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At least 1,279 records · Page 71Linked to original sources
PubMed1999

The treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Review.

A task force consisting of six authors reviewed the published literature on the therapy of the restless legs syndrome or periodic limb movements in sleep available in indices through April, 1998. They selected the 45 articles for detailed review which presented original investigations of therapeutic impact on the restless legs syndrome (RLS) or periodic limb movements (PLM) and which met minimal standards. These articles dealt with a range of pharmacological and other treatment modalities, although most dealt with medications and almost half of those concentrated on dopaminergic agents, especially levodopa in various formulations. Almost half of the articles reviewed used controlled methodologies, most commonly cross-over methodologies with randomized allocation of subjects. Multi-center studies with large numbers of subjects and long-term controlled studies were not found. Information was extracted from the articles and study design, clinical definition, evaluative measures, side effects, and outcomes were tabulated in 6 evidence tables and summarized in the accompanying text. This literature was evaluated for the nature of the studies performed and its coverage of potential therapies. The review concludes with comments on possible future directions for therapeutic investigation based on the current state of the literature.

Diagnosis, Differential↗
PubMed1984

Myorhythmia: a widespread movement disorder. Clinicopathological correlations.

The clinical manifestations of 24 cases and the autopsy findings of 6 cases of extremity myorhythmia are presented. Extremity myorhythmia is that form of myorhythmia in which rhythmic alternating movements predominantly involve the limbs. The main difference between the tremor of extremity myorhythmia and the tremor of parkinsonism is the slower tremor rate, 2 to 3 cycles/s in myorhythmia and 4 to 6 cycles/s in parkinsonism. The mechanograms, except for the slower frequencies in myorhythmia, can be very similar, including sinusoidal oscillation patterns in both conditions. Myorhythmia may be defined as a coarse, alternating tremor, present at rest and usually during movement, which occurs at rates varying from 50 to 240 oscillations/min but mostly at either 120 to 140 or 160 to 180 cycles/min. The alternating movements may be intermittent or continuous or both types may be present in different body parts. When multiple parts are involved, synchronous or asynchronous movements are about equally common. Movements are usually relatively rhythmic and regular but may vary over periods of time in rate, rhythm or amplitude and rarely so, even over the course of a few hours and are absent during sleep. Movements may involve single limbs, several limbs or a combination of limbs plus face, palate, head, jaw, neck, tongue, eyes or trunk. The frequency of the movements in the 24 cases varied from 120 to 180 oscillations/min with two exceptions the slowest being 60 and the fastest 240, with most tending to cluster near either 120 or 180 cycles/min. The most common aetiologies were brainstem vascular disease and cerebellar degeneration secondary to chronic alcoholism-nutritional deficiency. The best prognosis occurred in the latter group. Clinicopathological correlations in our autopsy series indicate that myorhythmia of the limbs may occur ipsilateral to the dentate nucleus or superior cerebellar peduncle lesions or contralateral to inferior olive involvement. Unilateral lesions of the dentate nucleus may result in bilateral limb movements and bilateral dentate lesions may be associated with unilateral limb movements. The frequent involvement of the cerebellum and the substantia nigra suggests possible roles for the cerebellum and substantia nigra in the myorhythmia process.

Adult↗
PubMedDate not supplied

[Objective evaluation of movement disorders using the Aktograf].

The authors describe the application of Akt -30 Aktograf apparatus designed by the branch of the Centre of Medical Technique in Bia ł ystok for recording extrapyramidal involuntary movements, cerebellar dyssynergia and clonic movements.

Adolescent↗
PubMed1992

Tardive dyskinesia. Patients' lack of awareness of movement disorder.

Of 113 patients in long-stay wards of a psychiatric hospital, 43 had TD. Twenty-six of the 39 patients who consented to take part in the study were unaware of abnormal involuntary movements. These patients scored significantly lower on a short test of cognitive function than patients who were aware of such movements. The diagnosis of schizophrenia, particularly the 'defect' state with cognitive deficit and negative symptoms, was found to be associated with lack of awareness of TD.

Adult↗
PubMed1992

Gaze and eye movement disorders.

