Hemiplegic stroke patients may have abnormal awareness or perception of the affected limb (s). For example, patients may experience their limb as not belonging to them (asomatognosia) or attribute their own body parts to other persons (somatoparaphrenia). Disturbed sensation of limb ownership (asomatognosia, somatoparaphrenia) for the hemiplegic limb has been reported in patients with right insula lesion. We report a case of a 70-year-old right handed female who had somatoparaphrenia and neglect dyslexia after right posterior cerebral artery and posterior corpus callosal infarction. Additionally, she showed visual defect, dyschromatopsia, and hemispatial neglect
Aged ; Dyslexia ; Extremities ; Female ; Hand ; Human Body ; Humans ; Infarction ; Infarction, Posterior Cerebral Artery ; Ownership ; Perceptual Disorders ; Posterior Cerebral Artery ; Sensation ; Stroke

Sarcopenia is an age-related condition which is characterized by a decrease in the mass and function of skeletal muscle and can affect the muscles of the trunk and extremities and the muscles to be used in swallowing. Early diagnosis and appropriate intervention of sarcopenic dysphagia is very crucial for older adults. Sarcopenic dysphagia can be diagnosed by measuring the function, strength, and mass of the affected muscle. In addition, dietary function assessments, functional eating scales and food swallow level scales, video fluoroscopic assessments, and electromyography or manometry can be used to diagnose the sarcopenic dysphagia. Although studies have been published using ultrasound to determine the amount and function of muscle in the body and physical function in sarcopenia, few studies have used ultrasound to diagnose sarcopenia.This paper aims to introduce the use of ultrasonography to assess sarcopenic dysphagia and suggest future research directions.

Sarcopenia is an age-related condition which is characterized by a decrease in the mass and function of skeletal muscle and can affect the muscles of the trunk and extremities and the muscles to be used in swallowing. Early diagnosis and appropriate intervention of sarcopenic dysphagia is very crucial for older adults. Sarcopenic dysphagia can be diagnosed by measuring the function, strength, and mass of the affected muscle. In addition, dietary function assessments, functional eating scales and food swallow level scales, video fluoroscopic assessments, and electromyography or manometry can be used to diagnose the sarcopenic dysphagia. Although studies have been published using ultrasound to determine the amount and function of muscle in the body and physical function in sarcopenia, few studies have used ultrasound to diagnose sarcopenia.This paper aims to introduce the use of ultrasonography to assess sarcopenic dysphagia and suggest future research directions.

Sarcopenia is an age-related condition which is characterized by a decrease in the mass and function of skeletal muscle and can affect the muscles of the trunk and extremities and the muscles to be used in swallowing. Early diagnosis and appropriate intervention of sarcopenic dysphagia is very crucial for older adults. Sarcopenic dysphagia can be diagnosed by measuring the function, strength, and mass of the affected muscle. In addition, dietary function assessments, functional eating scales and food swallow level scales, video fluoroscopic assessments, and electromyography or manometry can be used to diagnose the sarcopenic dysphagia. Although studies have been published using ultrasound to determine the amount and function of muscle in the body and physical function in sarcopenia, few studies have used ultrasound to diagnose sarcopenia.This paper aims to introduce the use of ultrasonography to assess sarcopenic dysphagia and suggest future research directions.

Sarcopenia is an age-related condition which is characterized by a decrease in the mass and function of skeletal muscle and can affect the muscles of the trunk and extremities and the muscles to be used in swallowing. Early diagnosis and appropriate intervention of sarcopenic dysphagia is very crucial for older adults. Sarcopenic dysphagia can be diagnosed by measuring the function, strength, and mass of the affected muscle. In addition, dietary function assessments, functional eating scales and food swallow level scales, video fluoroscopic assessments, and electromyography or manometry can be used to diagnose the sarcopenic dysphagia. Although studies have been published using ultrasound to determine the amount and function of muscle in the body and physical function in sarcopenia, few studies have used ultrasound to diagnose sarcopenia.This paper aims to introduce the use of ultrasonography to assess sarcopenic dysphagia and suggest future research directions.

Phantom limbs are usually observed after amputation of extremities. In patients after a stroke, a similar but rarely occurring phenomenon consisting of the patient experiencing the presence of an additional limb has been described. This phenomenon, generally called supernumerary phantom limb (SPL), may be caused by lesions in the right or left cerebral hemisphere, but has been predominantly reported in patients who have had a right hemispheric stroke. We report two cases of atypical SPL and phantom limb pain (PLP) after pontine hemorrhage. The patients were treated conservatively and their symptoms lasted more than 1 month. This is the first report of SPLs after left pontine hemorrhage, and phantom perception and pain lasted longer than those in previously observed cases. Our results indicate that SPL may be more common than reported; therefore, thorough examinations are essential for the care of stroke patients.
Cerebral Hemorrhage/*complications ; Cerebral Infarction/complications ; Female ; Humans ; Male ; Middle Aged ; Pain/etiology ; Phantom Limb/*diagnosis/etiology/therapy ; Psychomotor Performance/physiology ; Stroke/complications ; Tomography, X-Ray Computed

