scholarly journals Abdominal tendon reflexes in lesions of the pyramidal tract

2021 ◽  
Vol 25 (11) ◽  
pp. 1239-1239
Keyword(s):  
Pyramidal Tract ◽  
Rectus Abdominis ◽  
Lower Limbs ◽  
Tendon Reflexes

Abdominal tendon reflexes were studied in Th. Dosuzkov and Fr. Bodlakova (Revue v. Neurologii i psychiatrii, 1928, no. 4). They find the reflex of the rectus abdominis muscles described by Astvatsaturov not only in paraplegia (and hemiplegia) with the lower limbs in the extension position (Erb'a type), but also in the flexion position (Babinsky type).

scholarly journals Disulfiram-induced polyneurophaty

2012 ◽  
Vol 69 (5) ◽  
pp. 453-475
Author(s):  
Slavica Vujisic ◽  
Ljiljana Radulovic ◽  
Sladjana Knezevic-Apostolski ◽  
Stevan Petkovic ◽  
Filip Vukmirovic ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Laboratory ◽  
Chronic Alcoholism ◽  
Lower Limbs ◽  
Sensory Impairment ◽  
Treatment Cessation ◽  
Below The Knee ◽  
Toxic Neuropathy ◽  
Soles Of The Feet ◽  
Tendon Reflexes

Introduction. Disulfiram is used in the treatment of chronic alcoholism, because of the unpleasant symptoms produced after ethanol intake. Although it is well tolerated in most patients, one in 15,000 patients will develop peripheral neuropathy every year, which is frequently misdiagnosed as alcoholic neuropathy. Case report. We report clinical, laboratory, electrophysiological and histopathological features in a 19-year-old patient who developed an acute distal sensorymotor neuropathy during the treatment of alcoholism. At the end of 4-month treatment with disulfiram 250 mg/day, the patient complained of weakness in distal segments of the lower limbs associated with burning dysesthesias, numbness and pain in the soles of the feet and the legs below the knees; reduction in foot strength, the absence of ankle jerk tendon reflexes, and tactile stocking pin-pick and vibratory sensory impairment in the lower limbs below the knee. Recovery was successful after treatment cessation. Conclusion. The significance of toxic neuropathy is shown by the fact that the recognition of clinical picture, identifying etiological factors and its elimination may prevent the evolution of polyneuropathy. This allows for more effective treatment of these neuropathies as apposite to idiopathic ones which can be treated only symptomatically. Our case report indicates the possibilities during a period with no serious damage to the axons manifested.

scholarly journals Clinical Manifest X-Linked Recessive Adrenoleukodystrophy in a Female

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Gyda Hlin Skuladottir Jack ◽  
Karolina Malm-Willadsen ◽  
Anja Frederiksen ◽  
Dorte Glintborg ◽  
Marianne Andersen
Keyword(s):  
Adrenal Glands ◽  
Present Report ◽  
Lower Limbs ◽  
Long Chain Fatty Acids ◽  
Intracellular Accumulation ◽  
Biochemical Tests ◽  
The Central Nervous System ◽  
Climbing Stairs ◽  
Long Chain ◽  
Tendon Reflexes

Adrenoleukodystrophy (ALD) is a rare X-linked inherited leukodystrophy with a reduced capacity for degradation of very long chain fatty acids (VLCFAs). The intracellular accumulation of VLCFA leads to demyelination in the central nervous system (CNS) and cell destruction in the adrenal glands. ALD primarily affects males; however, females may develop milder symptoms that may be difficult to recognize. The present report describes a 35-year-old female who experienced a feeling of heaviness in the upper and lower limbs, pain in both knees, and difficulty climbing stairs, running, and jumping. Clinical examination revealed decreased sensitivity in the feet, particularly to touch. Deep tendon reflexes in the lower limbs were brisk, and Babinski's sign was present bilaterally. Multiple sclerosis (MS) was excluded, and all clinical and biochemical tests were normal. After two years of progressing symptoms, the patient was reevaluated and plasma levels of VLCFA were found to be elevated. Seven years prior to this finding, the patient had been found to be heterozygous for the missense mutation c.1679C>T, p.Pro560Leu on theABCD1gene (ATP-Binding Cassette subfamily D1). In conclusion, the patient's symptoms could be attributed to ALD. The present case underlines the importance of reevaluating family history in women presenting with vague neurological symptoms.

