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Unaffected Side (unaffected + side)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Neurology	37%
Nursing General	25%

Selected Abstracts

Axonal excitability properties in hemifacial spasm

MOVEMENT DISORDERS, Issue 9 2007
Arun V. Krishnan PhD, FRACP
Abstract Hemifacial spasm (HFS) is characterized by involuntary, irregular contractions of muscles innervated by the facial nerve. Whether the facial nerve has a relative predisposition for ectopic activity has not been clarified. Nerve excitability techniques, which provide information about membrane potential and axonal ion channel function, were initially measured in 12 control subjects looking for biophysical differences that may predispose the facial nerve to generate ectopic activity. In a second series of studies, facial nerve excitability was assessed in nine HFS patients. In both series, stimulus,response behavior, threshold electrotonus, a current threshold relationship, and the recovery of excitability following supramaximal stimulation were recorded following stimulation of the facial nerve. When compared to normative data from nerves in the upper and lower limbs, there was a relative "fanning-in" of threshold electrotonus, reduced superexcitability, and increased subexcitability in facial nerve studies from control subjects (P < 0.05), consistent with relative axonal depolarization. These findings may underlie the propensity for the facial nerve to develop ectopic impulse activity in motor axons. In the HFS patient study, there were no significant differences in distal facial nerve excitability properties from the affected side in HFS patients when compared either to the unaffected side or to normative facial nerve data. It is concluded that the impulse generator underlying HFS must consequently be sited more proximally and does not cause a generalized disturbance of motor axon excitability. © 2007 Movement Disorder Society [source]

(613) Radiculopathy Treatment Assessment Using Pain Tolerance Test

PAIN MEDICINE, Issue 2 2000
Article first published online: 25 DEC 200
Authors: Y. Eugene Mironer, Carolinas Center for Advanced Management of Pain; Judson J. Somerville, The Pain Management Clinic of Laredo Current measurements of the outcomes of chronic radiculopathy treatment are limited to subjective criteria: level of pain, range of motion, etc. Our previous study showed that nerve conductivity does not correlate well with the intensity of pain after treatment of radiculopathy (1). In the current study we looked at the Pain Tolerance Threshold (PTT) as a possible measurement of the results of radiculopathy treatment. Twenty patients with chronic radiculopathy (13 lumbar and 7 cervical) underwent epidural steroid injections at the level of involvement. Before, and approximately one week after the procedure, we measured PTT in both the involved and contralateral extremity at 3 different frequencies (5Hz, 250Hz, and 2000 Hz) using Neurometer. Level of pain was also assessed using a Visual Analog Scale (VAS). Initial PTT results showed great interpersonal variability. Nearly half of the patients did not show significant differences in PTT between affected and unaffected sides. Of interest, the majority experienced intolerable pain at 2000 Hz stimulation at lower than maximal intensity output, which contradicts previous findings (2). Dynamics of the PTT measurements after treatment did not directly correlate with changes in the level of pain. Nevertheless, in 7 out of 8 patients with low PTT (relative to the unaffected side) it increased significantly, with noticeable decrease of VAS score. Similar results were not found in patients with either normal initial PTT score or minimal improvement of pain. 1. Mironer YE, Somerville JJ The current perception threshold evaluation in radiculopathy: efficacy in diagnosis and assessment of treatment results. Pain Digest 1998;8:37,38. 2. Liu SS, Gerancher JC, Bainton BG, et al. The effects of electrical stimulation at different frequencies on perception and pain in human volunteers: epidural versus intravenous administration of fentanyl. Anesth Analg 1996;82:98,102. [source]

Computer-assisted therapy in orbital and mid-facial reconstructions

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 2 2009
A. Schramm
Abstract Background Management of orbital and mid-facial fractures requires a thorough ophthalmic evaluation and precise imaging. A principle goal of therapy is to anatomically reduce fracture segments and to restore a normal orbital volume as soon as possible. Diagnostic advances such as new surgical and imaging techniques have dramatically improved both the functional and aesthetic outcome of reconstructions. Methods Orbital reconstruction is performed using computer-assisted navigation. This technique makes preoperative simulation by mirroring the unaffected side onto the affected side. Results Results from computer-assisted navigation application to both primary and secondary orbital and mid-facial reconstruction are shown. Conclusion Navigation technique it offers significant advantages in both primary and secondary reconstructions. Navigation facilitates reconstruction in unilateral defects through mirroring techniques, and in bilateral defects by importing virtual models from standard CT datasets improving the software tool to fulfil the need for maxillofacial surgery reconstruction. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Multimodal microglia imaging of fiber tracts in acute subcortical stroke,

