Anterior horn cell disorders
|
|
- Brice Wood
- 7 years ago
- Views:
Transcription
1 Anterior horn cell disorders Lower motor neurons The LMNs are located in the brainstem and spinal cord The spinal LMNs are also known as anterior horn cell. Dorsal anterior horn cells innervate distal muscles, ventral located cells- proximal muscles, medially located neurons- truncal and axial muscles. Large spinal cord LMNs are called alpha neurons. Signs and Symptoms of Lower Motor Neuron Dysfunction Weakness: denervation as well as decreased number of functional LMN units reduces overall muscles strength. Muscle atrophy and Hyporeflexia Muscle hypotonicity and flaccidity Fasciculations Muscle cramps Motor Neuron Disease Incidence/100,000/year : Overall: 1.5 to 2 Age : 65 to 74 years Prevalence: 3 to 8 per 100,000 Risk increases with age up to 74 years Mortality Causes 1 in 700 deaths Rate: 1.9/100,000/year Male:Female 1.5:1 More male predominance in younger onset cases Clinical features Typical pattern: Upper + Lower motor neuron signs with normal sensation Onset & Patterns of weakness: Common features Asymmetric limb weakness : Upper > Lower extremity
2 Areas of weakness with some specificity for ALS Very proximal denervation 1. Paraspinous 2. Posterior neck Jaw weakness: Closure; Opening Voice 1. Nasal, slurred speech 2. Continuous emission of sound Poliomylitis Only a small proportion of people who are exposed to poliovirus develop either minor illness (gastroenteritis) or the major illness several days after the infection. Major illness resembles aseptic meningitis. Approximately 50% of patient progress to paralytic disease within 2-5 days. Paralytic phase: localized fasciculations, severe myalgia, hyperesthesia, and usually fulminant focal and asymmetrical paralysis. Leg muscle involvement is more frequent, than arm, respiratory, and bulbar muscles. Recovery may begin during fist week, but it estimated that 80% of recovery occurs in 6 months. Further improvement may continue over the ensuing months. CSF: PN cells, protein is mild-to-moderately increased. Stool culture are positive nearly in 90% of patients by the 10 th day of illness Progressive Post Poliomyelitis Muscular Atrophy (PPMA) In the USA ~ 250k-640k people survived acute poliomyelitis during the last epidemics in the 1940s-1950s. The reported incidence of PPMA ranges from 0 to 64%
3 PPMA includes progressive LMN syndrome, and post polio syndrome or late effect of remote polio, chronic fatigue, orthopedic and musculoskeletal problems Benign Focal Amyotrophy/ Hirayama's disease Onset: Young adult; 15 to 25 years; Up to 40 years in India Epidemiology: more than 60% are man Male > Female: Up to 10:1 Usually sporadic Occasional familial occurrence Common in Eastern India The etiology is unknown. The number of large and small motor neurons is reduced. It may have some connection with segmental SMA. Weakness: Often confined to a single arm Distal involvement (97%): C7, C8 & T1 innervated muscles; Hand & Forearm Proximal > Distal: 10% Side: Right = Left Atrophy: "Oblique amyotrophy"; Sparing brachioradialis Tremor (80%): On finger extension Typical Hirayama syndrome Progression: Over 1 to 5 years; Occasionally as long as 8 years Static after progression phase: May persist for decades Disability: Mild or none in 73% Laboratory, EMG: Chronic denervation In affected limb(s) (100%) Opposite arm or lower extremities in some patients Signs of acute denervation in 45% NCS: Small CMAPs in affected limbs Sympathetic skin response: May be abnormal MRI? Some patients with inelastic dura: Spinal cord compression with neck flexion No major spinal anomalies T2 signal in anterior horns of gray matter Spinal cord atrophy: C6 & C7 Mild flexion-induced cord displacement Spinal muscular atrophy