scholarly journals Reconstructive Treatment following Resection of High-Grade Soft-Tissue Sarcomas of the Lower Limb

2005 ◽  
Vol 13 (1) ◽  
pp. 58-63 ◽  
Author(s):  
AM Leow ◽  
AS Halim ◽  
Z Wan
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Soft Tissue Sarcomas ◽  
Free Tissue Transfer ◽  
Rectus Abdominis ◽  
Lower Limbs ◽  
High Grade ◽  
Rectus Abdominis Flap ◽  
Tissue Transfer ◽  
Fibula Flap

Purpose. To review the role of free tissue transfer in reconstructive surgery following resection of high-grade soft-tissue sarcomas of the lower limb. Methods. Medical records of all consecutive patients with high-grade soft-tissue sarcomas of the lower limbs between August 1997 and September 2003 were reviewed. Results. Of 8 patients (6 women and 2 men) aged between 19 and 65 years, 4 had malignant fibrous histiocytoma, one had malignant peripheral nerve sheath tumour, one had synovial sarcoma, one had recurrent liposarcoma, and one had epitheloid sarcoma. The tumour sizes ranged from 132 cm2 to 483 cm2. The soft-tissue defects following tumour extirpation ranged from 153 cm2 to 896 cm2. The flaps used were 3 free latissimus dorsi flaps, 2 free osteoseptocutaneous fibula flaps (one vascularised fibula flap and one ‘double barrel’ fibula flap), one free rectus abdominis flap, 2 free mini-transverse rectus abdominis flaps, and one pedicled rectus abdominis flap. Five patients did not have local recurrence and systemic metastases. Conclusion. Tissue transfer allows early adjuvant therapy facilitating the multimodal approach for the high-grade soft-tissue sarcomas of the lower extremity.

scholarly journals Pilot Study of Threonine Supplementation in Human Spasticity

1982 ◽  
Vol 9 (2) ◽  
pp. 141-145 ◽  
Author(s):  
A. Barbeau ◽  
M. Roy ◽  
C. Chouza
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Motor Performance ◽  
Pyramidal Tract ◽  
Controlled Trial ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Muscle Spasms ◽  
Objectively Measured ◽  
Observation Period

ABSTRACT:Threonine supplementation (500 mg/day) was given to 6 patients with genetic spasticity syndromes for a period of 12 months, followed by a 4-month observation period without medication. All 6 patients showed partial improvement of spasticity, intensity of knee jerks and muscle spasms without changes in true pyramidal tract signs. The improvement in motor performance, objectively measured, averaged 29% (19% in upper limbs and 42% in lower limbs). The range of overall improvement was 19–35% (7–30% for upper limbs; 25–67% for lower limbs). No toxic clinical or biochemical side effects were encountered. Thus threonine, a precursor of glycine, produced the same effect on spasticity than that previously observed with glycine. It is concluded that threonine supplementation is feasible and safe and that it deserves a controlled trial in well defined (preferably genetic) cases of spasticity.

Society vs the Wheelchair

PEDIATRICS ◽  
1979 ◽  
Vol 63 (4) ◽  
pp. 576-579
Author(s):  
Rose Marie MacElman
Keyword(s):  
Diabetes Mellitus ◽  
High School ◽  
Young Lady ◽  
Lower Limbs ◽  
Unknown Etiology ◽  
Cerebellar Disease ◽  
Childhood Illnesses ◽  
Unsteady Gait ◽  
Ecg Abnormalities ◽  
Tendon Reflexes

Rose Marie became a patient of mine at the age of 2½, just one month after I began practicing pediatrics in July of 1962. She had typical childhood illnesses and seemed otherwise normal until March of 1965, when on her preschool physical exam I picked up mild ataxia and a positive Romberg's sign. This showed slow but steady progression, so a year later I referred her to a neurologist. He felt she had a progressive degenerative cerebellar disease of unknown etiology. At that time, her only problems were an unsteady gait and "shaky" handwriting. In 1971 her sister, five years younger, was noted to have an identical disability. By 1972, Rose Marie had ECG abnormalities consistent with Friedreich's ataxia. By that time she was confined to a wheelchair, had slurred speech, and a progressive scoliosis. In five more years she had developed diabetes mellitus (felt to be unrelated), occasional choking spells, and marked weakness and ataxia of her upper as well as lower limbs, distally more than proximally. She has absent deep tendon reflexes and loss of position and vibratory sensation in the lower limbs. Despite her problems, Rose Marie is a B student and a very personable young lady. In the spring of 1978, a few months before she was to graduate from high school, I was sent a form from the state vocational rehabilitation director regarding her potential and prognosis. Although I felt I knew Rose Marie as well as any of my patients, my immediate reaction was, "Rehabilitation?

