Involuntary Calf Muscle Contractions
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Deformities of the Hands and Feet in Parkinsonism and Their Reversibility by Operation
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.26.1.33 on 1 February 1963. Downloaded from J. Neurol. Neurosurg. Psychiat., 1963, 26, 33 Deformities of the hands and feet in Parkinsonism and their reversibility by operation PETER GORTVAI From the National Hospital for Nervous Diseases, Queen Square, London Charcot (1877) described some aspects of the typical method using a small instrument which screws deformities of the hands and feet seen in Parkinson's directly into the skull and depends on localization disease. He likened the deformity of the hands to that of the target in the brain on the measurement of sometimes observed in chronic progressive rheu- angles in two planes. The lesions in the ventrolateral matism. He said that the differential diagnosis is nucleus of the thalamus were made by the injection usually made with ease, because in cases of Parkin- of 0 5 to 1 ml. of a mixture of Etopalin (Ciba) and sonism 'there is found neither the articular tume- kaolin. faction and stiffness, nor the osseous deposits and cracking sounds observed in nodose rheumatism'. DESCRIPTION OF THE DEFORMITIES guest. Protected by copyright. He describes the deformity of the toes as a 'griffe' (or claw), on account of the extension of the first and THE HANDS In its early and commonest stage the concomitant flexion of the second phalanges. deformity amounts to no more than a characteristic Hughlings Jackson (1899) also mentions deformity posture of the affected hand (Fig. 1). The fingers are of hands seen in some cases of Parkinsonism. He held extended at the interphalangeal joints and remarked that 'in paralysis agitans the interossei are flexed some 40° to 700 at the metacarpo-phalangeal the muscles of the hand which are preponderatingly joints. -
F-MARC Football Medicine Manual 2Nd Edition F-MARC Football Medicine Manual 2Nd Edition 2 Editors - Authors - Contributors | Football Medicine Manual
F-MARC Football Medicine Manual 2nd Edition F-MARC Football Medicine Manual 2nd Edition 2 Editors - Authors - Contributors | Football Medicine Manual Football Medicine Manual Editors DVORAK Jiri Prof. Dr F-MARC, Schulthess Clinic Zurich, Switzerland JUNGE Astrid Dr F-MARC, Schulthess Clinic Zurich, Switzerland GRIMM Katharina Dr FIFA Medical Offi ce Zurich, Switzerland Authors 2nd Edition 2009 ACKERMAN Kathryn E. Harvard Medical School Harvard, USA BABWAH Terence Dr Sports Medicine and Injury Rehabilitation Clinic Macoya, Trinidad BAHR Roald Prof. Dr Oslo Sports Trauma Research Center Oslo, Norway BANGSBO Jens Prof. Dr University of Copenhagen Copenhagen, Denmark BÄRTSCH Peter Prof. Dr University of Heidelberg Heidelberg, Germany BIZZINI Mario PT Schulthess Clinic Zurich, Switzerland CHOMIAK Jiri Dr Orthopaedic University Hospital Bulovka Prague, Czech Republic DVORAK Jiri Prof. Dr F-MARC, Schulthess Klinik Zurich, Switzerland EDWARDS Tony Dr Adidas Sports Medicine Auckland, New Zealand ENGEBRETSEN Lars Prof. Dr Oslo Sports Trauma Research Center Oslo, Norway FULLER Colin Prof. Dr University of Nottingham Nottingham, England GRIMM Katharina Dr FIFA Medical Offi ce Zurich, Switzerland JUNGE Astrid Dr F-MARC, Schulthess Clinic Zurich, Switzerland KHAN Karim Prof. Dr Editor in Chief British Journal of Sports Medicine Sydney, Australia Editors - Authors - Contributors | Football Medicine Manual 3 KOLBE John Prof. Dr University of Auckland Auckland, New Zealand LÜSCHER Thomas Prof. Dr University of Zurich Zurich, Switzerland MANDELBAUM Bert Dr Santa Monica Orthopaedic and Sports Medicine Group Santa Monica, USA MAUGHAN Ron Prof. Dr University of Loughborough Loughborough, Great Britain PETERSON Lars Prof. Dr Gothenburg Medical Center Gothenburg, Sweden REILLY Thomas Prof. Dr Liverpool John Moores University Liverpool, Great Britain SALTIN Bengt Prof. -
Movement Disorders in Metabolic Disorders