4 SMA was described independently by Werdnig and Hoffmann in 1891 Werdnig described the condition as "neurogenic dystrophy" Hoffmann established the spinal nature of the disease Clinical features: Congenital SMA (5q) with arthrogryposis Severe hypotonia Movements: Absent; Respiratory failure at birth Cranial nerves: Facial diplegia; ± External ophthalmoplegia Contractures: Especially knees Course: Death < 30 days Pathology Loss of motor & sensory myelinated axons Motor neurons: Preserved, swollen Rule out X-linked SMA Werdnig-Hoffmann (Type 1) Onset Usually before 3 months Range 0 to 6 months Some with in utero decreased fetal movements Acute onset in occasional patient Weakness Diffuse; Proximal > Distal Severe Poor feeding Respiratory insufficiency: Paradoxical respirations Sparing of facial & oculomotor Hypotonia Fasciculations: Tongue Tendon reflexes: Reduced or absent Intellect: Normal; Alert faces Prognosis Respiratory failure Death: 50% by 7 months; 95% by 17 months Chronic course in 5% Pathology: Muscle
5 Large regions of grouped muscle fiber atrophy Most larger fibers are type I Kugelberg-Welander (Types II & III) Classification Type II: Intermediate Onset: Often < 18 months Never stand Life span 1. Often shortened 2. Death > 2 years Type III: Mild Onset: Often > 18 months Stand independently Life span 1. ± Shortened 2. Death in adulthood Laboratory Serum CK: Normal Electrophysiology EMG: Fibrillations; Large amplitude action potentials NCS: Small amplitude CMAPs; Mild slowing; Sensory normal Muscle biopsy Grouped atrophy Type I muscle fiber predominance Bulbo-Spinal Muscular Atrophy (Kennedy's Syndrome) Most common adult onset SMA General frequency: 1 in 50,000 SBMA especially common in western Finland Some regions in Japan Age: Mean 27 years; Range 15 to 60 years Early symptoms & signs: Adolescence Muscle discomfort: Cramps or Pain Fatigue: General; Chewing Gynecomastia: May be asymmetric
6 Weakness: Not common early; May be distal Symptoms at 30 years Lower > Upper limb weakness Occasionally cramps Progressive muscular atrophy Widespread Lower Motor Neuron Syndrome Weakness: Distribution Distal & Proximal: Either may be more prominent Asymmetric Often involves paraspinous & respiratory muscles Often spares bulbar musculature Spontaneous motor activity Cramps: Common in legs, at night Fasciculations No upper motor neuron signs Pain: Related to immobility Time course Progressive Similar to, more rapid, or slower than, typical ALS Muscle pathology: Grouped atrophy > Fiber type grouping No serum antibodies No conduction block No evidence for response to treatment Pathology: Loss of motor neurons in anterior horn of spinal cord Shrinkage of remaining motor neurons Thank You
Neuromuscular diseases
Neuromuscular diseases Spinal muscular atrophy - SMA characterized by degeneration of the anterior horn cells in the spinal cord and motor nuclei in the lower brainstem. SMA type 1, is also known as Werdnig-
More informationRole of Electrodiagnostic Tests in Neuromuscular Disease
Role of Electrodiagnostic Tests in Neuromuscular Disease Electrodiagnostic tests Electroencephalogram (EEG) Electromyography (NCV, EMG) Cerebral evoked potentials (CEP) Motor evoked potentials (MEP) Electronystagmogram
More informationEMG and the Electrodiagnostic Consultation for the Family Physician
EMG and the Electrodiagnostic Consultation for the Family Physician Stephanie Kopey, D.O., P.T. 9/27/15 The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Marketing Committee
More informationMultifocal Motor Neuropathy. Jonathan Katz, MD Richard Lewis, MD
Multifocal Motor Neuropathy Jonathan Katz, MD Richard Lewis, MD What is Multifocal Motor Neuropathy? Multifocal Motor Neuropathy (MMN) is a rare condition in which multiple motor nerves are attacked by
More informationCERVICAL DISC HERNIATION
CERVICAL DISC HERNIATION Most frequent at C 5/6 level but also occur at C 6 7 & to a lesser extent at C4 5 & other levels In relatively younger persons soft disk protrusion is more common than hard disk
More informationDIAGNOSING CHILDHOOD MUSCULAR DYSTROPHIES
DIAGNOSING CHILDHOOD MUSCULAR DYSTROPHIES Extracts from a review article by KN North and KJ Jones: Recent advances in diagnosis of the childhood muscular dystrophies Journal of Paediatrics and Child Health
More information1: Motor neurone disease (MND)
1: Motor neurone disease (MND) This section provides basic facts about motor neurone disease (MND) and its diagnosis. The following information is an extracted section from our full guide Living with motor
More informationThe Polio Virus. Getting to Know Your Old Enemy. Marcia Falconer, Ph.D.
