Movement disorders secondary to adulterated medication.
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Injections of bicuculline into the medial segment of the globus pallidus (GPi) of the monkey induced dose-dependent hypokinesia with dystonic attitudes in contralateral limbs whereas muscimol injections elicited choreiform movements. Injections of the same drugs in substantia nigra pars reticulata (SNr) provoked severe axial postural anomalies with rotational behavior. Conversely, contralateral hypertonia after bicuculline and contralateral hypotonia after muscimol injections were observed. These data suggest that GABA inputs into GPi and SNr play different roles in terms of motor and postural control and add new insights into the pathophysiology of dystonias.
From the picture of the cerebral disturbances of movement, the basically possible psychic sequelae are derived and psychodiagnostic problems and possibilities for the appraisal of the developmental stage and the intelligence of early registered children with cerebral disturbances of movement are discussed.
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Based on blind review of videotape recordings, we analyzed the ability of tetrabenazine to suppress abnormal movements. The recordings were done before treatment, after 3 weeks on a stable dose (up to 200 mg daily) of tetrabenazine, and then after 3 weeks on placebo. Among the patients who completed the trial, improvement occurred in 6 of 8 with Huntington disease, 6 of 10 with tardive dyskinesia, and 3 of 8 with dystonic disorders. The drug was usually tolerated well.
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Three patients are described who displayed syntactic writing errors in combination with a motor speech disturbance and impaired motor limb function. Two of the patients had bulbar amyotrophic lateral sclerosis (ALS). Agraphia appeared when verbal communication was no longer possible. Autopsy in one patient disclosed only lesions consistent with ALS. The third patient had palilalia and chorea and although not aphasic, his written language showed persistent syntactic errors. We hypothesize that the agraphia in these patients occurred because of the combination of disordered feedback from the motor speech apparatus and limbs.
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The wrist angle in X-ray pictures of the hand in 47 children, aged 6-16 years, treated for bone growth disorders, was evaluated. The obtained results were compared with the wrist angle in normal children. The increase of the wrist angle was observed in deformations: dwarfism, gargoylism and dysplasia multiplex, and the decrease of this angle in the Turner syndrome. The range of passive and active movements of the wrist was evaluated. Passive and active mobility of the wrist (especially the radial and the ulnar deviations) was smaller in the cases of increased wrist angle.