producing a reduction of hypertone both through synaptic blockade and inhibition of stretch reflex loop and these changes may influence not only the spinal cord but also the central nervous system (CNS). The purpose of our study was to determine the neurophysiological changes induced by the BTX-A through an evaluation of cortical somatosensory Evoked Potential (SEP) and Soleus H wave, that is the index of excitability of stretch reflex loop. Eighteen children with Cerebral Palsy (CP), aged between 5 and 12, were recruited at Children's Hospital "Bambino Gesù" of Rome. All children were evaluated with appropriate clinical scales before and 1 month after the BTX-A injection. Neurophysiological measurements were performed before, and 1 month after botulinum toxin injection through lower limb SEPs, M-wave and Soleus H wave recording. After the injection the results showed a statistically significant improvement both of clinical scales and the neurophysiological variables. These findings suggest that spasticity itself can be considered as a factor affecting the cortical SEPs. And even though it seems that BTX-A does not have any direct central effect on sensory pathways we suppose an indirect mechanism on modulation of afferent fibers Ia due to the modification induced by BTX-A to central loop reflex.

  14. Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan

    Science.gov (United States)

    Hasegawa, Junichi; Toyokawa, Satoshi; Ikenoue, Tsuyomu; Asano, Yuri; Satoh, Shoji; Ikeda, Tomoaki; Ichizuka, Kiyotake; Tamiya, Nanako; Nakai, Akihito; Fujimori, Keiya; Maeda, Tsugio; Masuzaki, Hideaki; Suzuki, Hideaki; Ueda, Shigeru

    2016-01-01

    Objective The aim of this study was to identify the relevant obstetric factors for cerebral palsy (CP) after 33 weeks’ gestation in Japan. Study design This retrospective case cohort study (1:100 cases and controls) used a Japanese national CP registry. Obstetric characteristics and clinical course were compared between CP cases in the Japan Obstetric Compensation System for Cerebral Palsy database and controls in the perinatal database of the Japan Society of Obstetrics and Gynecology born as live singleton infants between 2009 and 2011 with a birth weight ≥ 2,000 g and gestation ≥ 33 weeks. Results One hundred and seventy-five CP cases and 17,475 controls were assessed. Major relevant single factors for CP were placental abnormalities (31%), umbilical cord abnormalities (15%), maternal complications (10%), and neonatal complications (1%). A multivariate regression model demonstrated that obstetric variables associated with CP were acute delivery due to non-reassuring fetal status (relative risk [RR]: 37.182, 95% confidence interval [CI]: 20.028–69.032), uterine rupture (RR: 24.770, 95% CI: 6.006–102.160), placental abruption (RR: 20.891, 95% CI: 11.817–36.934), and preterm labor (RR: 3.153, 95% CI: 2.024–4.911), whereas protective factors were head presentation (RR: 0.199, 95% CI: 0.088–0.450) and elective cesarean section (RR: 0.236, 95% CI: 0.067–0.828). Conclusion CP after 33 weeks’ gestation in the recently reported cases in Japan was strongly associated with acute delivery due to non-reassuring fetal status, uterine rupture, and placental abruption. PMID:26821386

  15. Neuroplastic Sensorimotor Resting State Network Reorganization in Children With Hemiplegic Cerebral Palsy Treated With Constraint-Induced Movement Therapy.

    Science.gov (United States)

    Manning, Kathryn Y; Menon, Ravi S; Gorter, Jan Willem; Mesterman, Ronit; Campbell, Craig; Switzer, Lauren; Fehlings, Darcy

    2016-02-01

    Using resting state functional magnetic resonance imaging (MRI), we aim to understand the neurologic basis of improved function in children with hemiplegic cerebral palsy treated with constraint-induced movement therapy. Eleven children including 4 untreated comparison subjects diagnosed with hemiplegic cerebral palsy were recruited from 3 clinical centers. MRI and clinical data were gathered at baseline and 1 month for both groups, and 6 months later for the case group only. After constraint therapy, the sensorimotor resting state network became more bilateral, with balanced contributions from each hemisphere, which was sustained 6 months later. Sensorimotor resting state network reorganization after therapy was correlated with a change in the Quality of Upper Extremity Skills Test score at 1 month (r = 0.79, P = .06), and Canadian Occupational Performance Measure scores at 6 months (r = 0.82, P = .05). This clinically correlated resting state network reorganization provides further evidence of the neuroplastic mechanisms underlying constraint-induced movement therapy.

  16. [Video Instruction for Synchronous Video Recording of Mimic Movement of Patients with Facial Palsy].

    Science.gov (United States)

    Schaede, Rebecca Anna; Volk, Gerd Fabian; Modersohn, Luise; Barth, Jodi Maron; Denzler, Joachim; Guntinas-Lichius, Orlando

    2017-05-03

    Photografy and video are necessary to record the severity of a facial palsy or to allow offline grading with a grading system. There is no international standard for the video recording urgently needed to allow a standardized comparison of different patient cohorts. A video instruction was developed. The instruction was shown to the patient and presents several mimic movements. At the same time the patient is recorded while repeating the presented movement using commercial hardware. Facial movements were selected in such a way that it was afterwards possible to evaluate the recordings with standard grading systems (House-Brackmann, Sunnybrook, Stennert, Yanagihara) or even with (semi)automatic software. For quality control, the patients evaluated the instruction using a questionnaire. The video instruction takes 11 min and 05 and is divided in 3 parts: 1) Explanation of the procedure; 2) Foreplay and recreating of the facial movements; 3) Repeating of sentences to analyze the communication skills. So far 13 healthy subjects and 10 patients with acute or chronic facial palsy were recorded. All recordings could be assessed by the above mentioned grading systems. The instruction was rated as well explaining and easy to follow by healthy persons and patients. There is now a video instruction available for standardized recording of facial movement. This instruction is recommended for use in clinical routine and in clinical trials. This will allow a standardized comparison of patients within Germany and international patient cohorts. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis

    Institute of Scientific and Technical Information of China (English)

    QIAN Bang-ping; QIU Yong; WANG Bin; YU Yang; ZHU Ze-zhang

    2007-01-01

    Objective: To explore the clinical features and treatment results of brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis.Methods: A total of 300 cases of severe scoliosis received halo traction before posterior correction in our department from July 1997 to November 2004. Among them, 7 cases were complicated with brachial plexus palsy.The average Cobb angle was 110° (range, 90°-135°).Diagnoses were made as idiopathic scoliosis in 1 case,congenital scoliosis in 3 cases, and neuromuscular scoliosis in 3 cases. Additionally, diastematomyelia and tethered cord syndrome were found in 3 cases and thoracolumbar kyphosis in 2 cases. Weight of traction was immediately reduced when the patient developed any abnormal neurological symptoms in the upper extremity, and rehabilitation training was undertaken. Simultaneously,neurotrophic pharmacotherapy was applied, and the neurological function restoration of the upper limbs and the recovery time were documented.Results: Traction was used for an average of 3.5 weeks (range, 2-6 weeks) before spinal fusion for these 7 patients. The average traction weight was 8 kg, which was 19% on average (range, 13%-26%) of the average body weight (40.2 kg). These 7 patients had long and thin body configuration with a mean height of 175 cm. The duration between symptoms of brachial plexus paralysis and the diagnosis was 1-3 hours. All of these 7 patients presented various degrees of numbness in the ulnar side of the hand and forearm. Median nerve paresis was found in 3 cases and ulnar nerve paresis in 4 cases. Complete recovery of the neurological function had been achieved by the end of three months.Conclusions: The clinical features of brachial plexus palsy caused by halo traction include median nerve paresis,ulnar nerve paralysis, and numbness in the ulnar side of the hand and forearm, which may be due to the injury of the inferior part of the brachial plexus, i.e. , damage of Cs and

  18. Postural control in sitting children with cerebral palsy

    NARCIS (Netherlands)

    Brogren, E; Hadders-Algra, M; Forssberg, H

    1998-01-01

    Children with cerebral palsy (CP) display postural problems, largely interfering with daily life activities. Clarification of neural mechanisms controlling posture in these children could serve as a base for more successful intervention. Studies on postural adjustments following horizontal forward a

  19. Pain symptoms in patients with severe cerebral palsy: Prevalence ...

    African Journals Online (AJOL)

    of Exceptional Children (APAE) diagnosed with cerebral palsy and with severe locomotor disability. (GMFCS levels IV and ... osteoporosis, esophagitis, gastroesophageal reflux ... presented by CP patients, pain, caused by the progression of ...

  20. Lame from birth: early concepts of cerebral palsy.

    Science.gov (United States)

    Obladen, Michael

    2011-02-01

    Deformations have been attributed to supernatural causes since antiquity. Cerebral palsy was associated with God's wrath, witchcraft, the evil eye, or maternal imagination. Greek scholars recommended prevention by tight swaddling, a custom that persisted into modern times. In the Middle Ages, the midwife's negligence was held responsible as was difficult teething. Morgagni described in 1769 that the neonatal brain can liquefy, and Bednar described leukomalacia in 1850 as a distinct disorder of the newborn. In 1861, Little associated cerebral palsies with difficult or protracted labor and neonatal asphyxia, but he was challenged by Freud, who in 1897 declared that most cases are prenatal in origin. In 1868, Virchow demonstrated inflammatory changes, a view recently confirmed by Leviton and Nelson. Although a causal relationship of cerebral palsy to the birth never has been established, the habit to put the blame for cerebral palsy on someone remained a frequent attitude.

  1. Postural control in sitting children with cerebral palsy

    NARCIS (Netherlands)

    Brogren, E; Hadders-Algra, M; Forssberg, H

    1998-01-01

    Children with cerebral palsy (CP) display postural problems, largely interfering with daily life activities. Clarification of neural mechanisms controlling posture in these children could serve as a base for more successful intervention. Studies on postural adjustments following horizontal forward a

  2. Health-related physical fitness for children with cerebral palsy.

    Science.gov (United States)

    Maltais, Désirée B; Wiart, Lesley; Fowler, Eileen; Verschuren, Olaf; Damiano, Diane L

    2014-08-01

    Low levels of physical activity are a global health concern for all children. Children with cerebral palsy have even lower physical activity levels than their typically developing peers. Low levels of physical activity, and thus an increased risk for related chronic diseases, are associated with deficits in health-related physical fitness. Recent research has provided therapists with the resources to effectively perform physical fitness testing and physical activity training in clinical settings with children who have cerebral palsy, although most testing and training data to date pertains to those who walk. Nevertheless, on the basis of the present evidence, all children with cerebral palsy should engage, to the extent they are able, in aerobic, anaerobic, and muscle-strengthening activities. Future research is required to determine the best ways to evaluate health-related physical fitness in nonambulatory children with cerebral palsy and foster long-term changes in physical activity behavior in all children with this condition.

