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O Soto

Publications and source records attributed to O Soto.

16 recordsLinked to original sources
PubMed1999

Transcranial magnetic stimulation identifies upper motor neuron involvement in motor neuron disease.

OBJECTIVE: To evaluate the sensitivity of transcranial magnetic stimulation (TMS) to identify upper motor neuron involvement in patients with motor neuron disease. BACKGROUND: Diagnosis of ALS depends on upper and lower motor neuron involvement. Lower motor neuron involvement may be documented with electromyography, whereas definite evidence of upper motor neuron involvement may be elusive. A sensitive, noninvasive test of upper motor neuron function would be useful. METHODS: TMS and clinical assessment in 121 patients with motor neuron disease. RESULTS: TMS revealed evidence of upper motor neuron dysfunction in 84 of 121 (69%) patients, including 30 of 40 (75%) patients with only probable upper motor neuron signs and unsuspected upper motor neuron involvement in 6 of 22 (27%) patients who had purely lower motor neuron syndromes clinically. In selected cases, upper motor neuron involvement identified with TMS was verified in postmortem examination. Increased motor evoked potential threshold was the abnormality observed most frequently and was only weakly related to peripheral compound muscle action potential amplitude. In a subset of 12 patients reexamined after 11+/-6 months, TMS showed progression of abnormalities, including progressive inexcitability of central motor pathways and loss of the normal inhibitory cortical stimulation silent period. CONCLUSIONS: TMS provides a sensitive means for the assessment and monitoring of excitatory and inhibitory upper motor neuron function in motor neuron disease.

Adult↗
PubMed1997

Adult botulism.

Explore the source record for details and available documents.

Botulism↗
PubMed1994

Severe central nervous system toxicity after chronic treatment with cyclosporine.

Severe neurologic complications following treatment with cyclosporine are uncommon. They tend to occur during the first month of treatment and disappear after withdrawal or reduction of the dose of the drug. We report the case of a man who underwent a liver transplantation and subsequently developed severe central nervous system toxicity. After two years receiving cyclosporine, he presented with a brachial monoparesis and a complex visual disturbance. Symptoms slowly worsened during four months. On admission, he had confusion and seizures. Multiple areas of T2 prolongation, located in cerebral white matter, were seen on magnetic resonance imaging (MRI). Symptoms partially improved after cyclosporine withdrawal, but brain lesions shown on MRI persisted in serial imaging studies after two years of follow-up. We discuss the mechanisms that have been proposed to explain this clinical picture. Severe cyclosporine-associated neurotoxicity can also occur after chronic administration, even with serum levels in therapeutic range.

Brain Diseases↗
PubMedDate not supplied

[Ilioinguinal neuropathy: usefulness of conduction studies].

Ilioinguinal neuropathy is an under-recognized etiology of pelvic pain, that is frequently misdiagnosed with alternative etiologies of pelvic pain. This is partially due to the limited usefulness of neurophysiological studies. Indeed, electromyography of the lower abdominal musculature identifies slightly more than half of the cases. In spite of an available conduction technique described in normal subjects, the usefulness of nerve conduction studies in ilioinguinal neuropathy is uncertain because their use has not been validated with patients. We describe the case of a patient with left inguinal pain following left inguinal herniorraphy. He underwent repeated surgeries and several analgesic treatments, without amelioration of pain. Conduction studies were consistent with ilioinguinal neuropathy. Anesthetic block relieved symptoms temporarily, and the symptoms disappeared upon section of the ilioinguinal nerve. This case describes the usefulness of conduction studies in the diagnosis of ilioinguinal neuropathy.

Adult↗
PubMedDate not supplied

Combined median and medial antebrachial cutaneous neuropathies: an upper-arm neurovascular syndrome.

The neurovascular bundle anatomy in the upper arm displays changing relationships of nerve and vascular structures along short segments. Fibrous tissues segregate these elements into enclosed compartments allowing for specific patterns of injury. We report a patient with a iatrogenic brachial artery injury in this region who featured combined median and MAC neuropathies, which were consistent with complete axonotmesis on neurophysiological assessment. Increased intracompartmental pressure may have led to nerve injury either thorough an ischemic mechanism or to focal compression. Recognition of this unusual pattern of nerve damage is important, since injury can be accurately localized to the midportion of the neurovascular compartment in the upper arm.

Aged↗