Current Neurology and Neuroscience Reports (2019) 19: 7 https://doi.org/10.1007/s11910-019-0921-3 NEUROLOGY OF SYSTEMIC DISEASES (J BILLER, SECTION EDITOR) Movement Disorders in Metabolic Disorders José Luiz Pedroso1 & Orlando G. Barsottini1 & Alberto J. Espay2 Published online: 9 February 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose of Review We provide a review of the movement disorders that complicate selected metabolic disorders, including the abnormal movements that may appear during or after their treatment. Recent Findings Movement disorders may be underrecognized when arising in the context of a broad range of metabolic disorders. Summary Abnormal movements may occur as the initial manifestation of a systemic disease, at any time during its course, or as a result of the medical interventions required for its management. Ascertaining movement phenome- nology in acute and subacute presentations may assist in the determination of the specific underlying metabolic disorder. The management of movement disorders associated with metabolic disorders depends on the underlying pathophysiology. Keywords Movement disorders . Abnormal movements . Metabolic disorders . Electrolytes . Internal medicine Introduction such as disorders of consciousness, headache, and sei- zures [3]. The metabolic origin can also be suspected Movement disorders such as parkinsonism, tremor, dys- when movement abnormalities appear in emergency set- tonia, chorea, and myoclonus most often arise in several tings or in intensive care units [4]. neurodegenerative or structural diseases of the basal Some common metabolic disorders, such as organ ganglia [1]. They may also be part of the clinical man- failure (particularly liver or renal insufficiency), endocri- ifestations of systemic metabolic disorders, as the initial nological diseases (e.g., hyperglycemia), and electrolyte feature, complicating its course, or as a result of the disturbances, are frequently present with neurological corrective treatment [2•]. -
Hypocalcaemic Tetany After Total Thyroidectomy Original Article
Faridpur Med. Coll. J. 2015;10(2):59-62 Original Article Hypocalcaemic Tetany After Total Thyroidectomy NN Biswas1, WA Chaudhury2, JA Khan3, AC Biswas4, KM Arif5, S Ghosh6, S Akter7 Abstract: Hypocalcaemic tetany is one the commonest complication after total thyroidectomy. It may cause significant morbidity. Early detection and treatment have better out come. The main objective of the study is to find the incidence of hypcalcaemic tetany in post operative period after total thyroidectomy and average interval period of hypocalcaemia following surgery. This was an observational study conducted in the department of Otolaryngology & head-Neck Surgery Sylhet M.A.G. Osmani Medical College Hospital during 1st January 2006 to 31st December 2007. Pre-operative routine investigation, Thyroid Function test, Ultrasonography thyroid gland and cytological evaluation by FNAC were done in all patients. Ten patient developed hypocalcaemia after surgery. Among them only one suffered from permanent hypocalcaemia. Most of the patient developed symptoms about 48 hours after surgery. The Incidence and time interval of development of hypocalcaemic tetany after total thyroidectomy found in the series fully coincides with the results of other researchers globally. Key words: Tetany, Total Thyroidectomy, Hypocalcaemic. Introduction: Total thyroidectomy is a logical treatment for patients with thyroid disease in whom the pathologic process Calcium is the sedater of nerve. It is the free, ionized involves both lobes of the thyroid or difficult is a calcium in the body fluids that is necessary for nerve significant consideration as in benign multinodular conduction, muscle contraction and blood coagulation. A goitre, Grave's disease and cancer. Meticulous and decrease in extracellular Ca++ exerts a net excitatory clean cut identification of parathyroid with its effect on nerve and muscle cells. -
The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines
ICD-10 ThelCD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines | World Health Organization I Geneva I 1992 Reprinted 1993, 1994, 1995, 1998, 2000, 2002, 2004 WHO Library Cataloguing in Publication Data The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. 1.Mental disorders — classification 2.Mental disorders — diagnosis ISBN 92 4 154422 8 (NLM Classification: WM 15) © World Health Organization 1992 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. -