The Polio Virus Getting to Know Your Old Enemy Marcia Falconer, Ph.D. The Polio Virus Virus is smallest living thing that can reproduce itself Outer shell (capsid) Inner genetic material (RNA) and one
More informationDifferentiating Cervical Radiculopathy and Peripheral Neuropathy. Adam P. Smith, MD
Differentiating Cervical Radiculopathy and Peripheral Neuropathy Adam P. Smith, MD I have no financial, personal, or professional conflicts of interest to report Radiculopathy versus Neuropathy Radiculopathy
More information3nd Biennial Contemporary Clinical Neurophysiological Symposium October 12, 2013 Fundamentals of NCS and NMJ Testing
3nd Biennial Contemporary Clinical Neurophysiological Symposium October 12, 2013 Fundamentals of NCS and NMJ Testing Peter D. Donofrio, M.D. Professor of Neurology Vanderbilt University Medical Center
More informationCerebral palsy can be classified according to the type of abnormal muscle tone or movement, and the distribution of these motor impairments.
The Face of Cerebral Palsy Segment I Discovering Patterns What is Cerebral Palsy? Cerebral palsy (CP) is an umbrella term for a group of non-progressive but often changing motor impairment syndromes, which
More informationChapter 7: The Nervous System
Chapter 7: The Nervous System I. Organization of the Nervous System Objectives: List the general functions of the nervous system Explain the structural and functional classifications of the nervous system
More informationNeonatal Hypotonia. Clinical Approach to Floppy Baby
Neonatal Hypotonia Clinical Approach to Floppy Baby Hypotonia in the newborn is a common presenting feature of systemic illness or neurologic dysfunction at any level of the central or peripheral nervous
More informationRadiculopathy vs. Peripheral Neuropathy. What to do with arm pain? Defining Arm Pain. Arm Pain
Radiculopathy vs. Peripheral Neuropathy What to do with arm pain? Miriana G. Popadich RN, MSN Clinical Care Coordinator Brachial Plexus Program Department of Neurosurgery University of Michigan Timing
More informationMuscular Dystrophy and Multiple Sclerosis. ultimately lead to the crippling of the muscular system, there are many differences between these
Battles 1 Becky Battles Instructor s Name English 1013 21 November 2006 Muscular Dystrophy and Multiple Sclerosis Although muscular dystrophy and multiple sclerosis are both progressive diseases that ultimately
More informationClosed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario
Page 1 Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Injury Descriptions Developed from Newfoundland claim study injury definitions No injury Death Psychological
More informationELECTRODIAGNOSTIC MEDICINE
ELECTRODIAGNOSTIC MEDICINE OBJECTIVES BEGINNER Patient Care Perform a comprehensive electrodiagnostic evaluation of each patient and to provide a concise diagnosis and plan for further treatment Describe
More informationICD-10 Cheat Sheet Frequently Used ICD-10 Codes for Musculoskeletal Conditions *
ICD-10 Cheat Sheet Frequently Used ICD-10 Codes for Musculoskeletal Conditions * Finding the ICD-10 equivalent for an ICD-9 code can be a challenge. This resource of frequently used codes can help when
More informationElectrodiagnostic Testing
Electrodiagnostic Testing Electromyogram and Nerve Conduction Study North American Spine Society Public Education Series What Is Electrodiagnostic Testing? The term electrodiagnostic testing covers a
More informationSymptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries
1 Symptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries J Bone Joint Surg (Br) 2001 Mar;83(2):226-9 Ide M, Ide J, Yamaga M, Takagi K Department of Orthopaedic Surgery, Kumamoto University
More informationNervous System: Spinal Cord and Spinal Nerves (Chapter 13) Lecture Materials for Amy Warenda Czura, Ph.D. Suffolk County Community College
Nervous System: Spinal Cord and Spinal Nerves (Chapter 13) Lecture Materials for Amy Warenda Czura, Ph.D. Suffolk County Community College Primary Sources for figures and content: Eastern Campus Marieb,
More informationICD-9-CM coding for patients with Spinal Cord Injury*
ICD-9-CM coding for patients with Spinal Cord Injury* indicates intervening codes have been left out of this list. OTHER DISORDERS OF THE CENTRAL NERVOUS SYSTEM (340-349) 344 Other paralytic syndromes
More informationModule 1: The Somato-Motor System: Tendon Tap reflex