  3. Experience with botulinum toxin in the treatment of cerebral palsy

    African Journals Online (AJOL)

    To asseS5 the effect of botulinum toxin on dynamic spasticity and dystonic posturing in children "Yith cerebral palsy. Design. ... muscles responsible for abnormal posture and movement. Institute of Child .... SUbsequently the right foot was fully ...

  4. Sciatic nerve palsy associated with intramuscular quinine injections ...

    African Journals Online (AJOL)

    Key Words: Sciatic nerve palsy, intramuscular injections, children, quinine dil~ ... adverse effects which include ototoxicity resulting .... quinine injection into the gluteal muscles of his right ... to maintain joint movement and avoid damage to.

  5. Therapeutic Potential of Autologous Stem Cell Transplantation for Cerebral Palsy

    National Research Council Canada - National Science Library

    Purandare, Chaitanya; Shitole, D. G; Belle, Vaijayantee; Kedari, Aarti; Bora, Neeta; Joshi, Meghnad

    2012-01-01

    ... to the decreased mortality of low-birth-weight infants together with an increased rate of cerebral palsy in the survivors [ 1]. CP describes a group of permanent disorders of the development of movem...

  6. Health-related physical fitness for children with cerebral palsy

    Science.gov (United States)

    Maltais, Désirée B.; Wiart, Lesley; Fowler, Eileen; Verschuren, Olaf; Damiano, Diane L.

    2014-01-01

    Low levels of physical activity are a global health concern for all children. Children with cerebral palsy have even lower physical activity levels than their typically developing peers. Low levels of physical activity, and thus an increased risk for related chronic diseases, are associated with deficits in health-related physical fitness. Recent research has provided therapists with the resources to effectively perform physical fitness testing and physical activity training in clinical settings with children who have cerebral palsy, although most testing and training data to date pertains to those who walk. Nevertheless, based on the present evidence, all children with cerebral palsy should engage, to the extent they are able, in aerobic, anaerobic and muscle strengthening activities. Future research is required to determine the best ways to evaluate health-related physical fitness in non-ambulatory children with cerebral palsy and foster long-term changes in physical activity behavior in all children with this condition. PMID:24820339

  7. Probability of walking in children with cerebral palsy in Europe

    DEFF Research Database (Denmark)

    Beckung, E.; Hagberg, G.; Uldall, P.

    2008-01-01

    OBJECTIVES: The purpose of this work was to describe walking ability in children with cerebral palsy from the Surveillance of Cerebral Palsy in Europe common database through 21 years and to examine the association between walking ability and predicting factors. PATIENTS AND METHODS: Anonymous data...... on 10042 children with cerebral palsy born between 1976 and 1996 were gathered from 14 European centers; 9012 patients were eligible for the analyses. RESULTS: Unaided walking as the primary way of walking at 5 years of age was reported for 54%, walking with assistive devices was reported for 16......%, and no walking ability was reported for 30%. The proportion of children who were unable to walk was rather stable over time in all of the centers, with a mean proportion of 28%. Walking ability related significantly to cerebral palsy types, that is, spastic unilateral, spastic bilateral, dyskinetic, and ataxic...

  8. Pseudoradial Nerve Palsy Caused by Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Hassan Tahir MD

    2016-07-01

    Full Text Available Pseudoperipheral palsy has been used to characterize isolated monoparesis secondary to stroke. Isolated hand nerve palsy is a rare presentation for acute cerebral stroke. Our patient presented with clinical features of typical peripheral radial nerve palsy and a normal computed tomography scan of the head, which, without a detailed history and neurological examination, could have been easily misdiagnosed as a peripheral nerve lesion deferring further investigation for a stroke. We stress the importance of including cerebral infarction as a critical differential diagnosis in patients presenting with sensory-motor deficit in an isolated peripheral nerve pattern. A good history and physical exam can differentiate stroke from peripheral neuropathy as the cause of radial nerve palsy.

  9. Profile of Children with Cerebral Palsy Attending Out- patient ...

    African Journals Online (AJOL)

    Olusola Ayanniyi

    Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria. 1. Sports Medicine ... Cerebral palsy (CP) is a major cause of childhood disability. The objective of this ... born to women of African origin. According to ...

  10. Obstetrical brachial plexus palsy (OBPP) outcome with conservative management

    NARCIS (Netherlands)

    Eng, GD; Binder, H; Getson, P; ODonnell, R

    1996-01-01

    Resurgence of neurosurgical intervention oi obstetrical brachial plexus palsy prompted our review of 186 patients evaluated between 1981 and 1993, correlating clinical examination, electrodiagnosis, and functional outcome with conservative management. Eighty-eight percent had upper brachial plexus p

  11. Combination of Citicoline and Physiotherapy in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Jafar Nasiri

    2014-01-01

    Conclusions: Results demonstrated that citicoline in combination to physiotherapy appears to be a promising agent to improve gross motor function in patients with cerebral palsy versus physiotherapy alone. Although, further studies are need to be done.

  12. Attentional and executive impairments in children with spastic cerebral palsy

    DEFF Research Database (Denmark)

    Bottcher, Louise; Flachs, Esben Meulengracht; Uldall, Peter

    2010-01-01

    Children with cerebral palsy (CP) are reported to have learning and social problems. The aim of the present study was to examine whether children with CP have impairments in attention or executive function.......Children with cerebral palsy (CP) are reported to have learning and social problems. The aim of the present study was to examine whether children with CP have impairments in attention or executive function....

  13. POSTURAL DISTURBANCES AND FEET DEFORMITIES IN CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    V. M. Kenis

    2011-01-01

    Full Text Available The purpose of study was to estimate common postural disturbances in children with cerebral palsy in relation to feet deformities. 100 children were investigated. Age-related changes in postural patterns are described. Five stereotypical postural patterns are most common in children with cerebral palsy. Proper management of feet deformities is necessary for correction of postural disturbance. Inadequate surgical treatment, as a contrast, may be harmfull and dangerous.

  14. POSTURAL DISTURBANCES AND FEET DEFORMITIES IN CHILDREN WITH CEREBRAL PALSY

    OpenAIRE

    V. M. Kenis; Ivanov, S V; Yu. A. Stepanova

    2011-01-01

    The purpose of study was to estimate common postural disturbances in children with cerebral palsy in relation to feet deformities. 100 children were investigated. Age-related changes in postural patterns are described. Five stereotypical postural patterns are most common in children with cerebral palsy. Proper management of feet deformities is necessary for correction of postural disturbance. Inadequate surgical treatment, as a contrast, may be harmfull and dangerous.

  15. Stability and Harmony of Gait in Children with Cerebral Palsy

    Science.gov (United States)

    Iosa, Marco; Marro, Tiziana; Paolucci, Stefano; Morelli, Daniela

    2012-01-01

    The aim of this study was to quantitatively assess the stability and harmony of gait in children with cerebral palsy. Seventeen children with spastic hemiplegia due to cerebral palsy (5.0 [plus or minus] 2.3 years old) who were able to walk autonomously and seventeen age-matched children with typical development (5.7 [plus or minus] 2.5 years old,…

  16. The Effect of Hominis Placenta Herbal Acupuncture on Bell's palsy

    OpenAIRE

    2000-01-01

    This report was done to observe the effect of Hominis placenta herbal acupuncture on Bell's palsy. The study group comprised 16 patients who arrived at Woo-suk university oriental hospital from January, 1999 till January, 2000 for Bell's palsy. All patients were divided into two group. One was herbal acupunture group, and the other was control group. Acupunture group was done herbal acupuncture therapy on the facial acupuncture points. Followings are achievement and a term of each group. I...

  17. Clinical significance of the corpus callosum in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Kim, Ji Chang [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Jong Chul [School of Medicine, Chungnam National University, Taejon (Korea, Republic of); And Others

    2000-10-01

    To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury.

  18. Stability and Harmony of Gait in Children with Cerebral Palsy

    Science.gov (United States)

    Iosa, Marco; Marro, Tiziana; Paolucci, Stefano; Morelli, Daniela

    2012-01-01

    The aim of this study was to quantitatively assess the stability and harmony of gait in children with cerebral palsy. Seventeen children with spastic hemiplegia due to cerebral palsy (5.0 [plus or minus] 2.3 years old) who were able to walk autonomously and seventeen age-matched children with typical development (5.7 [plus or minus] 2.5 years old,…

  19. A comparison of cryopreservation methods: Slow-cooling vs. rapid-cooling based on cell viability, oxidative stress, apoptosis, and CD34+ enumeration of human umbilical cord blood mononucleated cells

    Directory of Open Access Journals (Sweden)

    Sandra Ferry

    2011-09-01

    Full Text Available Abstract Background The finding of human umbilical cord blood as one of the most likely sources of hematopoietic stem cells offers a less invasive alternative for the need of hematopoietic stem cell transplantation. Due to the once-in-a-life time chance of collecting it, an optimum cryopreservation method that can preserve the life and function of the cells contained is critically needed. Methods Until now, slow-cooling has been the routine method of cryopreservation; however, rapid-cooling offers a simple, efficient, and harmless method for preserving the life and function of the desired cells. Therefore, this study was conducted to compare the effectiveness of slow- and rapid-cooling to preserve umbilical cord blood of mononucleated cells suspected of containing hematopoietic stem cells. The parameters used in this study were differences in cell viability, malondialdehyde content, and apoptosis level. The identification of hematopoietic stem cells themselves was carried out by enumerating CD34+ in a flow cytometer. Results Our results showed that mononucleated cell viability after rapid-cooling (91.9% was significantly higher than that after slow-cooling (75.5%, with a p value = 0.003. Interestingly, the malondialdehyde level in the mononucleated cell population after rapid-cooling (56.45 μM was also significantly higher than that after slow-cooling (33.25 μM, with a p value p value = 0.138. However, CD34+ enumeration was much higher in the population that underwent slow-cooling (23.32 cell/μl than in the one that underwent rapid-cooling (2.47 cell/μl, with a p value = 0.001. Conclusions Rapid-cooling is a potential cryopreservation method to be used to preserve the umbilical cord blood of mononucleated cells, although further optimization of the number of CD34+ cells after rapid-cooling is critically needed.