CLINICAL, ELECTROPHYSIOLOGICAL, AND HISTOPATHOLOGIC STUDIES IN HEREDITARY MOTOR AND SENSORY NEUROPATHY V: ONE CASE REPORT

1999 ◽  
Vol 03 (02) ◽  
pp. 157-165
Author(s):  
Yue-Hong Bai ◽  
Akira Tokuhiro ◽  
Masakazu Takemitsu ◽  
Yuji Atsuta ◽  
Kazuhiko Cho ◽  
...  
Keyword(s):  
Conduction Velocity ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Pyramidal Tract ◽  
Muscular Atrophy ◽  
Sensory Neuropathy ◽  
Lower Limbs ◽  
Hereditary Motor ◽  
Peroneal Muscular Atrophy ◽  
Motor And Sensory Neuropathy

Hereditary motor and sensory neuropathy type V (HMSN V) is a rare disorder characterized by the clinical features of spastic paraplegia with peroneal muscular atrophy. A patient with progressive deformity of the feet due to HMSN V underwent clinical, electrophysiological, histopathological examinations, and surgical treatments. Physical examination revealed bilateral pes equinovarus and peroneal muscular atrophy with pyramidal tract features. In the lower limbs, motor nerve conduction velocity could not be determined, and sensory nerve conduction velocity was decreased. In contrast, the results of both the conduction studies were normal for the upper limbs. A sural nerve biopsy revealed a decrease in the number of myelinated fibers and in the diameter of the unmyelinated fibers, and axonal and myelin regeneration was found on light and electron microscopic examinations, suggesting an axonopathy. Since the patient had pyramidal tract features, the same pathological changes may be present in the spinal cord. In the surgical treatment to correct deformity of the feet in this patient, triple arthrodesis was necessary.

scholarly journals Organophosphate-induced delayed neuropathy: case report

2002 ◽  
Vol 60 (4) ◽  
pp. 1003-1007 ◽  
Author(s):  
Luiz Felipe R Vasconcellos ◽  
Ana Cláudia Leite ◽  
Osvaldo J M Nascimento
Keyword(s):  
Pyramidal Tract ◽  
Electrophysiological Study ◽  
Axonal Neuropathy ◽  
Cholinergic Receptor ◽  
Lower Limbs ◽  
Delayed Neuropathy ◽  
Axonal Polyneuropathy ◽  
Central Nervous Systems ◽  
The Central Nervous System ◽  
Stimulation Of

Organophosphate induced delayed neuropathy (OPIDN) is an uncommon clinical condition. It occurs in association with the ingestion of great amounts of organophosphate after the stimulation of cholinergic receptor. The clinical picture is characterized by a distal paresis in lower limbs associated with sensitive symptoms. Electrodiagnostic studies show a motor axonal neuropathy. Involvement of the central nervous system may occur. We describe a 39 years-old female patient who developed hyperesthesia associated with lower limbs paresis, fourteen days after she had ingested a Dichlorvos-based insecticide. Electrophysiological study was characterized by an axonal polyneuropathy pattern. Pyramidal tract dysfunction was observed later in upper limbs. Considering that both peripheral and central nervous systems are involved we believe that the more appropriated term would be organophosphate induced delayed neuropathy (OPIDN) instead of organophosphate induced delayed polyneuropathy (OPIDP).

scholarly journals Late adult-onset Hereditary Sensory and Motor Neuropathy due to TECPR2 mutations

2020 ◽  
Vol 28 ◽  
pp. 1-6
Author(s):  
Paulo Victor Sgobbi de Souza ◽  
Bruno De Mattos Lombardi Badia ◽  
Eduardo Augusto Gonçalves ◽  
Roberta Ismael Lacerda Machado ◽  
José Marcos Vieira de Albuquerque Filho ◽  
...  
Keyword(s):  
Late Onset ◽  
Lower Limbs ◽  
Compound Heterozygous ◽  
Motor Neuropathy ◽  
Charcot Marie Tooth Disease ◽  
Pathogenic Variants ◽  
Brazilian Woman ◽  
Neurophysiological Studies ◽  
History Of ◽  
Tendon Reflexes

