Monoplegia of the upper limb is sometimes referred to as brachial monoplegia, and that of the lower limb is called crural monoplegia. Monoplegia in the lower extremities is not as common of an occurrence as in the upper extremities. Monoparesis is a similar, but less severe, condition because one limb is very weak, not paralyzed. For more information, see paresis.
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Many conditions that cause paraplegia or quadriplegia begin as monoplegia. Thus, the diagnosis of spinal paraplegia must also be consulted. In addition, multiple cerebral disorders that cause hemiplegia may begin as monoplegia. Monoplegia is also frequently associated with, and considered to be the mildest form of, cerebral palsy.
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Monoplegia is paralysis of a single limb, usually an arm. Common symptoms associated with monoplegic patients are weakness, numbness, and pain in the affected limb. Monoplegia is a type of paralysis that falls under hemiplegia. While hemiplegia is paralysis of half of the body, monoplegia is localized to a single limb or to a specific region of the body.
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There are a number of symptoms associated with monoplegia. Curling of the hands or stiffness of the feet, weakness, spasticity, numbness, paralysis, pain in the affected limb, headaches, and shoulder pain are all considered to be symptoms of monoplegia. Patients of monoplegia typically feel symptoms of weakness and loss of sensation in the affected extremity, usually an arm. Despite these symptoms, the extremity with paralysis continues to maintain a strong pulse.
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Monoplegia is diagnosed by a physician after a physical examination and sometimes after further neurologic examination as well. As monoplegia is fairly rare, after physical examination of a patient complaining of monoplegia, sometimes weakness of an additional limb is also identified and the patient is diagnosed with hemiplegia or paraplegia instead. After neurologic examination of the limb, a diagnosis of a monoplegic limb can be given if the patient receives a Medical Research Council power grade of 0, which is a measurement of the patient's limb strength. Needle Electromyography is often used to study all limbs, essentially showing the extent in each limb involvement.
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Human motor cortex The motor tract. In monoplegia, the spine and the proximal portion of nerves are usually the abnormal sites of limb weakness. Monoplegia resulting from upper extremity impairments following a stroke occurs due to direct damage to the primary motor cortex, primary somatosensory cortex, secondary sensorimotor cortex, sensorimotor cortical areas, subcortical structures, and/or the corticospinal tract. It is often found that impairments following stroke are either caused by damage to the same or adjacent neurological structures.
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There is no cure for monoplegia, but treatments typically include physical therapy and counseling to help recover muscle tone and function. Recovery will vary depending on diagnosis of temporary, partial or complete paralysis. Much of the therapies focus on the upper limb due to the fact that monoplegia in the upper limbs is much more common than in the lower limbs. It has been found that intense activity-based and goal-directed therapy, such as constraint-induced movement therapy and bimanual therapy, are more effective than standard care.
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Some potential causes of monoplegia are listed below. # Cerebral palsy # Physical trauma to the affected limb # Central nervous mass lesion, including tumor, hematoma, or abscess # Complicated migraine # Epilepsy # Head or spinal trauma # Hereditary brachial neuritis # Hereditary neuropathy with liability to pressure palsy # Neonatal brachial plexus paralysis # Neuropathy # Plexopathy # Traumatic peroneal neuropathy # Vaccine-associated paralytic poliomyelitis # Hemiparetic seizures # Monomeric spinal muscular atrophy # Stroke Specifically, monoplegia in the lower extremities is typically caused by Brown Sequard syndrome and hematomas in the frontoparietal cortex near the middle that could produce a deficit such as this, but this is a very uncommon occurrence.
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If four limbs are affected by paralysis, tetraplegia or quadriplegia is the correct term. If only one limb is affected, the correct term is monoplegia. Spastic paraplegia is a form of paraplegia defined by spasticity of the affected muscles, rather than flaccid paralysis.
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Hemiplegia, is a type of paralysis that effects one side of the body. Monoplegia is a condition that impacts only one limb. Spasticity limits muscle movement as a result of tightness in muscle. Athetosis is a condition that has resulted in damage to the basal ganglia.
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Spastic triplegia, meanwhile, involves three limbs (such as one arm and two legs, or one leg and two arms, etc.); spastic diplegia affects two limbs (commonly just the legs), spastic hemiplegia affects one or another entire side of the body (left or right); and spastic monoplegia involves a single limb.
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If four limbs are affected by paralysis, tetraplegia or quadriplegia is the correct term. If only one limb is affected, the correct term is monoplegia. Spastic paraplegia is a form of paraplegia defined by spasticity of the affected muscles, rather than flaccid paralysis. The American Spinal Injury Association classifies spinal cord injury severity.
