Cryosurgery for parkinsonism and other abnormal movement disorders.
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The past year's literature on eye movements is characterized by two trends: first by the examination of eye movement organization in the three planes of eye rotation in normal subjects (there is yet no publication about abnormalities of this three-dimensional organization in patients) and second by the increasing awareness of clinicians that the characteristics of saccades are highly task-dependent, and that the saccadic performance of patients must be tested under various conditions. Several papers try to establish a correlation between the site of a lesion and abnormalities of specific parameters of task-dependent saccades. For a better understanding, the different experimental tasks for the elicitation of saccades are explained in the text.
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Defective pursuit eye movements were recorded by electrooculography (EOG) in 11 of 18 patients (61%) with amyotrophic lateral sclerosis. Pursuit defects consisted of a breakdown of smooth tracking into saccadic motions that were grossly in excess (frequencies and amplitudes) of saccadic interruptions of pursuit in normal subjects. In nine patients, defective pursuits cogwheeling) were obvious by visual inspection as well as by EOG; in two, this abnormality was seen only by EOG. In eight patients, the pursuit defect was the only abnormality of oculomotor function; in three, there were also saccadic defects (optokinetic nystagmus or conjugate gaze) discerned by EOG. Autopsy revealed neuronal degeneration in substantia nigra and demyelination in integral capsule in one patient with the pursuit defect but not in another patient without the defect. The pursuit defect may be a sign of extrapyramidal or supratentorial pyramidal involvement in ALS.
Two children developed involuntary movements while taking felbamate as an adjunct to their antiepileptic regimen. One exhibited choreoathetosis and the other an acute dystonic reaction. In both children the symptoms resolved with no recurrence after felbamate discontinuance.
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