Cortical areas were explored with regard to saccade control: the lateral intraparietal (LIP) area is involved in the spatial aspects of sensorimotor processing; the supplementary motor area in goal-directed gaze control; and from lesion studies; the posterior parietal cortex in triggering visually guided saccades. Different studies have suggested that the spatial-to-temporal transformation takes place in the superior colliculus (SC) and the cerebellum. When the vestibulo-ocular reflex (VOR) produces inadequate eye movements, other supplementary mechanisms (e.g. non-visual, saccade) may play a role in correcting gaze. A classification of central vestibular disorders of the brainstem and VOR has been proposed, as manifested in any one of the three major planes of action (yaw, pitch and role).

Cerebral Cortex↗
PubMed1994

Propofol--contrasting effects in movement disorders.

We report two patients presenting for thalamotomy in whom tremor was abolished for 8 h after propofol anaesthesia. Propofol has two contrasting actions. It may have an anti-Parkinsonion effect, abolishing abnormal limb movements. On other occasions, propofol is known to induce spontaneous abnormal limb movements, as well as epileptiform activity. Propofol is probably best avoided for stereotactic procedures. It is difficult to reconcile these two opposing actions.

Anesthesia, Intravenous↗
PubMedDate not supplied

[Dissociation between movement disorders and EEG shifts in amphetamine-induced stereotypy in the cat].

In experiments on cats it is established that between the degree of EEG desynchronization in the sensorimotor cortex and expressiveness of the stereotype movements, a dissociation is possible which is most distinctly revealed in comparative studies of haloperidol, clozapine and metoclopramide--neuroleptics with different correlation of antipsychotic and extra-pyramidal properties. Local destruction of the ventral parts of the caudate nucleus head enhances motor disturbances resulting from amphetamine administration, but weakens its effect on the cortex. Elimination of the dorsal parts produces an opposite effect. It is suggested that the cause of the dissociation consists in different sensitivity to amphetamine of the dorsal and ventral parts of the neostriatum which are differently involved in organization of stereotype movements and EEG disturbances in amphetamine stereotypy.

Amphetamine↗
PubMed1991

Patterns of manual dominance in patients with neuroleptic-induced movement disorders.

To explore the association between patterns of manual dominance and extrapyramidal symptoms we examined 32 chronic schizophrenic inpatients at Camarillo State Hospital for signs of tardive dyskinesia (TD) and neuroleptic-induced parkinsonism (NIP) using clinical rating scales (Abnormal Involuntary Movement Scale and Columbia Unified Parkinsons Disease Rating Scale) and specialized electromechanical instruments. Manual dominance was assessed using an eight-item hand preference demonstration test. Patients were divided into dextral (consistent use of right hand) and nondextral (any use of the left hand) groups. Dextrals showed a higher prevalence of TD than nondextrals on clinical rating measures (p less than 0.01). Orofacial ultrasound measures of TD revealed a similar association between TD and handedness. The two handedness groups did not differ on either the clinical or electromechanical measures of NIP. Interestingly, 28 of the 32 patients showed greater left than right facial movement. It is hypothesized that patients with more standard patterns of manual dominance may be at higher risk for TD than those with atypical patterns.

Adult↗
PubMedDate not supplied

H-reflex testing to determine the neural basis of movement disorders of neurologically impaired individuals.

The H-reflex is an indirect measure of the excitability levels of alpha motoneurons. The authors have developed an adaptation of H-reflex testing which allows the continuous monitoring of human alpha motoneuron activity during movement. The technique differs from previously used H-reflex testing techniques in that it utilizes a 5 Hz stimulation to elicit the H-reflex. This allows for continuous and concomitant H- and M-wave recordings during a movement. This is an improvement over past single stimulus techniques in that the time and discomfort associated with this type of experimentation is greatly decreased. The repetitive stimulation technique enables H-reflex testing to be used clinically with neurologically impaired patient populations. Thus far, the authors have used the repetitive H-reflex testing procedures to assess alpha motoneuron activation and reciprocal inhibition of antagonist musculature during voluntary movement and anticipatory postural control responses of non-disabled individuals and of individuals with cerebral palsy. This paper describes the methodology involved in this technique and reports the results obtained.

Adolescent↗