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Infantile Spasms
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
There are several controversial questions regarding the treatment of infantile spasms which engender little agreement. These may be summarized as follows: Which is the most effective therapy, ACTH or oral steroids?What is the optimal dose of either one of these drugs?How long should the patient be treated?Does it make a difference in the ultimate outcome whether the patient is treated early or late in regard to onset of the spasms?Does it make any difference in the outcome in a patient with preexisting mental retardation and an abnormal brain whether the spasms are treated at all?
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
Patients should be given a thorough description of their functional disorder, including what is known and unknown. It should be stressed that these conditions are extremely common but their cause in unknown. Patients should be told that everyone has an extraordinary number of nerves and hormones in the gut, which respond to a variety of poorly understood factors. Symptoms arise either from an increased sensitivity to minor pain or distension or from an increased reactivity to various factors, resulting in spasm or hypomotility. Although a variety of dietary, environmental, physiological, and psychological factors may trigger symptoms in some people, most patients are unable to identify specific inciting factors. The importance of the “mind-gut” interaction should be mentioned, but also that it is only beginning to be studied. Physicians should strive to avoid a “mind-versus-body” dualism, lest patients infer that the physician has concluded that they are “crazy” or that “it’s all in my head.” Patients should be reassured that the overwhelming majority of those with such disorders are otherwise perfectly normal people who lead productive lives. Fears that the symptoms will progress, require surgery, or degenerate into other illnesses should be allayed (5,23,24).
The Musculoskeletal 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
Myalgia denotes pain in a muscle. Injury can involve myorrhexis, a tear in the muscle, or miyostasis, stretching. Muscular spasms may cause myotomes or myospasm.
Management and Treatment Modalities in Traumatic Brain Injury
Published in Journal of Binocular Vision and Ocular Motility, 2020
Following a TBI, a patient may experience an Accommodative Spasm. With a mild spasm, the patient may be making themselves pseudo-myopic with blurred vision. Or they may have a more severe spasm with an intermittent esotropia and diplopia with miotic pupils. In this case (with intermittent spasms), the treatment can be simply encouragement and relaxing techniques. Possibly giving an uncorrected hypermetropic prescription or Base-Out prism may help when there is a long and difficult episode of diplopia. Or, cycloplegics to break the spasm may be useful. If cycloplegics are given, readers should also be included to clear any blurred near vision. Miotics, which facilitate accommodation, have also been used in adults. Typically, miotic drops have been used in children for an accommodative esotropia when not wearing glasses.4–6
The impact of early spasticity on the intensive functional rehabilitation phase and community reintegration following traumatic spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2020
Andréane Richard-Denis, Bich-Han Nguyen, Jean-Marc Mac-Thiong
A majority of our cohort (63.3%) developed signs and/or symptoms of spasticity (as defined in this study as the presence of the following: 1) velocity-dependant muscle hypertonia, 2) spasms reported by the patient or noted at physical examination, 3) clonus reported by the patient or noted at physical examination, during the acute care hospitalization. The incidence of spasticity observed in this study is in the lower range previously reported in the SCI population (65–78%).2,8 This result was expected since previous studies have investigated the incidence of spasticity in the subacute or chronic phases following TSCI. This study suggests that a great majority of individuals who will develop spasticity will present signs and/or symptoms within the first month following the injury. This finding may help in defining the natural history of spasticity, as the proportion of individuals who develop spasticity prior to admission to intensive functional rehabilitation has never been reported in the SCI literature, to our knowledge. It is important to note that our cohort was similar to the Canadian SCI population in term of baseline characteristics.26
Black widow spider bite in Johannesburg
Published in Southern African Journal of Infectious Diseases, 2018
Teressa Sumy Thomas, Alan Kemp, Kim Pieton Roberg
Following the bite, he experienced the typical features of latrodectism. Symptoms included intense muscle pain and rigidity over the bite site, which radiated to his trunk, arms and neck. On examination he had a mild tachycardia. Muscle spasm was evident. He was flushed, sweaty and anxious (Figure 3). Inspection revealed an erythematous area on the right lower quadrant of his abdomen, which was thought to be the bite mark (see Figure 3). His blood pressure, temperature and neurological state remained stable throughout his admission. Blood investigations revealed a mild leucocytosis of 13.61 x109 cells/l and a creatine kinase of 1171 U/l. The remainder of the full blood count, urea and electrolytes, calcium, magnesium, phosphate, C-reactive protein and liver function tests were all normal. A toxicology screen for over-the-counter medication (paracetamol, barbiturates, salicylates and benzodiazepines), cerebrospinal fluid examination and blood cultures were all negative.