When recovery of specific reflexes after acute spinal cord injury are delayed or absent, we should consider an acute local complication or other factors that influence reflex function. We observed three spinal cord injury cases with a long-standing delayed plantar reflex and no evolution of Babinski sign despite enough recovery time had passed for the flexor spasm and all deep tendon reflexes of the lower extremities. In these cases we confirmed common peroneal nerve neuropathy at the fibular head by the nerve conduction study and electromyography. Long-standing delayed plantar reflex without evolution of Babinski sign, beyond expected recovery period, would be considered as a sign of local complication such as common peroneal nerve injury.
Electromyography ; Head ; Lower Extremity ; Neural Conduction ; Peroneal Nerve ; Reflex* ; Reflex, Babinski ; Reflex, Stretch ; Spasm ; Spinal Cord Injuries* ; Spinal Cord*

A 38-year-old man developed weakness in all limbs 3 days prior to admission. Motor examination showed decreased strength in the limbs, but sensory examination was normal. Deep tendon reflexes were hyperactive. Electrophysiological examination showed conduction blocks with nearly normal conduction velocities and terminal latencies in the motor nerves and normal amplitudes and velocities in the sensory nerves. Acute motor conduction block neuropathy with hyperreflexia may be another variant of Guillain-Barre syndrome.
Adult ; Extremities ; Guillain-Barre Syndrome ; Humans ; Reflex, Abnormal ; Reflex, Stretch

Cystic retrochiasmatic craniopharyngioma may reach enormous size by expanding into the posterior fossa along the retroclival area, which is very unusual finding. An 11-year-old girl presented with walking disturbance and irritability. On the neurological examination, she had positive Babinski sign, hyperactive deep tendon reflex, and left lateral gaze nystagmus. She also had right hearing disturbance. Initial magnetic resonance(MR) images revealed a huge, thin capsuled cystic mass which extended into the cerebellopontine angle down to the medulla oblongata. Secondary adjuvant chemotherapy, radiotherapy, and reoperation were necessary after first tumor removal by a suboccipital approach, due to the progression of disease. Finally, neurological condition was much improved without remnant tumor although some sequelae were remained. We report this interesting case because of its rarity, complex clinical presentation, and challenge in its management.
Cerebellopontine Angle ; Chemotherapy, Adjuvant ; Child ; Craniopharyngioma* ; Female ; Hearing ; Humans ; Medulla Oblongata* ; Neurologic Examination ; Radiotherapy ; Reflex, Babinski ; Reflex, Stretch ; Reoperation ; Walking

OBJECTIVE: To determine the effect of cold air therapy on relieving spasticity, the optimal intramuscular temperature, and the duration of spasticity relief. METHOD: Twenty-three 4 months old Korean white rabbits weighing 2 to 3 kg were used. After posterior laminectomy at thoracolumbar junction, the spinal cord was completely transected. After spasticity occurred, cold air was applied to the triceps surae muscles for 30 minutes at three different intramuscular temperatures (32.5, 30, and 25degrees C). Spasticity was measured pre-treatment, immediately following treatment, after 30 minutes, and after 60 minutes. Clinical parameters (muscle tone, deep tendon reflex, ankle clonus, and Babinski's sign) and electrophysiologic parameters (F/M ratio and H/M ratio) were measured. RESULT: Muscle tone and Babinski's sign significantly decreased immediately following treatment in the 32.5degrees C group, immediately following treatment and after 30 minutes in the 30degrees C and 25degrees C group. Deep tendon reflex and ankle clonus significantly decreased immediately following treatment in the 32.5degrees C group, immdiately following treatment, after 30 minutes in the 30degrees C group, immediately following treatment, after 30 minutes and after 60 minutes in the 25degrees C group. The F/M ratio and H/M ratio were not significantly affected in the 32.5degrees C group but decrease immediately following treatment in the 30degrees C and 25degrees C groups. Compound motor unit action potentials were not evoked in 6 out of 16 cases (37.5%) in the 25degrees C group, resulting in blockage of conduction. CONCLUSION: To relieve spasticity with cold air therapy, the intramuscular temperature should be maintained at 30degrees C. The duration of spasticity relief lasted from 30 minutes to one hour after cold air therapy.
Action Potentials ; Ankle ; Humans ; Infant ; Laminectomy ; Muscle Spasticity* ; Muscles ; Rabbits ; Reflex, Babinski ; Reflex, Stretch ; Spinal Cord ; Spinal Cord Injuries