  20. Comparison of outcomes of treating central cord injury syndrome with surgery and conservative regime%脊髓中央管损伤综合征手术和保守治疗的疗效比较

    Institute of Scientific and Technical Information of China (English)

    韩玮; 胡志毅; 张宁; 殷国勇

    2011-01-01

    目的 比较前路手术、后路手术及保守治疗脊髓中央管损伤综合征的疗效.方法 脊髓中央管损伤综合征患者37例,前路手术治疗24例,后路手术治疗7例,保守治疗6例.比较治疗前、后的JOA评分.结果 37例患者均获得随访4~24个月.术后改善率:前路手术组(68.21±25.57)%,后路手术组(60.61±9.63)%,均明显高于保守治疗组的(46.41±7.18)%(P<0.05).结论 前路手术及后路手术治疗脊髓中央管损伤综合征效果明显好于保守治疗.%Objective To compare the outcomes of treating central cord injury syndrome with surgery and conservative regime. Methods The treatments of 37 cases with central cord injury syndrome were performed with surgery via anterior aproach in 24 cases, with surgery via posterior aproach in 7 cases, and with conservative therapy in 6 cases evaluated by Japanese Orthopaedic Association(JOA) score. Results All cases were followed up for 4 to 24 months. The recovery rate was significantly higher in the patients underwent surgery than that in those recieved conservative therapy [(68. 21± 25. 57 )% and (60. 61 ± 9. 63)% vs. (46. 41 ± 7. 18) % ] (P< 0.05). Conclusion The efficiency of surgical treatment for cervical central cord injury via anterior or posterior aproach is better than that of conservative therapy.

  1. Curative effect comparison of different treatments for neurogenic bladder after spinal cord injury%不同方法治疗脊髓损伤后神经源性膀胱的疗效比较

    Institute of Scientific and Technical Information of China (English)

    谌德雄

    2015-01-01

    Objective:To explore the curative effect of different treatments for neurogenic bladder after spinal cord injury.Methods:60 patients with neurogenic bladder after spinal cord injury were divided into A group(needle warming moxibustion),B group(bladder function training),C group(needle warming moxibustion plus bladder function training).We compared the efficacy of the 3 groups.Results:After 2 months of treatment,in the C group,the bladder residual urine volume,bladder balance and overall efficacy was higher than the other two groups(P<0.05).Conclusion:Needle warming moxibustion plus bladder function training for treatment of neurogenic bladder after spinal cord injury can reduce the residual urine volume,and improve the voiding dysfunction and quality of life of patients.%目的:比较不同方法治疗脊髓损伤后神经源性膀胱的效果。方法:将60例脊髓损伤后神经源性膀胱病例分为A组(温针灸)、B组(膀胱功能训练)、C组(温针灸+膀胱功能训练),统计3组疗效。结果:治疗2个月后,C组膀胱残余尿量、膀胱平衡状态及总体疗效均高于其他两组(P<0.05)。结论:温针灸联用膀胱功能训练治疗脊髓损伤后神经源性膀胱,可减少残余尿量,改善患者排尿障碍及生活质量。

  2. Can global positioning systems quantify participation in cerebral palsy?

    Science.gov (United States)

    Ben-Pazi, Hilla; Barzilay, Yair; Shoval, Noam

    2014-06-01

    This study examined whether motor-related participation could be assessed by global positioning systems in individuals with cerebral palsy. Global positioning systems monitoring devices were given to 2 adolescent girls (14-year-old with diplegic cerebral palsy and her 15-year-old healthy sister). Outcome measures were traveling distances, time spent outdoors, and Children's Assessment of Participation and Enjoyment questionnaires. Global positioning systems documented that the girl with cerebral palsy did not visit nearby friends, spent less time outdoors and traveled shorter distances than her sister (P = .02). Participation questionnaire corroborated that the girl with cerebral palsy performed most activities at home alone. Lower outdoor activity of the girl with cerebral palsy measured by a global positioning system was 29% to 53% of that of her sibling similar to participation questionnaires (44%). Global positioning devices objectively documented low outdoor activity in an adolescent with cerebral palsy compared to her sibling reflecting participation reported by validated questionnaires. Global positioning systems can potentially quantify certain aspects of participation.

  3. Clinical Studies on Herbal Acupuncture Therapy in Peripheral Facial Palsy

    Directory of Open Access Journals (Sweden)

    Shin, Min-Seop

    2001-06-01

    Full Text Available Objectives : The treatment of Bell's palsy must be divided into three states(acute, subacute and healing state. 41 cases of the patient suffering from Bell's palsy were treated and observed from january 2000 to July 2001. The usage of herbal acupunctures on that disease have been effective. So I propose a method of herbal acupunctures on Bell's palsy. Methods : By the states(acute, subacute and healing state of Bell's palsy, SY(消炎 herbal acupuncture is used at the acute state, Hominis Placenta(紫河車 at the subacute, JGH(中氣下陷 at the healing state. Results : 1. At the acute state, SY(消炎 herbal acupuncture is effective to postauricular pain. 2. At the subacute state, Hominis Placenta(紫河車 herbal acupuncture is effective to decreasing pain and improving symptoms. 3. By the states(acute, subacute and healing state of Bell's palsy, SY(消炎, Hominis Placenta(紫河車 and JGH(中氣下陷 herbal acupuncture is effective to improving symptoms of Bell's palsy.

  4. 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.

  5. Evaluation of postural stability in children with hemiplegic cerebral palsy

    Science.gov (United States)

    Kenis-Coskun, Ozge; Giray, Esra; Eren, Beyhan; Ozkok, Ozlem; Karadag-Saygi, Evrim

    2016-01-01

    [Purpose] Postural stability is the ability of to maintain the position of the body within the support area. This function is affected in cerebral palsy. The aim of the present study was to compare static and dynamic postural stability between children with hemiplegic cerebral palsy and healthy controls. [Subjects and Methods] Thirty-seven children between the ages of 5 and 14 diagnosed with hemiplegic cerebral palsy (19 right, 18 left) and 23 healthy gender- and age-matched controls were included in the study. Postural stability was evaluated in both of the groups using a Neurocom Balance. Sway velocity was measured both with the eyes open and closed. Sit to stand and turning abilities were also assessed. [Results] The sway velocities with the eyes open and closed were significantly different between the groups. The weight transfer time in the Sit to Stand test was also significantly slower in children with cerebral palsy. Children with cerebral palsy also showed slower turning times and greater sway velocities during the Step and Quick Turn test on a force plate compared with their healthy counterparts. [Conclusion] Both static and dynamic postural stability parameters are affected in hemiplegic cerebral palsy. Further research is needed to define rehabilitation interventions to improve these parameters in patients. PMID:27313338

  6. Non-functioning parathyroid adenoma: a rare differential diagnosis for vocal-cord paralysis.

    Science.gov (United States)

    Kamali, D; Sharpe, A; Nagarajan, S; Elsaify, W

    2016-07-01

    Introduction Adenomas of the parathyroid gland typically present with symptoms of hyperparathyroidism, manifested by fatigue, bone pain, abdominal pain, weakness, dyspepsia, nephrolithiasis and skeletal bone disease. Here, we describe, for the first time, a case of a non-functioning benign tumour of the parathyroid gland presenting as vocal-cord paralysis. Case History A 49-year-old male presented with a 10-week history of dysphonia and the feeling of having 'something stuck in my throat'. History-taking elicited no other associated symptoms. Flexible nasal endoscopy demonstrated paralysis of the left vocal cord. Computed tomography of the neck revealed a cystic lesion, 18mm in diameter adjacent to the oesophagus. After more rigorous tests, a neck exploration, left hemithyroidectomy, excision of the left paratracheal mass and level-VI neck dissection was undertaken, without incident to the patient or surgical team. Histology was consistent with a parathyroid adenoma. Conclusions This case emphasises the importance of including adenomatous disease of the parathyroid gland in the differential diagnosis despite normal parathyroid status as a cause of vocal cord palsy.

  7. Evaluating perfusion of thoracic spinal cord blood using CEUS during thoracic spinal stenosis decompression surgery.

    Science.gov (United States)

    Ling, J; Jinrui, W; Ligang, C; Wen, C; Xiaoguang, L; Liang, J

    2015-01-13

    Study design:A clinical study in human spinal cord.Objectives:To evaluate changes in spinal cord blood perfusion in patients with thoracic spinal stenosis using contrast-enhanced ultrasonography and to semiquantitatively analyze blood perfusion changes in compressed spinal cord before and after ventral decompression.Setting:Ultrasound department of a university hospital.Methods:Twelve patients with confirmed thoracic spinal stenosis who needed decompression surgery participated. They underwent an intravenous injection of a contrast agent before and after ventral decompression. Quantitative analysis software (Philips Healthcare, Bothell, WA, USA) was used to perform time-intensity curve (TIC) analysis. The enhanced intensity (ΔI), rise time (ΔT) and slope of the TIC (β) were separately calculated; t-tests of the independent samples were performed on the indicators.Results:The TICs showed no significant differences between compressed spinal cord and normal spinal cord in ΔT, enhanced ΔI and β (P= 0.46, P=0.23 and P=0.16, respectively). After ventral decompression, ΔI of the originally compressed spinal cord increased substantially (P= 0.04) compared with ΔI of the normal spinal cord; however, the ΔT and β showed no significant differences (P= 0.18 and P=0.09, respectively). Comparison of the blood perfusion parameters (that is, ΔT and ΔI) of the compressed spinal cords before and after ventral decompression showed no significant differences (P=0.14 and P=0.12, respectively), but β showed significant difference (P=0.02).Conclusion:Contrast-enhanced ultrasonography can dynamically display spinal cord blood perfusion. The characteristics of blood perfusion can be semiquantitatively analyzed using a software technique.Spinal Cord advance online publication, 13 January 2015; doi:10.1038/sc.2014.213.

