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Stroke
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Intracerebral hemorrhage usually starts with a sudden headache that commonly happens during physical activity. The headache can be mild or absent in older patients. Often, the patient loses consciousness in only seconds or minutes. Other common symptoms include delirium, focal or generalized seizures, nausea, and vomiting. The neurologic deficits are usually sudden and very progressive. Large hemorrhages in the brain hemispheres cause hemiparesis. If they occur in the posterior fossa, cerebellar or brainstem deficits occur. These include conjugate eye deviation, ophthalmoplegia, pinpoint pupils, breathing that resembles snoring, and coma. In about 50% of patients, large hemorrhages are fatal in a few days. Those that survive experience a return to consciousness. Neurologic deficits slowly reduce as extravasated blood is resorbed. Since hemorrhage is not as destructive to brain tissue as an infarction, some patients have only a few neurologic deficits. If the hemorrhage is small, there may be focal deficits, but no impairment of consciousness. Headache or nausea may be only very slight. These hemorrhages can mimic an ischemic stroke.
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
The classic clinical picture of PML is that of subacute onset of focal neurologic deficits without fever or other constitutional manifestations. Common signs and symptoms include hemiparesis, visual field defects, cortical blindness, cognitive impairment, ataxia, aphasia, and cranial nerve dysfunction. Rapid progression occurs following diagnosis, resulting in quadriparesis, severe dementia, seizures, and coma.
The Nervous System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Diseases of the nervous system can result from injury to nerve tissue, infection, anatomical abnormalities, or several other causes. Injury may be severe and affect large areas, such as with a transection (severing) of the spinal cord. If a spinal transection occurs between the cervical and lumbosacral enlargements, the result is a paraplegia, loss of motor or sensory function in both lower extremities. An injury higher in the spinal cord can cause quadriplegia, paralysis of all four limbs and any parts of the body below the injury. Management of the quadriplegic patient is usually much more difficult because of the effects of muscle inactivity on other body systems such as respiration and the cardiovascular system. Damage can also affect only one side, causing hemiplegia (or hemiparesis, a milder form of paralysis of one side).
The Effect of Rhythm Abilities on Metronome-Cued Walking with an Induced Temporal Gait Asymmetry in Neurotypical Adults
Published in Journal of Motor Behavior, 2022
Lucas D. Crosby, Joyce L. Chen, Jessica A. Grahn, Kara K. Patterson
Hemiparesis is commonly experienced after stroke. This affects gait in many ways, including spatiotemporal deviations such as reduced velocity, cadence, and stride length. Moreover, greater than 50% of post-stroke individuals exhibit temporal gait asymmetry (TGA, Patterson et al., 2008, 2010b), a timing inequality between the legs during gait. Improving the temporal symmetry of gait is essential because of its association with secondary health issues such as bone density loss (Jorgensen et al., 2000), joint pain and degeneration (Norvell et al., 2005), deficiencies in balance control (Teasell et al., 2003), and energy inefficient locomotion (Ellis et al., 2013). Unfortunately, TGA is resistant to improvement with conventional gait retraining techniques during inpatient rehabilitation (Patterson et al., 2015) and may worsen over time for some individuals with stroke (Patterson et al., 2010a; Turnbull & Wall, 1995).
Concurrent impact of bilateral multiple joint functional electrical stimulation and treadmill walking on gait and spasticity in post-stroke survivors: a pilot study
Published in Physiotherapy Theory and Practice, 2021
Azadeh Hakakzadeh, Ardalan Shariat, Roshanak Honarpishe, Vahideh Moradi, Shima Ghannadi, Bahram Sangelaji, Noureddin Nakhostin Ansari, Scott Hasson, Lee Ingle
A spatial characteristic of the gait cycle was measured using an ink footprint record. Patients were asked to walk 10 m at a self-selected and comfortable speed while wearing nonpermanent ink patches on their footwear. A perpendicular distance (meters) from foot contact to the contact of the opposite foot was recorded for each step taken during the 10-m walk. The first and final 2 m of the walk were not calculated due to changes in walking gait/velocity. The test was performed on two trials, and mean step length was recorded; both sound and affected side were assessed for each participants. The validity of the test has been previously demonstrated in patients with hemiparesis (Graham et al., 2008), Inter-rater and test–retest reliability has been showed in patients with hemiparesis (Holden et al., 1984).
Focal arm weakness following intradetrusor botulinum toxin administration in spinal cord injury: Report of two cases
Published in The Journal of Spinal Cord Medicine, 2020
Christopher Goodrich, Henry York, Andrew Shapiro, Peter Howard Gorman
The question of why the presentation in these two cases was focal and not systemic remains puzzling especially in case one where baseline motor strength was greater. There have only been a small number of reported cases of focal and/or asymmetric symptoms. Joshi detailed the case of generalized weakness with particularly severe weakness of the left wrist flexors following intramuscular botulinum toxin administration.21 Another case noted onset of contralateral weakness following administration to the upper extremity of a patient with hemiparesis, though given the hemiparesis it is unclear whether this is localized or systemic spread.22 Some cases of contralateral limb weakness in hemiparetic patients without systemic side effects have additionally been reported.23 However, none of these cases involved intradetrusor botulinum toxin administration.