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Hysteria
Published in Francis X. Dercum, Rest, Suggestion, 2019
Quite often the patient will declare that he is utterly unable to walk or even to sit up and, in such case, will remain continuously in bed. Under these circumstances he moves his legs about more or less spontaneously, especially when not under observation. Being urged by the physician to raise one of Ms legs off the bed, he may with much show of effort move it very slightly. If, while this test is being made, the physician slips Ms hand under the opposite limb, it is found that this limb although supposedly paralyzed is depressed into the bed, often with force. The procedure should then be repeated with the opposite limb. The test is especially valuable in hysteric monoplegia. If, in such instance, the physician having placed Ms hand under the paralyzed leg, directs the patient to raise the sound leg from the bed, the paralyzed leg is depressed into the bed in proportion to the degree and force with which the sound leg is elevated.
Examine the lower limbs
Published in Hani TS Benamer, Neurology for MRCP PACES, 2019
Q: What are the causes of monoplegia? Cerebrovascular disease (sudden onset).Brain tumour (gradual onset).Spinal cord lesion (gradual onset).
Common neurological patterns
Published in Hani Ts Benamer, Essential Revision Notes in Clinical Neurology, 2017
➤ The causes of monoplegia/hemiplegia are: ➣ cerebrovascular disease (sudden onset)➣ brain tumour (gradual onset)➣ spinal cord lesion (gradual onset).
Effectiveness of different extrinsic feedback forms on motor learning in children with cerebral palsy: a systematic review
Published in Disability and Rehabilitation, 2023
Jorine Schoenmaker, Han Houdijk, Bert Steenbergen, Heleen A. Reinders-Messelink, Marina M. Schoemaker
Cerebral palsy is a collection of permanent disorders involving motor, sensory, and cognitive disabilities that are attributed to non-progressive disturbances in the developing brain (i.e., perinatal brain lesions or anomalies or postnatal injuries or infections) [1,2]. Location and extent of the cerebral damage differ between cases and, as a consequence, so does the symptomatic expression. This heterogeneity necessitates a structured classification. Distinctions are therefore made based on type (spastic, dyskinetic, ataxic, or mixed) and patterns of neurologic involvement (primary distinction between unilateral and bilateral CP; further specified into monoplegia, hemiplegia, paraplegia, diplegia or quadriplegia) [3,4]. The Gross Motor Function Classification Scale (GMFCS) classifies patients into five groups based on functional mobility and independency (level I–V) [5].
Stroke mimics: incidence, aetiology, clinical features and treatment
Published in Annals of Medicine, 2021
Brian H. Buck, Naveed Akhtar, Anas Alrohimi, Khurshid Khan, Ashfaq Shuaib
Stroke mimics have less clearly defined neurological symptoms that typically do not adhere to well-defined stroke syndromes [12]. The suddenness at onset is not always evident, fluctuations in severity are common and systemic signs including drowsiness, confusion, agitation and fever may be present [6]. Common presenting symptoms include vertigo and dizziness, altered level of consciousness, paraesthesia and numbness, monoplegia, speech dysfunction, limb ataxia, headache and visual disturbances (see Table 2). There is often a previous history of seizures, migraine, depression or other psychiatric disorders or dementia [4]. Mimics can be particularly difficult to differentiate from acute stroke when symptoms are brief and resolve before the patient is examined, especially when advanced brain imaging including MRI is normal. Prompt identification that symptoms are secondary to a stroke mimic and appropriate treatment of the underlying condition will lead to avoidance of potential misdiagnosis and the unnecessary long-term use of antithrombotic and other stroke prevention medication.
What makes children with cerebral palsy vulnerable to malnutrition? Findings from the Bangladesh cerebral palsy register (BCPR)
Published in Disability and Rehabilitation, 2019
Israt Jahan, Mohammad Muhit, Tasneem Karim, Hayley Smithers-Sheedy, Iona Novak, Cheryl Jones, Nadia Badawi, Gulam Khandaker
Both underweight and stunting were significantly higher among children with spastic CP compared with than other neurological types of CP (p < 0.001). The spastic monoplegia/diplegia group had high proportions of moderate underweight and moderate stunting (46.9% and 58.0% respectively) whereas the spastic triplegia/quadriplegia group had a high proportion of severe underweight and severe stunting (43.2% and 48.0%, respectively). Moreover, 58.5% (n = 24) of our dyskinetic children were severely underweight and 60.0% (n = 36) were severely stunted (Table 2).