ANNALS OF NEUROLOGY, Issue 6 2009
Basia A. Radlinska BSc
Objective Case series with 11C-PK11195 and positron emission tomography (PET) in stroke patients suggest that activated microglia may be detected in remote brain regions with fiber tract connections to the lesion site as an indicator of poststroke neuroinflammation. However, the specificity of these imaging findings remains to be demonstrated. Methods In a prospective controlled study, we measured microglia activity using 11C-PK11195-PET along the pyramidal tract, as defined by diffusion tensor imaging, in 21 patients with first-time acute subcortical ischemia within 2 weeks of stroke. Uptake ratios (affected vs unaffected side) were determined for a set of standardized volumes of interest along the pyramidal tracts (PT). Uptake ratios from patients in whom the PT was affected were compared with those in whom the PT was not affected. Uptake ratios were related to motor deficit and lesion size according to correlation analyses. Results Increased uptake ratios were only found in patients in whom the PT was affected by stroke. In the affected hemisphere, uptake was increased at the level of pons, midbrain, and internal capsule, but not in the oval center. The extent of remote microglia activation was independent of infarct size or clinical measures of stroke severity. Interpretation A specific activation of microglia was only found in patients in whom the PT was affected by the stroke and only caudal (anterograde) to the lesion; no activation was found in the retrograde direction or in those patients in whom the PT was not affected. These findings were independent of infarct size and may represent changes secondary to early Wallerian degeneration. Ann Neurol 2009;66:825,832 [source]

A comparison study on nurses' and therapists' perception on the positioning of stroke patients in Singapore General Hospital

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2007
Lilian Yew Siew Mee Adv.
Before developing a study to evaluate the effect of positioning on outcome after stroke, it was important to explore whether there were differences in perception between neurology/neurosurgery nurses, nurses from other wards, occupational therapists (OTs) and physiotherapists (PTs) over the positioning of stroke patients in Singapore General Hospital (SGH). Questionnaires were sent to 227 nurses, seven PTs and six OTs from six wards where more stroke patients are cared for in SGH. Seventy-two per cent of the respondents identified bed positioning as their positioning strategy. ,Sitting in a chair' was selected as the best position by most of the respondents in the three specialty groups for nursing conscious hemiplegic stroke patients. ,A 30 degree propped-up angle in bed' was selected as the best position by the majority of the nurses from the neuroscience wards while ,lying horizontally on the unaffected side' of the body was selected as the best position by most of the nurses from other wards, PTs and OTs for nursing unconscious hemiplegic stroke patients. However, no significant difference was found between the groups in what they considered the best position for stroke patients. The lack of consensus between these respondents is probably because there are few studies to guide nursing practices for the positioning of stroke patients. Hence, research to confirm which positions improve or hinder outcome after stroke is indispensable. [source]

Physiological characteristics of the body fluid in lymphedematous patients postbreast cancer surgery, focusing on the intracellular/extracellular fluid ratio of the upper limb

JAPAN JOURNAL OF NURSING SCIENCE, Issue 1 2010
Hiromi SAKUDA
Abstract Aim:, The aim of this research was to determine the physiological characteristics of patients with lymphedema following breast cancer surgery, based on differences between the quantity of body water in the right and left fingertips, with a view to establishing whether or not this simple measurement could serve as a predictive index for the onset of lymphedema. Method:, The research was conducted at a hospital in Hiroshima, Japan (August 2004 to December 2004). Observations were made on 39 female breast cancer patients who had undergone surgery and 45 healthy female participants. Additional information was collected via interviews with the individual participants. The quantity of body water in all the participants was measured by using a bioimpedance spectrum analysis system. Comparisons of the intracellular/extracellular fluid ratios (I/Es) were made between the edema patients and the non-edema patients, with further testing being done between the affected and unaffected sides of the upper limb in the edema patients. Results:, In the edema patients, significant differences were recognized between the affected side's upper limb I/E and the unaffected side's upper limb I/E. In relation to the affected side's upper limb I/E of the edema patients, even when the mean value and standard deviation were included, the value did not exceed 1.0 and the mean , 3 SD value of the affected side's upper limb I/E in the non-edema patients was 1.04. Conclusions:, The results suggest that measurements of the affected and unaffected sides' upper limb I/E showed a potential for use as a reliable predictive index for lymphedema. [source]

(613) Radiculopathy Treatment Assessment Using Pain Tolerance Test

Carotid plaque computed tomography imaging in stroke and nonstroke patients

ANNALS OF NEUROLOGY, Issue 2 2008
Max Wintermark MD
Objective To identify a set of computed tomographic (CT) features of carotid atherosclerotic plaques that is significantly associated with ischemic stroke. Methods In a cross-sectional study, we retrospectively identified 136 consecutive patients admitted to our emergency department with suspected stroke who underwent a CT-angiogram of the carotid arteries. CT-angiographic studies of the carotid arteries were processed automatically using automated computer classifier algorithm that quantitatively assesses a battery of carotid CT features. Acute stroke patients were categorized into "acute carotid stroke patients" and "nonacute carotid stroke patients" independent of carotid wall CT features, using the Causative Classification System for Ischemic Stroke, which includes the neuroradiologist's review of the imaging studies of the brain parenchyma and of the degree of carotid stenosis, and charted test results (such as electrocardiogram). Univariate followed by multivariate analyses were used to build models to differentiate between these patient groups and to differentiate between the infarct and unaffected sides in the "acute carotid stroke patients." Results Forty "acute carotid stroke" patients and 50 "nonacute carotid stroke" patients were identified. Multivariate modeling identified a small number of the carotid wall CT features that were significantly associated with acute carotid stroke, including wall volume, fibrous cap thickness, number and location of lipid clusters, and number of calcium clusters. Interpretation Patients with acute carotid stroke demonstrate significant differences in the appearance of their carotid wall ipsilateral to the side of their infarct, when compared with either nonacute carotid stroke patients or the carotid wall contralateral with the infarct side. Ann Neurol 2008;64:149,157 [source]