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At least 307 records · Page 17Linked to original sources
PubMed1982

Neuropathy following paracervical block in the obstetric patient.

A distinct clinical syndrome of severe buttock pain radiating down the posterior surface of the ipsilateral leg and subsequent inability to ambulate has recently been recognized. The syndrome may develop in the parturient following a paracervical block. This study analyzes 4 cases from the authors' institution and reviews 2 cases from the literature. Onset of the syndrome ranges from 12 hours to 10 days but progressive improvement and complete recovery are the rule. The cause is believed to be secondary to direct trauma or hematoma formation in the area of the sacral plexus. Pelvic induration or a mass in the sacroiliac area may be noted bur abscess formation is not associated. Prevention is difficult but early recognition will facilitate treatment, which is mostly symptomatic.

Adolescent↗
PubMed1981

Spinal tumors induced by neonatal administration of N-ethyl-N-nitrosourea in Wistar rats.

The carcinogenic effect of N-ethyl-N-nitrosourea (ENU) administered by single neonatal injection (40 mg/kg) was examined in wistar rats. By 2 months after ENU administration, 30% of the examined animals had spinal cord tumors. After months all rats had neurogenic tumors, and the incidence of spinal tumor was as high as 86%. Spinal cord tumors were observed at all levels of the white matter of the spinal cord without any predilection site, though spinal root tumors were located exclusively on lumbosacral plexuses. Most of the spinal cord tumors were oligodedrogliomas or glioependymomas, whereas all the spinal root tumors were anaplastic schwannomas.

Animals↗
PubMed1978

Relationship of the patellar tendon reflex to the ventral branch of the fifth lumbar spinal nerve in the dog.

The lumbosacral plexuses of dogs were exposed, using a ventral abdominal approach. In 4 dogs, the ventral branches (VB) of the 4th, 5th, 6th, or 7th lumbar spinal nerves were severed bilaterally. In 4 other dogs, the VB of combinations of 3 of these lumbar spinal nerves were severed so that the branch of only 1 nerve was kept intact. Among many neurologic deficits seen, the reflex of the patellar tendon was absent if the VB of the 5th lumbar spinal nerve was severed and was present if the branch was left intact. This finding was confirmed in another 12 dogs in which the VG of the 5th lumbar spinal nerve was severed on 1 side and the VB of the 4th and 6th lumbar spinal nerves were severed on the opposite side. In 4 additional dogs, the dorsal and ventral roots of the 5th lumbar spinal cord segment were isolated by dorsal laminectomy. Severing the dorsal root caused loss of the patellar tendon reflex, whereas severing the ventral root resulted in hyporeflexia. These findings would suggest that the major afferent impulse elicited by tapping the patellar tendon reaches the spinal cord by way of the dorsal root of the 5th lumbar spinal nerve.

Animals↗
PubMed1996

[Helical CT for lumbosacral spinal].

PURPOSE: The aim of this study was to investigate the efficacy of helical CT for lumbosacral pathology. MATERIALS AND METHODS: We performed helical CT with multiplanar reconstruction, including the formation of oblique transaxial and coronal images, in 62 patients with various lumboscral disorders, including 32 non-enhanced CT and 36 CT after myelography. We correlated the appearance of the stenotic spinal canal and neoplastic disease with the findings on MRI obtained at nearly the same time. RESULTS: We obtained helical CT images in all cases in about 30 seconds. The diagnostic ability of helical CT was roughly equal to that of MRI in patients with spondylosis deformans, spondylolisthesis and herniated nucleus pulposus. There was no significant difference in diagnostic value for degenerative lumbosacral disease with canal and foramnial stenosis between non-enhanced and post-myelography helical CT. However, non-enhanced helical CT could not clearly demonstrate neoplastic disease because of the poor contrast resolution. CONCLUSION: Helical CT was useful in evaluating degenerative disorder and its diagnostic value was nearly equal to that of MRI. We considered that helical CT may be suitable for the assessment of patients with severe lumbago owing to the markedly shortened examination time. However, if helical CT is used as a screening method for lumbosacral disease, one must be careful of its limitations, for example, poor detectability of neoplastic disease, vascular anomalies and so on.

Adult↗
PubMedDate not supplied

Neurological investigations in 23 cases of pyrethroid intoxication reported to the German Federal Health Office.

