Approach to Limb Weakness

2021 ◽  
Vol 41 (06) ◽  
pp. 644-666
Author(s):  
Sachin M. Bhagavan ◽  
Swathi B. Ramaswamy ◽  
Tejas R. Mehta ◽  
Raghav Govindarajan
Keyword(s):  
Motor System ◽  
Limb Weakness ◽  
Diagnostic Approaches

Abstract“Approach to limb weakness” provides an overview of the pathways of the motor system and the type of weakness seen with pathology at each level from the cortex to the muscle. This article provides the clinical pearls needed to identify different patterns of weakness and accurately localize the level of weakness. It offers important pointers that help distinguish among the different etiologies of weakness at each level, as well as various diagnostic approaches and treatments of diseases that lead to limb weakness. The diagnoses discussed are meant to be representative and not exhaustive, as a complete differential for each pattern of weakness is beyond the scope of this article.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

Does the Motor System Facilitate Spatial Imagery?

2017 ◽  
Vol 49 (3) ◽  
pp. 127-137 ◽  
Author(s):  
Markus Krüger ◽  
Horst Krist
Keyword(s):  
Motor System ◽  
Third Graders ◽  
External Support ◽  
New Paradigm ◽  
Perceptual Condition ◽  
Imagery Condition ◽  
Passive Rotation ◽  
Perception Condition ◽  
Motor Condition ◽  
Dynamic Imagery

Abstract. Recent studies have ascertained a link between the motor system and imagery in children. A motor effect on imagery is demonstrated by the influence of stimuli-related movement constraints (i. e., constraints defined by the musculoskeletal system) on mental rotation, or by interference effects due to participants’ own body movements or body postures. This link is usually seen as qualitatively different or stronger in children as opposed to adults. In the present research, we put this interpretation to further scrutiny using a new paradigm: In a motor condition we asked our participants (kindergartners and third-graders) to manually rotate a circular board with a covered picture on it. This condition was compared with a perceptual condition where the board was rotated by an experimenter. Additionally, in a pure imagery condition, children were instructed to merely imagine the rotation of the board. The children’s task was to mark the presumed end position of a salient detail of the respective picture. The children’s performance was clearly the worst in the pure imagery condition. However, contrary to what embodiment theories would suggest, there was no difference in participants’ performance between the active rotation (i. e., motor) and the passive rotation (i. e., perception) condition. Control experiments revealed that this was also the case when, in the perception condition, gaze shifting was controlled for and when the board was rotated mechanically rather than by the experimenter. Our findings indicate that young children depend heavily on external support when imagining physical events. Furthermore, they indicate that motor-assisted imagery is not generally superior to perceptually driven dynamic imagery.

Higher-order representations of newly learnt action sounds in the human motor system

2011 ◽  
Author(s):  
F. Waszak ◽  
S. Schuetz-Bosbach ◽  
C. Weiss ◽  
L. Ticini
Keyword(s):  
Motor System ◽  
Higher Order ◽  
Human Motor

EEG Investigation of Motor System Activity During Language Comprehension

2013 ◽  
Author(s):  
Julie Carranza ◽  
Matthew Bachman ◽  
Michael P. Kaschak ◽  
Edward M. Bernat ◽  
John L. Jones ◽  
...  
Keyword(s):  
Language Comprehension ◽  
Motor System ◽  
System Activity

Linitis Plastica of The Stomach: A Review

2020 ◽  
Vol 22 (2) ◽  
pp. 125-138
Author(s):  
Md Mizanur Rahman
Keyword(s):  
Gastric Cancer ◽  
Treatment Outcome ◽  
Surgical Resection ◽  
Linitis Plastica ◽  
Diffuse Gastric Cancer ◽  
Biological Behaviour ◽  
Desmoplastic Reaction ◽  
The Poor ◽  
Diagnostic Approaches ◽  
Poor Outcomes

Linitis plastica (LP) is a particular subtype of diffuse gastric cancer and is thought to have a separate entity in respect with its biological behaviour, pathology, presentation and treatment outcome. The poor prognosis of LP gastric cancer is due primarily to its advanced stage at diagnosis. The characteristic histopathological feature of this entity is cellular spread to the submucosa and stroma with minimal mucosal alterations accompanied by an excessive desmoplastic reaction. Despite recent research on alternative therapies, surgical resection appears the only potentially curative approach. Patient selection and multidisciplinary management are paramount when considering surgical resection in patients with gastric LP. The operative approach in patients with LP has historically been questioned because of the poor outcomes. The aim of this review is to highlight different dimension of linitis plastica stomach in respect to its definition, classification, clinico-pathological characters, diagnostic approaches and treatment outcome. Journal of Surgical Sciences (2018) Vol. 22 (2) : 125-138

Multiple diagnostic approaches to palpable breast mass

1985 ◽  
Vol 21 (6) ◽  
pp. 923
Author(s):  
S Y Chin ◽  
K H Kim ◽  
N M Moon ◽  
Y K Kim ◽  
J J Jang
Keyword(s):  
Breast Mass ◽  
Diagnostic Approaches ◽  
Palpable Breast

An Inverter-Driven Induction Motor System with a Deadlock Breaking Capability

2012 ◽  
Vol 132 (8) ◽  
pp. 802-807
Author(s):  
Takuto Ichikawa ◽  
Toshiya Yoshida ◽  
Osamu Miyashita
Keyword(s):  
Induction Motor ◽  
Motor System
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