Module 1: The Somato-Motor System: Tendon Tap reflex Module Objectives: 1. Describe the anatomic pathway of a tendon tap reflex. 2. Explain how a tendon tap reflex assessment assists in diagnosis of a
More informationUlnar Neuropathy Differential Diagnosis and Prognosis. Disclosures: None
Ulnar Neuropathy Differential Diagnosis and Prognosis Disclosures: None Goals of Lecture Describe anatomy: sites of entrapment Ulnar nerve Discuss differential diagnosis of ulnar nerve pathology Identify
More informationAetna Nerve Conduction Study Policy
Aetna Nerve Conduction Study Policy Policy Aetna considers nerve conduction velocity (NCV) studies medically necessary when both of the following criteria are met: 1. Member has any of the following indications:
More informationUpdate: The Care of the Patient with Amyotrophic Lateral Sclerosis
Update: The Care of the Patient with Amyotrophic Lateral Sclerosis Case Presentation: Part I A 54-year-old woman presents to the neurology clinic referred by her primary care physician for evaluation of
More informationNeuromuscular disorders Development of consensus for diagnosis and standards of care. Thomas Sejersen, Pediatric neurology
Neuromuscular disorders Development of consensus for diagnosis and standards of care Thomas Sejersen, Pediatric neurology What are neuromuscular disorders? How does the field of neuromuscular disorders
More informationMuscular Dystrophy. By. Tina Strauss
Muscular Dystrophy By. Tina Strauss Story Outline for Presentation on Muscular Dystrophy What is Muscular Dystrophy? Signs & Symptoms Types When to seek medical attention? Screening and Diagnosis Treatment
More informationChapter 13. The Nature of Somatic Reflexes
Chapter 13 The Nature of Somatic Reflexes Nature of Reflexes (1 of 3) A reflex is an involuntary responses initiated by a sensory input resulting in a change in a gland or muscle tissue occur without our
More informationReflex Physiology. Dr. Ali Ebneshahidi. 2009 Ebneshahidi
Reflex Physiology Dr. Ali Ebneshahidi Reflex Physiology Reflexes are automatic, subconscious response to changes within or outside the body. a. Reflexes maintain homeostasis (autonomic reflexes) heart
More informationReturn to same game if sx s resolve within 15 minutes. Return to next game if sx s resolve within one week Return to Competition
Assessment Skills of the Spine on the Field and in the Clinic Ron Burke, MD Cervical Spine Injuries Sprains and strains Stingers Transient quadriparesis Cervical Spine Injuries Result in critical loss
More informationTransverse Sections of the Spinal Cord
Transverse Sections of the Spinal Cord The spinal cord is perhaps the most simply arranged part of the CNS. Its basic structure, indicated in a schematic drawing of the eighth cervical segment (Figure
More informationWebinar title: Know Your Options for Treating Severe Spasticity
Webinar title: Know Your Options for Treating Severe Spasticity Presented by: Dr. Gerald Bilsky, Physiatrist Medical Director of Outpatient Services and Associate Medical Director of Acquired Brain Injury
More informationMUSCULAR SYSTEM REVIEW. 1. Identify the general functions of the muscular system
MUSCULAR SYSTEM REVIEW 1. Identify the general functions of the muscular system 2. Define the four characteristics of muscular tissue a. irritability (excitability) - b. extensibility- c. contractibility
More informationP U T T I N G T H E P I E C E S T O G E T H E R
MEDICAL THERAPY PROGRAM P U T T I N G T H E P I E C E S T O G E T H E R CALIFORNIA CHILDREN SERVICES CCS is a statewide program providing medical care and rehabilitation to children with physical disabilities.
More informationNeurogenic Disorders of Speech in Children and Adults
Neurogenic Disorders of Speech in Children and Adults Complexity of Speech Speech is one of the most complex activities regulated by the nervous system It involves the coordinated contraction of a large
More informationPARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS
PARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS De Anna Looper, RN CHPN Corporate Clinical Consultant / Legal Nurse Consultant Carrefour Associates L.L.C. PARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS
More informationLimb girdle muscular dystrophies (LGMDs)
Limb girdle muscular dystrophies (LGMDs) This factsheet is for all people for whom a diagnosis of limb girdle muscular dystrophy (LGMD) has been suggested. This is a complicated subject since there are
More informationDevelopmental delay and Cerebral palsy. Present the differential diagnosis of developmental delay.