Objective: The description of a new genetic association with late-onset axonal Charcot-Marie-Tooth disease (CMT). Method. A 57-year-old Brazilian woman presented with a slowly progressive history of paresthesia, muscle wasting and weakness in her lower limbs since age 50 years. Examination disclosed peroneal amyotrophy, bilateral pes cavus, mild distal weakness, reduced vibration, pain and temperature sensation in the the lower limbs and brisk tendon reflexes. Results. Neurophysiological studies showed chronic sensorimotor axonal polyneuropathy. Whole-genome sequencing showed compound heterozygous pathogenic variants in the TECPR2 gene (14q32.31). Conclusion. This novel genetic presentation of late-onset axonal CMT with brisk tendon reflexes associated with TECPR2.

scholarly journals Clinical Description and Roentgenologic Evaluation of Patients with Friedreich's Ataxia

1976 ◽  
Vol 3 (4) ◽  
pp. 279-286 ◽  
Author(s):  
G. Geoffroy ◽  
A. Barbeau ◽  
G. Breton ◽  
B. Lemieux ◽  
M. Aube ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Friedreich’S Ataxia ◽  
Friedreich's Ataxia ◽  
Lower Limbs ◽  
Babinski Sign ◽  
Pes Cavus ◽  
Clinical Description ◽  
Incomplete Picture ◽  
Symptoms And Signs ◽  
Tendon Reflexes

SUMMARY:The 50 patients in this survey were classified by a panel of neurologists into 4 clinical sub-groups: Group la (“typical” Friedreich's ataxia, complete picture), Group lb (“typical” Friedreich's ataxia, incomplete picture), Group Ila (“atypical” Friedreich's ataxia, possible recessive Roussy-Levy syndrome), Group lib (heterogeneous ataxias). The clinical symptoms and signs were analyzed for each of these groups. A constellation of signs constantly present in Friedreich's ataxia and obligatory for diagnosis was described. Other important symptoms, such as the Babinski sign, kyphoscoliosis and pes cavus were found to be progressive, but not essential for the diagnosis at any given time. Finally, a host of other symptoms can only be called accessory. The progression of scoliosis was found to be an important tool in the differential diagnosis of ataxias. Our study also indicates, in contrast to the opinion of some authors, that absent deep tendon reflexes in the lower limbs and early dysarthria are essential in “typical” Friedreich's ataxia.

scholarly journals TMS Correlates of Pyramidal Tract Signs and Clinical Motor Status in Patients with Cervical Spondylotic Myelopathy

2020 ◽  
Vol 10 (11) ◽  
pp. 806
Author(s):  
Giuseppe Lanza ◽  
Valentina Puglisi ◽  
Luisa Vinciguerra ◽  
Francesco Fisicaro ◽  
Carla Vagli ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Pyramidal Tract ◽  
Tibialis Anterior Muscle ◽  
Motor Evoked Potential ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Motor Deficits ◽  
Conduction Time ◽  
The Difference ◽  
Group 1

Background: While the association between motor-evoked potential (MEP) abnormalities and motor deficit is well established, few studies have reported the correlation between MEPs and signs of pyramidal tract dysfunction without motor weakness. We assessed MEPs in patients with pyramidal signs, including motor deficits, compared to patients with pyramidal signs but without weakness. Methods: Forty-three patients with cervical spondylotic myelopathy (CSM) were dichotomized into 21 with pyramidal signs including motor deficit (Group 1) and 22 with pyramidal signs and normal strength (Group 2), and both groups were compared to 33 healthy controls (Group 0). MEPs were bilaterally recorded from the first dorsal interosseous and tibialis anterior muscle. The central motor conduction time (CMCT) was estimated as the difference between MEP latency and peripheral latency by magnetic stimulation. Peak-to-peak MEP amplitude and right-to-left differences were also measured. Results: Participants were age-, sex-, and height-matched. MEP latency in four limbs and CMCT in the lower limbs were prolonged, and MEP amplitude in the lower limbs decreased in Group 1 compared to the others. Unlike motor deficit, pyramidal signs were not associated with MEP measures, even when considering age, sex, and height as confounding factors. Conclusions: In CSM, isolated pyramidal signs may not be associated, at this stage, with MEP changes.

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