Dystonias (except torticollis)
[…] (11.1/100,000)4 Acquired Brain injury – cerebral palsy, stroke, neoplasm, medications (tardive syndrome), autoimmune encephalopathies Intrauterine crowding Nasopharyngeal infections, posterior fossa/cervical spinal cord lesions Compensation for visual disturbances (diplopia/nystagmus) or Sandifer’s syndrome Psychogenic causes Physical examination Dystonia is defined as involuntary […]
Down Syndrome
[…] instability in asymptomatic children are not recommended. Education on certain sports that can place the child at increased risk of spinal cord injury should be provided to caregivers. Echocardiogram prior to discharge from the hospital at birth or before 1 month. Feeding […]
Inflammatory Arthritides
[…] absence of acute inflammation. Patients with cervical spine involvement should avoid high-impact activities due to the risk of fracture or spinal cord injury. Resistance and aerobic training decrease inflammation, disease activity, and improve function and QOL in inflammatory myositis.34 Aquatic therapy reduces […]
Hyperkinetic Movement Disorders
[…] Myoclonus can be caused by irritation or destruction of gray matter and can result from insult to the cortex, brainstem, spinal cord, or peripheral nerves. Tremors are associated with brainstem, cerebellum, or thalamic lesions. Chorea and ballism have been linked […]
Stiff Person Syndrome
[…] become a frequent concern. Patients may present to emergency departments with severe spasms which, when affecting respiratory and thoracic para spinal muscles, lead to severe breathing difficulty in a phenomenon coined “status spasticus.”1,2 Due to development of total body stiffness […]
Osteogenesis Imperfecta
[…] age 18 months to prevent basilar impression.16 CVJ abnormalities can lead to compression of the cranial nerves, medulla, and cervical spinal cord, the latter two of which can result in hydrocephalus and syrinx.6,17,18 Fusion may ultimately be required.6 Essentials of […]
Immune Mediated Brachial Plexopathy
[…] noted on brachial plexus biopsy and complement-fixing antibodies to peripheral nerve myelin though biopsy is not typically pursued.10 Routine Cerebral spinal fluid (CSF) analysis may show seroprevalence of antimyelin and antiganglioside antibodies and disruption of the blood-brain barrier; 36% of […]
Peripheral Neuropathies Associated with Drugs and Toxins
[…] prevention.44 Preliminary evidence for novel neuropathic pain management has varied in options such as cannabinoids45, 46, lidocaine infusion47, ketamine infusions48, spinal cord stimulators4, and scrambler therapy.50,51 Future research is needed to further investigate these and other novel CIPN treatments as […]
Communication Issues in Physical Medicine and Rehabilitation
[…] (SNF). Table 4: Communication Advantages and Disadvantages of Inpatient PM&R Settings Communication-Issues-in-PMR-Table-4Download In an ethnographic study at a single inpatient spinal cord rehabilitation care unit in Canada, the authors concluded that the physical layout of the unit influenced the quality […]
Critical Illness Myopathy
[…] usually normal.12,20 Imaging Careful neuraxial imaging is often necessary to rule out other possibilities of weakness, such as stroke or spinal cord infarct, especially when patients are non-communicative. Magnetic resonance imaging of muscle tissue using a myositis protocol can show enhancement in short-tau inversion-recovery images when there is diffuse muscle edema. However, this finding is nonspecific and can be associated with rhabdomyolysis or inflammatory myositis. Currently there is no specific imaging modality or finding known to be uniquely associated with CIM.21,22 Muscle ultrasound may help evaluate muscle thickness and echogenicity in neuromuscular conditions. In a prospective study of 95 patients with critical illness, probable CIM/CIP was diagnosed in 17. Among 67 patients in whom ultrasound of the muscles was performed, increased echogenicity in any muscle was found to be 82 percent sensitive and 57 percent specific for CIM/CIP. An abnormal ultrasound was associated with a lower chance of discharge to home, suggesting that ultrasound may also have potential as a prognostic tool.7 Supplemental assessment tools Electrodiagnostic studies are a crucial part of diagnosis yet may be difficult to perform in patients with diminished level of consciousness in the ICU setting, and typically requires greater than 3 weeks of symptoms to arrive at a diagnosis.23 Nerve Conduction Study14,18,24-26 Sensory nerve action potentials should be > 80% of the lower limit for at least two nerves unless there is a history of peripheral neuropathy or coexisting […]