Developmental delay and Cerebral palsy objectives 1. developmental delay Define developmental delay Etiologies of developmental delay Present the differential diagnosis of developmental delay. 2. cerebral
More informationFundamentals of Electromyography. Amanda Peltier, MD MS Department of Neurology
Fundamentals of Electromyography Amanda Peltier, MD MS Department of Neurology Importance of EMG Studies Diagnosis Localization Assist in further testing (i.e. identify potential biopsy sites) Prognosis
More informationMultiple Sclerosis (MS)
Multiple Sclerosis (MS) Purpose/Goal: Care partners will have an understanding of Multiple Sclerosis and will demonstrate safety and promote independence while providing care to the client with MS. Introduction
More informationC CS. California Children Services Alameda County
C CS California Children Services Alameda County The California Children Services (CCS) Program strives to assure access to medical services essential to the health and well-being of children with catastrophic
More informationRigid spine syndrome (RSS) (Congenital muscular dystrophy with rigidity of the spine, including RSMD1)
Rigid spine syndrome (RSS) (Congenital muscular dystrophy with rigidity of the spine, including RSMD1) What is RSMD1? The congenital muscular dystrophies are a group of conditions which share early presentation
More informationF r e q u e n t l y A s k e d Q u e s t i o n s
Myasthenia Gravis Q: What is myasthenia gravis (MG)? A: Myasthenia gravis (meye-uhss- THEEN-ee-uh GRAV uhss) (MG) is an autoimmune disease that weakens the muscles. The name comes from Greek and Latin
More informationNeuromuscular Medicine Fellowship Curriculum
Neuromuscular Medicine Fellowship Curriculum General Review Goals and Objectives Attend weekly EMG sessions as assigned Take a Directed History and Exam of each EMG patient Attend every other week Muscle
More informationSpinal Cord Injury Education. An Overview for Patients, Families, and Caregivers
Spinal Cord Injury Education An Overview for Patients, Families, and Caregivers Spinal Cord Anatomy A major component of the Central Nervous System (CNS) It is 15 to 16 inches long, and weighs 1 to 2 ounces
More informationElectrodiagnostic Assessment: An Introduction to NCS and EMG
Electrodiagnostic Assessment: An Introduction to NCS and EMG Barry Bernacki BSc MD FRCPC CSCN (EMG) Clinical Asst. Professor EMG Lab Director Saskatoon City Hospital Objectives Understand technique and
More informationManagement in the pre-hospital setting
Management in the pre-hospital setting Inflammation of the joints Two main types: Osteoarthritis - cartilage loss from wear and tear Rheumatoid arthritis - autoimmune disorder Affects all age groups,
More informationNURS 821 Alterations in the Musculoskeletal System. Rheumatoid Arthritis. Type III Hypersensitivity Response
NURS 821 Alterations in the Musculoskeletal System Margaret H. Birney PhD, RN Lecture 12 Part 2 Joint Disorders (cont d) Rheumatoid Arthritis Definition: Autoimmune disorder occurring in genetically sensitive
More informationMember, National Honor Society, 1982-1986 President, National Honor Society, 1985-1986
Rolando Amadeo, M.D., FAAPMR 2014 S. Orange Ave., Suite 200-B Orlando, FL 32806 668 N. Orlando Ave., Suite 1005 Maitland, FL 32751 (407) 379-2780 (407) 740-0324 fax EDUCATION: 1982-1986 H.S. - Colegio
More informationRheumatoid Arthritis. Nicole Klett,, M.D.
