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Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Falcine meningioma: Lower extremity spastic paresis or paraparesis.Focal motor or sensory seizures.Headache from tumor mass or occlusion of the superior sagittal sinus.
Clinical Management of Spasticity and Contractures in Spinal Cord Injury
Published in Anand D. Pandyan, Hermie J. Hermens, Bernard A. Conway, Neurological Rehabilitation, 2018
The diagnosis of a spastic paresis is based on the examination of tendon tap reflexes and muscle stiffness in the passive subject. Early after an acute damage of the CNS, tendon tap reflexes are exaggerated, but muscle stiffness develops only after some weeks. When stretching a limb muscle of a spastic patient (Ashworth Test) during the clinical examination a tonic muscle, activation occurs in this muscle, leading to an increased resistance [62]. This observation has led to the assumption that exaggerated reflexes result in an increased muscle activity and, consequently, are responsible for the movement disorder. However, electrophysiological investigations on the neuronal adaptations after a complete spinal cord injury indicate a divergent course of increasing clinical signs of spasticity but decreasing or stable values of their potential neuronal correlates (M-wave, F-wave, H-reflex, and flexor reflex) [24]. Consequently, non-neuronal mechanisms were assumed to contribute to spastic muscle stiffness. In addition, according to all investigations of natural, complex movements in patients with spasticity, the assumption of a relevant ‘extra-activity’ contributing to spastic muscle stiffness could not be confirmed [19].
Assessment, goal setting, and botulinum neurotoxin a therapy in the management of post-stroke spastic movement disorder: updated perspectives on best practice
Published in Expert Review of Neurotherapeutics, 2022
Not included in the definition of the Spasm consortium are complications of spasticity that in most patients starts to develop in the early subacute phase following stroke, too [2] and lead to progressive soft tissue and muscle shortening and may lead to the development of contractures and stretch induced pain in the limbs involved [1,2,8,9]. Also not included, but relevant for goal setting and prognosis of early rehabilitation is the level of muscle weakness, fatigue, slowing of voluntary movements, and dexterity problem as the so-called “Minus” symptoms of the UMNS, which are understood as the reduction or the loss of physical as well as mental functions due to injuries of upper motor neurons [2,10,11]. However, as PS-SMD is always combined with some degree of weakness in the muscles, the term “Spastic Paresis” (SP) is also legitim and frequently used [12].
The NEALS primary lateral sclerosis registry
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2020
Sabrina Paganoni, Fabiola De Marchi, James Chan, Sara K. Thrower, Nathan P. Staff, Neil Datta, Yaz Y. Kisanuki, Vivian Drory, Christina Fournier, Erik P. Pioro, Stephen A. Goutman, Nazem Atassi, Maryangel Jeon, Sarah Caldwell, Timothy Mcdonough, Caroline Gentile, Jianing Liu, Michelle Turner, Carol Denny, Kevin Felice, Misty Green, Stephanie Scarberry, Saad Abu-Saleh, Beatrice Nefussy, Debbie Hastings, Sangri Kim, Blake Swihart, Ximena Arcila-Londono, Daniel S. Newman, Michael Silverman, Angela Genge, Kristiana Salmon, Lauren Elman, Leo Mccluskey, Kelly Almasy, Marc Gotkine, Kimberly Goslin, Arlena Cummings, Eli K. Edwards, Michael Rivner, Kristy Bouchard, Brandy Quarles, Justin Kwan, Matthew Jaffa, Robert Baloh, Peggy Allred, David Walk, Samuel Maiser, Georgios Manousakis, Valerie Ferment, J. Americo M. Fernandes, Pariwat Thaisetthawatkul, Deborah Heimes, Melissa Phillips, Laura Sams, Melissa Kahler, Alecia Corcoran, Daniel G. Larriviere, Sadie Chotto, Gracy Juba
The study included patients who met Pringle criteria (2) for PLS (i.e., insidious onset of spastic paresis; adult onset; gradually progressive course; duration of at least 3 years; clinical findings limited to corticospinal dysfunction; normal EMG or, at most, minor and late EMG changes in a few muscles with normal brain and spine MRI; and normal laboratory values). Patients’ charts were reviewed retrospectively. Patients with a positive family history of MND or HSP were excluded. For this study, the date of PLS diagnosis was considered as the “baseline” visit. The baseline visit occurred at least 3 years after symptom onset to fulfill Pringle criteria. Results from all diagnostic tests performed prior to the baseline visit were collected as they supported the diagnosis. Visits that occurred after baseline (i.e., after the diagnosis of PLS) were analyzed to describe the longitudinal natural history of the disease after diagnosis.
Stratified management of hemiplegic shoulder pain using an integrated care pathway: an 18-year clinical cohort analysis
Published in Disability and Rehabilitation, 2022
Michele Walsh, Stephen Ashford, Hilary Rose, Ejessie Alfonso, Aideen Steed, Lynne Turner-Stokes
At the other end, patients with spastic paresis typically present with a tight adducted and internally-rotated shoulder, often with marked spasticity-related pain requiring interventions to maintain range and reduce unwanted muscle activity.