3.The Effect of Hot Bath and Infrared Radiation on Hypertomia in the Affected Upper Extremity of Hemiplegic Patients. Changes in surface electromyogram.
Yorimichi IZUMI ; Tsutomu FUJITA ; Nobuo YANAGISAWA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1997;60(4):209-220
We investigated the effect of hot bath and infrared radiation on tonic muscle discharges due to hypertonia in the affected upper extremity of hemiplegic patients using surface electromyography (EMG). Subjects were 15 hemiplegic patients with cerebrovascular diseases. The subjects were selected on the basis of the presence of considerable rigidospasticity in the biceps brachii muscle (BBM). Hot bath (42°C) was applied for more than 3 minutes in the supine position with the cubital joint fixed in flexion in 11 subjects. Infrared radiation (300 watts) was applied to the flexor side of the affected upper extremity in the same posture in 13 subjects. Surface EMGs of the BBM and triceps brachii muscle (TBM) were recorded bipolarly with waterproof disc electrodes before, during, and after the trials of hot bath and infrared radiation. The recorded EMG was rectified and integrated, and then converted into sequential pulses. The amount of EMG was calculated as the number of pulses. The EMG of the affected side was normalized as a percentage of the amount versus that of the unaffected side in maximum voluntary contraction. The EMGs of the BBM and TBM showed tonic muscle discharges in all subjects in the resting state. The EMGs of the BBM and TBM averaged 6.4% and 1.4% before hot bath and 3.3% and 1.2% before infrared radiation. The EMG of the BBM in the third 1 minute during hot bath decreased by 58.8% (p<0.01) and increased slightly after the trial. The EMG of the TBM during hot bath increased insignificantly, and decreased by 25.3% (p<0.05) in the second 1 minute after the trial. The EMGs of the BBM and TBM in the third 1 minute during infrared radiation decreased by 31.9% (p<0.01) and 9.3% (p<0.05), and the decrease persisted after the trial. The results demonstrated that thermotherapy, especially hot bath, decreases the tonic muscle discharges due to rigidospasticity.
4.A Case of Meige Syndrome in 80-year-old Patient Under Treatment of Cerebral Hemorrhage
Akiko TERAUCHI ; Yasushi KUROIWA ; Yorimichi IZUMI ; Tadasige FUJII
Journal of the Japanese Association of Rural Medicine 2015;64(4):705-710
Meige syndrome is an idiopathic disorder characterized by blepharospasm and oromandibular dystonia. Symptoms persist for a long time and treatment is difficult. This disease is categorized as a neurodegenerative disorder of extrapyramidal tract. The causes are not known well as yet. However, it has been recognized that the disease is induced by several kinds of drugs such as antipshycotic drugs and antiparkinson agents. We have treated a patient with Meige syndrome for several years. The patient is an 80-year-old-man. At age 54, he underwent total gastrectomy for stomach cancer. After the surgical therapy, he landed a job as office worker. At age 74, he suffered a left thalamic hemorrhage. He was treated conservatively. After six weeks from the onset, he was transferred to our hospital. His cognitive and daily life function were gradually deteriorating and became bedridden. When he reached somewhere around 76 years of age, he presented some of the typical symptoms of Parkinson’s disease, akinesia, tremor or muscle rigidity, so we started medication of dopamin. Three years after, he exhibited blepharospasm, retroflexion of the head and grimaced face. As this conditions continued for several months, we diagnose him as having Meige syndrome. We have decreased antiparkinsonian drugs, and started medication with trihexyphenidyl hydrochloride, clonazepam, muscle relaxant or injection botulinum toxin on eye lid and muscle of neck. Now the symptoms still linger, but his condition is not so poor.