摘要:

AbstractThe purpose of this study was to determine the prevalence and functional and diagnostic correlates of reported shaking in the community‐dwelling elderly. We conducted a standardized neurological evaluation of 1,056 nondemented Medicare recipients in Washington Heights‐Inwood, Northern Manhattan (New York). Of 1,056 patients, 108 reported shaking (10.2%). The prevalence of reported shaking did not increase with age. It did differ between ethnic groups, but when adjusted for depression and score on the Schwab and England Activities of Daily Living (ADL) scale, this difference was insignificant. The age‐adjusted prevalence was similar for women and men. Neurological examination of the 108 who reported shaking showed that 8.3% had tremor at rest, 17.6% had tremor with action, 5.6% had dyskinesia or chorea, and an additional 28.7% had various problems in coordination or movement. The remaining 39.8% had neither tremor nor problems in coordination or movement. Only 2.9% of individuals with reported shaking had Parkinson's disease (PD), 8.7% had essential tremor, and 2.1% had oral‐buccal‐lingual dyskinesia. Of the remaining 86.3%, 29 (31%) had no identifiable medical condition. Those who reported shaking were less independent with ADLs, regardless of presence of tremor on examination. Shaking is commonly reported by the community‐dwelling elderly. It does not necessarily identify individuals with essential tremor and PD, and is related to decreased independe

ISSN:0885-3185    

DOI:10.1002/mds.870110112

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

摘要:

AbstractEighty‐seven patients, aged 15–84 years (mean, 61.8 ± 16.2 SD), with essential tremor wrote two series of cursive e's and cursive l's on a standard sheet of ruled paper that was mounted on a commercially available digitizing tablet. Forty patients also drew an Archimedes spiral. Postural wrist tremor was measured with a triaxial accelerometer on the dorsum of the horizontally extended hand. The digitizing tablet was sufficiently sensitive to measure sustained visible tremor. Very severe tremor could not be recorded when it prevented a patient from keeping the ballpoint pen on the tablet. The intertrial variability of the handwriting data was such that a 36.0% change in mean acceleration amplitude (cm/s2) and an 8.3% change in mean tremor frequency (Hz) could be detected in a hypothetical population of 30 patients (paired‐samplettest,p= 0.01, power = 90%). The intertrial changes detectable with accelerometry were 35.9% (amplitude) and 7.8% (frequency). The correlations between wrist tremor and writing tremor were<0.60 for amplitude and<0.25 for frequency. Significant correlations between patient age and tremor frequency and between tremor amplitude and frequency existed for postural tremor but not for writing or drawing tremor. Standard digitizing tablets for personal computers are useful in the quantitative assessment of writing tremor. The amplitude and frequency characteristics of tremor in posture, writing, and drawing may differ signifi

ISSN:0885-3185    

DOI:10.1002/mds.870110113

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

摘要:

AbstractPatients with cervical dystonia or tics of the nuchal muscles can develop serious cervical spine disease. We report a series of four patients who received botulinum toxin injections to control their movement disorders prior to their required surgery. One patient with cervical tic–induced radiculomyelopathy required botulinum toxin injection postoperatively to facilitate stabilization of the cervical fusion. Two patients with torticollis‐induced cervical radiculomyelopathy, and one patient with dystonia‐induced C5 fracture, had botulinum toxin injected pre‐operatively to facilitate postoperative recovery. Botulinum toxin appears to be a useful adjunct in the treatment of cervical movement disorders prior to or following surgery for associated cervical spine

ISSN:0885-3185    

DOI:10.1002/mds.870110114

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

摘要:

AbstractPainful legs, moving toes is a rare syndrome characterized by leg pain and uncontrolled toe movements. We present a 35‐year‐old man with a 1‐year history of unilateral knee, calf, and medial ankle pain with spontaneous movements of second through fifth toes. Electrodiagnostic studies showed an absent lateral plantar nerve response consistent with a tarsal tunnel entrapment neuropathy. Cine magnetic resonance imaging revealed a large accessory soleus muscle compressing the flexor hallucis longus in the tarsal tunnel of the affected extremity. Lidocaine block of the tibial nerve at the popliteal fossa did not stop these movements, but blockade of the medial and lateral plantar nerves distal to the medial malleolus stopped them temporarily. Treatment with foot orthotics and cessation of running activity decreased the symptoms. We conclude that painful leg and moving toes in this patient resulted from a compression neuropathy at the tarsal tunnel possibly caused by a large adjacent accessory soleus m

ISSN:0885-3185    

DOI:10.1002/mds.870110115

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

摘要:

AbstractThe clinical and electrophysiological features of stimulus‐sensitive truncal myoclonus are described in a 49‐year‐old woman. Touching the skin of the back and abdomen would evoke jerks in both ipsilateral and contralateral axial muscles; there was no spontaneous jerking. Multichannel EMG recordings showed bilateral short‐latency muscle bursts at truncal recording sites both rostral and caudal to stimulus sites. The short latencies of muscle bursts in adjacent segments give evidence of a spinal origin of myoclonus; the pattern of recruitment and the velocity of spread suggest the involvement of propriospinal pathways. The presence of intrathecal IgG synthesis and of oligoclonal bands in the CSF point towards an inflammatory process which may underly the unusual type of myoclonus in this

ISSN:0885-3185    

DOI:10.1002/mds.870110116

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

摘要:

AbstractThe motor effects of the short‐acting, full D1agonist SKF 82958 were studied in three drug‐naive, 1‐methyl‐4‐phenyl‐1, 2, 3, 6‐tetrahydropyridine‐lesioned, parkinsonian monkeys treated for 4 weeks. D1receptor stimulation with SKF 82958 effectively relieved parkinsonism but induced choreic dyskinesia (n = 2) and a shorter duration of motor benefit (n = 3) over time. Isolated, short‐lived D1receptor activation would not appear to confer advantage over levodopa for dyskinesia prevention. Our data also support the involvement of postsynaptic dopamine receptor mechanisms in the wearing‐off phenomenon seen in levodopa‐treated

ISSN:0885-3185    

DOI:10.1002/mds.870110117

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

ISSN:0885-3185    

DOI:10.1002/mds.870110118

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

ISSN:0885-3185    

DOI:10.1002/mds.870110119

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

ISSN:0885-3185    

DOI:10.1002/mds.870110120

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY

ISSN:0885-3185    

DOI:10.1002/mds.870110121

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1996

数据来源: WILEY