Rheumatoid Arthritis Nicole Klett,, M.D. Rheumatoid Arthritis Systemic Chronic Inflammatory Primarily targets the synovium of diarthrodial joints Etiology likely combination genetic and environmental Diarthrodial
More informationCAMBRIDGE UNIVERSITY CENTRE FOR BRAIN REPAIR A layman's account of our scientific objectives What is Brain Damage? Many forms of trauma and disease affect the nervous system to produce permanent neurological
More informationSheep Brain Dissection
Sheep Brain Dissection http://www.carolina.com/product/preserved+organisms/preserved+animals+%28mammal s%29/sheep+organs/preserved+sheep+dissection.do Michigan State University Neuroscience Program Brain
More informationAngela Wilkin May 2013
Angela Wilkin May 2013 Upper Motor Neuron v Lower Motor Neuron Lesions UMN Lesion LMN Lesion Forehead usually unaffected (bilateral innervation) Forehead affected Contralateral side Ipsilateral side Often
More informationBiology 141 Anatomy and Physiology I
Fall 2016 Biology 141 Anatomy and Physiology I COURSE OUTLINE Faculty Name: Enter Faculty Name Here Program Head: Enter Program Head Here Dean s Review: Dean s Signature: Date Reviewed: / / Revised: Fall
More informationAUBMC Multiple Sclerosis Center
AUBMC Multiple Sclerosis Center 1 AUBMC Multiple Sclerosis Center The vision of the American University of Beirut Medical Center (AUBMC) is to be the leading academic medical center in Lebanon and the
More informationChetek-Weyerhaeuser High School
Chetek-Weyerhaeuser High School Anatomy and Physiology Units and Anatomy and Physiology A Unit 1 Introduction to Human Anatomy and Physiology (6 days) Essential Question: How do the systems of the human
More informationDisease Surveillance in New Jersey Spring 2006
Creutzfeldt-Jakob Disease Surveillance in New Jersey Spring 2006 Shereen Brynildsen, MS Epidemiologist, Infectious & Zoonotic Disease Program New Jersey Department of Health & Senior Services Phone: 609-588
More informationClassification of Cerebral Palsy and Major Causes Physiologic Topographic Etiologic Function. trauma, infection)
Cerebral palsy (CP) It is a diagnostic term used to describe a group of motor syndromes. a static encephalopathy, a term previously used, is now inaccurate because of the recognition that the neurologic
More informationNEUROLOCALIZATION MADE EASY
NEUROLOCALIZATION MADE EASY Jared B. Galle, DVM, Diplomate ACVIM (Neurology) Dogwood Veterinary Referral Center 4920 Ann Arbor-Saline Road Ann Arbor, MI 48103 Localizing a neurologic problem to an anatomical
More informationPediatric Neuromuscular Disorders: Transitions to Adult Providers
Pediatric Neuromuscular Disorders: Transitions to Adult Providers 29 th Annual Update in Physical Medicine and Rehabilitation January 29, 2015 Russell Butterfield MD, PhD Assistant Professor, Departments
More informationUltrasound of muscle disorders
Ultrasound of muscle disorders Sigrid Pillen MD PhD Pediatric neurologist The Netherlands Disclosures None "Muscle ultrasound disclaimer" Muscle ultrasound Introduction Specific NMD Quantification Dynamic
More informationBACK PAIN PATHWAY DEFINTIONS
BACK PAIN PATHWAY DEFINTIONS Cauda Equina Syndrome (CES) Current or imminent compression of the sacral nerve roots resulting in neurogenic bladder and bowel dysfunction. Symptoms typically include: severe
More informationNerve Conduction Velocity (NCV) & Electromyography (EMG) Studies
Nerve Conduction Velocity (NCV) & Electromyography (EMG) Studies [Preauthorization Required] Medical Policy: MP-ME-09-09 Original Effective Date: November 5, 2010 Reviewed: November 5, 2010 Reviewed: November
More informationWhat is PD? Dr Catherine Dotchin MD MRCP Consultant Geriatrician
What is PD? Dr Catherine Dotchin MD MRCP Consultant Geriatrician Overview of presentation Case history Video example pre and post treatment Historical review PD in the UK Epidemiology and aetiology Making
More informationWeakness More diffuse More focal Atrophy Mild, general Severe, focal Atrophy versus weakness
Spinal Cord Disorders (Dr. Merchut) Clinical signs and symptoms in spinal cord lesions 1. Motor signs and symptoms Lower motor neuron (LMN) signs (Table 1) are found in a limb if some of its muscles are
More information1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or
1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual
More informationNeuromuscular disorders in children
Programma Spierziekten bij Kinderen Nieuwe inzichten Algemene inleiding- Klinische symptomen Respiratoire aspecten Orthopedische aspecten- beleid Cardiale aspecten Nieuwe therapeutische strategieën N.Goemans
More informationINFORMED CONSENT INFORMED CONSENT FOR PARTICIPATION IN A HEALTH AND FITNESS TRAINING PROGRAM
INFORMED CONSENT INFORMED CONSENT FOR PARTICIPATION IN A HEALTH AND FITNESS TRAINING PROGRAM NAME: DATE: 1. PURPOSE AND EXPLANATION OF PROCEDURE I hereby consent to voluntarily engage in an acceptable
More informationAppendix B: Provincial Case Definitions for Reportable Diseases
Infectious Diseases Protocol Appendix B: Provincial Case Definitions for Reportable Diseases Disease: West Nile Virus Illness Revised December 2014 West Nile Virus Illness 1.0 Provincial Reporting Confirmed
More informationALL ABOUT SPASTICITY. www.almirall.com. Solutions with you in mind
ALL ABOUT SPASTICITY www.almirall.com Solutions with you in mind WHAT IS SPASTICITY? The muscles of the body maintain what is called normal muscle tone, a level of muscle tension that allows us to hold
More informationOVERVIEW. NEUROSURGICAL ASSESSMENT CERVICAL PROBLEMS Dirk G. Franzen, M.D. WHAT IS THE MOST IMPORTANT PART OF THE PHYSICAL EXAM?