In 1993, 64 cases of chronic pyrethroid intoxication were reported to the Federal Health Office in Germany. Shortly afterwards the media spoke of thousands of cases of pyrethroid intoxication in homes. 23 of the persons reported were examined in a neurological department on an inpatient basis using clinical neurological, neuroradiological and laboratory investigations, including the examination of pyrethroid values in blood and urine. The pyrethroid exposure involved carpets, moth killers, pesticide sprays and wood preservatives. Nine of the cases presented with severe somatic or psychiatric disorders with completely different clinical diagnoses, such as pituitary tumor, radiogenic lumbosacral plexus paralysis, Guillain- Barré syndrome, spinal muscular atrophy, with no plausible relationship to exposure. Eight cases presented with multiple chemical sensitivity syndrome (MCS) and normal somatic findings. In six of the cases, a causal link between acute complaints and pyrethroid exposure could be established or not ruled out. There was, however, not a single case in which evidence for irreversible PNS or CNS lesions could be found.

Adult↗
PubMed1991

Unusual amyloid polyneuropathy with predominant lumbosacral nerve roots and plexus involvement.

We report a 25-year-old patient with a progressive asymmetric peripheral neuropathy of the distal lower limbs. Imaging studies showed enlargement of lumbosacral roots, plexus, and proximal sciatic nerve. Sacral plexus biopsy revealed amyloidosis associated with endoneurial edema. Immunohistochemistry with anti-prealbumin, serum amyloid A, and immunoglobulin light chain antisera failed to label the amyloid.

Adult↗
PubMed1999

Microvasculitis and ischemia in diabetic lumbosacral radiculoplexus neuropathy.

OBJECTIVE: To determine whether microscopic vasculitis explains the clinical and pathologic features of diabetic lumbosacral radiculoplexus neuropathy (DLSRPN). BACKGROUND: DLSRPN is usually attributed to metabolic derangement or ischemic injury, but microscopic vasculitis as the sole cause needs consideration. METHODS: We prospectively studied the clinical, laboratory, and EMG features as well as the pathology of distal cutaneous nerve biopsy specimens of patients with DLSRPN. RESULTS: Study of DLSRPN nerve biopsy specimens (n = 33) compared with those from healthy controls (n = 14) and those with diabetic polyneuropathy (n = 21) provided strong evidence for ischemic injury (axonal degeneration, multifocal fiber loss, focal perineurial necrosis and thickening, injury neuroma, neovascularization, and swollen fibers with accumulated organelles), which we attribute to microscopic vasculitis (epineurial vascular and perivascular inflammation, vessel wall necrosis, and evidence of previous bleeding). Segmental demyelination was significantly associated with multifocal fiber loss. CONCLUSIONS: 1) This severe, debilitating neuropathy begins with symptoms unilaterally and focally in the leg, thigh, or buttock and spreads to involve the other regions of the same and then opposite side and is due to multifocal involvement of lumbosacral roots, plexus, and peripheral nerve (i.e., diabetic lumbosacral radiculoplexus neuropathy). 2) Motor, sensory, and autonomic fibers are all involved. 3) Ischemic injury explains the clinical features and pathologic abnormalities of nerve. 4) The proximate cause of the ischemic injury appears to be microscopic vasculitis. 5) The segmental demyelination is probably secondary to ischemic axonal dystrophy, thus providing a unifying hypothesis for both axonal degeneration and segmental demyelination.

Adult↗
PubMedDate not supplied

[Segmental motor paralysis caused by the varicella zoster virus. Clinical study and functional prognosis].

INTRODUCTION: Segmental motor paralysis of the limbs (SMP) complicates 2-3% of the cases of cutaneous herpes zoster. Viral invasion and inflammation of the motor neurons of the anterior horn cells by the varicella-zoster virus (VVZ) causes clinical weakness at the same time and site as the cutaneous eruption. OBJECTIVES: To analyze the clinical findings, complementary investigations and functional prognosis of patients with SMP at brachial plexus and lumbosacral levels. PATIENTS AND METHODS: We made a retrospective study of 10 patients with SMP admitted to the Hospital Universitario Gregorio Maranon de Madrid during 1989-1999, aged between 38 and 84 years (6 women, 4 men). Neurological examination was done, including muscle balance, complementary studies including microbiology (serum and CSF serology, viral PCR-ADN), neurophysiology using MNR of the spine and plexuses and functional prognosis on the NDS, NSS and RANKIN scales. RESULTS: There is a close relationship between dermatome and myotome involvement (90%). The brachial and lumbosacral plexuses were equally affected (50%). Plasma and CSF VVZ serology was positive in 50% of the cases, permitting diagnosis of a patient with no cutaneous lesions (zoster sine herpete). Denervation of the myotomes involved and the paraspinal muscles was shown on neurophysiological studies. In most cases there was functional improvement, with complete functional recovery in 80% of the cases after 12 months. CONCLUSIONS: VVZ should be considered amongst the aetiologies of SMP, even in the absence of cutaneous lesions (zoster sine herpete). The SMP coincides in time and place with the dermatome lesions. In most patients there is complete functional recovery within 12 months.

