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[PMID]: 25580802
[Au] Autor:Tu B; Assassi NJ; Bazil CW; Hamberger MJ; Hirsch LJ
[Ad] Address:*Department of Neurology, Columbia University Comprehensive Epilepsy Center, New York, New York, U.S.A.; †New York University Pre-Medicine Neural Science Program, New York, New York, U.S.A.; and ‡Yale University Comprehensive Epilepsy Center, New Haven, Connecticut, U.S.A.
[Ti] Title:Quantitative EEG is an objective, sensitive, and reliable indicator of transient anesthetic effects during wada tests.
[So] Source:J Clin Neurophysiol;32(2):152-8, 2015 Apr.
[Is] ISSN:1537-1603
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The intracarotid amobarbital or Wada procedure is a component of the presurgical evaluation for refractory epilepsy, during which monitoring the onset and offset of transient anesthetic effects is critical. In this study, the authors characterized changes of 8 quantitative measures during 26 Wada tests, which included alpha, beta, theta, and delta powers, alpha/delta power ratio, beta/delta power ratio, median amplitude-integrated EEG, and 90% spectral edge frequency (SEF90), and correlated them with contralateral hemiplegia. The authors found that on the side of injection, delta and theta powers, alpha/delta power ratio, beta/delta power ratio, and SEF90 peaked within 1 minute after injection of 70 to 150 mg amobarbital or 4 to 7 mg methohexital. When contralateral arm strength returned to 3/5, delta power and amplitude-integrated EEG decayed on average 24% and 19%, respectively, for amobarbital, similar to that of methohexital (27% and 18%). Because delta power resolution most closely mirrored that of the hemiplegia and amplitude-integrated EEG had the highest signal/noise ratio, these quantitative values appear to be the best measures for decay of anesthetic effects. Increase in alpha power persisted longest, and therefore may be the best measure of late residual anesthetic effects.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Cu] Class update date: 150404
[Lr] Last revision date:150404
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/WNP.0000000000000154

  2 / 11913 MEDLINE  
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[PMID]: 25830084
[Au] Autor:Ikeda H; Enatsu R; Yamana N; Nishimura M; Saiki M
[Ad] Address:Department of Neurosurgery, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji City, Hyogo 670-8520 Japan....
[Ti] Title:Multiple extra-ischemic hemorrhages following intravenous thrombolysis in a patient with Trousseau syndrome: case study.
[So] Source:Springerplus;4:141, 2015.
[Is] ISSN:2193-1801
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intracerebral hemorrhage is the most feared complication of intravenous thrombolysis for acute ischemic stroke. Such hemorrhage usually occurs within or at the margin of ischemic or manifestly infarcted brain tissue. A patient with Trousseau syndrome who developed multiple extra-ischemic hemorrhages following intravenous thrombolysis is described. CASE DESCRIPTION: An 80-year-old Japanese man with no other underlying disease was diagnosed with unresectable advanced lung cancer (stage IV) without brain metastasis and had not yet been treated. The patient suddenly presented with disturbance of consciousness, right hemiplegia, and total aphasia, and was admitted to our hospital. Magnetic resonance imaging revealed acute cerebral infarction extending from the basal ganglia to the corona radiata of the left cerebrum and multiple small areas of bilateral cerebral cortices. Cardiogenic cerebral embolism was considered among the differential diagnoses, but the brain natriuretic peptide level was within the normal range, and no arrhythmias such as atrial fibrillation were observed. With no other causes, the patient was diagnosed with Trousseau syndrome due to hypercoagulability associated with the advanced lung cancer. The patient received intravenous tissue plasminogen activator (t-PA) at 96 minutes after onset of symptoms. His symptoms partially improved, but they suddenly deteriorated at 84 minutes after the thrombolysis. A computed tomography (CT) scan immediately after the neurological deterioration revealed a subcortical hemorrhage in the left occipital lobe. A repeat CT scan the day after onset showed enlargement of the left occipital hemorrhage and two new subcortical hemorrhages in the right frontal and right temporal lobes. These hemorrhages were located in areas remote from the acute ischemic lesions. CONCLUSION: To the best of our knowledge, this is the first reported case of multiple extra-ischemic hemorrhages following intravenous thrombolysis in a patient with Trousseau syndrome. The course of this case suggests that intravenous t-PA administration for acute ischemic stroke with Trousseau syndrome may be associated with a higher risk of intracranial hemorrhage.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Cu] Class update date: 150404
[Lr] Last revision date:150404
[Da] Date of entry for processing:150401
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1186/s40064-015-0920-z