NEUROSURGICAL ASSESSMENT CERVICAL PROBLEMS Dirk G. Franzen, M.D. Neurological Surgery Bluegrass Orthopaedics and Hand Care OVERVIEW SCOPE OF THE PROBLEM PREVALENCE PATHOLOGY ANATOMIC CONSIDERATIONS ASSESSMENT
More informationThe Reflex Arc and Reflexes Laboratory Exercise 28
The Reflex Arc and Reflexes Laboratory Exercise 28 Background A reflex arc represents the simplest type of nerve pathway found in the nervous system. This pathway begins with a receptor at the dendrite
More informationICD-9-CM coding for patients with Traumatic Brain Injury*
ICD-9-CM coding for patients with Traumatic Brain Injury* The diagnostic code for sequelae of traumatic brain injury is: 907.0 Late effect of intracranial injury without mention of skull fracture (Late
More informationZika Virus. Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases
Zika Virus Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases What is the incubation period for Zika virus infection? Unknown but likely to be several
More informationSpinal Muscular Atrophy
Maryam Oskoui, MD, MSc, FRCPC Pediatric Neurologist Spinal Muscular Atrophy Elise Historical Timeline In vitro and animal studies Werdnig and Hoffmann describe SMA 1 (Arch Psych Nervenkrankheiten) Disease
More informationLow Back: Sacroiliac Dysfunction. Presented by Dr. Ben Benjamin
Debilitating Orthopedic Injury Sampler #1 Low Back: Sacroiliac Dysfunction Presented by Dr. Ben Benjamin 1 Instructor: Ben Benjamin, Ph.D. 2 Instructor: Ben Benjamin, Ph.D. drben@benbenjamin.com 3 1 Thank
More informationPeripheral Nervous System
Nervous system consists of: Peripheral Nervous System CNS = brain and spinal cord ~90% (90 Bil) of all neurons in body are in CNS PNS = Cranial nerves and spinal nerves, nerve plexuses & ganglia ~10% (10
More informationSPINAL CORD CIRCUITS AND MOTOR CONTROL
OVERVEW The proximate control of movement is provided by neurons in the spinal cord and brainstem. The primary motor neurons located in the ventral horn of the spinal cord gray matter (and the corresponding
More informationCerebral Palsy. In order to function, the brain needs a continuous supply of oxygen.
Cerebral Palsy Introduction Cerebral palsy, or CP, can cause serious neurological symptoms in children. Up to 5000 children in the United States are diagnosed with cerebral palsy every year. This reference
More informationREVIEW OF RADICULOPATHY
REVIEW OF RADICULOPATHY Ileana Howard, MD Clinical Assistant Professor of Rehabilitation Medicine, University of Washington VA Puget Sound Health Care System March 17, 2015 Overview Introduction Pathophysiology
More informationELECTROMYOGRAPHY (EMG), NEEDLE, NERVE CONDUCTION STUDIES (NCS) AND QUANTITATIVE SENSORY TESTING (QST)
AND QUANTITATIVE SENSORY TESTING (QST) Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical
More informationUpdating the Vaccine Injury Table: Guillain-Barré Syndrome (GBS) and Seasonal Influenza Vaccines
Updating the Vaccine Injury Table: Guillain-Barré Syndrome (GBS) and Seasonal Influenza Vaccines Ahmed Calvo, M.D., M.P.H. Medical Officer, National Vaccine Injury Compensation Program (VICP) Advisory
More informationCase Study: John Woodbury
Case Presentation John is 44 years old. He is sitting in the chair in the examination room. As he moves to the table, he stumbles on the carpet, laughs at himself and says that happens all the time. John
More informationGuideline for the Management of Acute Peripheral Facial nerve palsy. Bells Palsy in Children
Guideline for the Management of Acute Peripheral Facial nerve palsy Definition Bells Palsy in Children Bell palsy is an acute, idiopathic unilateral lower motor neurone facial nerve palsy that is not associated
More informationHuman Anatomy & Physiology Spinal Cord, Spinal Nerves and Somatic Reflexes 13-1
Human Anatomy & Physiology Spinal Cord, Spinal Nerves and Somatic Reflexes 13-1 Spinal Cord, Spinal Nerves and Somatic Reflexes Spinal cord Spinal nerves Somatic reflexes 13-2 Overview of Spinal Cord Information
More informationFunctions of the Brain