  8. Bancos de cordón umbilical Umbilical cord banks

    OpenAIRE

    2009-01-01

    La utilización de sangre de cordón como fuente de precursores hematológicos se remonta a 1983 cuando Boyse apuntó el potencial en progenitores existente en la sangre de cordón, realizándose un año más tarde las primeras experiencias sobre modelos murinos. Tuvieron que pasar más de cinco años para que Gluckman realizara la primera experiencia en humanos. Un niño afecto de anemia de Fanconi fue trasplantado con progenitores de sangre de cordón umbilical de su hermana HLA idéntica, realizándose ...

  9. Persistence of Cerebral Palsy Diagnosis: Assessment of a Low-Birth-Weight Cohort at Ages 2, 6, and 9 Years.

    Science.gov (United States)

    Korzeniewski, Steven J; Feldman, Judith F; Lorenz, John M; Pinto-Martin, Jennifer A; Whitaker, Agnes H; Paneth, Nigel

    2016-03-01

    We examined the stability of nondisabling and disabling cerebral palsy at age 2 in a longitudinally followed tri-county low-birth-weight (cerebral palsy diagnoses at age 2, 61 (9% of the cohort, n = 61/777) had disabling cerebral palsy and 52 (7%, n = 52/777) had nondisabling cerebral palsy. Of 48 followed children diagnosed with disabling cerebral palsy at age 2, 98% were again classified as having cerebral palsy at school age, and 1 had an uncertain cerebral palsy status. By contrast, 41% (n = 17) of the 43 children diagnosed with nondisabling cerebral palsy at age 2 were classified as not having cerebral palsy. Of the 517 followed children who were not diagnosed with cerebral palsy at age 2, 7% (n = 35) were classified as having late emerging nondisabling cerebral palsy at school age.

  10. Reduced accommodation in children with cerebral palsy.

    Science.gov (United States)

    Leat, S J

    1996-09-01

    Accommodation in 43 subjects with cerebral palsy was measured objectively using a dynamic retinoscopy technique, which has already been shown to be reliable and repeatable. The subject's ages ranged from 3 to 35 years. Of these, 42% were found to have an accommodative response pattern which was different from the normal control group for his/her age. Nearly 29% had an estimated amplitude of accommodation of 4 D or less. The presence of reduced accommodation was found to be associated with reduced visual acuity, but was not associated with cognitive or communication ability, refractive error or age. The prevalence of other ocular disorders in this group is also high. These findings have developmental and educational implications.

  11. Acute sciatic neuropathy: "Saturday night palsy"

    Directory of Open Access Journals (Sweden)

    Manigoda Miodrag

    2005-01-01

    Full Text Available This is a case report of 25-year old, unemployed male, admitted to hospital due to acute onset of the left foot drop, subsequent walking difficulty and numbness of the left calf and foot. Symptoms began after prolonged sleep with previous heroin abuse by sniffing. During neurological examination, mild weakness of knee flexors, moderate weakness of plantar flexors and paralysis of foot dorsiflexors, together with hypesthesia of the left calf, foot and fingers, predominantly in the innervation area of common peroneal nerve on the same side, were observed. The electrophysiologic examination revealed predominant involvement of peroneal division within the sciatic nerve, together with recorded conduction block indicating the compression as possible mechanism of nerve injury. The patient was administered corticosteroid therapy during two months, what resulted in almost complete recovery. The peculiarity of this case report is in the presence of the sciatic nerve "Saturday night palsy" with possible effect of former heroin abuse.

  12. The Child with Cerebral Palsy and Anaesthesia

    Directory of Open Access Journals (Sweden)

    A Rudra

    2008-01-01

    Full Text Available Cerebral palsy (CP is the result of an injury to the developing brain during the antenatal, perinatal or postnatal period. Clinical manifestation relate to the areas affected. Patients with CP often present for elective surgical proce-dures to correct various deformities. Anaesthetic concerns of anaesthesia are intraoperative hypothermia , and slow emergence. Suxamethonium does not cause hyperkalaemia in these patients, and a rapid sequence induction may be indicated. Temperature should be monitored and an effort made to keep the patient warm. Cerebral abnormalities may lead to slow awakening; the patient should remain intubated until fully awake and airway reflexes have returned. Pulmonary infection can complicate the postoperative course. Postoperative pain management and the prevention of muscle spasms are important and drugs as baclofen and botulinum toxin are discussed. Epidural analgesia is particu-larly valuable when major orthopaedic procedures are performed.

  13. Family adaptation to cerebral palsy in adolescents

    DEFF Research Database (Denmark)

    Guyard, Audrey; Michelsen, Susan I; Arnaud, Catherine

    2017-01-01

    modelled with structural equations. RESULTS: 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best...... of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were...... protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. CONCLUSIONS: Particular attention must be paid...

  14. 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.

  15. Nutritional management of children with cerebral palsy.

    Science.gov (United States)

    Bell, K L; Samson-Fang, L

    2013-12-01

    Children with severe cerebral palsy and particularly those with oropharyngeal dysfunction are at risk of poor nutritional status. Determining the need and the mode of nutritional intervention is multifactorial and requires multiple methodologies. First-line treatment typically involves oral nutritional support for those children who are safe to consume an oral diet. Enteral tube feeding may need to be considered in children with undernutrition where poor weight gain continues despite oral nutritional support, or in those with oropharyngeal dysphagia and an unsafe swallow. Estimates for energy and protein requirements provide a starting point only, and ongoing assessment and monitoring is essential to ensure nutritional needs are being met, that complications are adequately managed and to avoid over or under feeding.

  16. Early identification and intervention in cerebral palsy.

    Science.gov (United States)

    Herskind, Anna; Greisen, Gorm; Nielsen, Jens Bo

    2015-01-01

    Infants with possible cerebral palsy (CP) are commonly assumed to benefit from early diagnosis and early intervention, but substantial evidence for this is lacking. There is no consensus in the literature on a definition of 'early', but this review focuses on interventions initiated within the first 6 months after term age. We cover basic neuroscience, arguing for a beneficial effect of early intervention, and discuss why clinical research to support this convincingly is lacking. We argue that infants offered early intervention in future clinical studies must be identified carefully, and that the intervention should be focused on infants showing early signs of CP to determine an effect of treatment. Such signs may be efficiently detected by a combination of neuroimaging and the General Movements Assessment. We propose a research agenda directed at large-scale identification of infants showing early signs of CP and testing of high-intensity, early interventions. © 2014 Mac Keith Press.

  17. Change of direction ability performance in cerebral palsy football players according to functional profiles

    Directory of Open Access Journals (Sweden)

    Raul eReina

    2016-01-01

    Full Text Available The aims of the present study were to evaluate the validity and reliability of the two different change of direction ability (CODA tests in elite football players with cerebral palsy (CP and to analyse the differences in performance of this ability between current functional classes (FT and controls. The sample consisted of 96 international cerebral palsy football players (FPCP and 37 football players. Participants were divided into four different groups according to the International Federation of Cerebral Palsy Football classes and a control group (CG: FT5 (n = 8; FT6 (n = 12; FT7 (n = 62; FT8 (n = 14; and CG (n = 37. The reproducibility of Modified Agility Test (MAT and Illinois Agility Test (IAT (ICC = 0.82-0.95, SEM = 2.5-5.8% showed excellent to good values. In two CODA tests, CG performed faster scores compared with FPCP classes (p < 0.01, d = 1.76-3.26. In IAT, FT8 class comparisons regarding the other classes were: FT5 (p = 0.047, d = 1.05, FT6 (p = 0.055, d = 1.19 and FT7 (p = 0.396, d = 0.56. With regard to MAT, FT8 class was also compared with FT5 (p = 0.006, d = 1.30, FT6 (p = 0.061, d = 0.93 and FT7 (p = 0.033, d = 1.01. No significant differences have been found between FT5, FT6 and FT7 classes. According to these results, IAT and MAT could be useful and reliable and valid tests to analyse CODA in FPCP. Each test (IAT and MAT could be applied considering the cut point that classifiers need to make a decision about the FT8 class and the other FT classes (FT5, FT6 and FT7.

  18. Advanced fiber tracking in early acquired brain injury causing cerebral palsy.

    Science.gov (United States)

    Lennartsson, F; Holmström, L; Eliasson, A-C; Flodmark, O; Forssberg, H; Tournier, J-D; Vollmer, B

    2015-01-01

    Diffusion-weighted MR imaging and fiber tractography can be used to investigate alterations in white matter tracts in patients with early acquired brain lesions and cerebral palsy. Most existing studies have used diffusion tensor tractography, which is limited in areas of complex fiber structures or pathologic processes. We explored a combined normalization and probabilistic fiber-tracking method for more realistic fiber tractography in this patient group. This cross-sectional study included 17 children with unilateral cerebral palsy and 24 typically developing controls. DWI data were collected at 1.5T (45 directions, b=1000 s/mm(2)). Regions of interest were defined on a study-specific fractional anisotropy template and mapped onto subjects for fiber tracking. Probabilistic fiber tracking of the corticospinal tract and thalamic projections to the somatosensory cortex was performed by using constrained spherical deconvolution. Tracts were qualitatively assessed, and DTI parameters were extracted close to and distant from lesions and compared between groups. The corticospinal tract and thalamic projections to the somatosensory cortex were realistically reconstructed in both groups. Structural changes to tracts were seen in the cerebral palsy group and included splits, dislocations, compaction of the tracts, or failure to delineate the tract and were associated with underlying pathology seen on conventional MR imaging. Comparisons of DTI parameters indicated primary and secondary neurodegeneration along the corticospinal tract. Corticospinal tract and thalamic projections to the somatosensory cortex showed dissimilarities in both structural changes and DTI parameters. Our proposed method offers a sensitive means to explore alterations in WM tracts to further understand pathophysiologic changes following early acquired brain injury. © 2015 by American Journal of Neuroradiology.

