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Biomedical subjects

Nestor Galvez-Jimenez

Publications and source records attributed to Nestor Galvez-Jimenez.

4 recordsLinked to original sources

A pilot study of botulinum toxin A for headache in cervical dystonia.

OBJECTIVE: To evaluate the prevalence of associated headache (HA) pain with craniocervical dystonia and the therapeutic effect of BoNT-A injections on the HA component when injected for cervical dystonia. BACKGROUND: HA associated with craniocervical dystonia is a recent formally codified entity, but has not been systematically studied. METHODS: We identified 44 subjects from three movement disorder clinics who presented with craniocervical dystonia and concurrent HA pain. The subjects were injected with botulinum toxin type A (BoNT-A) and prospectively evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), headache diaries, Headache Impact Test (HIT-6), and Migraine Disability Assessment Scale (MIDAS), along with HA pain anatomy and adverse events, at baseline, and at 4, 8, and 12 weeks post-injection. RESULTS: As expected, all aspects of the TWSTRS robustly improved. Headache diaries and the HIT-6 also improved at 4, 8, and 12 weeks post-injection. Sections of the MIDAS improved, and adverse events were minimal. CONCLUSION: BoNT-A safely improves headache associated with craniocervical dystonia when administered for the primary condition of craniocervical dystonia.

Adult↗

Psychogenic movement disorders.

Psychogenic movement disorders (PMD) are challenging to diagnose and to treat. Since the nineteenth century, PMDs were recognized and described in painstaking detail. In the modern neurology clinic, PMDs may comprise 2-25% of the patient population. Recognition of the various types of PMDs, differentiation from organic illness and an approach to PMDs are described in this article.

Diagnosis, Differential↗

Inter- and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity.

OBJECTIVE: To evaluate the reliability of the Ashworth Scale and the Disability Assessment Scale (DAS) in poststroke patients with upper-limb spasticity and functional disability. DESIGN: Single-center trial. SETTING: University medical center. PARTICIPANTS: Nine patients > or = 6 months poststroke with upper-limb spasticity and impairment in the areas of hygiene, dressing, limb posture, or pain were included in the analysis. INTERVENTIONS: Ten experienced medical professionals rated each patient in randomized order twice on the same day (results based on mean of evaluations at times 1 and 2). Elbow, wrist, finger, and thumb flexion tones were assessed by using the Ashworth score (range, 0-4), and functional disability was assessed using the DAS (range, 0-3). MAIN OUTCOME MEASURES: Intra- and interrater reliability of the Ashworth Scale and DAS. RESULTS: For the Ashworth parameters, 38 of 40 evaluations indicated excellent (weighted kappa > or = .75) or good (weighted kappa > or = .4) intrarater reliability. For DAS parameters, 31 of 40 evaluations indicated excellent or good intrarater reliability. The interrater reliability was also good for both the Ashworth Scale (Kendall W=.598-.792) and DAS (Kendall W=.494-.772) with statistically significant agreement found among raters (all P<.001). CONCLUSIONS: In patients with upper-limb spasticity after stroke, the Ashworth Scale and DAS had good intra- and interrater reliability when used by trained medical professions.

Adult↗