Topical Diagnosis in Neurology
V Preface In 2005 we publishedacomplete revision of Duus’ Although the book will be useful to advanced textbook of topical diagnosis in neurology,the first students, also physicians or neurobiologists inter- newedition since the death of its original author, estedinenriching their knowledge of neu- Professor PeterDuus, in 1994.Feedbackfromread- roanatomywith basic information in neurology,oR ers wasextremelypositive and the book wastrans- for revision of the basics of neuroanatomywill lated intonumerous languages, proving that the benefit even morefromit. conceptofthis book wasasuccessful one: combin- This book does notpretend to be atextbook of ing an integrated presentation of basic neu- clinical neurology.That would go beyond the scope roanatomywith the subject of neurological syn- of the book and also contradict the basic concept dromes, including modern imaging techniques. In described above.Firstand foremostwewant to de- this regard we thank our neuroradiology col- monstratehow,onthe basis of theoretical ana- leagues, and especiallyDr. Kueker,for providing us tomical knowledge and agood neurological exami- with images of very high quality. nation, it is possible to localize alesion in the In this fifthedition of “Duus,” we have preserved nervous system and come to adecision on further the remarkablyeffective didactic conceptofthe diagnostic steps. The cause of alesion is initially book,whichparticularly meets the needs of medi- irrelevant for the primarytopical diagnosis, and cal students. Modern medical curricula requirein- elucidation of the etiology takes place in asecond tegrative knowledge,and medical studentsshould stage. Our book contains acursoryoverviewofthe be taught howtoapplytheoretical knowledge in a major neurologicaldisorders, and it is notintended clinical settingand, on the other hand, to recognize to replace the systematic and comprehensive clinical symptoms by delving intotheir basic coverage offeredbystandardneurological text- knowledge of neuroanatomyand neurophysiology. -
Therapeutic Effect of Total Ablation of Normal Thyroid on Congestive Heart Failure and Angina Pectoris
THERAPEUTIC EFFECT OF TOTAL ABLATION OF NORMAL THYROID ON CONGESTIVE HEART FAILURE AND ANGINA PECTORIS. IX. POSTOPERATIVE PARATHYROID FUNCTION. CLINICAL OBSERVATIONS AND SERUM CALCIUM AND PHOSPHORUS STUDIES D. R. Gilligan, … , B. Stern, H. L. Blumgart J Clin Invest. 1934;13(5):789-806. https://doi.org/10.1172/JCI100622. Research Article Find the latest version: https://jci.me/100622/pdf THERAPEUTIC EFFECT OF TOTAL ABLATION OF NORMAL THYROID ON CONGESTIVE HEART FAILURE AND AN- GINA PECTORIS.' IX. POSTOPERATIVE PARATHY- ROID FUNCTION. CLINICAL OBSERVATIONS AND SERUM CALCIUM AND PHOSPHORUS STUDIES BY D. R. GILLIGAN, D. D. BERLIN, M. C. VOLK, B. STERN, AND H. L. BLUMGART (From the Medical and Surgical Services amtd the Medical Research Laboratories of the Beth Israel Hospital, and the Department of Medicine, Harvard University Medaical School, and the Department of Surgery, Tufts College Medical School, Boston) The occurrence of tetany as an infrequent postoperative complication following subtotal removal of the abnormal thyroid gland is well recognized (1) (2). McCullagh in 1932 (2), reported an incidence of tetany of 1.3 per cent in a series of 11,500 cases in which thyroidectomy was performed at the Cleveland Clinic. The anatomical proximity of the parathyroid glands to the thyroid, the similarity of the signs and symptoms of postoperative tetany to those of idiopathic hypoparathyroidism, and the specific effect of calcium therapy, offer strong evidence that tetany following thyroid surgery is due to re- moval of, or injury to, the parathyroid glands during operation. Means and Richardson (1) observed that the frequency of postoperative para- thyroid tetany depends roughly upon the amount of thyroid tissue removed. -
Tingles, Tetany, and Electrolyte Derangements