Schwannomas are benign, usually slow-growing tumors that originate from Schwann cells surrounding peripheral, cranial, or autonomic nerves. The most common form of these tumors is acoustic neuroma. Schwannomas of the brachial plexus are quite rare, and symptomatic schwannomas of the brachial plexus are even rarer. A 47-year-old woman presented with a 1-year history of dysesthesia, neuropathic pain, and mild weakness of the right upper limb. Results of physical examination and electrodiagnostic studies supported a diagnosis as thoracic outlet syndrome. Conservative treatment did not relieve her symptoms. After 9 months, a soft mass was found at the upper margin of the right clavicle. Magnetic resonance imaging showed a 3.0x1.8x1.7 cm ovoid mass between the inferior trunk and the anterior division of the brachial plexus. Surgical mass excision and biopsy were performed. Pathological findings revealed the presence of schwannoma. After schwannoma removal, the right hand weakness did not progress any further and neuropathic pain gradually reduced. However, dysesthesia at the right C8 and T1 dermatome did not improve.
Autonomic Pathways ; Biopsy ; Brachial Plexus* ; Clavicle ; Diagnosis ; Female ; Hand ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neuralgia ; Neurilemmoma* ; Neuroma, Acoustic ; Paresthesia ; Physical Examination ; Schwann Cells ; Thoracic Outlet Syndrome* ; Upper Extremity

OBJECTIVE: To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. METHOD: Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapula. RESULTS: In patients with unilateral shoulder impingement syndrome, the frequency of shoulder impingement syndrome was 76.2% (16 of 21) on the side of the relatively lower shoulder. The mean acromiohumeral interval on the side of the lower shoulder was 10.03+/-1.28 mm, compared with 10.46+/-1.50 mm for the higher shoulder. The angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapular of the side of the lower shoulder was -0.31+/-3.73 degrees, compared with 3.85+/-4.42 degrees for the higher shoulder. CONCLUSION: The frequency of shoulder impingement syndrome was significantly higher on the side of the relatively lower shoulder, and there is no significant difference in the acromiohumeral interval between the side of the lower shoulder and that of the higher shoulder. In patients with unilateral shoulder impingement syndrome, the scapular on the side of lower shoulder was more rotated downward than on the side of the higher shoulder.
Humans ; Shoulder ; Shoulder Impingement Syndrome

Monomelic amyotrophy (MMA), also known as Hirayama disease, is a sporadic juvenile muscular atrophy in the distal upper extremities. This disorder rarely involves proximal upper extremities and presents minimal sensory symptoms with no upper motor neuron (UMN) signs. It is caused by anterior displacement of the posterior dural sac and compression of the cervical cord during neck flexion. An 18-year-old boy visited our clinic with a 5-year history of left upper extremity pain and slowly progressive weakness affecting the left shoulder. Atrophy was present in the left supraspinatus and infraspinatus. On neurological examination, positive UMN signs were evident in both upper and lower extremities. Electrodiagnostic study showed root lesion involving the fifth to seventh cervical segment of the cord with chronic and ongoing denervation in the fifth and sixth cervical segment innervated muscles. Cervical magnetic resonance imaging (MRI) showed asymmetric cord atrophy apparent in the left side and intramedullary high signal intensity along the fourth to sixth cervical vertebral levels. With neck flexion, cervical MRI revealed anterior displacement of posterior dural sac, which results in the cord compression of those segments. The mechanisms of myelopathy in our patient seem to be same as that of MMA. We report a MMA patient involving proximal limb with UMN signs in biomechanical concerns and discuss clinical importance of cervical MRI with neck flexion. The case highlights that clinical variation might cause misdiagnosis.
Adolescent ; Atrophy ; Biological Assay ; Denervation ; Diagnostic Errors ; Extremities ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Motor Neurons* ; Muscles ; Neck ; Neurologic Examination ; Shoulder ; Spinal Cord Diseases ; Spinal Muscular Atrophies of Childhood ; Upper Extremity

OBJECTIVE: To compare the efficacy of ultrasonography guided stellate ganglion block (US-SGB) with that of blind SGB in management of the stroke patients with complex regional pain syndrome (CRPS) type 1. METHOD: Forty-two patients with post-stroke CRPS were randomly assigned to either US-guided SGB (22 patients) or blind SGB group (20 patients). The mean age of US-guided SGB and blind SGB groups was 61.3+/-5.6 years and 59.1+/-4.5 years. We performed two blockades at 7-day intervals on the affected side of patients with CRPS. Pain intensity, using a visual analog score (VAS), score of CRPS clinical severity, and the amounts of affected hand swelling with a hand volumeter were assessed before, 2 weeks and 4 weeks after treatment. RESULTS: In both groups, VAS and the amount of hand swelling were significantly decreased after 2 weeks and after 4 weeks. Between two groups, VAS difference of US-guided SGB group and that of blind SGB group were 2.61+/-1.09, 1.88+/-0.62 at 2 weeks and 3.67+/-1.03, 3.13+/-0.62 at 4 weeks, respectively. US-guided SGB group showed more significant improvement in mean change of VAS compared to the blind SGB group (p-value<0.05). CONCLUSION: Both US-guided SGB and blind SGB techniques were effective in relieving pain in subacute stroke patients with CRPS. US-guided SGB was better in pain relief but has no advantages in reduction of hand swelling in this study.
Hand ; Humans ; Stellate Ganglion ; Stroke