摘要:

AbstractThree patients with a clear‐cut history of essential tremor of the upper limbs presented with the clinical features reported by Heilman as orthostatic tremor. Electromyographic findings included 6–8 Hz postural tremor in all four limbs. Highly synchronized 16 Hz rhythmic discharges were found in the legs upon standing. This peculiar pattern of discharge was also observed in the upper limbs and spinal muscles. High frequency rhythmic bursts, either alternating or co‐contracting were present in specific postures not necessarily related to standing. An additional group of 12 patients with postural tremor of the legs was studied; seven of these showed modification in the frequency and synchronization of the muscle discharges upon standing. Although none of them had the full‐blown clinical syndrome of orthostatic tremor, they complained of mild unsteadiness upon standing, together with a vague sensation of stiffness in the lower limbs. The present findings induce us to think that there might be a link between essential tremor and the so‐called orthostatic tremor. Orthostatic tremor might be an essential‐tremor‐related entity that may be caused by a derangement in the central mechanism in charge of the organization of certain motor activities, not necessarily controlling the stan

ISSN:0885-3185    

DOI:10.1002/mds.870030201

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

年代:1988

数据来源: WILEY

摘要:

AbstractMovement disorders other than cerebellar tremor are rare clinical manifestations of multiple sclerosis (MS). Two cases of parkinsonism and a case of chorea associated with MS are reported, and the literature is reviewed.

ISSN:0885-3185    

DOI:10.1002/mds.870030202

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

年代:1988

数据来源: WILEY

摘要:

AbstractAdministration ofL‐dopa (L, 4‐dihydroxyphenylalanine) (200mg/kg p.o.) to rats produced elevated plasma and muscle concentrations of bothL‐dopa and 3‐O‐methyldopa (3‐OMD). This effect was potentiated by simultaneous administration of carbidopa (25 mg/kg p.o.) bothL‐dopa and 3‐OMD accumulated in muscle after administration ofL‐dopa with or without carbidopa. Elevated dopamine levels were detected in both muscle and plasma after treatment withL‐dopa alone. Concurrent administration of carbidopa only diminished dopamine levels in plasma, and the duration of raised dopamine levels in muscle was increased. Carbidopa administration had no effect on the elevated plasma concentrations of 3,4‐dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) caused byL‐dopa administration. In muscle, carbidopa treatment tended to prolong the duration of raised metabolite levels. Muscle appears to accumulateL‐dopa at a site where decarboxylation is not totally prevented by concurrent carbidopa administration, and where dopamine is not degraded as actively as in other tissues. The muscle sink forL‐dopa may influence the plasma profile of the amino acid, which has implications for the therapeutic response toL

ISSN:0885-3185    

DOI:10.1002/mds.870030203

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

年代:1988

数据来源: WILEY

摘要:

AbstractRapid elbow flexion movements were studied in patients with an upper motor neuron syndrome following a stroke. The velocity of movements was slower than normal. The initial bursts of electromyographic (EMG) activity in both the agonist and antagonist muscles were prolonged. As in normal subjects, the first agonist burst increased in duration with larger movements, but it generally remained about 40 ms longer than normal. The size of the first agonist burst also increased with larger movements. A fixed linkage between burst duration and level of motor unit recruitment, together with a deficient corticospinal command, could explain the prolonged burst duration with preserved ability to modulate the burst.

ISSN:0885-3185    

DOI:10.1002/mds.870030204

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

年代:1988

数据来源: WILEY

摘要:

AbstractThe effect of isoniazid on levodopa‐induced dyskinesias has been evaluated in 20 patients with Parkinson's disease, following a serendipitous observation that choreic dyskinesias induced by levodopa in one parkinsonian patient were markedly reduced during treatment with isoniazid for tuberculous infection. A mean average isoniazid dose of 290 mg was given without any change in current antiparkinsonian treatment. “Benefit of dose” choreic dyskinesias were markedly reduced in 18 patients within the first few weeks of treatment. This effect was accompanied by an intolerable worsening of parkinsonian signs. All patients returned to their basal situation after isoniazid interferes with the therapeutic action of levodopa and dopamine agonists. The precise mechanism by which this action occurred is not known, but several possible explanations are disc