  3 / 11913 MEDLINE  
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[PMID]: 25830141
[Au] Autor:Lee YC; Yi ES; Choi WH; Lee BM; Cho SB; Kim JY
[Ad] Address:Department of Sport Science, College of Art, Gachon University, Seongnam, Korea....
[Ti] Title:A study on the effect of self bedside exercise program on resilience and activities of daily living for patients with hemiplegia.
[So] Source:J Exerc Rehabil;11(1):30-5, 2015 Feb.
[Is] ISSN:2288-176X
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:The purpose of this study was to design a repeatable universal rehabilitation program in which patients with hemiplegia can participate voluntarily, complementing physical and occupational therapies to increase voluntary exercise practice rate. Also, this study attempted to identify the relationship between psychological resilience due to the implementation of self-bedside exercise and functional recovery of activity of daily living (ADL). 12 patients with hemiplegia voluntarily participated in 8 weeks of self-bedside exercise 5 times a day and more than 5 days a week. Their program implementation, resilience, activities of daily living (MBI), upper limb motor functions (MFT), and balance ability (BBS) were analyzed and compared before and after the program. Compared to before implementing the program, significant increases were found in resilience, MBI, BBS, and MFT in the affected side after the implementation, and the resilience scores showed statistically positive correlation in MBI and MFT. Also, the change in resilience before and after the program implementation showed a statistically positive correlation. Therefore, it can be concluded that the self-bedside exercise developed in this study had a positive effect on voluntary participation in exercise as well as resilience and ADL. However, many studies which complement the psychological aspects of hemiparetic patients with stroke are still needed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Cu] Class update date: 150404
[Lr] Last revision date:150404
[Da] Date of entry for processing:150401
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.12965/jer.140159

  4 / 11913 MEDLINE  
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[PMID]: 25802661
[Au] Autor:Habunaga H; Nakamura H
[Ad] Address:Department of Orthopedic Surgery, Ishikiriseiki Hospital, Osaka, Japan.
[Ti] Title:Intracranial subdural hematoma as a cause of postoperative delirium and headache in cervical laminoplasty: A case report and review of the literature.
[So] Source:SAS J;5(1):1-3, 2011.
[Is] ISSN:1935-9810
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To describe a rare case of acute intracranial subdural hematoma as a cause of postoperative delirium and headache following cervical spine surgery. SUMMARY OF BACKGROUND DATA: Headache is uncommon following spinal surgery, but can be observed in cases of accidental tearing of the dura during surgery. The causes of headache after surgery are thought to include dural tear and CSF leakage. On the other hand, intracranial subdural hematoma can be a cause of headache and cognitive dysfunction. However, only 4 cases as a postoperative complication of spinal surgery have been reported in the literature. METHODS: A 55-year-old man underwent re-explorative surgery due to postoperative hematoma causing hemiplegia following cervical laminoplasty. During this operation, accidental dural tear occurred and induced CSF leakage. On the following day, headache and delirium were noted. CSF leakage continued despite intraoperative repair of the dural laceration. Cranial CT at that time clearly demonstrated subdural hematoma. RESULTS: We reexplored the surgical site and attempted to stop the CSF leakage with meticulous suturing of the dural sac under microscopic observation. The intracranial subdural hematoma was carefully observed under consultation with a specialist neurosurgeon. Following this reexploration, the headache and delirium gradually improved, with spontaneous resolution of intracranial hematoma over a two-month period of observation. CONCLUSIONS: We have reported a rare case of acute intracranial subdural hematoma caused by CSF leakage following cervical spine surgery. This report demonstrates the possibility of intracranial hematoma as a cause of postoperative cognitive dysfunction or headache, especially when accidental tearing of the dura has occurred in spinal surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150404
[Lr] Last revision date:150404
[Da] Date of entry for processing:150324
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.esas.2010.11.001