Early diagnosis of persistent abnormal reflexes may be of great significance to a more effective functioning of the cerebral palsied child. It is important to know the normal and abnormal reflex responses and their effect upon motor development for providing a basis for evaluation in the diagnosis and treatment of the cerebral palsied child. We studied 28 cerebral palsied children, between 1 to 12 years old, who were treated at Sam Yook Childrens Rehabilitation Center from May 1975 to December 1977. The pathologic reflexes were checked, and the relationship between pathologic reflexes and walking was compared. The following results were obtained. 1. The following were the most important pathologic reflexes in non-walking fgroup: a. Positive supporting reaction b. Protective extensor thrust c. Moro reflex 2. If they are present, the prognosis for walking ambulation was bad and surgery will not improve for the chances of walking.
Child ; Diagnosis ; Early Diagnosis ; Humans ; Prognosis ; Reflex ; Reflex, Abnormal ; Reflex, Startle ; Rehabilitation Centers ; Walking

Gap prepulse inhibition of acoustic startle (GPIAS) method has been used effectively for the objective assessment of tinnitus in animals. Among two types of enclosures for the GPIAS, the unconstrained type carries less risk of animal death due to the absence of binding stress in the enclosure, and lack of need for alteration to animal size variation as it grows. However, animals' voluntary movements, which have no relation to the startles evoked by acoustic stimuli, are problematic, as they cannot be excluded in the case of the unconstrained enclosure based GPIAS measurement system. In order to discount voluntary movements which are not associated with external acoustic stimuli, we propose the conditional random interstimulus interval (CR ISI) method for unconstrained enclosure based GPIAS measurement. With the proposed ISI method, the unconstrained enclosure based acoustic startle response measurement system has been implemented in this paper. As a result, the effectiveness of the proposed CR ISI method has been verified and compared with those of conventional ISI methods through animal experiments using SD-rats. The experimental results showed that abnormal startle responses and invalid GPIAS values caused by motion were prevented when our proposed CR ISI method was applied to our implemented system. It was also verified that our proposed CR ISI method is advantageous in reducing the total experimental time for acquiring normal startle responses and valid GPIAS values, compared to conventional ISI methods, since our proposed CR ISI can begin the acoustic stimulation only when the animal gets stable and motionless.
Acoustic Stimulation ; Acoustics ; Animal Experimentation ; Animals ; Integrin alpha2 ; Methods ; Prepulse Inhibition ; Reflex, Startle ; Tinnitus

Herpes zoster can be associated with a number of neurologic complications but meningoencephalitis with herpes zoster is rarely seen. We report a case of herpes zoster ophthalmicus followed by the meningoencephalitis, which developed during treatment with acyclovir infusion. A 73-year-old male patient developed a fever and mental confusion on the third day of the treatment. Neurological examination revealed neck stiffess, increased deep tendon reflex and positive Babinski sign. The cerebrospinal fluid examination revealed increased opening pressure, increased protein and a lymphocytic pleocytosis. The glucose level was decreased, which is a very unusual feature in viral meningoencephalitis.
Acyclovir ; Aged ; Cerebrospinal Fluid ; Encephalitis, Varicella Zoster ; Fever ; Glucose ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Humans ; Leukocytosis ; Male ; Meningoencephalitis ; Neck ; Neurologic Examination ; Reflex, Babinski ; Reflex, Stretch