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When the cyst is in muscular or subcutaneous issue, it causes painful lesions to form. When the cyst is in the brain, the patient will experience neurological symptoms. These symptoms include headaches, seizures, ataxia, vomiting, monoplegia, and hemiplegia. Since coenurosis is very rare in humans, there are not many ways to diagnose the disease.
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The cerebral palsy sport classification system is designed for people with several types of paralysis and movement including quadriplegia, triplegia, diplegia, hemiplegia, monoplegia, spasticity, athetosis, and ataxia. Quadriplegia impacts the whole body, including the head, torso and all the limbs. Triplegia impacts three of the four limbs. Diplegia is when there is greater functional use of the lower limbs than the upper limbs.
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While chronic progressive brachial monoplegia is uncommon, syringomyelia and tumors of the cervical cord or brachial plexus may be the cause. The onset of brachial plexus paralysis is usually explosive where pain is the initial feature. Pain localizes to the shoulder but may be more diffuse, or could be limited to the lower arm. Pain is severe and often described as sharp, stabbing, throbbing, or aching.
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This approach to therapy is carried out during ordinary and daily activities by the affected person. It has been found that CIMT is more effective at specifically improving arm movement than a physiotherapy approach or no treatment at all. This type of therapy has proved to provide an only moderate improvement in patients with monoplegia. More research needs to be conducted in order to establish the lasting benefit of constraint-induced movement therapy.
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It is targeted at patients who acquired monoplegia through incidents such as a spinal cord injury, stroke, multiple sclerosis, or cerebral palsy and utilizes electrical stimulation in order to cause the remaining motor units in the paralyzed muscles to contract. As in traditional muscular training, FES improves the force with which the unaffected muscles contract. For less severely affected patients, FES allows for greater improvement in range of motion than traditional physical therapy.
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This leads to activity-dependent plasticity within the user, requiring them to pay careful attention to tasks that require the activation or deactivation of specific brain areas. BCI systems utilize different sources of information for feedback, including electroencephalography (EEG), magnetoencephalography, functional magnetic resonance imaging, near-infrared spectroscopy, or electrocorticography. Among all of these, the EEG signals are the most useful for this type of rehabilitation because they are highly accurate and stable. Another form of treatment for monoplegia is functional electrical stimulation (FES).
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Spastic cerebral palsy is the type of cerebral palsy characterized by spasticity or high muscle tone often resulting in stiff, jerky movements. Cases of spastic CP are further classified according to the part or parts of the body that are most affected. Such classifications include spastic diplegia, spastic hemiplegia, spastic quadriplegia, and in cases of single limb involvement, spastic monoplegia. Spastic cerebral palsy affects the motor cortex of the brain, a specific portion of the cerebral cortex responsible for the planning and completion of voluntary movement.
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A combination of these impairments is more likely than just one in isolation. Damage to the corticospinal system results in an inability to activate muscles with enough force or in a coordinated manner, which can lead to paresis, loss of fractional movement, and abnormal muscle tone. Damage to the somatosensory cortical areas causes loss of somatosensation which results in an impaired ability to monitor movement. Considering monoplegia as it relates to cerebral palsy, in premature infants, the most common cause of cerebral palsy is periventricular hemorrhagic infarction.
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Furthermore, magnetic resonance imaging (MRI) is the diagnostic modality of choice for investigating all forms of hemiplegia. It is especially informative to show migrational defects in hemiplegic cerebral palsy associated with seizures. An approach called single-pulse transcranial magnetic stimulation (spTMS) has also been used to help diagnose motor deficits such as monoplegia. This is done by evaluating the functional level of the corticospinal tract through stimulation of the corticospinal lesions in order to obtain neurophysiologic evidence on the integrity of the corticospinal tracts.
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Studies suggest the less affected hand could provide a template for improving motor performance of the more affected hand, and provides a strong rationale for the development of bimanual training approaches. In addition to that, there is strong evidence to support that occupational therapy home programs that are goal-directed could be used to supplement hands-on direct therapy. Constraint- induced movement therapy (CIMT) is specifically targeted at upper limb monoplegia as a result of a stroke. In CIMT the unaffected arm is restrained, forcing the use and frequent practice of the affected arm.
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Spastic tetraplegia (all four limbs affected equally). People with spastic quadriplegia are the least likely to be able to walk, or if they can, to want to walk, because their muscles are too tight and it is too much effort to do so. Some children with quadriplegia also have hemiparetic tremors, an uncontrollable shaking that affects the limbs on one side of the body and impairs normal movement. Occasionally, terms such as monoplegia, paraplegia, triplegia, and pentaplegia may also be used to refer to specific manifestations of the spasticity.
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This classification is used in para-Alpine and para-Nordic standing skiing, where LW stands for Locomotor Winter. Skiers in this class have a disability in one lower extremity, which may be a result of a leg amputation below the knee, knee arthrodesis or a hip arthrodesis. If there are functional problems on the leg, the strength of the leg will be 30 or less, where a fully functional leg normally has a strength of 40. Lower limb monoplegia is a type disability that is comparable to knee amputation for this class.