  19. A case of atypical progressive supranuclear palsy

    Directory of Open Access Journals (Sweden)

    Spaccavento S

    2013-12-01

    Full Text Available Simona Spaccavento, Marina Del Prete, Angela Craca, Anna Loverre IRCCS Salvatore Maugeri Foundation, Cassano Murge, Bari, Italy Background: Progressive supranuclear palsy (PSP is a neurodegenerative extrapyramidal syndrome. Studies have demonstrated that PSP can present clinically as an atypical dementing syndrome dominated by a progressive apraxia of speech (AOS and aphasia. Aim: We aimed to investigate the clinical presentation of PSP, using a comprehensive multidimensional evaluation, and the disease response to various pharmacological treatments. Methods: A 72-year-old right-handed male, with 17 years education, who first presented with aphasia, AOS, depression, apathy, and postural instability at 69 years; a complete neuropsychological evaluation, tapping the different cognitive domains, was performed. Results: Testing revealed a moderate global cognitive deficit (Mini-Mental State Examination test score =20, low memory test scores (story recall, Rey’s 15-word Immediate and Delayed Recall, and poor phonemic and semantic fluency. The patient’s language was characterized by AOS, with slow speech rate, prolonged intervals between syllables and words, decreased articulatory accuracy, sound distortions, and anomia. Behavioral changes, such as depression, anxiety, apathy, and irritability, were reported. The neurological examination revealed supranuclear vertical gaze palsy, poor face miming, and a mild balance deficit. Magnetic resonance imaging showed only widespread cortical atrophy. Single photon emission computed tomography demonstrated left > right frontotemporal cortical abnormalities. After 6 months, a further neuropsychological assessment showed a progression in cognitive deficits, with additional attention deficits. The patient reported frequent falls, but the neurological deficits remained unchanged. Neuroimaging tests showed the same brain involvement. Conclusion: Our case highlights the heterogeneity of the clinical features in

  20. Prednisolone and acupuncture in Bell's palsy: study protocol for a randomized, controlled trial

    National Research Council Canada - National Science Library

    Xia, Feng; Han, Junliang; Liu, Xuedong; Wang, Jingcun; Jiang, Zhao; Wang, Kangjun; Wu, Songdi; Zhao, Gang

    2011-01-01

    .... Acupuncture is one of the most commonly used methods to treat Bell's palsy in China. Recent studies suggest that staging treatment is more suitable for Bell's palsy, according to different path-stages of this disease...

  1. Excess Pre-Pregnancy Weight May Slightly Raise Baby's Cerebral Palsy Risk

    Science.gov (United States)

    ... Excess Pre-Pregnancy Weight May Slightly Raise Baby's Cerebral Palsy Risk But, study found overall odds remain quite ... slight increased risk of having a baby with cerebral palsy, a new study suggests. After reviewing data from ...

  2. Suicide in a spinal cord injured population

    DEFF Research Database (Denmark)

    Hartkopp, A; Brønnum-Hansen, Henrik; Seidenschnur, A M

    1998-01-01

    To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI).......To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI)....

  3. Spinal Cord Injury Model System Information Network

    Science.gov (United States)

    ... Go New to Website Managing Bowel Function After Spinal Cord Injury Resilience, Depression and Bouncing Back after SCI Getting ... the UAB-SCIMS Contact the UAB-SCIMS UAB Spinal Cord Injury Model System Newly Injured Health Daily Living Consumer ...

  4. Percutaneous umbilical cord blood sampling - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100196.htm Percutaneous umbilical cord blood sampling - series—Normal anatomy To use the ... or blood disorder, your doctor may recommend percutaneous umbilical cord blood sampling (PUBS), which is performed at 18 ...

  5. Effects of retractor application on cuff pressure and vocal cord function in patients undergoing anterior cervical discectomy and fusion

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2010-01-01

    Full Text Available Anterior cervical discectomy and fusion is a commonly performed procedure for prolapse of cervical intervertebral disc. It involves retraction of soft tissue of neck for adequate exposure of anterior spinal canal. Increased cuff pressure with retractor application may affect the postoperative vocal cord function. Cuff pressures of tracheal tube were measured continuously in 37 patients using air-filled pressure transducer connected to the pilot balloon. Changes of pressure from baseline values were noted after application of cervical retractor. At the end of procedure, vocal cord movement was observed using fibreoptic bronchoscope. Significant increase in cuff pressure (168% of baseline values and airway pressure of tracheal tube during cervical retraction was observed. The vocal cord function was assessed using fibreoptic laryngoscope. One patient developed right vocal cord palsy (2.7% and two patients had postoperative hoarseness of voice (5.4%. All these complications improved over a period of time. It is suggested that the cuff of tracheal tube should be inflated to achieve ′just seal′, with adequate cuff pressure monitoring. Intermittent release of cervical retraction may help to prevent laryngeal morbidities.

  6. Effects of retractor application on cuff pressure and vocal cord function in patients undergoing anterior cervical discectomy and fusion.

    Science.gov (United States)

    Garg, Rakesh; Rath, Girija P; Bithal, Parmod K; Prabhakar, Hemanshu; Marda, Manish K

    2010-07-01

    Anterior cervical discectomy and fusion is a commonly performed procedure for prolapse of cervical intervertebral disc. It involves retraction of soft tissue of neck for adequate exposure of anterior spinal canal. Increased cuff pressure with retractor application may affect the postoperative vocal cord function. Cuff pressures of tracheal tube were measured continuously in 37 patients using air-filled pressure transducer connected to the pilot balloon. Changes of pressure from baseline values were noted after application of cervical retractor. At the end of procedure, vocal cord movement was observed using fibreoptic bronchoscope. Significant increase in cuff pressure (168% of baseline values) and airway pressure of tracheal tube during cervical retraction was observed. The vocal cord function was assessed using fibreoptic laryngoscope. One patient developed right vocal cord palsy (2.7%) and two patients had postoperative hoarseness of voice (5.4%). All these complications improved over a period of time. It is suggested that the cuff of tracheal tube should be inflated to achieve 'just seal', with adequate cuff pressure monitoring. Intermittent release of cervical retraction may help to prevent laryngeal morbidities.

  7. Timing of Surgery After Spinal Cord Injury.

    Science.gov (United States)

    Piazza, Matthew; Schuster, James

    2017-01-01

    Although timing for surgical intervention after spinal cord injury remains controversial, there is accumulating evidence suggesting that early surgery may improve neurologic outcomes, particularly with incomplete spinal cord injury, and may reduce non-neurologic complications and health care resource utilization. Moreover, even in patients with complete spinal cord injury, minor improvement in neurologic function can lead to significant changes in quality of life. This article reviews the experimental and clinical data examining surgical timing after spinal cord injury.

  8. Management of umbilical cord clamping.

    Science.gov (United States)

    Webbon, Lucy

    2013-02-01

    The Royal College of Midwives (RCM) has updated its third stage of labour guidelines (RCM 2012) to be clearly supportive of a delay in umbilical cord clamping, although specific guidance on timing is yet to be announced. It is therefore imperative that both midwives and student midwives understand and are able to integrate delaying into their practice, as well as communicating to women the benefits; only in this way can we give women fully informed choices on this aspect of care. The main benefit of delayed cord clamping is the protection it can provide in reducing childhood anaemia, which is a major issue, especially in poorer countries. A review of the evidence found no risks linked to delayed clamping, and no evidence that it cannot be used in combination with the administration of uterotonic drugs. Delayed cord clamping can be especially beneficial for pre term and compromised babies.

  9. Aquaporins in the Spinal Cord

    Directory of Open Access Journals (Sweden)

    Michal K. Oklinski

    2016-12-01

    Full Text Available Aquaporins (AQPs are water channel proteins robustly expressed in the central nervous system (CNS. A number of previous studies described the cellular expression sites and investigated their major roles and function in the brain and spinal cord. Among thirteen different mammalian AQPs, AQP1 and AQP4 have been mainly studied in the CNS and evidence has been presented that they play important roles in the pathogenesis of CNS injury, edema and multiple diseases such as multiple sclerosis, neuromyelitis optica spectrum disorders, amyotrophic lateral sclerosis, glioblastoma multiforme, Alzheimer’s disease and Parkinson’s disease. The objective of this review is to highlight the current knowledge about AQPs in the spinal cord and their proposed roles in pathophysiology and pathogenesis related to spinal cord lesions and injury.

  10. What consistency of food is best for children with cerebral palsy who cannot chew?

    OpenAIRE

    Croft, R D

    1992-01-01

    Video recordings were made of 67 children with cerebral palsy and 64 able bodied children eating soft boiled ('non-mashed') and mashed potato. Those children with cerebral palsy who had no speech, presumed to have poor oral motor function, took significantly longer to eat non-mashed than mashed potato. Children with cerebral palsy, especially those with no speech, were more likely to cough or choke while eating non-mashed than mashed potato. It is recommended that children with cerebral palsy...

  11. Remote results of observation patients with cerebral palsy in spastic diplegia form after course of muscles electrostimulation

    Directory of Open Access Journals (Sweden)

    Eliseev V.V.

    2016-06-01

    Full Text Available The aim of the research is to estimate remote results of observation patients with cerebral palsy in spastic diplegia form. Materials and methods. Under observation were 71 patients with cerebral palsy in spastic diplegia form in the age from 3 to 16 years were described in the present article. Parameters of walking were registrated before, after treatment and 6 months later have finished of treatment. Patients were distributed by two groups. 38 children were included into the first group. They have gotten course of complex rehabilitation with addition functional programmed muscles electrostimulation. The second group was composed by 33 patients. These children have been spent a course of complex rehabilitation like first group besides type of electrostimulation. Second group of patients received passive electrostimulation. Results. At the children of the first group a reliably (p<0,05 good remote result (increasing indexes to 35% had been registrated in comparison with them condition after treatment. The first group of patients had reliably (p<0,05 good result then the second group. Conclusion. Significantly good results on several symptoms (limping, moving in knee and coxal joints received with use functional programmed electrostimulation of muscles in children with spastic diplegia form of cerebral palsy.

  12. Effects of assisted aquatic movement and horseback riding therapies on emotion and brain activation in patients with cerebral palsy.

