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PubMed1989

Cervical myelopathy secondary to movement disorders: case report.

Involuntary cervical movements that result in cervical spondylosis and secondary myelopathy have not been adequately emphasized in the literature. We present two patients with cerebral palsy and long histories of involuntary movements who developed cervical myelopathy. We use these illustrative cases to emphasize that in the presence of underlying neurological symptoms and signs due to advanced cerebral palsy, any recent worsening should provoke a higher index of suspicion for myelopathy. The mechanics of neck movements and surgical treatment are discussed.

Cerebral Palsy↗
PubMed2005

Unified Parkinson's disease rating scale motor examination: are ratings of nurses, residents in neurology, and movement disorders specialists interchangeable?

The Unified Parkinson's Disease Rating Scale (UPDRS) is widely used for the clinical evaluation of Parkinson's disease (PD). We assessed the rater variability of the UPDRS Motor examination (UPDRS-ME) of nurse practitioners, residents in neurology, and a movement disorders specialist (MDS) compared to a senior MDS. We assessed the videotaped UPDRS-ME of 50 PD patients. Inter-rater and intra-rater variability were estimated using weighted kappa (kappa(w)) and intraclass correlation coefficients (ICC). Additionally, inter-rater agreement was quantified by calculation of the mean difference between 2 raters and its 95% limits of agreement. Intra-rater agreement was also estimated by calculation of a 95% repeatability limits. The kappa(w) and ICC statistics indicated good to very good inter-rater and intra-rater reliability for the majority of individual UPDRS items and the sum score of the UPDRS-ME in all raters. However, for inter-rater agreement, it appeared that both nurses, residents, and the MDS consistently assigned higher scores than the senior MDS. Mean differences ranged between 1.7 and 5.4 (all differences P < 0.05), with rather wide 95% limits of agreement. The intra-rater 95% repeatability limits were rather wide. We found considerable rater difference for the whole range of UPDRS-ME scores between a senior MDS and nurse practitioners, residents in neurology, and the MDS. This finding suggests that the amount by which raters may disagree should be quantified before starting longitudinal studies of disease progression or clinical trials. Finally, evaluation of rater agreement should always include the assessment of the extent of bias between different raters.

Adult↗
PubMed1992

Neuroleptic-induced movement disorders and body iron status.

1. The distribution of iron in the human brain, what is known about its biological functions, and the interaction of neuroleptics with iron suggest that this trace metal may play an important role in the pathogenesis of neuroleptic-induced movement disorders (NIMD). 2. The availability of magnetic resonance imaging has made some of the hypotheses testable in human subjects. 3. This article is a brief overview of the current literature on the association between NIMD and brain iron.

Antipsychotic Agents↗
PubMed2007

Transcranial brain parenchyma sonography in movement disorders: state of the art.

The present paper summarizes recommendations on transcranial sonography (TCS) application in neurodegenerative diseases, resulting from a consensus meeting of the European Society of Neurosonology and Cerebral Hemodynamics. TCS of distinct infra- and supratentorial brain structures detects characteristic changes in several movement disorders, such as abnormal hyperechogenicity of substantia nigra (SN) in Parkinson's disease and of lenticular nucleus in dystonia, Wilson's disease and atypical Parkinsonian disorders. In healthy adults, the TCS finding of marked SN hyperechogenicity indicates a subclinical functional impairment of the nigrostriatal dopaminergic system. The finding of marked SN hyperechogenicity in combination with normal lenticular-nucleus echogenicity discriminates idiopathic Parkinson's disease from multiple-system atrophy and progressive supranuclear palsy with a positive predictive value of more than 90%. As TCS is a quick and noninvasive method, using the same duplex-ultrasound machines as for investigation of intracranial vessels, applicable even in agitated patients, this method has a great potential to be more widely used.

Humans↗
PubMed1981

Are movement disorders the most serious side effects of maintenance therapy with antipsychotic drugs?

This paper concerns assessment of the full range of risks associated with prolonged use of antipsychotic medication. It is generally accepted that the most common side effects of drug therapy involve motor problems. Movement disorders arise because antipsychotics, in a substantial proportion of patients, disrupt the basal ganglia. The basal ganglia, however, are involved in much more than simply motor control. Specifically, this neural system has been implicated in sensory reactivity, attention, memory, and cognition. It follows from this that antipsychotic drugs, in addition to causing motor problems, might also disrupt complex psychological processes.

