- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The human body is made of a complex system of ascending and descending pathways that permit communication between the brain and spinal cord. There are also pathways connecting different areas of the ...
The human body is made of a complex system of ascending and descending pathways that permit communication between the brain and spinal cord. There are also pathways connecting different areas of the brain. These pathways are called white matter tracts in the central nervous system (CNS). These are all nerve fibers covered with myelin sheaths which are derived from oligodendrocytes. The corticospinal tract belongs to one of the most important descending tracts of the CNS. It contains fibers from the upper motor neurons to synapse on the lower motor neurons. Upper motor neurons (UMN) can be described as the nerve fibers responsible for the communication between the brain to the spinal cord. Lower motor neurons (LMN) are the nerve fibers responsible for the communication between the spinal cord to muscle. Although damage to both UMN and LMN result in muscle weakness, damage to upper motor neurons may result in increased reflexes, increased tone, (+) Babinski, and spastic paresis. On the other hand, damage to lower motor neurons is usually accompanied by muscle atrophy, fasciculations, and flaccid paralysis. Descending tracts are responsible for relaying information from cortical regions to the periphery to initiate and modulate movement. The corticospinal tract is the largest descending tract present in humans and is divided into anterior and lateral components. The lateral corticospinal tract sends fibers predominantly to the extremity muscles, and the cortical innervation is contralateral, in other words, the left motor cortex controls the right extremities. The anterior corticospinal tract sends fibers mainly to the trunk or axial muscles. The control is both ipsilateral and contralateral. Therefore, trunk muscles are generally bilaterally cortically innervated.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Botulinum antitoxin, also known as botulism antitoxin, is comprised of antibodies or antibody antigen-binding fragments that block the neurotoxin produced by the bacterial species Clostridium botulin...
Botulinum antitoxin, also known as botulism antitoxin, is comprised of antibodies or antibody antigen-binding fragments that block the neurotoxin produced by the bacterial species Clostridium botulinum. Botulinum toxin causes botulism, a paralytic syndrome classically characterized by symptoms of descending symmetric muscle weakness. Symptoms can include blurry vision, inability to speak or swallow, and weakness in the bilateral upper extremities with progression to the chest and lower extremities.
- Unexpected photosensitivity - a patient with dermatomyositis and concomitant solar urticaria. [Journal Article]
- JEJ Eur Acad Dermatol Venereol 2018 Dec 05
- Dermatomyositis (DM) is a connective tissue disease with rare incidence, characterized by progressive muscle weakness and typical cutaneous manifestations. Its pathogenesis is still incompletely unde...
Dermatomyositis (DM) is a connective tissue disease with rare incidence, characterized by progressive muscle weakness and typical cutaneous manifestations. Its pathogenesis is still incompletely understood, but next to genetic predisposition environmental factors seem to be implicated in the development of DM (1). Photosensitivity is one important factor for the onset and exacerbation of DM, which is corroborated by the distribution of the cutaneous features on sun-exposed areas and disease photoaggravation (2,3). This article is protected by copyright. All rights reserved.
- The Wrong Turn to Tijuana: Dry Beriberi after Gastric Bypass Surgery with Incidental Spinal Stenosis. [Journal Article]
- CRCase Rep Neurol 2018 Sep-Dec; 10(3):309-313
- Thiamine deficiency is a condition characterized by several different presentations, but one of the most devastating is dry beriberi. It is associated with polyneuropathy and muscle weakness which ty...
Thiamine deficiency is a condition characterized by several different presentations, but one of the most devastating is dry beriberi. It is associated with polyneuropathy and muscle weakness which typically affects the lower extremities and progressively involves the upper extremities. This case outlines a case of a 41-year-old man that presented to the hospital with diffuse weakness and decreased sensation in his legs and hands over a 3-day period. The patient's medical history revealed a gastric bypass surgery 4 months previously in Tijuana, Mexico, with no follow-up, binge drinking on weekends, and emesis in the past few weeks. A physical examination revealed a significant decrease in strength in the lower extremities bilaterally as well as in the hands bilaterally. MRI showed central disc protrusion at T6-T7 that indented the spinal cord, consistent with spinal stenosis. Neurosurgery was counseled and corpectomy was recommended. While awaiting surgery, a low thiamine level resulted. Neurology was consulted, and it was recommended that high-dose IV thiamine treatment be started. An EMG study further supported the diagnosis of thiamine deficiency. The patient received high-dose IV thiamine for 2 weeks and was discharged to acute rehabilitation on a high oral dose of thiamine. While at the rehabilitation facility, the patient continued to achieve functional gains and was later discharged to a skilled nursing facility, where he continues to make progress in his activities of daily living. This case serves to remind practitioners that early recognition and treatment of thiamine deficiency is imperative, especially when other clinical evidence may point to a different diagnosis.
- Pulmonary veno-occlusive disease as a cause of severe pulmonary hypertension in a dog. [Journal Article]
- AVActa Vet Scand 2018 Dec 05; 60(1):78
- CONCLUSIONS: This case report confirms that PVOD should be a diagnostic consideration in dogs presenting with dyspnea and unexplained PH. In the present case, no casual genetic mutations known to be involved in humans with PVOD and PAH were found.
- Public knowledge of dehydration and fluid intake practices: variation by participants' characteristics. [Journal Article]
- BPBMC Public Health 2018 Dec 05; 18(1):1346
- CONCLUSIONS: The participants displayed good knowledge of dehydration definition, prevention, and water intake recommendation. The participants also displayed good knowledge of the common symptoms, however knowledge was lacking for uncommon symptoms. Moreover, participants had reported adequate water intake, meeting the daily water intake recommendation of ≥3.7 l for men and ≥ 2.7 l for women.
- Bereaved Parents More Satisfied With the Care Given to Their Child With Severe Spinal Muscular Atrophy Than Nonbereaved. [Journal Article]
- JCJ Child Neurol 2018 Dec 05; :883073818811544
- CONCLUSIONS: This study highlights the importance of improving disease-specific competence, communication and knowledge exchange among staff. For optimal care for these children and families, parents should be included in dialogues on care and staff should be more proactive and take care management initiatives.
- Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication. [Journal Article]
- JAJ Audiol Otol 2018 Dec 07
- CONCLUSIONS: : In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.
- [Simvastatin-Induced Myopathy after Dose Increase]. [Journal Article]
- DMDtsch Med Wochenschr 2018; 143(24):1791-1794
- CONCLUSIONS: In case of unclear neurological symptoms and under therapy with statins, a myopathy should be considered.
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- Recognizing and Managing Snapping Hip Syndrome in Dancers. [Review]
- MPMed Probl Perform Art 2018; 33(4):286-291
- CONCLUSIONS: Early and comprehensive examination and management can help to reduce SHS risk and potentially decrease the ability of this debilitating condition to derail a dancer's career.