ISSN:0885-3185    

DOI:10.1002/mds.870030205

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

年代:1988

数据来源: WILEY

摘要:

AbstractA 60‐year‐old man who had Parkinson's disease for 25 year became unable to maintain the upright position of the trunk while standing or walking. Because of a loss of postural fixation, his trunk sank forward until his back was horizontal. Fifteen years before, a bifocal implantation of radioactive yttrium‐90 had been performed by a stereotaxic procedure at the level of the globus pallidus (GP) and the ventrolateral thalamus, respectively on the right side. A second operation, 2 years later, had been made by electrocoagulation in the left ventrolateral thalamus. Postmortem examination showed the following features (a) neuronal cell loss in the pigmented nuclei of the brainstem with intracellular Lewy bodies and gliosis. These data corresponded with the usual pathology of idiopathic Parkinson's disease; (b) surgical lesions resulting from the previous stereotaxic operations in the right GP and the ventrolateral thalamus on both sides and (c) neuronal cell loss without gliosis in the right GP that was evident in regions spared by the surgical lesion. Moreover, these degenerative changes were particularly seen in the left GP, which was surgically unlesioned. The ansa lenticularis was demyelinated on both sides. These data might be consistent with a retrograde degenerative process affecting the pallidothalamic projections. Beside the role of the neuronal cell loss affecting the pars compacta of the substania nigra (SN) in akinesia, the role of the lesions affecting the G.P. in the genesis of postural disorders is sugg

ISSN:0885-3185    

DOI:10.1002/mds.870030206

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

年代:1988

数据来源: WILEY

摘要:

AbstractIt has been suggested that patients with Parkinson's disease have a basic deficit in shifting “set.” Previous authors have used this hypothesis as an explanation for deficits on a range of cognitive tasks. An experiment was conducted to investigate this phenomenon. A reaction time paradigm was used in which the subject had to make left‐right decisions under two stimulus conditions. Both patients and controls showed a facilitation in performance with repetition within each blcok of trials, followed by a deterioration in performance when the stimulus type switched. Furthermore, the shapes of the reaction‐time functions were equivalent in both groups, suggesting that the patients had no deficit in either switching or establishing set in this task. In contrast, they were impaired on the Wisconsin Card Sorting Test. This dissociation suggests that patients with Parkinson's disease do not have a generalized deficit in switching set. It is suggested that patients with Parkinson's disease are impaired on tasks where they have to rely upon internal control for the regulation of behaviour, but are relatively unimpaired on tasks where external cues are av

ISSN:0885-3185    

DOI:10.1002/mds.870030207

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

年代:1988

数据来源: WILEY

摘要:

AbstractA 45‐year‐old women with an acquired multifocal neurologic syndrome, including chorea, dystonia, cerebellar dysfunction, multiple cranial neuropathies, and pure sensory neuropathy, was found at autopsy to have oat cell carcinoma. Neuropathologic examination revealed serveral features typically associated with remote effects of malignancy on the nervous system. We believe that this is the first described case of chorea as a remote effect of maligna

ISSN:0885-3185    

DOI:10.1002/mds.870030208

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

年代:1988

数据来源: WILEY

摘要:

AbstractPrimary Meige syndrome is a form of cranial dystonia of unknown cause. Only three postmortem studies have been reported, and the results of these studies have not been consistent. We have examined the brain of a 72‐year‐old man with typical primary Meige syndrome and found mild to moderate cell loss in the zona compacta of the substanita nigra, locus ceuleus, midbrain tectum, and dentate nucleus of the cerebellum. Also frequent lewy bodies were present in pigmented nuclei of the brainstem. No abnormalities were detected elsewhere. These pathological findings support the notion that brainstem pathology is important in the pathophysiology of cranial dysto

ISSN:0885-3185    

DOI:10.1002/mds.870030209

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

年代:1988

数据来源: WILEY

摘要:

AbstractA 49‐year‐old man developed a syndrome of crural‐axial dystonia combined with segmental myoclonus 3 months after the onset of meralgia paraesthetica of the left leg. The association of this remarkable movement disorder with the pain syndrome is disc

ISSN:0885-3185    

DOI:10.1002/mds.870030210

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

年代:1988

数据来源: WILEY