Animals↗
PubMed2006

A collaborative model of service delivery for children with movement disorders: a framework for evidence-based decision making.

Models of physical therapist service delivery provide a framework for integration of knowledge, research, and assumptions in a clinically relevant context that facilitates evidence-based decision making. In this perspective, a collaborative model of service delivery for children with movement disorders is presented. The focus is on services that address child and family priorities and preferences in settings where children live, learn, and play. The International Classification of Functioning, Disability and Health (ICF) is applied to identify relationships among the components of functioning, environmental, and personal factors that are important for the plan of care and achievement of outcomes. An assumption of the model is that physical therapists use multiple types of evidence to guide decision making. Application of the model and how child and family priorities change over time are illustrated through a longitudinal case report of a child with cerebral palsy.

Cerebral Palsy↗
PubMed1997

Aromatic L-amino acid decarboxylase deficiency: an extrapyramidal movement disorder with oculogyric crises.

Aromatic L-amino acid decarboxylase (AADC) deficiency results in an impaired synthesis of catecholamines and serotonin, and has been reported only in two middle eastern families. We report on a European family with an affected child. The child showed the characteristic clinical picture of an extrapyramidal movement disorder, oculogyric crises and vegetative symptoms seen in the three patients described previously. Treatment with a combination of the AADC cofactor pyridoxine, the monoamine oxidase B inhibitor selegiline and bromocriptine was started during the fifth year of life and showed only a moderate clinical improvement in contrast to patients who have been treated since the first year of life.

Amino Acid Metabolism, Inborn Errors↗
PubMed1988

Dexamethasone suppression test, schizophrenia and movement disorder.

The dexamethasone suppression test (DST) was administered to 20 patients with schizophrenic illness. Ten of these patients also had tardive dyskinesia (TD). The scores on TD and parkinsonism scales were significantly higher in DST nonsuppressors. There was also a significant positive correlation between the post-dexamethasone cortisol level and the movement disorder scales.

Adult↗
PubMed1990

Vermal infarct with pursuit eye movement disorders.

Severe deficits of foveal smooth pursuit and optokinetic nystagmus in all directions were electro-oculographically recorded in an 80 year old woman. Magnetic resonance imaging (MRI) showed an infarct involving the postero-inferior part of the vermis (lobules VI to X) and a portion of the left cerebellar hemisphere, with apparent preservation of the flocculus and the brainstem. The role of the vermal lesion in these pursuit eye movement disorders is discussed.

Aged↗
PubMed1991

Delayed onset movement disorders as a complication of central pontine myelinolysis.

This report describes a case of central pontine myelinolysis occurring after a rapid correction of profound hyponatremia. Delayed-onset generalized dystonia and choreoathetosis then appeared. A small pontine myelinolysis was demonstrated by magnetic resonance images, but striatal myelinolysis could not be established. Aspects of movement disorders associated with the osmotic demyelination syndrome are briefly reviewed and discussed.

Athetosis↗
PubMed2005

Amphetamine-induced movement disorder.

Recreational use of amphetamines is common in Australia and New Zealand when compared with other developed nations. The clinical effects are variable because of the potential of these drugs to increase the proportion of different biogenic amines in the central nervous system (CNS). The substances affected are adrenaline, noradrenaline, serotonin and dopamine. Movement disorders represent one of the less common presentations of amphetamine toxicity but one that health care workers should be aware of nonetheless.

Amphetamine-Related Disorders↗
PubMed2000

Hyperkinetic movement disorders caused by corpus striatum infarcts: brain MRI/CT findings in three cases.

Three patients with hemichorea/hemiballismus/hemidystonia caused by discrete contralateral infarction of the corpus striatum are presented. The infarcts were all small on CT or MRI brain scan and were lacunar in type. Small discrete infarction of basal ganglionic structures allows such adventitious movements to be manifested. Involvement of contiguous areas, seen with larger infarcts, can suppress such movements. The infrequency of such hyperkinetic movement disorders, and the subtle infarct appearance on brain scan, can lead to a delay in the diagnosis.

Adult↗
PubMed2005

Occupation and parkinsonism in three movement disorders clinics.

