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Hideto Miwa

Publications and source records attributed to Hideto Miwa.

44 records · Page 3Linked to original sources
PubMed2002

[Generalized muscle weakness mimicking periodic paralysis in a patient with toluene abuse].

A 23-year-old Japanese man was admitted to our hospital because of acute generalized muscle weakness and frequent vomiting. He had been diagnosed as having hypokalemic periodic paralysis, since he had recurrent episodes of transient generalized muscle weakness with a hypokalemia. Laboratory studies have revealed a severe hypokalemic hyperchloremic metabolic acidosis, elevated serum levels of creatine phosphokinase and ammonia. The urinary level of the hippuric acid, a metabolic product of toluene, was found to be extremely high, suggesting that he had been exposed to toluene. With intravenous supplement of potasium, his muscle strength improved. Chronic exposure to toluene induces various neurological disorders, such as encephalopathy, cerebellar and pyramidal signs, peripheral neuropathy. In addition, it should be kept in mind that hypokalemic muscle weakness can be induced by the renal tubular acidosis resulting from chronic toluene exposure, and that it is by no means easy to distinguish hypokalemic periodic paralysis if it occurs recurrently.

Acidosis, Renal Tubular↗
PubMed2002

[Effect of quetiapine fumarate on drug-induced psychosis in patients with Parkinson's disease].

Among atypical antipsychotics, quetiapine is characterized by a lower incidence of aggravation of parkinsonism due to its lower affinity to D 2. In this study, the effect of quetiapine fumarate (quetiapine) on antiparkinsonian-drug-induced psychosis (e.g. hallucination and delusion) in patients with Parkinson's disease was examined. Ten patients with antiparkinsonian-drugs-induced psychosis were enrolled in this study. The average age of the patients was 69 years and the mean duration of illness was 7 years and 5 months. Psychosis and parkinsonism in these patients were assessed by the Japanese version of PANSS (Positive and Negative Symptom Scale) and UPDRS (Unified Parkinson's Disease Rating Scale) before and during administration of quetiapine, respectively. During the assessment of the effect of quetiapine, the antiparkinsonian drugs that the patients were taking were unchanged. In nine out of the 10 patients, psychotic symptoms disappeared following administration of a relative small dose of quetiapine. No remarkable aggravation of parkinsonism was observed. The present results indicate that quetiapine is an useful drug for treating antiparkinsonian-drug-induced psychosis in the patient with Parkinson's disease.

Aged↗
PubMed2002

[Isolated finger flexion caused by continuous muscle fiber activity].

We report two patients who presented with progressive involuntary flexion of fingers. Both of them were women (Case 1 and 2 were 23 year old and 86 year old, respectively), and developed involuntary finger flexions, particularly of the ring and little fingers, following a localized pain of their hands and forearms. The other neurological findings were not present. There was no abnormal finding in their serum, and anti-voltage-gated potassium channel antibodies were negative. Nerve conduction velocity studies revealed no obvious peripheral neuropathy or conduction block. EMG studies revealed continuous muscle fiber activities only in the flexor digitorum superficialis muscles in both patients. Additionally, in Case 1, neuromyotonic discharges at frequencies of 100-200 Hz were recorded only from the flexor digitorum superficialis muscle. The present findings are likely to be similar to those of a novel form of focal neuromytonia reported recently as 'isolated finger flexion'.

Adult↗
PubMed2002

[Recurrent unipolar depression with 48-hour cycle and the state--dependent abnormal involuntary movements following right thalamic hemorrhage].

A 70-year-old woman was admitted because of depression and abnormal involuntary movements of her left extremities. Six months before the admission, she developed left hemiparesis caused by right thalamic hemorrhage. On neurological examination, she had mild motor and sensory hemiparesis on the left side. She showed recurrent depression each other days with a 48-hour cycle, and hemichorea-hemiballism appeared in her left upper and lower extremities exclusively on the days with depressive phase. Her depressive symptoms were characterized by psychomotor retardation but not by feeling of suicide or guilty. She was then diagnosed as having a rapid cycler following the right thalamic hemorrhage. To our knowledge, it is extremely rare to see the state-dependent involuntary movements in patients with rapid cycler. The coexistence of post-stroke depression and hemichorea-hemiballism in the present patient may suggest that both disorders appear on the basis of the common pathophysiological mechanism such as dysfunction on frontal cortico-basal ganglia-thalamo-cortical loops.

Aged↗
PubMed2002

[The frontal assessment battery at bed side(FAB) in patients with Parkinson's disease].

It is by no means easy to assess the frontal lobe function precisely in patients with neurological disorders. Recently, Dubois et al. (2000) reported a new bedside cognitive and behavioral battery for evaluating frontal lobe function. To evaluate the clinical efficacy of this frontal assessment battery at bedside (FAB), we performed both FAB and Hasegawa's dementia scale (HDS), a Japanese version of convenient clinical scaling of dementia resembling the Mini-Mental State Examination, in patients with Parkinson's disease (PD) and age-matched controls. The FAB global score was significantly lower in the PD patients compared to the controls. On the other hand, there was no significant difference in the scores of HDS between the PD patients and controls. In the PD patients, there was no correlation between the FAB scores and their age or duration of the illness. The FAB is likely to be useful and convenient battery for assessing frontal lobe function at bedside in the PD patients.

Aged↗
PubMed2002

[Transient improvement of writing tremor by holding breath in volition: a case report].

We report a 76-year-old Japanese woman who had tremor of her hand during writing. Her past and family histories were unremarkable. On neurological examination, there was no abnormal finding except the writing tremor and the postural tremor of her lips and jaw. Surface EMG studies revealed that regular grouped discharges, at a frequency of about 5 Hz, appeared in the wrist flexor and extensor muscles soon after she start writing; these grouped discharges were inhibited while holding breath. Her postural tremor improved after consumption of a small amount of alcohol, suggesting that she had essential tremor. Thus, she may be diagnosed as having a variant of essential tremor. On the other hand, this tremor may be interpreted as a variant of writer's cramp, since her writing tremor transiently improved when she hold breath, just like a trick. In patients with dystonia, it is well known that dystonic symptoms can be temporally ameliorated by geste movement like a "trick". Although the pathophysiological relationship between primary writing tremor and writer's cramp are unclear, the unique characters of this tremor may suggest that a focal task-specific tremor and essential tremor can co-exist.

Aged↗