  5 / 11913 MEDLINE  
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[PMID]: 25759148
[Au] Autor:Tatla SK; Shirzad N; Lohse KR; Virji-Babul N; Hoens AM; Holsti L; Li LC; Miller KJ; Lam MY; Van der Loos HF
[Ad] Address:Sunny Hill Health Centre for Children, Vancouver, BC, Canada. statla2@cw.bc.ca.
[Ti] Title:Therapists' perceptions of social media and video game technologies in upper limb rehabilitation.
[So] Source:JMIR Serious Games;3(1):e2, 2015.
[Is] ISSN:2291-9279
[Cp] Country of publication:Canada
[La] Language:eng
[Ab] Abstract:BACKGROUND: The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians' perspectives regarding technology adoption by their clients. OBJECTIVE: The objective of our study was to explore therapists' perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation. METHODS: We conducted two focus groups comprised of ten occupational therapists/physiotherapists who provide neurorehabilitation to individuals with hemiplegia secondary to stroke or cerebral palsy. Data was analyzed using inductive thematic analysis. The diffusion of innovations theory provided a framework to interpret emerging themes. RESULTS: Therapists were using technology in a limited capacity. They identified barriers to using social media and gaming technology with their clients, including a lack of age appropriateness, privacy issues with social media, limited transfer of training, and a lack of accessibility of current systems. Therapists also questioned their role in the context of technology-based interventions. The opportunity for social interaction was perceived as a major benefit of integrated gaming and social media. CONCLUSIONS: This study reveals the complexities associated with adopting new technologies in clinical practice, including the need to consider both client and clinician factors. Despite reporting several challenges with applying gaming and social media technology with clinical populations, therapists identified opportunities for increased social interactions and were willing to help shape the development of an upper limb training system that could more readily meet the needs of clients with hemiplegia. By considering the needs of both therapists and clients, technology developers may increase the likelihood that clinicians will adopt innovative technologies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150404
[Lr] Last revision date:150404
[Da] Date of entry for processing:150311
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.2196/games.3401

  6 / 11913 MEDLINE  
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[PMID]: 25724259
[Au] Autor:Malone A; Kiernan D; French H; Saunders V; O'Brien T
[Ad] Address:Gait Laboratory, Central Remedial Clinic, Vernon Avenue, Clontarf, Dublin 3, Ireland. Electronic address: ailishmcd@gmail.com....
[Ti] Title:Do children with cerebral palsy change their gait when walking over uneven ground?
[So] Source:Gait Posture;41(2):716-21, 2015 Feb.
[Is] ISSN:1879-2219
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Independently ambulant children with Cerebral Palsy (CP) often report balance difficulties when walking in challenging settings. The aim of this study was to compare gait in children with CP to typically developing (TD) children walking over level ground and uneven ground, as an evaluation of dynamic balance. Thirty-four children participated, 17 with CP (10 hemiplegia and 7 diplegia, mean age 10 years) and 17 TD (mean age 10 years 1 month). Three-dimensional kinematic and kinetic data of the lower limbs and trunk were captured during walking over level and uneven ground using Codamotion(®). Statistical analysis was performed using a mixed-effects model two-factor Analysis of Variance (Group×Surface). Over both surfaces, children with CP showed increased trunk movement in the sagittal (Group effect, p<0.001) and transverse planes (p<0.001), and increased pelvic movement in the coronal plane (p=0.008), indicating impaired trunk control. Peak separation between the centre of mass and centre of pressure was reduced in CP, indicating impaired dynamic balance (p=0.027). TD children made a number of significant adaptations to uneven ground, including reduced hip extension (mean difference 3.4°, 95% CI [-5.3, -1.0] p=0.006), and reduced ankle movement in the sagittal (5.2°, 95% CI [0.01, 10] p=0.049) and coronal planes (2.4°, 95% CI [0.3, 4.5], p=0.029), but these adaptations were not measured in CP. A significant Group×Surface interaction was detected for knee sagittal range (p=0.009). The findings indicate that children with CP walk show impaired control of trunk movement and are less able to adapt their gait to uneven ground, particularly at the ankle.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Js] Journal subset:IM
[St] Status:In-Data-Review