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Spastic cerebral palsy is the type of cerebral palsy characterized by spasticity or high muscle tone often resulting in stiff, jerky movements. Itself an umbrella term encompassing spastic hemiplegia, spastic diplegia, spastic quadriplegia and — where solely one limb or one specific area of the body is affected— spastic monoplegia. Spastic cerebral palsy affects the motor cortex of the brain, a specific portion of the cerebral cortex responsible for the planning and completion of voluntary movement. Spastic CP is the most common type of overall cerebral palsy, representing about 80% of cases.
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Barbara Minneci (born 12 June 1969, in Brussels) is a Belgian Para-Equestrian Grade II, in dressage who is well recognised for riding side saddle. She rode her horse Barilla at the 2012 Summer Paralympics and stood out due to her riding style and Barilla being a Gypsy Cob type. They did not place in the medals. Barbara took up para-equestrian in 2009 at age 40 in Brussels, Belgium after suffering from cancer in 1996 and 2004 left her with monoplegia in her left leg and muscle loss in her right leg.
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Brain computer interface (BCI) systems have been proposed as a tool for rehabilitation of monoplegia, specifically in the upper limb after a stroke. BCI systems provide sensory feedback in the brain via functional electrical stimulation, virtual reality environments, or robotic systems, which allows for the use of brain signals. This is extremely crucial because the networking in the brain is often compromised after a stroke, leading to impaired movement or paralysis. BCI systems allow for detection of intention to move through the primary motor cortex, then provide the matched sensory stimulation according to feedback that is provided.
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LW12 is a para-Alpine and para-Nordic sit skiing sport class defined by the International Paralympic Committee (IPC). An LW12 skier needs to meet a minimum of one of several conditions including a single below knee but above ankle amputation, monoplegia that exhibits similar to below knee amputation, legs of different length where there is at least a 7 centimetres difference, combined muscle strength in the lower extremities less than 71. For international competitions, classification is done through IPC Alpine Skiing or IPC Nordic Skiing. For sub-international competitions, classification is done by a national federation such as Alpine Canada.
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These conditions include a single below knee but above ankle amputation, monoplegia that exhibits similar to below knee amputation, legs of different length where there is at least a difference, and combined muscle strength in the lower extremities less than 71. Assessment for this classification includes consideration of the skier's medical history and disability, a physical examination, and an in-person assessment of the skier training or competing. During the assessment process, six different tests are conducted that look at the skier's balance on different planes, and test for upper body strength and levels of mobility. The guideline scores for people to be assessed in this classification are 0–8.
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LW12 classified Australian skier David Munk at the 1994 Winter Paralympics This is a para-Alpine and para-Nordic sit-skiing classification, where LW stands for Locomotor Winter. To generally be eligible for a sit- skiing classification, a skier needs to meet a minimum of one of several conditions including a single below knee but above ankle amputation, monoplegia that exhibits similar to below knee amputation, legs of different length where there is at least a difference, combined muscle strength in the lower extremities less than 71. Skiers in this class "may have Grade 3-5 hip flexion and extension (unilateral or bilateral)". This classification is comparable to para classes 5 and 6.
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T serialis and T. glomerata cysts present in the CNS, muscles, or subcutaneous tissue, and T. brauni cysts occupy these same areas but occur in the eye more frequently than the other three species. When the cyst occurs in the brain, as it often does, the infected individual may experience headaches, seizures, vomiting, paralysis affecting one side of the body (hemiplegia), paralysis involving one limb (monoplegia), and loss of ability to coordinate muscles and muscle movements. Many of these symptoms are due to the buildup of inter-cranial pressure from the growing cyst or from the cyst pressing on other parts of brain. When the cyst occurs in the spinal cord, it can cause severe pain and inflammation, and loss of feeling in some nerves.
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The National Team, in addition to friendly matches and invitational tournaments, competes in the following events: Intercontinental Cup, Copa America, World Championships, Parapan American Games, Paralympic Games. For players to be eligible, they must be ambulant (no requirement for assistive walking aids) and have one of the following neurological conditions, have had a Stroke, have Cerebral Palsy, have had a Traumatic Brain Injury / Acquired Brain Injury. Individuals with the above conditions may display varying degrees of the following impairments: Diplegia, Hemiplegia, Triplegia, Quadriplegia, Monoplegia, Dystonia, Athetosis, Ataxia, Balance issues, Co- ordination issues, Weakness in certain areas of the body. In many cases the above conditions may result in only minimal levels of motor dysfunction (some not noticeable to the untrained eye); however, under the rules of the sport, this could still make players eligible for the U.S. Paralympic National Team.
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