Open Access Case Report DOI: 10.7759/cureus.7854 Tingles, Tetany, and Electrolyte Derangements Amardeep Singh 1 , Ramandeep Kaur 2 , Bhagwan Dass 1 , Abutaleb Ejaz 1 1. Nephrology, University of Florida Health, Gainesville, USA 2. Miscellaneous, Virginia Commonwealth University, Richmond, USA Corresponding author: Amardeep Singh, [email protected] Abstract We report a patient who presented with anxiety, hyperventilation, perioral paresthesia, and tingling in the fingers associated with hypomagnesemia, hypocalcemia, and hypokalemia. We discuss the possible mechanistic basis for sequence of events that may have led to this presentation. Categories: Family/General Practice, Internal Medicine, Nephrology Keywords: hypomagnesemia, hypocalcemia, hypokalemia, mechanisms, electrolyte disturbances, tetany, paresthesia, chronic kidney disease, genetic syndromes, general internal medicine Introduction Hypomagnesemia is defined as serum magnesium level <1.5 mEq/L and can be seen in ~12% of hospitalized patients. It is typically associated with volume expansion, chronic diarrhea, diuretic and antibiotic use, and malnutrition [1]. Hypomagnesemia can cause life-threatening cardiac arrhythmias through its influence on potassium and calcium homeostasis. We discuss the interconnectedness of magnesium, potassium, and calcium in this case report. Case Presentation A 47-year-old female presented to the ER with severe anxiety, palpitations, and hyperventilation associated with perioral tingling and numbness of the fingers that started several hours previously. She had similar episodes two years ago without elucidations of the etiology of her symptoms. She was not on any medication; social history was negative for alcohol or illicit drug use. On physical examination, blood pressure was 131/83 mmHg, heart rate 122 beats per minute, respiratory rate 16 per minute, temperature 36.7°C, and oxygen saturation 98%. -
Disorders of the Contractile Structures 54
Disorders of the contractile structures 54 CHAPTER CONTENTS and is felt as a sudden, painful ‘giving way’ at the front of the Extensor mechanism 713 thigh. Alternatively, the muscular lesion may result from a direct contusion during contact sports (judo or American foot- Quadriceps strains and contusions . 713 ball), known as ‘Charley Horse’. Adherent vastus intermedius . 714 Patients who suffer an acute quadriceps strain will usually Tendinous lesions about the patella . 714 know right away. They are typically involved in sports requiring Rupture of the quadriceps tendon . 718 kicking, jumping, or initiating a sudden change in direction while running. Frequently, a sharp pain is felt, associated with Lesions of the infrapatellar tendon . 718 a loss in function of the quadriceps. Sometimes pain will not Lesions of the insertion at the tibial tuberosity . 719 fully develop during the athlete’s activity while the thigh is Patellar fracture . 719 warm; consequently, the extent of the injury is underesti- Patellofemoral disorders 719 mated. Stiffness, disability and pain then set in some time Introduction . 719 afterwards, e.g. late at night, and the following morning the patient can walk only with a limp.1 Mechanical theory . 719 Clinical examination shows a normal hip and knee, although Neural theory . 720 passive knee flexion is painful or both painful and limited, Clinical examination . 720 depending on the size of the rupture. Resisted extension of the Clinical manifestations . 722 knee is painful and slightly weak. As a rule, the lesion is in the 2 Strained iliotibial band 724 rectus femoris, usually at mid-thigh level. The affected muscle belly is hard and tender over a large area. -
Porro NEWORK NEWS
International Polio Network SAINT LOUIS, MISSOURIUSA Winter 2003 .Vol. 19, No. 1 Porro NEWORKNEWS Straight Answers to Your "Cramped" Questions Holly H. Wise, P7; PhD, and Kerri A. Kolehma, MS, MD, Coastal Post-Polio Clinic, Charleston, South Carolina Tired in the morning? Is it diffi- Cramps can occur throughout origins anywhere in the central cult to get comfortable for a good the day but more often occur at and peripheral nervous systems night of sleep? A complaint often night or when a person is resting. and may explain the wide range reported at the Coastal Post-Polio Although it is not known exactly of conditions in which the Clinic in Charleston, South why cramps happen mostly at cramping occurs (Bentley, 1996). Carolina, is the inability to get these times, it is thought that to sleep at night due to leg pain, the resting muscle is not being Seeking Answers twitching, or