  7 / 11913 MEDLINE  
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[PMID]: 25467429
[Au] Autor:Krzak JJ; Corcos DM; Damiano DL; Graf A; Hedeker D; Smith PA; Harris GF
[Ad] Address:Midwestern University, Physical Therapy Program, College of Health Sciences, 555 31st Street, Downers Grove, IL, United States; Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Avenue, Chicago, IL, United States. Electronic address: joekrzak@sbcglobal.net....
[Ti] Title:Kinematic foot types in youth with equinovarus secondary to hemiplegia.
[So] Source:Gait Posture;41(2):402-8, 2015 Feb.
[Is] ISSN:1879-2219
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Elevated kinematic variability of the foot and ankle segments exists during gait among individuals with equinovarus secondary to hemiplegic cerebral palsy (CP). Clinicians have previously addressed such variability by developing classification schemes to identify subgroups of individuals based on their kinematics. OBJECTIVE: To identify kinematic subgroups among youth with equinovarus secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during locomotion as inputs for principal component analysis (PCA), and K-means cluster analysis. METHODS: In a single assessment session, multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were collected in 24 children/adolescents with equinovarus and 20 typically developing children/adolescents. RESULTS: PCA was used as a data reduction technique on 40 variables. K-means cluster analysis was performed on the first six principal components (PCs) which accounted for 92% of the variance of the dataset. The PCs described the location and plane of involvement in the foot and ankle. Five distinct kinematic subgroups were identified using K-means clustering. Participants with equinovarus presented with variable involvement ranging from primary hindfoot or forefoot deviations to deformtiy that included both segments in multiple planes. CONCLUSION: This study provides further evidence of the variability in foot characteristics associated with equinovarus secondary to hemiplegic CP. These findings would not have been detected using a single segment foot model. The identification of multiple kinematic subgroups with unique foot and ankle characteristics has the potential to improve treatment since similar patients within a subgroup are likely to benefit from the same intervention(s).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Js] Journal subset:IM
[St] Status:In-Data-Review

  8 / 11913 MEDLINE  
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[PMID]: 25690116
[Au] Autor:Bassolino M; Sandini G; Pozzo T
[Ad] Address:Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy.
[Ti] Title:Activating the motor system through action observation: is this an efficient approach in adults and children?
[So] Source:Dev Med Child Neurol;57 Suppl 2:42-5, 2015 Apr.
[Is] ISSN:1469-8749
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Observing an action performed by another person to learn a new movement is a frequent experience in adult daily life, such as in sports. However, it is an especially common circumstance during the development of motor skills in childhood. Studies on healthy humans indicate that action observation induces a facilitation in the observer's motor system. This effect is supported by an action-perception matching mechanism available both in adults and in children. Because of the simplicity of action observation, it has been proposed to apply this method in clinical contexts. After a brief, non-exhaustive introduction of the essential features underlying action observation in healthy people, we review recent studies reporting beneficial effects of rehabilitative training based on a combination of action perception and execution. We focus on therapeutic interventions for patients with upper-limb motor disabilities such as adults after stroke or children with hemiplegia due to cerebral palsy. Further, we consider data from basic science demonstrating that the facilitation induced by visual perception of the action can be modulated by the combination of multimodal stimuli related to the movement (e.g. visual and acoustic action-related inputs). In line with this, we discuss possible new directions to improve basic knowledge and therapeutic applications of action observation.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1502
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1111/dmcn.12686

