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Biomedical subjects

D Tarsy

Publications and source records attributed to D Tarsy.

At least 37 records · Page 2Linked to original sources
PubMed1996

Botulinum toxin A in the treatment of spasticity: functional implications and patient selection.

OBJECTIVE: To explore the range of functional indications and benefit of botulinum toxin A (BTA) in spastic patients. DESIGN: Case report of a series of patients selected for BTA treatment. Clinical information was collected in a prospective fashion on each patient. SETTING: Freestanding acute rehabilitation hospital. PATIENTS: 39 consecutive patients with 40 limbs with acquired spasticity. INTERVENTION: All 39 patients received BTA injections into muscles targeted for treatment based on functional indications. MAIN OUTCOME MEASURES: Objective evaluation of outcome was measured by Ashworth Scale, goniometry, ambulation score, and brace wear scale. Subjective measures included patient self report of improvement and pain relief. RESULTS: Mean BTA dose per limb was 180 units, mean number of muscles injected per limb was 2. Twenty-nine patients had subjective and/or objective improvement with treatment. Mean Ashworth Scale improvement was one point. Mean gain in active range of motion (AROM) was 17.0 degrees, and in passive range of motion (PROM) 18.4 degrees. Brace tolerance improved in 14 of 22 patients and pain relief occurred in 10 of 13 patients. There were no adverse effects, and there was no difference in duration of effect compared to dystonia patients. CONCLUSION: BTA is a useful intervention in the treatment of spasticity, with the majority of patients demonstrating improvement on objective measures of tone and function, and reporting improvement on subjective measures. Careful patient selection will maximize functional benefit.

Activities of Daily Living↗
PubMed1994

Stiff-man syndrome. Report of a case.

Stiff-man syndrome is a well-described, but rare and often overlooked, neuromuscular syndrome of rigidity, spasm, and gait abnormality that is associated with several endocrinologic and autoimmune disorders. A patient exhibiting many typical features of stiff-man syndrome had intermittent symptoms for 22 years before the correct diagnosis was made. Similar to many described patients, she was diabetic, hyperthyroid, and had elevated islet cell, antithyroid, and glutamic acid decarboxylase antibody levels. The high frequency of diabetes mellitus among patients with stiff-man syndrome is emphasized, as is increasing evidence to suggest that elaboration of anti-glutamic acid decarboxylase and anti-islet cell antibodies may play a role in the pathophysiologic state of the disorder.

Autoantibodies↗
PubMed1994

Limb dystonia following electrical injury.

Electrical injuries of the extremities may cause paralysis, muscle atrophy, sensory deficit, causalgia, and reflex sympathetic dystrophy (RSD). Limb dystonia has rarely been reported following electrical injury to an extremity, although it may result from cerebral hemisphere electrical trauma. Following electrical injury to the upper extremity, three patients developed limb dystonia accompanied by severe pain and sensory symptoms in two patients and features of RSD in one patient. Two patients received botulinum toxin injections without functional benefit. The mechanism of dystonia following peripheral trauma is unknown but may relate to reorganization of central synaptic connections, possibly in the spinal cord.

Adult↗
PubMed1993

Spontaneous calcific embolization to the supraclinoid internal carotid artery from a regurgitant bicuspid aortic valve.

Calcific brain embolization leading to stroke is rarely recognized. We report a case of spontaneous embolization to the right cerebral circulation from a severely regurgitant, calcified bicuspid valve. Bicuspid aortic valves constitute the most common congenital heart abnormality, and have a tendency to become stenosed, regurgitant, calcified, or infected. The presence of heavy calcification in a noninfected bicuspid valve may lead to dislodgement of calcific embolic material which is not necessarily heralded by acute valvular rupture. Accurate localization of the calcific embolus to the right supraclinoid internal carotid artery was provided by spiral CT imaging in this case.

Adult↗
PubMed1990

Pseudallescheria boydii infection of the central nervous system.

Pseudallescheria boydii is a rare cause of central nervous system infection characteristically presenting as a neutrophilic meningitis or multiple brain abscesses. Factors predisposing to central nervous system infection with this fungus include immunosuppression and near drowning. The organism is infrequently cultured from fluid obtained by lumbar puncture, delaying clinical recognition and appropriate antifungal therapy. All untreated patients with P boydii infection of the central nervous system died. We describe a patient who developed a persistent neutrophilic meningitis with focal neurologic deficits due to P boydii 6 months after a freshwater aspiration pneumonia. We also review the characteristic clinical and pathologic features of previously reported cases and emphasize the importance of early detection and treatment in the management of this frequently intractable disease.

Adult↗
PubMed1984

Tardive dyskinesia.

Tardive dyskinesia is an involuntary movement disorder associated with the prolonged use of antipsychotic drugs. The estimated prevalence rate is 10-15%. Elderly individuals are at greater risk than those below age 50. Although its cause is unknown, increased sensitivity to dopamine in the basal ganglia may contribute to the pathophysiology. No satisfactory treatment is currently available, restricted indications for chronic antipsychotic drug treatment, but early recognition of tardive dyskinesia, and prompt discontinuation of antipsychotic drugs when appropriate may reduce the incidence of this disorder.

Antipsychotic Agents↗
PubMed1984

Movement disorders with neuroleptic drug treatment.

Antipsychotic drugs produce several neurologic complications including acute dyskinesia, parkinsonism, neuroleptic malignant syndrome, akathisia, and tardive dyskinesia. Despite increased awareness of these syndromes, they continue to be underdiagnosed among patients receiving antipsychotic drugs. The clinical features, possible pathophysiologic mechanisms, and treatment of these conditions are discussed in this review.

Acute Disease↗
PubMed1981

Clonazepam and phenobarbital in tardive dyskinesia.

Benzodiazepines have several advantages over other antidyskinetic drugs in treating tardive dyskinesia. The authors conducted a controlled study of clonazepam versus the active placebo of phenobarbital in 21 psychiatric patients with tardive dyskinesia. Both drugs significantly reduced dyskinetic movements: clonazepam had a stronger effect on orofacial dyskinesia, and phenobarbital was more effective for limbs and axial movements. Clonazepam was also more effective for drug-free patients and those receiving low doses of neuroleptics than for all patients given phenobarbital and for clonazepam patients taking high doses of neuroleptics. The authors suggest that future treatment studies focus on the effects of antidyskinetic drugs on distinct body regions.

Adult↗
PubMed1979

Tardive dyskinesia: a clinical test of the supersensitivity hypothesis.

Patients with tardive dyskinesia showed no significant difference in CSF HVA when compared with groups of schizophrenic or depressives. CSF cAMP in the tardive dyskinesia group was significantly lower when compared to schizophrenics but not depressives. These results do not support a dopamine-receptor supersensitivity hypothesis in permanent tardive dyskinesia.

Adult↗