scholarly journals A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 45
Author(s):  
Simone Benvenuto ◽  
Andrea Trombetta ◽  
Egidio Barbi
Keyword(s):  
Central Nervous System ◽  
Daily Living ◽  
Motor Impairment ◽  
Self Report ◽  
Recurrent Pain ◽  
Pragmatic Approach ◽  
Basic Principles ◽  
Neurologic Impairment ◽  
Medical Complexity ◽  
The Central Nervous System

The term “severe neurologic impairment” (SNI) is used to describe a group of disorders of the central nervous system which arise in childhood, resulting in motor impairment, cognitive impairment and medical complexity. As a result, much assistance is required with activities of daily living. Since these patients are often unable to self-report pain, or they may exhibit uncommon behaviors when suffering, pain manifestations may go unrecognized. In this article, the basic principles of how to approach pain in children with SNI are discussed.

Bradykinesia in Parkinson's disease and cocontraction activity in dystonia are unlikely to be due to adaptive changes in the CNS

1996 ◽  
Vol 19 (1) ◽  
pp. 69-69
Author(s):  
A. Berardelli ◽  
R. Agostino ◽  
A. Currà ◽  
M. Manfredi
Keyword(s):  
Parkinson’S Disease ◽  
Central Nervous System ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Motor Impairment ◽  
Spatial Accuracy ◽  
Adaptive Changes ◽  
Postural Reactions ◽  
The Central Nervous System

AbstractLatash & Anson's explanation of bradykinesia in patients with Parkinson's disease and cocontraction in dystonic patients is intriguing. However, the proposed adaptive changes in the central nervous system do not fit well with both clinical and experimental evidence of motor impairment in these patients. In particular, we question the explanation of: (1) the role of postural reactions and spatial accuracy in bradykinesia, (2) certain abnormalities during the execution of sequential and simultaneous movements, (3) the sudden changes in mobility (ON and OFF) of Parkinsonian patients, and (4) the meaning of reflex circuitry changes in dystonia.

HIV-Associated Neurocognitive Disorders

2017 ◽  
Author(s):  
Scott Letendre ◽  
Jennifer Iudicello ◽  
Beau Ances ◽  
Thomas D. Marcotte ◽  
Serena Spudich ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cognitive Impairment ◽  
Daily Living ◽  
Motor Impairment ◽  
Neurocognitive Disorders ◽  
Neurocognitive Performance ◽  
Immunodeficiency Virus ◽  
The Central Nervous System ◽  
The Brain

The human immunodeficiency virus (HIV) enters the central nervous system soon after infection; can infect glia and tissue macrophages in the brain; and can injure neurons, resulting in loss of dendrites. These and other processes underpin a syndrome of cognitive and motor impairment termed HIV-associated neurocognitive disorder (HAND). This chapter principally focuses on HAND, although delirium and other neurocognitive disorders are also discussed and should remain in the differential diagnosis of cognitive impairment in persons with HIV. A differential diagnosis of cognitive impairment in HIV also includes multimorbid conditions that can influence neurocognitive performance, such as metabolic syndrome, vascular disease, medication toxicity, and substance use disorders. When developing treatment recommendations for HAND, initiation of ART and treatment of multimorbid conditions and other neurocognitive disorders should be prioritized. It is important for clinicians to regularly monitor HIV patients for HAND and other neurocognitive disorders since cognitive impairment can affect activities of daily living; quality of life; adherence to risk reduction, medical care, and medication; and survival.

scholarly journals Social preference is maintained in mice with impaired startle reflex and glutamate/D-serine imbalance induced by chronic cerebral toxoplasmosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mariana Acquarone ◽  
A. Poleto ◽  
A. F. Perozzo ◽  
P. F. R. Gonçalves ◽  
R. Panizzutti ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Social Preference ◽  
Neurological Diseases ◽  
Motor Impairment ◽  
Chronic Phase ◽  
Neuropsychiatric Disorders ◽  
Cerebral Toxoplasmosis ◽  
Startle Amplitude ◽  
The Central Nervous System