A 42-year-old male was admitted to our clinic on May 4, 1980, because of slight neck stiffness, quadriparesis and urinary difficulty. On admission, neurological examination revealed alert mental state, slight neck stiffness, quadriparesis and loss of pain and temperature sense below the level of C3 sensory dermatome. All deep tendon reflexes were hyperactive and Babinski's sign was positive. Roentgenographic examination of the cervical spine showed widened interpedicular distance at C5 to C7 in A-P view. Myelogram disclosed widening of the dye column at C4 to T1 vertebral level, suggesting intramedullary tumor. Laminectomy was performed from the C5 to T2. The cord appeared to be widened and swollen at the C6-7 segment level. 1ml of yellowish pus was aspirated from the distended spinal cord at the C6 level. Mid-line posterior myelotomy was performed and hard cavity wall was visible. Upon incision of cavity wall, about 5ml of yellowish purulent pus exuded, allowing the cord to become "flaccid". The abscess cavity was irrigated with saline and penicillin solutions and a small rubber drain catheter was placed in the abscess cavity. The organism from the abscess was identified as Staphylococcus aureus. Postoperative course was uneventful. Antibiotic therapy was continued for four weeks after operation. The patient's condition was much improved and he could walk with assistance on discharge time.
Abscess* ; Adult ; Catheters ; Humans ; Laminectomy ; Male ; Neck ; Neurologic Examination ; Penicillins ; Quadriplegia ; Reflex, Babinski ; Reflex, Stretch ; Rubber ; Spinal Cord ; Spine ; Staphylococcus aureus ; Suppuration ; Thermosensing

BACKGROUND: Small subcortical infarctions of basal ganglia can be divided into either lacunes or striatocapsular infarctions by size of lesion. However, there are some controversies concerning the size criteria of lacune and striatocapsular infarction. To better understand differences among these patients, we elucidated clinical and other properties of deep small basal ganglia infarctions (DSBIs), which could not be clearly classified as either lacunes or striatocapsular infarction by their sizes only. METHODS: We analyzed 27 patients with acute ischemic lesion of basal ganglia with which the size varying from 1.5 cm to 3 cm in their maximal diameters. We assessed clinical features, laboratory data, stroke risk factors, and radiologic findings such as MRI and MR angiography. RESULTS: These patients could be largely divided into two distinct groups, either with or without associated cortical symptoms and signs. The most common clinical feature was motor weakness that was found in all but one patient. Sensory disturbances, altered deep tendon reflexes, and positive Babinski signs were also commonly found. Ten of the 27 patients showed cortical manifestations such as eyeball deviation, visual field defect, aphasia and neglect. Eight of the 10 patients with cortical manifestations showed MCA or ICA stenotic lesions. CONCLUSIONS: We found that many patients with 1.5 cm to 3 cm sized DSBIs could have the features of either lacune or striatocapsular infarction. Careful evaluation of clinical and radiologic findings should be performed in patients with clinically appearing lacunar syndrome in order to differentiate lacunar infarction of small vessel disease from striatocapsular infarction of other various pathophysiologies. Echocardiogram, cerebral angiogram and perfusion and diffusion MRI could be recommended for further evaluation and to better understand the pathogenesis in these patients.
Angiography ; Aphasia ; Basal Ganglia* ; Cerebral Infarction ; Diffusion Magnetic Resonance Imaging ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Perfusion ; Reflex, Babinski ; Reflex, Stretch ; Risk Factors ; Stroke ; Stroke, Lacunar ; Visual Fields

Hereditary spastic ataxia is a familial neurological disorder which exhibit the features of a progressive combined pyramidal tract and cerebellar deficiency. The main features are progressive gait disturbance, incoordination, nystagmus, visual impairment, hyperreflexia, extensor plantar response, peripheral neuropathy, and pes cavus. A 27-year-old male patient with spastic ataxic gait was evaluated. He showed characteristic features of hereditary spastic ataxia. There were another twelve affected members in four generations of his family which may be inherited by autosomal dominant pattern. One of them is reported with review of the literature on familial spastic ataxia.
Adult ; Ataxia* ; Family Characteristics ; Foot Deformities ; Gait ; Humans ; Male ; Muscle Spasticity* ; Nervous System Diseases ; Peripheral Nervous System Diseases ; Pyramidal Tracts ; Reflex, Abnormal ; Reflex, Babinski ; Vision Disorders