Weakness of the Neck Muscles

Author(s):  
Aziz Shaibani

The neck is furnished by dozens ofmuscles for flexion, extension, lateral bending, and rotation. It carries a 10-pound head at least two-thirds of every day. These muscles are under delicate central control, and they are subject to different central and peripheral malfunctions. Differential involvement of the neck flexors versus extensors helps in diagnosing different neuromuscular disorders. Weakness of the cervical extensors leads to head drop, a troubling condition that is caused by many neuromuscular disorders. Movement disorders such as cervical dystonia and Parkinson disease may also lead to head drop, causing confusion with neuromuscular causes such as myasthenia gravis and ALS. Head protrusion of the elderly (camptocormia) is a different entity.

Author(s):  
Aziz Shaibani

The neck is furnished by tens of muscles for flexion, extension, lateral bending, and rotation. It carries a 10-pound head for at least two-thirds of every day. These muscles are under delicate central control, and they are subject to different central and peripheral malfunctions. Differential involvement of the neck flexors’ Vs extensors helps with the diagnosis of various neuromuscular disorders. Weakness of the cervical extensors leads to head drop, a troubling condition that is caused by many neuromuscular disorders. Movement disorders such as cervical dystonia and Parkinson disease lead to head drop, causing confusion with neuromuscular causes such as myasthenia gravis (MG) and amyotrophic lateral sclerosis (ALS). Head protrusion of the elderly (camptocormia) is a different entity.


Author(s):  
Aziz Shaibani

Lack of function or malfunction of the vocal cords are not as common manifestations of neuromuscular disorders as dysarthria. It is typically seen in central diseases such as Parkinson disease. Certain muscle and nerve disorders affect the vocal cords, but in these cases, other features of these diseases make the diagnosis easy. Myasthenia gravis (MG) may present with intermittent hoarseness only early in the course of the disease. Consultation with an ear, nose, throat (ENT) specialist is recommended to characterize the type of cord pathology. Hysterical hoarseness and weakness are not unusual presentations to neuromuscular clinics. Unilateral vocal cord palsy is usually due to recurrent laryngeal nerve pathology.


Author(s):  
M. S. Marchuk

Acquired myasthenia gravis is a rare pathology of the spectrum of neuromuscular disorders and is characterized by the production of autoantibodies to various components of the neuromuscular synapse. The clinical picture is based on typical symptoms: dynamic ptosis, oculomotor dysfunction, diplopia, masticatory muscle weakness, pathological muscle fatigue, in case of dominance of oropharyngeal muscle weakness, patients complain of dysphagia, dysarthria, dyspnea resulting from insolvency.. This variant of the disease is the most dangerous, as it is characterized by a high risk of myasthenic crisis. In addition, the course of myasthenia gravis may be complicated by the development of comorbid pathology, which can be classified into four main groups. These include causal conditions in the development of diseases with a single mechanism of development for myasthenia gravis, such as cross‑autoimmune damage to the heart muscle. The group of complications of myasthenia includes myasthenic, cholinergic and mixed crises. Unrelated diseases are competitive, so in the elderly, myasthenia gravis is accompanied by a wide range of chronic diseases, such as hypertension, diabetes and others. The last group that should be targeted is intercurrent diseases — acute pathologies that develop against the background of myasthenia. Infectious diseases involving the most vulnerable respiratory system are potentially dangerous in the latter group. Knowledge of these potential factors of decompensation of myasthenia gravis will predict the development and timely diagnose the pathology. Timely treatment in a life‑threatening condition can be critical, since myasthenia gravis differs significantly from other diseases of the neuromuscular system in the rate of critical decompensation and the difficulty of normalizing the patient’s severe condition.


2021 ◽  
Vol 26 (1) ◽  
pp. 23-33
Author(s):  
S. V. Prokopenko ◽  
E. Yu. Mozheiko ◽  
M. V. Abroskina ◽  
V. S. Ondar ◽  
S. B. Ismailova ◽  
...  

Parkinson disease (PD) is one of the most common neurodegenerative diseases. Its main clinical manifestation is movement disorders. The study of innovative objective methods for the diagnosis and rehabilitation of movement disorders in PD is relevant and in demand taking into account the slowly progressive course of the disease and the complex set of symptoms that subsequently forms a characteristic movement pattern. This article provides an example of a personalized rehabilitation assessment of biomechanical manifestations of the gait function of a patient with exacted diagnosis, stage 3.5 PD according to Hoehn and Yahr, by means of the method of three-dimensional motion video analysis using the Vicon Motion Capture Systems soft-hardware complex. The patient has postural and gait disorders. This method was applied after a rehabilitation course based on the activation of lifting the foot from the support surface (“back push”). Changes in the tempo and rhythm parameters of gait in a patient with PD in comparison to a healthy person were revealed: acceleration of walking pace with shortening of the length of single and double step, a decrease in the time of limb advancement, acceleration of the moment of heel rise and a decrease in walking pace. Analysis of the locomotion also revealed a decrease in the amplitude of flexion-extension in the coxofemoral joint, knee joint and tibio-tarsic on the side with more pronounced Parkinsonism. Insufficient knee flexion and hip extension, excessive dorsal flexion of the foot with insufficient plantar flexion were noted. Revealing the last features of locomotion in a particular case allows one to make a plan for a targeted personalized rehabilitation program for a given patient. Thus, the method of three-dimensional video analysis is a valuable diagnostic tool that makes it possible to objectively assess the existing violations of locomotion and identify the targets of rehabilitation.


2021 ◽  
pp. 219256822110060
Author(s):  
Jun-Xin Chen ◽  
Yun-He Li ◽  
Jian Wen ◽  
Zhen Li ◽  
Bin-Sheng Yu ◽  
...  

Study Design: A biomechanical study. Objectives: The purpose of this study was to investigate the effects of cruciform and square incisions of annulus fibrosus (AF) on the mechanical stability of bovine intervertebral disc (IVD) in multiple degrees of freedom. Methods: Eight bovine caudal IVD motion segments (bone-disc-bone) were obtained from the local abattoir. Cruciform and square incisions were made at the right side of the specimen’s annulus using a surgical scalpel. Biomechanical testing of three-dimensional 6 degrees of freedom was then performed on the bovine caudal motion segments using the mechanical testing and simulation (MTS) machine. Force, displacement, torque and angle were recorded synchronously by the MTS system. P value <.05 was considered statistically significant. Results: Cruciform and square incisions of the AF reduced both axial compressive and torsional stiffness of the IVD and were significantly lower than those of the intact specimens ( P < .01). Left-side axial torsional stiffness of the cruciform incision was significantly higher than a square incision ( P < .01). Neither incision methods impacted flexional-extensional stiffness or lateral-bending stiffness. Conclusions: The cruciform and square incisions of the AF obviously reduced axial compression and axial rotation, but they did not change the flexion-extension and lateral-bending stiffness of the bovine caudal IVD. This mechanical study will be meaningful for the development of new approaches to AF repair and the rehabilitation of the patients after receiving discectomy.


2019 ◽  
Vol 22 (2) ◽  
pp. 448-448 ◽  
Author(s):  
Roy N. Alcalay ◽  
Caitlin Kehoe ◽  
Evan Shorr ◽  
Roseanna Battista ◽  
Anne Hall ◽  
...  

2013 ◽  
Vol 325 (1-2) ◽  
pp. 1-5 ◽  
Author(s):  
Mark A. Hellmann ◽  
Ronit Mosberg-Galili ◽  
Israel Steiner

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