BACKGROUND: Few occupational risk factors for Parkinson disease (PD) have been identified. Healthcare, teaching, and farming have been associated with increased risk, while welding has been proposed to accelerate age at PD onset. The aim of the present study was to investigate occupational associations with PD or parkinsonism drawing from three different movement disorders clinics. METHODS: Medical records of 2,249 consecutive patients with PD or parkinsonism from specialty clinics in Sunnyvale, CA, New York, NY, and Atlanta, GA, were reviewed for primary lifetime occupation. Job frequencies were compared with Department of Labor regional statistics. PD diagnosis age and risk of diagnosis < or =50 were determined for each job. RESULTS: Physicians/dentists, farmers, and teachers were significantly more common than expected among PD patients, as were lawyers, scientists, and religion-related jobs. Computer programmers had a younger age at PD diagnosis, and risk of diagnosis < or =50 was greater in computer programmers and technicians. CONCLUSIONS: Consistent with prior studies, healthcare, teaching, and farming were common occupations in Parkinson disease (PD) patients, but welders were not over-represented. Even though several occupations were associated with younger age at PD diagnosis, these results may reflect biases inherent in specialty clinic surveys, including over-representation of younger, employed, and insured patients. Carefully designed analytic studies utilizing appropriate control populations will be required to test hypotheses regarding occupation and PD risk.

Adult↗
PubMed1991

Movement disorder following herpes simplex encephalitis.

Two children, an eight-year-old girl and a seven-month-old boy, recovered from herpes simplex encephalitis with minimal neurological residua following acyclovir treatment. Subsequently, they experienced marked deterioration, interpreted as either recrudescent infection or a post-infectious phenomenon. Features of the deterioration included encephalopathy and hyperkinetic movement disorder. MRI studies showed extensive neocortical damage, without involvement of the basal ganglia, thalamus or subthalamic nuclei. With aggressive supportive care, both children made a slow, steady recovery over several months. This supportive care is best provided in a closely supervised interdisciplinary setting.

Acyclovir↗
PubMedDate not supplied

The evaluation and treatment of neuroleptic-induced movement disorders.

Tardive dyskinesia, tardive akathisia, and tardive dystonia are reviewed from a clinical perspective. The evaluation of each syndrome is discussed, and its clinical presentation and course are illustrated with case vignettes. Drugs used in the treatment of tardive dyskinesia are presented, with greater emphasis on the more recently introduced therapies such as clozapine and vitamin E. Although effective treatments remain elusive, neuroleptic-induced movement disorders can be managed satisfactorily in the majority of clinical situations. Algorithms are presented to outline treatment approaches for mild and moderate/severe tardive dyskinesia.

Adult↗
PubMed1975

[Eye movement disorders in visual agnosia].

By the aid of photooptical methods the authors studied eye movements in 6 patients with disorders of visual gnosis due to focal lesions in the occipitallbrain lobes. The examination included studies of a fixation of immovable objects, a tracing of linear and pendulum moving objects and a voluntary change of points of fixation in space. It was demonstrated that expressed symptoms of agnosia are accompanied by defects in the organization of all forms of opticomotor activity. The authors discuss problems of the pathogenesis of oculomotor disorders in optical agnosia.

Agnosia↗
PubMed2004

Restless legs syndrome and periodic limb movement disorder in the elderly.

Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by an urge to move the extremities, mostly the legs, caused or accompanied by unpleasant sensations in the affected limbs. Symptoms appear or increase in the evening or during the night and at rest. Sleep disturbances are the most frequent reason why patients seek medical aid. The diagnosis of periodic limb movement disorder (PLMD) requires polysomnographic confirmation and relies on the exclusion of other causes of sleep disturbances. The diagnosis of RLS is a clinical one and usually based on the patient's history. Diagnosis criteria should be applied in a modified form in the cognitively impaired elderly. The newly revised criteria emphasize behavioral indicators and supportive features in diagnosing RLS in this special population. Prevalence of both disorders increases strongly with age. Epidemiological studies revealed a 9% to 20% prevalence of RLS and an estimated 4% to 11% prevalence of PLMD in the elderly. Recent studies indicate RLS occurring approximately twice as often in older women than in older men. Treatment with dopaminergic drugs, opioids, anticonvulsants or hypnotics are usually well tolerated in the elderly. However, interaction with other medications and the possibility of severe sedation due to slower metabolism in the elderly should be considered.

Aged↗