Adult↗
PubMed2002

Postoperative neuropathies after major pelvic surgery.

OBJECTIVE: To estimate the incidence, etiology, and outcome of neuropathies after major gynecologic surgery and to recommend management and prevention strategies for these complications. METHODS: The medical records of women who suffered neuropathy after major pelvic surgery between July 1995 and June 2001 were reviewed. Mechanism of injury, treatment, and outcome were determined from the patient charts. RESULTS: Twenty-three of 1210 patients undergoing major pelvic surgery during the defined period suffered a postoperative neuropathy for an incidence of 1.9%. Neurologic injury involved the obturator (n = 9), ilioinguinal/iliohypogastric (n = 5), genitofemoral (n = 4), femoral (n = 3), and lumbosacral nerve plexus (n = 2) in these women. Etiologies were a result of direct surgical trauma, stretch injury, suture entrapment, or were retractor related. All patients with motor deficits were treated with physiotherapy, and pharmacologic or surgical management was used in women with sensory deficits or pain. Seventy-three percent of the women experienced full recovery; the only patients with persistent symptoms were those with unrepaired nerve transection or injury to the lumbosacral plexus. Both time to diagnosis and time to resolution varied widely. CONCLUSION: Neuropathies are infrequently associated with major pelvic surgery. We observed a 73% complete recovery rate, and time to resolution varied depending on the severity of injury. Physical therapy plays a valuable role in managing these patients, but some may require surgery for relief of their symptoms.

Adult↗
PubMed1993

Role of nitric oxide in sympathetic neurotransmission in opossum internal anal sphincter.

BACKGROUND: The role of nitric oxide in the gut in response to sympathetic nerve stimulation has not been examined. The present study examined the influence of the NO synthase inhibitor L-NG-nitro-arginine (L-NNA) on responses to hypogastric nerve stimulation (HGNS) in the opossum internal anal sphincter (IAS). METHODS: Resting pressures in the IAS (IASP) were monitored using low-compliance continuously perfused catheters. RESULTS: The predominant response to HGNS was an elevation of the resting tone in the IAS. The other responses of infrequent nature were a decrease in the IASP and a biphasic response (an initial increase followed by a decrease in the IASP). beta-Adrenoceptor antagonist propranolol had no significant effect on the increase in the IASP by HGNS but almost abolished the decrease in the IASP caused by HGNS and unmasked the excitatory responses. The IAS responses to HGNS were frequency dependent and abolished by guanethidine (adrenergic blocker). L-NNA caused significant and stereoselective suppression of all IAS responses to HGNS. The suppressed HGNS responses were completely reversed by the NO precursor L-arginine stereoselectively. The NO synthase inhibitor and guanethidine had no effect on the increase in IASP by phenylephrine. CONCLUSIONS: NO may play a significant role in the facilitatory modulation of sympathetic responses in the IAS.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

[Plexus lesions following radiation therapy. Report of nineteen cases (author's transl)].

Nineteen patients with plexus lesions following radiation therapy were investigated: fifteen with brachial plexus, 4 with lumbar or sacral plexus involvement. Symptoms at onset are usually sensory. Motor disturbances occur either simultaneously or after some delay, their course is generally gradual and unfavourable. Areflexia appears early and was present in every case. Important cutaneous lesions (radiodermitis) and considerable induration of soft tissues were observed in every patient. Diagnosis is a relapse of the mitotic process. Severity of prognosis makes imperative a definite technique of radiation therapy. In all the patients included in this study, dosage had exceded 1,600 rets. Patients were tentatively treated with D-penicillamine, an inhibitor of collagen synthesis.

Brachial Plexus↗