  9 / 11913 MEDLINE  
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[PMID]: 25131733
[Au] Autor:Uchiyama S; Nishino I; Izumi T
[Ad] Address:Department of Pediatrics and Child Neurology, Oita University Faculty of Medicine, Oita 879-5593, Japan. Electronic address: uchiyama@oita-u.ac.jp.
[Ti] Title:The muscle findings in a pediatric patient with live attenuated oral polio vaccine-related flaccid monoplegia.
[So] Source:Vaccine;32(42):5379-81, 2014 Sep 22.
[Is] ISSN:1873-2518
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:A pediatric patient, who was given live-attenuated oral polio vaccine twice without distinct gait disturbance during infancy, begun to present limp at 3 years. His gait disturbance became remarkable with aging. At 7 years, he was unable to dorsiflex the left ankle, and presented flaccid monoplegia of the left lower extremity, and the left Achilles tendon reflex was diminished. Magnetic resonance imaging revealed multiple crack-lines in the left anterior tibial muscle, but was unable to detect any distinct lesion at responsible level of L4, L5 and S1 anterior horn cells' degeneration. Electromyography showed continuous fibrillation potentials, but muscle biopsy presented nearly normal in this muscle. The serum levels of polio antibody type 1 and type 2 titers were elevated 64× respectively, while the type 3 antibody titer was not elevated 4×. This patient was diagnosed as live attenuated oral polio vaccine-related flaccid monoplegia, with mild clinical course.
[Mh] MeSH terms primary: Gait
Hemiplegia/chemically induced
Poliovirus Vaccine, Oral/adverse effects
[Mh] MeSH terms secundary: Antibodies, Viral/blood
Child
Child, Preschool
Humans
Magnetic Resonance Imaging
Male
Muscle, Skeletal/pathology
Vaccines, Attenuated/adverse effects
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Antibodies, Viral); 0 (Poliovirus Vaccine, Oral); 0 (Vaccines, Attenuated)
[Em] Entry month:1504
[Js] Journal subset:IM
[Da] Date of entry for processing:140908
[St] Status:MEDLINE

  10 / 11913 MEDLINE  
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[PMID]: 24341455
[Au] Autor:McConnell K; Johnston L; Kerr C
[Ad] Address:School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.
[Ti] Title:Efficacy and acceptability of reduced intensity constraint-induced movement therapy for children aged 9-11 years with hemiplegic cerebral palsy: a pilot study.
[So] Source:Phys Occup Ther Pediatr;34(3):245-59, 2014 Aug.
[Is] ISSN:1541-3144
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Assess efficacy and acceptability of reduced intensity constraint-induced movement therapy (CIMT) in children with cerebral palsy (CP). METHODS: Single-subject research design and semi-structured interviews. Children (9-11y) with hemiplegia underwent five baseline assessments followed by two weeks CIMT. Six further assessments were performed during treatment and follow-up phases. The primary outcome was the Melbourne Assessment of Unilateral Upper Limb Function (MUUL). Quantitative data were analysed using standard single-subject methods and qualitative data by thematic analysis. RESULTS: Four of the seven participants demonstrated statistically significant improvements in MUUL (3-11%, p < .05). Two participants achieved significant improvements in active range of motion but strength and tone remained largely unchanged. Qualitative interviews highlighted limitations of the restraint, importance of family involvement, and coordination of treatment with education. CONCLUSIONS: Reduced intensity CIMT may be effective for some children in this population; however it is not suitable for all children with hemiplegia.
[Mh] MeSH terms primary: Cerebral Palsy/rehabilitation
Exercise Therapy/methods
Patient Acceptance of Health Care
[Mh] MeSH terms secundary: Cerebral Palsy/complications
Cerebral Palsy/physiopathology
Child
Female
Hemiplegia/etiology
Hemiplegia/rehabilitation
Humans
Interviews as Topic
Male
Muscle Strength
Muscle Tonus
Muscle, Skeletal/physiopathology
Parents/psychology
Physical Exertion
Pilot Projects
Range of Motion, Articular
Restraint, Physical
Treatment Outcome
Upper Extremity/physiopathology
[Pt] Publication type:CLINICAL TRIAL; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1504
[Js] Journal subset:IM
[Da] Date of entry for processing:140708
[St] Status:MEDLINE
[do] DOI:10.3109/01942638.2013.866611


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