Shaheda N Azher | PubMed Health

PubMed2006

Botulinum toxin treatment of facial myoclonus in suspected Rasmussen encephalitis.

Patients with Rasmussen encephalitis (RE) may develop a variety of involuntary movements. We report a 26-year-old woman who presented with a 3-year history of progressive, continuous myoclonus of the left side of the face and left arm as well as left spastic hemiparesis. Magnetic resonance imaging of the brain showed right hemisphere and basal ganglia atrophy, and 24-hour electroencephalogram demonstrated diffuse slowing with random sharp waves in both hemispheres. An 18-fluoro-deoxy-glucose positron emission tomography scan indicated hypometabolism of the right cerebral hemisphere, including basal ganglia and thalamus. We successfully treated her myoclonus with injections of botulinum toxin A into the left zygomaticus muscle.

Adult↗

PubMed2005

Camptocormia: pathogenesis, classification, and response to therapy.

Originally considered a psychogenic disorder, camptocormia, an abnormal posture with marked flexion of thoracolumbar spine that abates in the recumbent position, is becoming an increasingly recognized feature of parkinsonian and dystonic disorders. Prior reports were limited by sample size, short follow-up, and paucity of data on response to therapy. The authors reviewed 16 patients evaluated in their PD Center and Movement Disorders Clinic diagnosed with camptocormia. In addition to detailed neurologic assessment all patients were videotaped. The mean age was 64.9 +/- 17.4 years, mean age at onset of neurologic symptoms was 51.5 +/- 19.9 years, duration from onset of neurologic symptoms to development of camptocormia was 6.7 +/- 7.6 years, and the mean duration of camptocormia was 4.5 +/- 3.9 years. Of the 16 patients, 11 (68.8%) had Parkinson disease (PD); others had dystonia (n = 4) and Tourette syndrome (n = 1). Twelve patients received levodopa, with minimal or no improvement in the camptocormia. Nine patients received botulinum toxin type A injections into the rectus abdominus, with notable improvement in their camptocormia in four. One patient underwent bilateral subthalamic nucleus deep brain stimulation for PD, but there was no improvement in camptocormia. Based on this series and a thorough review of the literature of camptocormia, head drop, and bent spine syndrome, the authors propose etiologic classification of camptocormia and conclude that this heterogeneous disorder has multiple etiologies and variable response to systemic and local therapies.

Abdominal Muscles↗