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Neuromuscular Pathology

Side Stitch

Common symptom in runners

  • Symptom: A sharp/stabbing pain in the right upper abdominal quadrant

  • Cause: Diaphragmatic muscle spasm 2° hypoxia

  • Rx #1: Breathe in through the nose & expire forcefully through pursed lips

  • Rx #2: Stretch the right UE over the head

  • Becomes evident between 2 and 15 years of age


Source: Lillegard WA, Burcher JD & Rucker KS (1999).

Tourette's Syndrome

Defined by multiple motor & vocal tics lasting for >1 year

  • Becomes evident between 2 and 15 years of age

  • Most common 1st symptom is a facial tic (eye blink, nose twitch, grimace)

  • Involuntary movements (tics) of the arms, limbs, or trunk

  • Other symptoms such as touching, repetitive thoughts & movements, & compulsions can occur

  • Verbal tics (vocalizations) usually occur with the mov'ts

  • Although unusual, verbal tics may also be expressed as coprolalia (the involuntary use of obscene words) or copropraxia (obscene gestures)


Possible Signs & Symptoms of a Brain Tumor

  • H/A— ↑ intracranial pressure

  • Vomiting

  • Visual changes

  • Mentation changes

  • Seizures

  • Muscle weakness

  • Bladder dysfunction

  • Coordination changes

  • (+) Babinski

  • Clonus (ankle or wrist)

Romberg's Test

Used to assess balance & coordination problems that may indicate a cerebellar pathology or an inner ear infection

  • Have athlete stand in a place free from obstacles

  • Instruct athlete to close his or her eyes

  • Instruct athlete to abduct arms to 90° with elbows extended

  • Instruct athlete to tilt head back & lift 1 leg off floor

  • Positive test = unsteadiness


Tandem Walking

  • Have athlete stand heel-to-toe (1 foot in front of the other)

  • Instruct the athlete to walk 10' along a straight line

  • Positive test = unsteady gait


Systemic Lupus Erythematosus

An autoimmune, disease of unknown etiology that results in inflammation & damage to various organs

Onset: 15–45 yo ♀ > ♂ 10–15:1

African (3x more common), Native-American, Asian > Caucasians

Signs & Symptoms

  • Unexplained fever

  • Swollen glands

  • Constitutional symptoms

  • Arthralgia—symmetrical

  • Swollen joints

  • Skin rash—"butterfly" pattern (cheeks)

  • Chest pain upon deep breathing

  • Extreme fatigue

  • Photosensitivity

  • Unusual hair loss

  • Pale or purple fingers or toes from cold or stress (Raynaud's phenomenon)

  • CNS px—seizures, h/a, neuropathy, CVA, OBS

  • Mouth, nose, vaginal ulcers

  • Symptoms get worse during menstruation

Complications of Lupus

  • Seizures/psychosis

  • Pleuritis/pericarditis

  • Endocarditis/myocarditis

  • Anemia

  • Glomerulonephritis

Note: A severe side effect of the acne medication minocycline, is lupuslike symptoms


Source: Gulick D (2006).

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