    Science.gov (United States)

    Ryu, Kwangmin; Ali, Asif; Kwon, Minji; Lee, Changyoung; Kim, Yujin; Lee, Gyusung; Kim, Jingu

    2016-12-01

    [Purpose] The purpose of this study was to determine the effects of assisted aquatic movement and horseback riding therapies on emotion and brain activation in patients with cerebral palsy. [Subjects and Methods] Thirty-two right-handed patients with cerebral palsy (18 male, 14 female) whose ages ranged from 8 to 48 years participated in this experiment. Their cerebral palsy levels ranged from 1 to 3. The participants were assigned to one of three groups according to the experimental conditions: an assisted aquatic movement therapy group, a horseback riding therapy group, or a control group. Electroencephalograms, the Feeling Scale and the Felt Arousal Scale were examined as dependent variables. [Results] Analysis of self-reported data demonstrated a significant positive improvement in the emotions of participants in the assisted aquatic movement therapy group in comparison with the control group. With regard to the electroencephalogram analysis, the results of this study showed increased alpha power in the assisted aquatic movement therapy group compared with the horseback riding and control groups. [Conclusion] The results of this study suggest that professionals can consider assisted aquatic movement therapy as an effective therapeutic intervention for the improvement of mental health and brain activation.

  13. Psychological Aspects of Spinal Cord Injury

    Science.gov (United States)

    Cook, Daniel W.

    1976-01-01

    Reviewing literature on the psychological impact of spinal cord injury suggests: (a) depression may not be a precondition for injury adjustment; (b) many persons sustaining cord injury may have experienced psychological disruption prior to injury; and (c) indexes of rehabilitation success need to be developed for the spinal cord injured. (Author)

  14. Evaluation of spinal cord injury animal models

    Institute of Scientific and Technical Information of China (English)

    Ning Zhang; Marong Fang; Haohao Chen; Fangming Gou; Mingxing Ding

    2014-01-01

    Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies.

  15. Delayed umbilical cord separation in alloimmune neutropenia.

    OpenAIRE

    Kemp, A S; Lubitz, L

    1993-01-01

    Delayed umbilical cord separation in association with neonatal alloimmune neutropenia is reported. Delayed umbilical cord separation has been described in association with defects in neutrophil function. The present case indicates that deficiency in neutrophil number should also be considered as a cause of delayed cord separation.

  16. Comparison of Barriers of Activity and Participation for 3-6 Years Aged Children with Cerebral Palsy, Intellectu-al Disability, and Autism Using ICF-CY Questionnaire%3~6岁脑性瘫痪、智力残疾、孤独症儿童活动和参与功能障碍比较

    Institute of Scientific and Technical Information of China (English)

    梁兵; 马洪卓; 邱卓英; 李沁燚; 王金元

    2015-01-01

    Objective To compare the features of activity and participation difficulty of children with cerebral palsy, intellectual disabili-ty and autism. Methods 42 children with cerebral palsy, intellectual disability, and autism aged 3-6 years were evaluated with ICF-CY Ques-tionnaire. Results There were mild barriers in the domains of learning and applying knowledge, communication, mobility, self-care, domes-tic life and major life areas, and the moderate barriers in the domains of general tasks and demands, interpersonal interactions and relations. There were more barriers in learning and applying knowledge in children with cerebral palsy and intellectual disability than those with au-tism. Conclusion There are various features in activity and participation difficulty in children with cerebral palsy, intellectual disability or autism, which required diversity of educational rehabilitation strategies.%目的:比较脑瘫、智力残疾、孤独症儿童主要活动和参与障碍的特点。方法3~6岁参与教育与康复训练的残疾儿童42名,采用ICF-CY功能检查表进行调查。结果残疾儿童在学习和应用知识、交流、活动、家庭生活、自理和主要生活领域属于轻度障碍;在一般任务和要求、人际交往与人际关系领域属于中度障碍。智力残疾和脑瘫儿童在学习和应用知识领域的障碍高于孤独症儿童。结论脑瘫、智力残疾、孤独症儿童的活动和参与功能障碍有其不同特点,应构建多样性、阶段性、连续性的教育康复策略,实现残疾儿童康复与教育效果的最大化。

  17. Cerebral Palsy. Fact Sheet = La Paralisis Cerebral. Hojas Informativas Sobre Discapacidades.

    Science.gov (United States)

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet on cerebral palsy is written in both English and Spanish. First, it provides a definition of cerebral palsy and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy:…

  18. Changes in Cardiorespiratory Responses and Kinematics with Hippotherapy in Youth with and without Cerebral Palsy

    Science.gov (United States)

    Rigby, Brandon Rhett; Gloeckner, Adam Robert; Sessums, Suzanne; Lanning, Beth Anne; Grandjean, Peter Walter

    2017-01-01

    Purpose: The purpose of this study was to characterize pelvic displacement and cardiorespiratory responses to simulated horseback riding and walking in youth with cerebral palsy and to compare responses to youth without cerebral palsy before and after 8 weeks of hippotherapy. Method: Eight youth with cerebral palsy (M[subscript age] = 10 ± 4…

  19. Using multivariate diagnostics to assess the functional status of children with cerebral palsy.

    Directory of Open Access Journals (Sweden)

    Vindiuk Pavel Andreevich

    2011-09-01

    Full Text Available The considered assessment of energy supply from children with cerebral palsy. The study involved 16 children with spastic forms of cerebral palsy secondary school age. The use of testimony bagatofaktonoї rapid diagnosis in this population. It is established that the rate of functional status of children with cerebral palsy grow under the influence of physical rehabilitation.

  20. Sustained delivery of bioactive neurotrophin-3 to the injured spinal cord.

    Science.gov (United States)

    Elliott Donaghue, Irja; Tator, Charles H; Shoichet, Molly S

    2015-01-01

    Spinal cord injury is a debilitating condition that currently lacks effective clinical treatment. Neurotrophin-3 (NT-3) has been demonstrated in experimental animal models to induce axonal regeneration and functional improvements, yet its local delivery remains challenging. For ultimate clinical translation, a drug delivery system is required for localized, sustained, and minimally invasive release. Here, an injectable composite drug delivery system (DDS) composed of biodegradable polymeric nanoparticles dispersed in a hyaluronan/methyl cellulose hydrogel was injected into the intrathecal space to achieve acute local delivery to the spinal cord after a thoracic clip compression injury. NT-3 was encapsulated in the DDS and released in vitro for up to 50 d. With a single injection of the DDS into the intrathecal space of the injured spinal cord, NT-3 diffused ventrally through the cord and was detectable in the spinal cord for at least 28 d therein. Delivery of NT-3 resulted in significant axon growth with no effect on the astroglial response to injury in comparison with vehicle and injury controls. NT-3 treatment promoted functional improvements at 21 d according to the Basso Beattie Bresnahan locomotor scale in comparison with the DDS alone. The sustained delivery of bioactive NT-3 to the injured spinal cord achieved in this study demonstrates the promise of this DDS for central nervous system repair.

  1. Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: an updated evidence-based systematic review.

    Science.gov (United States)

    Ravi, D K; Kumar, N; Singhi, P

    2017-09-01

    The use of virtual reality systems in the motor rehabilitation of children with cerebral palsy is new, and thus the scientific evidence for its effectiveness needs to be evaluated through a systematic review. To provide updated evidence-based guidance for virtual reality rehabilitation in sensory and functional motor skills of children and adolescents with cerebral palsy. PubMed, PEDro, Web of Science, OTseeker, PsycINFO and Cochrane Library were searched from their earliest records up to 1 June, 2016. Two reviewers applied the population intervention comparison outcome (PICO) question to screen the studies for this review. Information on study design, subjects, intervention, outcome measures and efficacy results were extracted into a pilot-tested form. Method quality was assessed independently by two reviewers using the Downs and Black checklist. Thirty-one studies included 369 participants in total. Best evidence synthesis was applied to summarize the outcomes, which were grouped according to International Classification of Functioning, Disability and Health. Moderate evidence was found for balance and overall motor development. The evidence is still limited for other motor skills. This review uncovered additional literature showing moderate evidence that virtual reality rehabilitation is a promising intervention to improve balance and motor skills in children and adolescents with cerebral palsy. The technique is growing, so long-term follow-up and further research are required to determine its exact place in the management of cerebral palsy. Systematic review registration number PROSPERO 2015:CRD42015026048. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  2. Aquatic exercise in the treatment of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Dimitrijević Lidija

    2012-01-01

    Full Text Available Introduction. Aquatic exercise is one of the most popular supplementary treatments for children with neuro-motor impairment, especially for cerebral palsy (CP. As water reduces gravity force which increases postural stability, a child with CP exercises more easily in water than on land. Objective. The aim of the study was to examine aquatic exercise effects on gross motor functioning, muscle tone and cardiorespiratory endurance in children with spastic CP. Methods. The study included 19 children of both sexes, aged 6 to 12 years, with spastic CP. They were included in a 12-week aquatic exercise program, twice a week. Measurements of GMFM (Gross Motor Function Measurement, spasticity (MAS – Modified Ashworth Scale, heart rate (HR and maximal oxygen consumption (VO2max were carried out before and after treatment. The measurement results were compared before and after treatment. Results. GMFM mean value before therapy was 80.2% and statistically it was significantly lower in comparison to the same value after therapy, which was 86.2% (p<0.05. The level of spasticity was considerably decreased after therapy; the mean value before treatment was 3.21 according to MAS, and after treatment it was 1.95 (p<0.001. After treatment there was a statistically significant improvement of cardiorespiratory indurance, i.e., there was a significant decrease in the mean value of HR and a significant increase of VO2max (p<0.001. Conclusion. Aquatic exercise program can be useful in improving gross motor functioning, reducing spasticity and increasing cardiorespiratory endurance in children with spastic CP. [Projekat Ministarstva nauke Republike Srbije, br. 175092

  3. Delayed umbilical cord clamping in premature neonates.

    Science.gov (United States)

    Kaempf, Joseph W; Tomlinson, Mark W; Kaempf, Andrew J; Wu, YingXing; Wang, Lian; Tipping, Nicole; Grunkemeier, Gary

