Lingual dystonia following electrical injury.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
W Ondo
Publications and source records attributed to W Ondo.
Restless legs syndrome: clinicoetiologic correlates.
Despite recent attempts to better characterize restless legs syndrome (RLS), this neurologic disorder remains poorly understood. The relationship between idiopathic and secondary and between familial and sporadic (nonfamilial) cases have not been previously defined. We studied 54 patients (29 women and 25 men) who satisfied the diagnostic criteria for RLS. The mean age of the patients was 62.69 +/- 13.82 years, and the mean age at onset was 34.13 +/- 20.30 years. We found that 92% of patients with idiopathic RLS (without neuropathy) had a family history of RLS, whereas only 13% of those with neuropathic RLS (associated with peripheral neuropathy) had a positive family history. The sporadic/neuropathic patients were older at symptom onset and tended to have a more rapid progression than the familial/idiopathic patients. There were no other significant differences between the subgroups. Levodopa and dopamine agonists were the most effective treatments. We conclude that there are two major etiologic subgroups of RLS but that the two share central pathophysiologic mechanisms.
Adult↗
When to worry about headache. Head pain as a clue to intracranial disease.
Careful evaluation of headache is important to detect potentially morbid but treatable causes. Although such causes represent only 10% of all emergency department visits for headache, the consequences of a missed diagnosis can be severe. Unfortunately, the cost of performing computed tomography or magnetic resonance imaging for every patient with headache is prohibitive. However, familiarity with the differential diagnostic considerations, together with a high index of suspicion, should allow physicians to perform efficient, cost-effective examinations of all patients who seek treatment for headache.
Adult↗
Efficacy and tolerability of a novel sublingual apomorphine preparation in patients with fluctuating Parkinson's disease.
We tested a novel preparation of sublingual apomorphine hydrochloride (APO) in 10 patients with advanced Parkinson's disease complicated by motor fluctuations and dyskinesias. After dose titration, patients underwent a blinded comparison of APO versus placebo, and an unblinded comparison of APO versus optimally dosed carbidopa/levodopa using timed tapping and walking paradigms. APO was significantly better than placebo in both measures: Tapping speed was 30.8% faster than with placebo (p < .0005), and ambulation speed was 45.2% faster than with placebo (p < .05). Ambulation speed with APO was also 15.9% faster than that with optimal doses of carbidopa/levodopa (p < .05). The latency to onset of clinical improvement with each APO dose was 10 to 40 minutes, and the duration of effect was 60 to 130 minutes. Adverse events included nausea, orthostatic hypotension, and disagreeable taste in the patient's mouth. Aside from the bitter taste, all other side effects resolved with continued use and did not limit dosing in any case. We feel that the good short-term efficacy and tolerability demonstrated in this study warrant further study of this new preparation, as there are several potential advantages of sublingual administration compared with traditional APO preparations.
Adult↗