Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- PART I CLINICAL MANIFESTATIONS
- 1 Stroke onset and courses
- 2 Clinical types of transient ischemic attacks
- 3 Hemiparesis and other types of motor weakness
- 4 Sensory abnormality
- 5 Cerebellar ataxia
- 6 Headache: stroke symptoms and signs
- 7 Eye movement abnormalities
- 8 Cerebral visual dysfunction
- 9 Visual symptoms (eye)
- 10 Vestibular syndromes and vertigo
- 11 Auditory disorders in stroke
- 12 Abnormal movements
- 13 Seizures and stroke
- 14 Disturbances of consciousness and sleep–wake functions
- 15 Aphasia and stroke
- 16 Agitation and delirium
- 17 Frontal lobe stroke syndromes
- 18 Memory loss
- 19 Neurobehavioural aspects of deep hemisphere stroke
- 20 Right hemisphere syndromes
- 21 Poststroke dementia
- 22 Disorders of mood behaviour
- 23 Agnosias, apraxias and callosal disconnection syndromes
- 24 Muscle, peripheral nerve and autonomic changes
- 25 Dysarthria
- 26 Dysphagia and aspiration syndromes
- 27 Respiratory dysfunction
- 28 Clinical aspects and correlates of stroke recovery
- PART II VASCULAR TOPOGRAPHIC SYNDROMES
- Index
- Plate section
24 - Muscle, peripheral nerve and autonomic changes
from PART I - CLINICAL MANIFESTATIONS
Published online by Cambridge University Press: 17 May 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- PART I CLINICAL MANIFESTATIONS
- 1 Stroke onset and courses
- 2 Clinical types of transient ischemic attacks
- 3 Hemiparesis and other types of motor weakness
- 4 Sensory abnormality
- 5 Cerebellar ataxia
- 6 Headache: stroke symptoms and signs
- 7 Eye movement abnormalities
- 8 Cerebral visual dysfunction
- 9 Visual symptoms (eye)
- 10 Vestibular syndromes and vertigo
- 11 Auditory disorders in stroke
- 12 Abnormal movements
- 13 Seizures and stroke
- 14 Disturbances of consciousness and sleep–wake functions
- 15 Aphasia and stroke
- 16 Agitation and delirium
- 17 Frontal lobe stroke syndromes
- 18 Memory loss
- 19 Neurobehavioural aspects of deep hemisphere stroke
- 20 Right hemisphere syndromes
- 21 Poststroke dementia
- 22 Disorders of mood behaviour
- 23 Agnosias, apraxias and callosal disconnection syndromes
- 24 Muscle, peripheral nerve and autonomic changes
- 25 Dysarthria
- 26 Dysphagia and aspiration syndromes
- 27 Respiratory dysfunction
- 28 Clinical aspects and correlates of stroke recovery
- PART II VASCULAR TOPOGRAPHIC SYNDROMES
- Index
- Plate section
Summary
Introduction
This chapter discusses the diseases of muscle and peripheral nerve that are associated with cerebrovascular events. The peripheral nervous system, defined anatomically by neural structures enveloped by a Schwann cell plasma membrane, includes cranial nerves III to XII, the spinal roots, the nerve trunks, the dorsal roots, the autonomic centers, ganglia and their nerves.
Involvement of muscle or peripheral nerve or autonomic system associated with cerebrovascular events, designated herein as multiple neurological complications (MNCs), may occur with varying frequency and pattern and may be seen as primary or secondary (Table 24.1). Early diagnosis of primary MNCs can give valuable information about a patient's causal disease, a vasculitis, for example, cardiomyopathy or mitochondrial changes in both muscles and central nervous system (CNS) cells. Secondary MNCs may induce increased mortality and morbidity rates of stroke. The large variety of presentations of these disorders means that the MNCs represent a potentially frequent problem in neurologic practice. The full characterization of MNCs, however, needs investigations, including radiological, immunological, biochemical and genetic analyses, as well as electrophysiologic and autonomic function tests coupled with muscle or nerve biopsies.
Primary changes
Primary MNCs can result from vascular and cardiogenic embolisms, dissection of large vessels, primary and secondary vasculitis and mitochondrial cytopathies (Table 24.1). Prognosis will be determined by, and therapy tailored to, each specific cause.
Vascular and cardiogenic embolism
Simultaneous or delayed involvement of the neuromuscular system and the CNS in embolism has received little attention except in infective endocarditis (IE) where neuropathy is known to be a possible initial complication of the disease.
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- Information
- Stroke Syndromes , pp. 323 - 333Publisher: Cambridge University PressPrint publication year: 2001