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Pete Rose disease.

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Compulsive Behavior↗

[Complex use of benzodiazepines, lithium salts and haloperidol in the treatment of obsessive movements and tics of different origin].

Seventy-two children and adolescents with obsessive movements and tics of residual-organic etiology were treated by combined application of benzodiazepins (diazepam, phenazepam), lithium carbonate and haloperidol. The nature of obsessive syndromes and tics is considered in the light of the theory of generator mechanisms of neuropathological syndromes. The use of the studied combination due to its synergic action on the structures of the pathological system elicited a good therapeutic response while using lower doses of each drug (half to two-thirds of the conventional age-specific dosage). Reduction in drug doses in combined therapy decreases the risk of side effects and complications. The above treatment was followed by disappearance of essential and facultative symptoms in 21 patients, considerable improvement with a marked reduction of facultative symptoms in 22 cases, clear-cut improvement in combination with decreased facultative symptomatology in 14 patients, and insignificant improvement in 6 patients.

Adolescent↗

Place of dexfenfluramine in the management of obesity.

The treatment of obesity remains a puzzling challenge because long-term maintenance of weight loss--one of the most suitable goals--is rarely achieved with conventional methods. Among the theoretical measures able to maintain a permanent and bearable constraint to obtain the maintenance of weight loss is long-term (life-long?) pharmacotherapy. Dexfenfluramine is a good candidate for such a use; the demonstration of its long-term efficacy, i.e., maintenance of the initial weight loss with no escape with time, is in progress (ISIS study). Although the correct use of dexfenfluramine in obese patients remains to be more precisely defined, its pharmacological profile leads us to consider that it could be useful for those with normo or hyperphagia and stress induced compulsive feeding behavior, and/or for avoiding relapse in restrained patients. The use of dexfenfluramine must not excuse other types of interventions when needed.

Fenfluramine↗

Neuropsychiatric observations of proprioceptive sensitivity in motion sickness susceptibility.

The assessment of motion sickness susceptibility is still an unsolved problem, due in part to its unclear etiology. We studied 16 referred patients suffering from "idiopathic motion sickness" and 4 pilots suffering from motion airsickness. All clinical and neurological tests proved negative, including electroencephalograms, electronystagmograms, Doppler studies, and computerized tomography of the brain. Cervical spine X-rays and personality characteristics were assessed. Simultaneously, 35 asymptomatic pilots and pilot applicants were studied as controls. Both groups were exposed to cross-coupled accelerations on a Barany chair at 15 rpm along with 0.5 Hz head flexions. The pathological group showed a straightened cervical curvature as well as a significantly higher degree of malaise (scale of Graybiel and Lackner). Their personalities were highly alexithymic or obsessive compared to the control group (Kruskal-Wallis Test). Alexithymic and obsessive personalities may express their stress reactions and psychic conflicts through somatic signs, such as cervical muscle contractures; consequently, straightening the cervical spine with the subsequent alteration of proprioceptive inputs to the vestibular nuclei may increase motion sickness susceptibility.

Adult↗

Semiology, nosology and criteria for tic disorders.

Precise description of the signs, symptoms, classification and criteria for Tic Disorder and Gilles de la Tourette Syndrome (GTS) is important to reduce heterogeneity in studies and to develop hypotheses about the pathophysiology of these disorders. Previous diagnostic categories and criteria for Tic Disorders and GTS in DSM-III and ICD-9 were derived from our study of 114 consecutive patients, questionnaire responses by 31 patients and data on 76 patients from 8 published reports. During the past 20 years we have evaluated 1490 patients for movement disorders, of whom 1210 had GTS and 137 had another tic disorder. Analysis of these data and review of the literature serve as the basis for proposed revision of the signs, symptoms, nosology and criteria for Tic Disorders and GTS.

Compulsive Behavior↗

Tourette's syndrome: a treatable tic.

Tourette's syndrome, or Gilles de la Tourette's disease, is a disorder characterized by involuntary tic-like muscular movements, compulsive behaviour and involuntary vocalization of sounds, words or profanities. It begins in childhood and may persist for life, with a varied pattern and course. Recent studies indicate an organic basis for the disorder, and an abnormality of dopamine or purine metabolism has been suggested. The treatment of choice is haloperidol administration; most patients do well with low or moderate doses for long periods. Because these patients are often mistakenly regarded as anxious, psychoneurotic or hysterical, correct diagnosis is important if they are to be treated appropriately and regarded properly in the home, school and society.

Butyrophenones↗