cramping. stretched and is therefore more A thorough history and possibly easily excited. Muscle cramping is a relatively a referral for screening labs will common, painful, and bother- The basis for the theory that help determine the causes for some complaint among generally I cramps occur more at rest, due to I leg pain and cramping. Polio healthy adults, and is more com- I the muscle not being stretched, I survivors can provide a descrip- mon in women than men. Some I is that passive stretching can I tion of their muscle cramps, studies estimate as many as 50- 1 relieve muscle cramping. Pain I identification of the time and 70% of older adults may experi- I associated with cramping is likely I place when they occur, and an ence nocturnal leg and foot I caused by the demand of the I activity log of the 24-48 hours cramps (Abdulla, et. -
Muscle Spasms and Strains
MUSCULOSKELETAL HEALTH Muscle spasms may have many possible causes, including, Muscle spasms but not limited to: • Poor blood circulation and strains • Overexertion of the muscles while exercising • Insufficient stretching before exercise • Excessive exercise in the heat Lynn Lambert, BPharm • Muscle fatigue Amayeza Info Centre • Dehydration • A magnesium and/or potassium deficiency • A side-effect of medication. Introduction A muscle locked in spasm produces a sudden, tight and Muscles are the “powerhouse” of the human body as their main intense pain. The pain can range in intensity from slight to agonising. A muscle in spasm may feel hard to the touch, function is to produce motion. Skeletal muscle is responsible and/or appear visibly distorted. A twitch beneath the skin can for the movement of external areas of the body, for example, be seen in some cases. A spasm can last a few seconds to the limbs. Most people experience a muscular injury, such as a 15 minutes or longer, and may recur a few times before it goes spasm or a strain, at some time during their lives. Such injuries away. can occur during sport or exercise, but can also take place while sitting, walking, or even during sleep. Muscle spasms Treatment and prevention and strains are a common complaint with which patients Muscle spasms usually resolve with self-care measures present at a pharmacy. Therefore, the pharmacist’s assistant without the need to see a doctor. It is important that the patient is in an ideal position to provide practical advice, combined stops the activity which triggered the spasm. -
Management of Calf Muscle Cramps by Prasarini Tailam in Sportsmen
INTERNATIONAL AYURVEDIC MEDICAL JOURNAL International Ayurvedic Medical Journal, (ISSN: 2320 5091) (May, 2017) 5 (5) MANAGEMENT OF CALF MUSCLE CRAMPS BY PRASARINI TAILAM IN SPORTSMEN Dhanokar Nitin Ramrao1, Dhanokar Anjali Nitin2 1Associate Professor & HOD Dept.of Rachana Sharir, RPAM, Purna. Maharashtra, India. 2M.D (Rasashastra & Bhaishajya Kalpana), Ayu.Consultant, Saiprabha Ayu. Panchakarma Clinic, Akola, Maharashtra, India Email: [email protected] ABSTRACT A cramp is sudden, prolonged and painful contraction of one or a group of muscle. It occurs usually in the lower extremities and often in the calves. This condition affects the efficiency of Players. In such conditions frequent use of Steroids and Analgesics has hazardous side effects like bleeding ten- dency (Anti-Platelet action), Skin irritation. Hence it was decided to treat such patients by Ayurvedic snehana karma using Tailam. The purpose of this treatment is to reduce the pain and relax the calf muscle. Keywords: Calf muscle cramps, Snehana, Prasarini Tailam INTRODUCTION A muscle cramp is an involuntarily and forci- seconds to a quarter of an hour or occasionally bly contracted muscle that does not relax. longer. It is not uncommon for a cramp to re- When we use the muscles that can be con- cur multiple times until it finally resolves. The trolled voluntarily, such as those of our arms cramp may involve a part of a muscle, the en- and legs, they alternately contract and relax as tire muscle, or several muscles that usually act we move our limbs. Muscles that support our together. Some cramps involve the simultane- head, neck, and trunk contract similarly in a ous contraction of muscles that ordinarily synchronized fashion to maintain our posture.