    2012-08-01

    Delayed umbilical cord clamping is reported to increase neonatal blood volume. We estimated the clinical outcomes in premature neonates who had delayed umbilical cord clamping compared with a similar group who had early umbilical cord clamping. This was a before-after investigation comparing early umbilical cord clamping with delayed umbilical cord clamping (45 seconds) in two groups of singleton neonates, very low birth weight (VLBW) (401-1,500 g) and low birth weight (LBW) (greater than 1,500 g but less than 35 weeks gestation). Neonates were excluded from delayed umbilical cord clamping if they needed immediate major resuscitation. Primary outcomes were provision of delivery room resuscitation, hematocrit, red cell transfusions, and the principle Vermont Oxford Network outcomes. In VLBW neonates (77 delayed umbilical cord clamping, birth weight [mean±standard deviation] 1,099±266 g; 77 early umbilical cord clamping 1,058±289 g), delayed umbilical cord clamping was associated with less delivery room resuscitation, higher Apgar scores at 1 minute, and higher hematocrit. Delayed umbilical cord clamping was not associated with significant differences in the overall transfusion rate, peak bilirubin, any of the principle Vermont Oxford Network outcomes, or mortality. In LBW neonates (172 delayed umbilical cord clamping, birth weight [mean±standard deviation] 2,159±384 g; 172 early umbilical cord clamping 2,203±447 g), delayed umbilical cord clamping was associated with higher hematocrit and was not associated with a change in delivery room resuscitation or Apgar scores or with changes in the transfusion rate or peak bilirubin. Regression analysis showed increasing gestational age and birth weight and delayed umbilical cord clamping were the best predictors of higher hematocrit and less delivery room resuscitation. Delayed umbilical cord clamping can safely be performed in singleton premature neonates and is associated with a higher hematocrit, less delivery room

  4. A rat pup model of cerebral palsy induced by prenatal inflammation and hypoxia

    Institute of Scientific and Technical Information of China (English)

    Yanrong Hu; Feng Gao; Jianxin Li; Lihui Zhao; Gang Chen; Hong Wan; Zhiyou Zhang; Hong Zhi; Wei Liu; Xinwei Qian; Mingzhao Chen; Linbao Wen

    2013-01-01

    Animal models of cerebral palsy established by simple infection or the hypoxia/ischemia method cannot effectively simulate the brain injury of a premature infant. Healthy 17-day-pregnant Wistar rats were intraperitoneally injected with lipopolysaccharide then subjected to hypoxia. The pups were used for this study at 4 weeks of age. Simultaneously, a hypoxia/ischemia group and a control group were used for comparison. The results of the footprint test, the balance beam test, the water maze test, neuroelectrophysiological examination and neuropathological examination demonstrated that, at 4 weeks after birth, footprint repeat space became larger between the forelimbs and hindlimbs of the rats, the latency period on the balance beam and in the Morris water maze was longer, place navigation and ability were poorer, and the stimulus intensity that induced the maximal wave amplitude of the compound muscle action potential was greater in the lipopolysaccharide/hypoxia and hypoxia/ischemia groups than in the control group. We observed irregular cells around the periventricular area, periventricular leukomalacia and breakage of the nuclear membrane in the lipopolysaccharide/hypoxia and hypoxia/ischemia groups. These results indicate that we successfully established a Wistar rat pup model of cerebral palsy by intraperitoneal injection of lipopolysaccharide and hypoxia.

  5. Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Citlali López-Ortiz

    2016-09-01

    Full Text Available Introduction: This pilot study evaluates the effects of a targeted dance class utilizing classical ballet principles for rehabilitation of children with cerebral palsy on balance and upper extremity control. Methods: Twelve children with cerebral palsy (ages 7–15 years with Gross Motor Function Classification scores II–IV participated in this study and were assigned to either a control group or targeted dance class group. Targeted dance class group participated in 1-h classes three times per week in a 4-week period. The Pediatric Balance Scale and the Quality of Upper Extremity Skills Test were administered before, after, and 1 month after the targeted dance class. Results: Improvements in the Pediatric Balance Scale were present in the targeted dance class group in before versus after and before versus 1 month follow-up comparisons (p-value = 0.0088 and p-value = 0.019, respectively. The Pediatric Balance Scale changes were not significant in the control group. The Quality of Upper Extremity Skills Test did not reach statistical differences in either group. Conclusion: Classical ballet as an art form involves physical training, musical accompaniment, social interactions, and emotional expression that could serve as adjunct to traditional physical therapy. This pilot study demonstrated improvements in balance control. A larger study with a more homogeneous sample is warranted.

  6. Comparative study between subjective assessment and quantitative evaluation of CT findings with cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Sugie, Y.; Sugie, H.; Kitai, A.; Maruyama, H.; Fukuyama, Y. (Tokyo Women' s Medical Coll. (Japan))

    1982-07-01

    Computed tomography (CT) was performed on 200 children with cerebral palsy with Hitachi CT-H250. The CT scans of 136 cases revealed cerebral atrophy with ventricular and/or subarachnoid space enlargement. The lateral ventricles, the third ventricle and the two parts of subarachnoid space on the CT picture were subjectively evaluated and divided into five grades ranging from no enlargement to marked enlargement. In addition, the size of the ventricles and the subarachnoid spaces were quantitatively determined; the transverse diameter of brain (b), the largest width of the anterior horns of the lateral ventricles (c), the bicaudate nuclear distance (d), the greatest width of the third ventricle, the longitudinal cerebral fissure and sylvian fissures as described by Miyao et al. (1978). Comparison of these quantitative techniques confirmed the initial subjective evaluation. However, in some cases, amendment of the subjective evaluation was needed. As mentioned before (Miyao et al.), the cerebral longitudinal fissure was relatively wide in normal infants. Accordingly, it was often difficult to find out abnormal widening only by subjective evaluation. The purpose of this paper was to establish the criteria of quantitative measuring and assessing of the lateral and third ventricles, the cerebral longitudinal fissures, and the sylvian fissures enlargement. Interpretation of some problem cases associated with measuring was also discussed. The quantitative CT evaluation may be a good reference in assessing cerebral atrophy in cerebral palsy and other neurological diseases.

  7. Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy

    Science.gov (United States)

    López-Ortiz, Citlali; Egan, Tara; Gaebler-Spira, Deborah J

    2016-01-01

    Introduction: This pilot study evaluates the effects of a targeted dance class utilizing classical ballet principles for rehabilitation of children with cerebral palsy on balance and upper extremity control. Methods: Twelve children with cerebral palsy (ages 7–15 years) with Gross Motor Function Classification scores II–IV participated in this study and were assigned to either a control group or targeted dance class group. Targeted dance class group participated in 1-h classes three times per week in a 4-week period. The Pediatric Balance Scale and the Quality of Upper Extremity Skills Test were administered before, after, and 1 month after the targeted dance class. Results: Improvements in the Pediatric Balance Scale were present in the targeted dance class group in before versus after and before versus 1 month follow-up comparisons (p-value = 0.0088 and p-value = 0.019, respectively). The Pediatric Balance Scale changes were not significant in the control group. The Quality of Upper Extremity Skills Test did not reach statistical differences in either group. Conclusion: Classical ballet as an art form involves physical training, musical accompaniment, social interactions, and emotional expression that could serve as adjunct to traditional physical therapy. This pilot study demonstrated improvements in balance control. A larger study with a more homogeneous sample is warranted. PMID:27721977

  8. MUSCLE TONICITY OF CHILDREN WITH SPASTIC CEREBRAL PALSY: HOW EFFECTIVE IS SWEDISH MASSAGE?

    Directory of Open Access Journals (Sweden)

    V. Alizad

    2009-08-01

    Full Text Available AbstractObjectiveMassage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of Swedish massage on the muscle tonicity of children with spastic cerebral palsy (CP.Materials & MethodsThis study was a single blind clinical trial conducted on forty children with spastic CP, recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. Routine occupational therapy techniques were performed during a 3 monthperiod in both groups, while the intervention group also received Swedish massage for 30 minutes before every rehabilitation session. Muscle tonicity was evaluated at the  beginning of the study and 3 months later using the Modified Ashworth Scale.ResultsThe average ages of children in the intervention (n=13 and control (n=14 groups were 49.5 and 42.1 months respectively. Although after intervention, tonicity of upper and lower limbs, trunk and neck in the intervention group in comparison with controls had no significant differences, there were statistically significant differences in reduction rate of tonicity in upper limbs and trunk between the two groups (P ConclusionMassage therapy is not a panacea for improvement of spasticity in children with CP but the encouraging results of other studies on children with CP indicate that further studies are needed for more definite results.Key Words:Spastic cerebral palsy , Muscle tone , Swedish massage , Children.

  9. Association between executive/attentional functions and caries in children with cerebral palsy.

    Science.gov (United States)

    Dourado, Maurício da Rocha; Andrade, Peterson Marco Oliveira; Ramos-Jorge, Maria Letícia; Moreira, Rafaela Nogueira; Oliveira-Ferreira, Fernanda

    2013-09-01

    The aim of the present study was to evaluate the existence of an association between attention/executive functions and the development of dental caries in individuals with cerebral palsy (CP). Seventy-six children with CP were selected from a physical rehabilitation center and a school serving children with disabilities. The control group was made up of 89 children without neurological impairment. Socioeconomic status, presence of teeth with cavities due to caries, degree of motor impairment and intellectual, executive and attentional functions were assessed. Mean age of participants was 8.9 years (SD=3.56). The CP group had a significantly lower performance (pattentional function and executive function tests in comparison to the control group. Controlling for the clinical diagnosis (CP or control group), motor impairment and intellectual function, the significant explanatory variables for the presence of teeth with cavities were performance on the Complex Rey figure test (OR=0.941) and the Digit Span subtest of the Wechsler Intelligence Scale for Children in backward order (OR=0.581). After controlling for intellectual function, clinical diagnosis and motor impairment, deficits in executive and attentional functions increased the odds of developing dental caries in children with cerebral palsy.

  10. Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis.

    Science.gov (United States)

    Bernstein, Jonathan Michael; Burrows, Stuart A; Saunders, Michael W

    2007-03-01

    An 11-month-old girl with an oesophageal foreign body was presented: from the radiographic appearance it was presumed to be a coin. Microlaryngoscopy 5 h after ingestion revealed a button battery impacted in the hypopharynx with severe damage to the oesophageal mucosa. The patient was intubated for 6 days in the intensive care unit because of stridor and respiratory distress. Repeat microlaryngoscopy demonstrated bilateral vocal cord palsy, which was presumed to be secondary to the involvement of the recurrent laryngeal nerves in the injury. We recommend that in the absence of a history of observed ingestion, it should be assumed that coin-like foreign bodies are button batteries until proven otherwise.