Objectives 0 Participants will be able to identify 4 characteristics of a healthy brain. 0 Participants will be able to state the functions of the brain. 0 Participants will be able to identify 3 types
More informationNerve conduction studies
clinical William Huynh Matthew C Kiernan Nerve conduction studies This article forms part of our Tests and results series for 2011 which aims to provide information about common tests that general practitioners
More informationCTS the Best EDX. Ernest W Johnson MD Emeritus Professor Physical Medicine & Rehabilitation The Ohio State University
CTS the Best EDX Ernest W Johnson MD Emeritus Professor Physical Medicine & Rehabilitation The Ohio State University 1 Definition of CTS A syndrome 2d to dysfunction of median nerve in carpal tunnel resulting
More informationCranial Nerves. Cranial Nerve 1: Olfactory Nerve. Cranial Nerve 1: Olfactory Nerve. Cranial Nerve 2: Optic Nerve. Cranial Nerve 2: Optic Nerve
Cranial Nerves Examination of Cranial Nerves and Palsies Drs Nathan Kerr and Shenton Chew 1 Olfactory On 2 Optic Old 3 Oculomotor Olympus 4 Trochlear Towering 5 Trigeminal Top 6 Abducens A 7 Facial Finn
More informationThe Anatomy of Spinal Cord Injury (SCI)
The Anatomy of Spinal Cord Injury (SCI) What is the Spinal Cord? The spinal cord is that part of your central nervous system that transmits messages between your brain and your body. The spinal cord has
More informationWhiplash injuries can be visible by functional magnetic resonance imaging. Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp.
Whiplash injuries can be visible by functional magnetic resonance imaging 1 Bengt H Johansson, MD FROM ABSTRACT: Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp. 197-199 Whiplash trauma can
More informationLOW BACK PAIN EXAMINATION
LOW BACK PAIN EXAMINATION John Petty, M.D. Medical Director Department of Physical Medicine & Rehabilitation Kettering Medical Center February 8, 2014 PRE-TEST QUESTION What part of the low back physical
More informationThe Carpal Tunnel CTS. Stålberg 1. Dysfunction of median nerve in the carpal tunnel resulting in
The Carpal Tunnel CTS Dysfunction of median nerve in the carpal tunnel resulting in 1 Symptoms in CTS pain and numbness in the abd worse on finger activity aggravated by forceful gripping g symptoms more
More informationMost active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma. Magee, 2008. pg.
PTA 216 Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma Magee, 2008. pg. 396 28 bones Numerous articulations 19 intrinsic muscles
More informationCerebral Palsy. 1995-2014, The Patient Education Institute, Inc. www.x-plain.com nr200105 Last reviewed: 06/17/2014 1
Cerebral Palsy Introduction Cerebral palsy, or CP, can cause serious neurological symptoms in children. Thousands of children are diagnosed with cerebral palsy every year. This reference summary explains
More informationName of Policy: Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies
Name of Policy: Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies Policy #: 228 Latest Review Date: August 2015 Category: Medicine Policy
More informationIII./8.4.2: Spinal trauma. III./8.4.2.1 Injury of the spinal cord
III./8.4.2: Spinal trauma Introduction Causes: motor vehicle accidents, falls, sport injuries, industrial accidents The prevalence of spinal column trauma is 64/100,000, associated with neurological dysfunction
More informationExamination Approach. Case 1: Mental Status. Examination Approach. The Neurological Exam In the ICU: High Yield Techniques 5/30/2013
The Neurological Exam In the ICU: High Yield Techniques S. Andrew Josephson MD Carmen Castro-Franceschi and Gladyne K. Mitchell Neurohospitalist Distinguished Professor Vice Chairman, Parnassus Programs
More informationTHE SPINAL CORD AND THE INFLUENCE OF ITS DAMAGE ON THE HUMAN BODY
THE SPINAL CORD AND THE INFLUENCE OF ITS DAMAGE ON THE HUMAN BODY THE SPINAL CORD. A part of the Central Nervous System The nervous system is a vast network of cells, which carry information in the form
More information