American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Apr 2008
Review Case ReportsAcute deterioration of bulbar function after botulinum toxin treatment for sialorrhoea in amyotrophic lateral sclerosis.
Transcutaneous botulinum toxin injection in the salivary glands was introduced in 2000 as a new treatment for sialorrhoea in amyotrophic lateral sclerosis (ALS). We describe an ALS patient who developed serious complications of botulinum toxin treatment for sialorrhoea, and we review the relevant literature. A 64-yr-old woman with bulbar ALS for 6 mos was treated for disabling sialorrhoea. ⋯ Four days later, her bulbar function rapidly deteriorated, resulting in complete aphagia and anarthria on the fifth day. A PEG catheter was placed. Although according to the literature this treatment can be made safer by cautiously increasing the dosage and injecting the parotid glands first, BTX should not be the first-line treatment of sialorrhoea in ALS; comparative studies of BTX, amitryptiline, scopolamine, and radiation should be performed first.
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Am J Phys Med Rehabil · Apr 2008
Rehabilitation outcomes after infection-related spinal cord disease: a retrospective analysis.
To compare injury characteristics, demographics, and functional outcomes of patients with infection-related spinal cord disease (IR-SCD) vs. those with traumatic spinal cord injury (SCI). ⋯ Patients with infection-related SCD comprise a significant subset of SCI/D rehabilitation admissions and have differing demographic and injury characteristics compared with traumatic SCI. Despite less-severe injury characteristics and similar rehabilitation LOS, they achieve lower functional improvements and are less often discharged home, underscoring the importance of patient/family education and discharge planning.
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Am J Phys Med Rehabil · Mar 2008
ReviewIntroduction to diagnostic musculoskeletal ultrasound: part 2: examination of the lower limb.
This is the second of two articles focusing on ultrasound examination of musculoskeletal components of the upper and lower limbs. Treatment of musculoskeletal injuries is based on establishing an accurate diagnosis. ⋯ This article describes the ultrasound examination of the lower limb in terms of anatomic structure. Normal and pathologic ultrasound features of these structures, including muscles, tendons, ligaments, bursae, and other soft tissues of the lower limb, will be described by reviewing several representative pathologies commonly seen in musculoskeletal medicine.
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Am J Phys Med Rehabil · Mar 2008
Association between the EMG self-assessment examination and later ABEM certification.
Our objective was to determine whether performance on the American Association of Neuromuscular and Electrodiagnostic Medicine Training Program Self-Assessment Examination (TPSAE) predicts subsequent performance on the American Board of Electrodiagnostic Medicine (ABEM) certification examination. The TPSAE results were closely associated (r = 0.57) with ranking on the ABEM examination. Those with scores <65% on the TPSAE had <50% chance of ABEM certification, whereas those with scores >84% correct had >90% chance of certification. The TPSAE is a useful predictor of later ABEM certification.
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Am J Phys Med Rehabil · Mar 2008
Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study.
To investigate whether cross-sectional area (CSA) of the suboccipital muscles was associated with active trigger points (TrPs) in chronic tension-type headache (CTTH). ⋯ It seems that muscle atrophy in the RCPmin, but not in the RCPmaj, was associated with suboccipital active TrPs in CTTH, although studies with larger sample sizes are now required. It may be that nociceptive inputs in active TrPs could lead to muscle atrophy of the involved muscles. Muscle disuse or avoidance behavior can also be involved in atrophy.