Presentation
Takashi Kageyama, Toshihiko Suenaga Department of Neurology, Tenri Hospital, Tenri, Nara, Japan Correspondence to Dr Kazuto Tsukita, kazusan{at}kuhp.kyoto-u.ac.jp Statistics from Altmetric.com Description An 85-year-old man with type 2 diabetes mellitus presented [casereports.bmj.com]
Injury to the corticospinal tract caudal to the decussation may present with varying types of paresis or paralysis of the upper and lower limbs. Unilateral lesions present with ipsilateral hemiparesis, hemiplegia, or monoplegia. [kenhub.com]
Design/Methods: Review of clinical presentations and brain MRIs. [neurology.org]
One month later she presented with mild dysarthria and mild left hemiparesis. Brain MRI disclosed an extensive pyramidal tract lesion from the right corona radiata to the pedunculus cerebri. [jstage.jst.go.jp]
Physiologically, it is normally present in infants from birth to 12 months. The presence of the Babinski sign after 12 months is the sign of a non-specific upper motor neuron lesion. [ipfs.io]
Neurologic
- Hyperreflexia
Interruption of corticospinal fibers rostral to the motor (pyramidal) decussation causes impairment of movement in the opposite body-half, which is especially severe in the arm and leg and is characterized by muscular weakness, spasticity and hyperreflexia [medical-dictionary.thefreedictionary.com]
Symptoms include an increase in the muscle tone in the lower extremities, hyperreflexia, positive Babinski and a decrease in fine motor coordination. [sideeffects.embl.de]
(Ottawa) Hyperreflexia from Dr. [library.med.utah.edu]
On exam there is a combined deficit of vibration and proprioception with pyramidal signs (plantar extension and hyperreflexia). [forums.studentdoctor.net]
There is hypertonia (increased muscle tone, stiffness), hyperreflexia (exaggerated reflexes), and an oscillatory movement known as clonus. [courses.washington.edu]
- Clonus
In a patient with clonus, a muscle stretch elicits alternating contractions of agonist and antagonist muscle groups. [courses.washington.edu]
In a few days to a few weeks, flaccidity gradually gives way to spasticity at the same time that the tendon reflexes reappear and eventually become hyperactive, as indicated by foot clonus and Hoffmann’s sign 17. [jneurology.com]
Primary lateral sclerosis The age of onset for primary lateral sclerosis (PLS) is usually between 40 and 60 years, with spasticity in the legs accompanied by hyperactive deep tendon reflexes, clonus, and Babinski sign. [emedicine.medscape.com]
- Spastic Paralysis
Pure spastic paralysis of corticospinal origin. Can J Neurol Sci. 1977; 4: 251-258. Jagiella WM, Sung JH. Bilateral infarction of the medullary pyramids in humans. Neurology. 1989; 39: 21-24. Meyer JS, Herndon RM. [jneurology.com]
- Pyramidal Tract Signs
Neurological examination revealed bilateral pyramidal-tract signs, and paresis of the right arm. [em-consulte.com]
- Spastic Paraplegia
Hereditary spastic paraparesis HSP, also known as familial spastic paraplegias or Strumpell-Lorrain disease, comprises a clinically and genetically heterogeneous group of hereditary disorders characterized by slowly progressive spastic paraparesis. [emedicine.medscape.com]
Treatment
[…] clinical assessments and outcome measurements fail to accurately predict treatment response ( 5 ). [frontiersin.org]
It is not intended as a substitute for professional medical advice, diagnosis or treatment. [sideeffects.embl.de]
Conclusions: Corticospinal tract lesions have a heterogenous etiology, with widely different treatments and prognoses. An understanding of these potential etiologies will assist neurologists confronted with this imaging finding. [neurology.org]
Página 470 - Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. [books.google.es]
It was suggested from these finding that clinicians using the PREP algorithm may be able to predict the likely extent of upper limb recovery and may be able to therefore manage of patient expectations from an earlier period. [10] Treatment Following a [physio-pedia.com]
Prognosis
Patients who have sustained damage to their corticospinal tract have a prognosis that varies, depending on the nature of the damage. Some patients may be able to regain motor control over the course of the healing process. [wisegeek.org]
This review was limited to the topics described above because other topics relevant to brain rehabilitation, such as recovery mechanisms or prognosis prediction using transcranial magnetic stimulation (TMS) or diffusion tensor imaging (DTI) have been [medicaljournals.se]
This distinction is important for genetic counseling of family members and for the patient’s prognosis, in that HSP generally carries a more favorable prognosis. [2] Other components of the differential diagnosis of HSP are similar to those of PLS. [emedicine.medscape.com]
Etiology
Conclusions: Corticospinal tract lesions have a heterogenous etiology, with widely different treatments and prognoses. An understanding of these potential etiologies will assist neurologists confronted with this imaging finding. [neurology.org]
Primary lateral sclerosis The etiology of primary lateral sclerosis (PLS) is unknown, but it may be similar to that proposed for ALS. [emedicine.medscape.com]
Epidemiology
Epidemiologic data suggest that smoking may be an established risk factor for sporadic ALS. [8] The peak age of onset is between 55 and 75 years. [emedicine.medscape.com]
Cerebral Palsies: Epidemiology and Causal Pathways. London: MacKeith Press (2000). 251 p. Google Scholar 2. Himmelmann K, Hagberg G, Uvebrant P. The changing panorama of cerebral palsy in Sweden. X. [frontiersin.org]
Pathophysiology
The views herein discussed reconcile several apparent incongruences concerning the pathophysiology of the human pyramidal syndrome. [jneurology.com]
There are three pathophysiological aspects. [em-consulte.com]
Cortical excitability and neurology: insights into the pathophysiology. Funct Neurol (2012) 27 (3):131–45. PubMed Abstract | Google Scholar 55. Gilbert DL, Garvey MA, Bansal AS, Lipps T, Zhang J, Wassermann EM. [frontiersin.org]
Prevention
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
[…] hypoglycaemic hemiplegia lesions might be present along the pyramidal tract, since the more compact neuronal tissue might be more vulnerable to hypoglycaemia. 3 The coronal section in this case shows that the lesion is actually along the pyramidal tract and, to prevent [casereports.bmj.com]
Because the interneuron is inhibitory, it prevents the opposing alpha motor neuron from firing, thereby reducing the contraction of the opposing muscle. [nba.uth.tmc.edu]
Termination of the trajectory occurs when d N falls below a threshold value which is set so as to prevent the trajectory entering the grey matter. [jnnp.bmj.com]
Author:Uchida, M; Kaneko, M; Kawa, S Evaluation of the spread of pandemic influenza A/H1N1 2009 among Japanese university students Environmental Health and Preventive Medicine,:in press 2014 Author:Uchida, M; Kaneko, M; Tsukahara, T; Washizuka, S; Kawa [soar-rd.shinshu-u.ac.jp]