AbstractToxoplasma gondii is an opportunistic protozoan pathogen with a wide geographic distribution. The chronic phase of toxoplasmosis is often asymptomatic in humans and is characterized by tissue cysts throughout the central nervous system and muscle cells. T. gondii and other pathogens with tropism for the central nervous system are considered risk factors in the etiology of several neuropsychiatric disorders, such as schizophrenia and bipolar disorder, besides neurological diseases. Currently, it is known that cerebral toxoplasmosis increases dopamine levels in the brain and it is related to behavioral changes in animals and humans. Here we evaluate whether chronic T. gondii infection, using the cystogenic ME-49 strain, could induce behavioral alterations associated with neuropsychiatric disorders and glutamatergic neurotransmission dysfunction. We observed that the startle amplitude is reduced in the infected animals as well as glutamate and D-serine levels in prefrontal cortical and hippocampal tissue homogenates. Moreover, we did not detect alterations in social preference and spontaneous alternation despite severe motor impairment. Thus, we conclude that behavioral and cognitive aspects are maintained even though severe neural damage is observed by chronic infection of C57Bl/6 mice with the ME-49 strain.

The goal of treatment for motor impairment is not to “normalize” but to “functionalize” through facilitative modulation and enabling context

1996 ◽  
Vol 19 (1) ◽  
pp. 75-76 ◽  
Author(s):  
Gary Goldberg ◽  
Nathaniel H. Mayer
Keyword(s):  
Central Nervous System ◽  
Motor Impairment ◽  
Therapeutic Interventions ◽  
Volitional Control ◽  
Motor Patterns ◽  
Functional Movement ◽  
External Context ◽  
The Central Nervous System ◽  
Functional Context ◽  
Motor Neuron Syndrome

AbstractAdaptations occurring in the central nervous system (CNS) in the presence of pathology are not uniformly “good” for the organism when viewed in a functional context. A functional reordering of CNS priorities can be produced by allowing restructuring of the external context or through modification of neuromuscular physiology or anatomy designed to reduce the inherent restriction of functional movement in upper motor neuron syndrome. In fact, volitional control can often be “unmasked” through such interventions. Therapeutic interventions should not be directed toward “normalization” of motor patterns but should permit a functional reordering of CNS priorities that would otherwise not be possible.

Effects of Hyperoxia on Lung Utrastructure

1970 ◽  
Vol 28 ◽  
pp. 26-27
Author(s):  
Gladys Harrison
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Light Microscopy ◽  
Oxygen Effects ◽  
Age Dependent ◽  
The Central Nervous System ◽  
The Subject ◽  
Space Age ◽  
Alveolar Septa ◽  
Extensive Damage

With the advent of the space age and the need to determine the requirements for a space cabin atmosphere, oxygen effects came into increased importance, even though these effects have been the subject of continuous research for many years. In fact, Priestly initiated oxygen research when in 1775 he published his results of isolating oxygen and described the effects of breathing it on himself and two mice, the only creatures to have had the “privilege” of breathing this “pure air”.Early studies had demonstrated the central nervous system effects at pressures above one atmosphere. Light microscopy revealed extensive damage to the lungs at one atmosphere. These changes which included perivascular and peribronchial edema, focal hemorrhage, rupture of the alveolar septa, and widespread edema, resulted in death of the animal in less than one week. The severity of the symptoms differed between species and was age dependent, with young animals being more resistant.

Emigration of neutrophils in the central nervous system

1983 ◽  
Vol 41 ◽  
pp. 788-789
Author(s):  
John L.Beggs ◽  
John D. Waggener ◽  
Wanda Miller ◽  
Jane Watkins
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Osmium Tetroxide ◽  
White Blood Cells ◽  
Arterial Perfusion ◽  
E Coli ◽  
Intracisternal Injection ◽  
The Central Nervous System ◽  
Brain And Spinal Cord ◽  
Interendothelial Junctions

Studies using mesenteric and ear chamber preparations have shown that interendothelial junctions provide the route for neutrophil emigration during inflammation. The term emigration refers to the passage of white blood cells across the endothelium from the vascular lumen. Although the precise pathway of transendo- thelial emigration in the central nervous system (CNS) has not been resolved, the presence of different physiological and morphological (tight junctions) properties of CNS endothelium may dictate alternate emigration pathways.To study neutrophil emigration in the CNS, we induced meningitis in guinea pigs by intracisternal injection of E. coli bacteria.In this model, leptomeningeal inflammation is well developed by 3 hr. After 3 1/2 hr, animals were sacrificed by arterial perfusion with 3% phosphate buffered glutaraldehyde. Tissues from brain and spinal cord were post-fixed in 1% osmium tetroxide, dehydrated in alcohols and propylene oxide, and embedded in Epon. Thin serial sections were cut with diamond knives and examined in a Philips 300 electron microscope.

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