Spontaneous Recovery of Penetrating Cervical Spinal Cord Injury with Physiotherapeutic Treatment: Case Report and Review of the Literature

Stab wounds to the cervical spine are less common than injuries from road accidents, sports injuries, and falls. The presence of vital, vascular, neural, respiratory, and digestive structures in the neck region mean that this kind of spinal injury is generally critical, and its management is a challenge. We report a unique case of a previously healthy 17-year-old adolescent admitted for quadriplegia secondary to a stab wound to the cervical spine at the C4C5 level. There was no surgical indication. The patient underwent physiotherapy. He showed spontaneous neurological improvement two weeks later and was able to sit on his own and to walk about three months of physical rehabilitation.

Sex and age impact prevalence and symptoms of vasovagal syncope: Implications for accurate diagnosis

Syncope is characterized by the transient loss of consciousness followed by spontaneous recovery. The mechanism which underlies this condition is reduced blood flow to the brain [1]. Vasovagal syncope, often termed reflex syncope, is the most common type of syncope [1]. Vasovagal Syncope is caused by the abnormal autonomic reflex to certain stimuli such as pain, micturition/defecation, fear, seeing blood, etc., which results in vasodilation and often times, bradycardia [1].

Spontaneous Recovery of Circadian Organization in Mice Lacking a Core Component of the Molecular Clockwork

Circadian rhythms are generated by interlocked transcriptional-translational feedback loops of circadian clock genes and their protein products. Mice homozygous for a functional deletion in the Period-2 gene ( Per2m/m mice) exhibit short free-running circadian periods and eventually lose behavioral circadian rhythmicity in constant darkness (DD). We investigated Per2m/m mice in DD for several months and identified a categorical sex difference in the dependence on Per2 for maintenance of circadian rhythms. Nearly all female Per2m/m mice became circadian arrhythmic in DD, whereas free-running rhythms persisted in 37% of males. Remarkably, with extended testing, Per2m/m mice did not remain arrhythmic in DD, but after varying intervals spontaneously recovered robust, free-running circadian rhythms, with periods shorter than those expressed prior to arrhythmia. Spontaneous recovery was strikingly sex-biased, occurring in 95% of females and 33% of males. Castration in adulthood resulted in male Per2m/m mice exhibiting female-like levels of arrhythmia in DD, but did not affect spontaneous recovery. The circadian pacemaker of many gonad-intact males, but not females, can persist in DD for long intervals without a functional PER2 protein; their circadian clocks may be in an unstable equilibrium, incapable of sustaining persistent coherent circadian organization, resulting in transient cycles of circadian organization and arrhythmia.

Botulinum Toxin for the Treatment of Hemifacial Spasm: An Update on Clinical Studies

Hemifacial spasm (HFS) is a movement disorder characterized by involuntary contractions of the facial muscles innervated by the seventh cranial nerve. Generally, it is associated with a poor quality of life due to social embarrassment and can lead to functional blindness. Moreover, it is a chronic condition, and spontaneous recovery is rare. Intramuscular injections of Botulinum Toxin (BoNT) are routinely used as HFS treatment. Methods: We reviewed published articles between 1991 and 2021 regarding the effectiveness and safety of BoNT in HFS as well as any reported differences among BoNT formulations. Results: The efficacy of BoNT for HFS treatment ranged from 73% to 98.4%. The mean duration of the effect was around 12 weeks. Effectiveness did not decrease over time. Adverse effects were usually mild and transient. The efficacy and tolerability of the different preparations appeared to be similar. Among the studies, dosage, injected muscles, intervals of treatment, and rating scales were variable, thus leading to challenges in comparing the results. Conclusions: BoNT was the treatment of choice for HFS due to its efficacy and safety profile. Further studies are needed to investigate the factors that influence the outcome, including the optimal timing of treatment, injection techniques, dosage, and the best selection criteria for formulations.

The effects of uncertain context inference on motor adaptation

Humans have been shown to adapt their movements when a sudden change to the dynamics of the environment is introduced, a phenomenon called motor adaptation. If the change is reverted, the adaptation is also quickly reverted. Human are also able to adapt to multiple changes in dynamics presented separately, and to be able to switch between adapted movements on the fly. Such switching relies on contextual information which is often noisy or misleading, which affects the switch between adaptations. In this work, we introduce a computational model to explain the behavioral phenomena effected by uncertain contextual information. Specifically, we present a hierarchical model for motor adaptation based on exact Bayesian inference. This model explicitly takes into account contextual information and how the dynamics of context inference affect adaptation and action selection. We show how the proposed model provides a unifying explanation for four different experimentally-established phenomena: (i) effects of sensory cues and proprioceptive information on switching between tasks, (ii) the effects of previously-learned adaptations on switching between tasks, (iii) the effects of training history on behavior in new contexts, in addition to (iv) the well-studied savings, de-adaptation and spontaneous recovery.

Effect of Mathieson Laryngeal Manual Therapy in Patients With Muscle Tension Dysphonia After a Therapeutic Course

Introduction: This study aimed to investigate the effect of Mathieson Laryngeal Manual Therapy (MLMT) following a therapeutic course in patients with primary Muscle Tension Dysphonia (MTD). Materials and Methods: Twelve patients with primary MTD participated in this study. At first, videostroboscopy and perceptual voice assessment was performed, and the Persian version of Vocal Tract Discomfort (VTDp) scale was completed. After two and a half weeks that patients received no treatment, the assessments were repeated to evaluate the effect of spontaneous recovery. For studying the effect of MLMT, it was presented in five sessions. Then, all assessments were repeated. The frequency of supraglottic activity was elicited. For the perceptual evaluation and VTDp, the Wilcoxon nonparametric test was used to study and compare the effect of spontaneous recovery and MLMT. Results: After spontaneous recovery, a significant difference was observed only in strain (P<0.05). After MLMT, the frequency of supraglottic activity decreased, and perceptual voice parameters significantly changed (P<0.05), but the VTDp showed no significant difference (P>0.05). There was no significant difference between spontanous recovery and MLMT based on the paerceptual voice evaluation and VTDp scale (P>0.05). Conclusion: The MLMT can remarkably improve the supraglottic activity and perceptual characteristics of voice in primary MTD after a therapeutic course. Further studies are recommended to confirm the effectiveness of MLMT on decreasing VTD sensations.