  11. Neuroimaging in Cerebral Palsy – Report from North India

    Directory of Open Access Journals (Sweden)

    Anju AGGARWAL

    2013-11-01

    Full Text Available How to Cite This Article: Aggarwal A, Mittal H, Debnath SKR, Rai A. Neuroimaging in Cerebral Palsy–Report from North India. Iran J Child Neurol. 2013 Autumn; 7(3:41- 46. ObjectiveOnly few Indian reports exist on neuroimaging abnormalities in children with cerebral palsy (CP from India. Materials & MethodsWe studied the clinico-radiological profile of 98 children diagnosed as CP at a tertiary centre in North India. Relevant investigations were carried out to determine the etiology. ResultsAmong the 98 children studied, 80.5% were males and 22.2% were premature. History of birth asphyxia was present in 41.9%. Quadriplegic CP was seen in 77.5%, hemiplegic in 11.5%, and diplegic in 10.5%. Other abnormalities were microcephaly (60.5%, epilepsy (42%, visual abnormality (37%, and hearing abnormality (20%. Neuroimaging was abnormal in 94/98 (95.91%.Abnormalities were periventricular white matter abnormalities (34%, deep grey matter abnormalities (47.8%, malformations (11.7%, and miscellaneous lesions (6.4%. Neuroimaging findings did not relate to the presence of birth asphyxia, sex, epilepsy, gestation, type of CP, or microcephaly. ConclusionsNeuroimaging is helpful for etiological diagnosis, especially malformations.  ReferencesSinghi PD, Ray M, Suri G. Clinical spectrum of cerebral palsy in north India-an analysis of 1000 cases. J Trop Pediatr 2002 48(3; 162-6.Sharma P, Sharma U, Kabra A. Cerebral Palsy-Clinical Profile and Predisposing Factors. Indian Pediatr 1999;36(10:1038-42.Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986 315(2:81-6.Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in elucidating the pathogenesis of cerebral palsy: a systematic review. Dev Med Child Neurol 2007; 49(2:144-51.Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007

  12. Laser Phototherapy As Modality of Clinical Treatment in Bell's Palsy

    Science.gov (United States)

    Marques, A. M. C.; Soares, L. G. P.; Marques, R. C.; Pinheiro, A. L. B.; Dent, M.

    2011-08-01

    Bell's palsy is defined as a peripheral facial nerve palsy, idiophatic, and sudden onset and is considered the most common cause of this pathology. It is caused by damage to cranial nerves VII, resulting in complete or partial paralysis of the facial mimic. May be associated with taste disturbances, salivation, tearing and hyperacusis. It is diagnosed after ruling out all possible etiologies, because its cause is not fully understood.Some researches shows that herpes virus may cause this type of palsy due to reactivation of the virus or by imunnomediated post-viral nerve demielinization. Physical therapy, corticosteroids and antiviral therapy have become the most widely accepted treatments for Bell's palsy. Therapy with low-level laser (LLLT) may induce the metabolism of injured nerve tissue for the production of proteins associated with its growth and to improve nerve regeneration. The success of the treatment of Bell's palsy by using laser phototherapy isolated or in association with other therapeutic approach has been reported on the literature. In most cases, the recovery occurs without uneventfully (complications), the acute illness is not associated with serious disorders. We will present a clinical approach for treating this condition.

  13. CT findings of cerebral palsy and behaviour development

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Zenji

    1987-06-01

    It is well recognized that CT scan is very useful in the early diagnosis of cerebral palsy. The author has studied this time the CT scan findings of cerebral palsy children in their relations to the type of palsy, cause of palsy, complications in the central nervous system, and prognosis of behaviour development, in order to predict the prognosis of behaviour development. Dilatation of the contralateral cerebral ventricle was found in 82 % of hemiplegic type. Abnormal EEG was found in 73 %, but their behaviour development was satisfactory, with good development of speech regardless to the side of palsy. This might be helped by compensational function of the brain due to plasticity. Diplegia presented bilateral moderate dilatation of ventricles with favorable prognosis. Tetraplegia was caused mostly by asphyxia or congenital anomaly and revealed marked dilatation of ventricles or severe cortical atrophy. Some cases presented diffuse cortical low-density, often associated with abnormal EEG, and their prognosis was worst. Athetosis had normal CT finding or mild ventricular dilatation, but all cases of ataxia presented normal CT findings. Hypotonia had mild ventricular dilatation. Two of three mixed type cases had normal CT findings and another had mild ventricular dilatation. No correlation was found between ventricular dilatation and behaviour development, but statistically significant difference was found in the cases with 30 % or more Evans' ratio (P < 0.05). Prognosis of severe ventricular dilatation cases was poor.

  14. Speech therapy in peripheral facial palsy: an orofacial myofunctional approach

    Directory of Open Access Journals (Sweden)

    Hipólito Virgílio Magalhães Júnior

    2009-12-01

    Full Text Available Objective: To delineate the contributions of speech therapy in the rehabilitation of peripheral facial palsy, describing the role of orofacial myofunctional approach in this process. Methods: A literature review of published articles since 1995, held from March to December 2008, based on the characterization of peripheral facial palsy and its relation with speechlanguage disorders related to orofacial disorders in mobility, speech and chewing, among others. The review prioritized scientific journal articles and specific chapters from the studied period. As inclusion criteria, the literature should contain data on peripheral facial palsy, quotes on the changes in the stomatognathic system and on orofacial miofunctional approach. We excluded studies that addressed central paralysis, congenital palsy and those of non idiopathic causes. Results: The literature has addressed the contribution of speech therapy in the rehabilitation of facial symmetry, with improvement in the retention of liquids and soft foods during chewing and swallowing. The orofacial myofunctional approach contextualized the role of speech therapy in the improvement of the coordination of speech articulation and in the gain of oral control during chewing and swallowing Conclusion: Speech therapy in peripheral facial palsy contributed and was outlined by applying the orofacial myofunctional approach in the reestablishment of facial symmetry, from the work directed to the functions of the stomatognathic system, including oralfacial exercises and training of chewing in association with the training of the joint. There is a need for a greater number of publications in this specific area for speech therapy professional.

  15. Sleep disorders in children with cerebral palsy: An integrative review.

    Science.gov (United States)

    Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A

    2016-12-01

    Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions.

  16. Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T

    2001-11-01

    AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

  17. Spinal cord injury at birth

    DEFF Research Database (Denmark)

    Fenger-Gron, Jesper; Kock, Kirsten; Nielsen, Rasmus G

    2008-01-01

    UNLABELLED: A case of perinatally acquired spinal cord injury (SCI) is presented. The foetus was vigorous until birth, the breech presented and delivery was performed by a non-traumatic Caesarean section. The infant displayed symptoms of severe SCI but diagnosis was delayed due to severe co...

  18. Depression and Spinal Cord Injury

    Science.gov (United States)

    ... About Us Patient Care Resources Information & Education SCI Empowerment Project Projects & Research FAQ © 2017 University of Washington ... Cord Injury” (PDF - 477KB)] Depression is a common illness that can affect ... or a mental health specialist immediately. Also, inform those around you ...

  19. Depression in Mothers of Children with Cerebral Palsy and Its Relation to Severity and Type of Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Firoozeh Sajedi

    2010-07-01

    Full Text Available "nChildren with cerebral palsy (CP suffer from several problems, so the family especially the mothers undertake a lot of social and emotional difficulties. The purpose of this study was to determine the severity of depression in mothers of children with CP in comparison with mothers who have normal children and its relation to the type of CP and severity of the disability. During this descriptive-analytic study, 43 mothers who had younger than 8 year-old children with CP under rehabilitation services in SABA clinic, related to the University of Social Welfare and Rehabilitation Sciences (USWR, Tehran, Iran, were selected as the case group by simple sampling. A data registration form and the Beck Depression Inventory II were completed by them. The type of CP and the severity of disability were determined by a pediatrician and an occupational therapist respectively, using the Gross Motor Function Classification System (GMFCS. Seventy-seven mothers of normal children, serving as the control group for comparing with case group, filled in the same questionnaires. There were significant differences in the mean depression scores (P=0.003 between the two groups. Having a child with CP also increases the risk of developing depression in mothers as much as 2.26 times (OR=2.26. There were no statistically significant differences in depression scores and the severity of disability and also among the five types of CP. It seems that having a child with CP is probably associated with higher prevalence and severity of depression in mothers. So treatment or prevention of depression in mothers of children with CP is highly recommended for improving the rehabilitation process and achieve better results in these children.

  20. Depression in Mothers of Children with Cerebral Palsy and Its Relation to Severity and Type of Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Firoozeh Sajedi

    2010-08-01

    Full Text Available Children with cerebral palsy (CP suffer from several problems, so the family especially the mothers undertake a lot of social and emotional difficulties. The purpose of this study was to determine the severity of depression in mothers of children with CP in comparison with mothers who have normal children and its relation to the type of CP and severity of the disability. During this descriptive-analytic study, 43 mothers who had younger than 8 year-old children with CP under rehabilitation services in SABA clinic, related to the University of Social Welfare and Rehabilitation Sciences (USWR, Tehran, Iran, were selected as the case group by simple sampling. A data registration form and the Beck Depression Inventory II were completed by them. The type of CP and the severity of disability were determined by a pediatrician and an occupational therapist respectively, using the Gross Motor Function Classification System (GMFCS. Seventy-seven mothers of normal children, serving as the control group for comparing with case group, filled in the same questionnaires. There were significant differences in the mean depression scores (P=0.003 between the two groups. Having a child with CP also increases the risk of developing depression in mothers as much as 2.26 times (OR=2.26. There were no statistically significant differences in depression scores and the severity of disability and also among the five types of CP. It seems that having a child with CP is probably associated with higher prevalence and severity of depression in mothers. So treatment or prevention of depression in mothers of children with CP is highly recommended for improving the rehabilitation process and achieve better results in these children.