ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The term ataxia was originally applied to a specific disturbance of motor function that results in loss of coordination and voluntary movements. Subsequently, ataxia was defined as a disturbance which, quite independent of any motor weakness, alters direction and extent of voluntary movement and impairs the sustained voluntary or reflex muscle contractions necessary for maintaining posture and equilibrium (1). This includes static or postural ataxia, which is a disorder of the maintenance and regulation of voluntary and reflex muscle contractions, and kinetic ataxia, the disturbed coordination of purposeful movements.The major types of ataxias are cerebellar, sensory, labyrinthine, and psychogenic. Until recently the treatment of ataxias has been mainly physical, e.g., the use of weight on limbs. Within the last decade, use of pharmacological agents has been attempted with varying degrees of success (Table 1). This review will evaluate various pharmacological agents that have been used in attempts to treat cerebellar ataxia.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

There is a widespread distribution of dopamine receptors throughout the body (1). From the viewpoint of the treatment of Parkinson's disease, these can be divided into three main anatomical divisions: (a) inside the brain; (b) inside the brain, but outside the blood-brain barrier for dopamine, decarboxylase inhibitors, and domperidone. This group probably includes dopamine receptors in the chemotrigger receptor zone in the area postrema within the fourth ventricle, and possibly hypothalamic dopamine systems involved in endocrine control; (c) peripheral dopamine receptors.The pituitary dopamine (D2) receptor and vascular dopamine receptors have been known for some time (2–5). Dopamine receptors have been characterized in the animal stomach (6), the retina (7), the carotid body (8,9), and the superior cervical ganglion (10).There are substantial differences between dopamine receptors in the brain and those in peripheral tissues (11). Major behavioural effects of levodopa that are usually attributed at least in part to peripheral dopamine receptor stimulation, or at least to stimulation of brain receptors outside the blood-brain barrier, and that can be prevented by either decarboxylase inhibitors or domperidone, include (a) nausea and vomiting (stimulation of area postrema and gastric dopamine receptors); (b) hypotension (stimulation of renal and mesenteric vascular receptors); (c) hypoprolactinaemia (stimulation of pituitary receptors); and (d) alteration in respiratory control mechanisms (stimulation of carotid body receptors). In addition, in both normal and parkinsonian subjects, but not in acromegalics, levodopa causes stimulation of pituitary growth hormone release, probably by stimulation of hypothalamic dopamine systems.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A bewildering variety of pharmacological approaches to postherpetic neuralgia (PHN) have been described. Many of these have been uncontrolled, nonblinded, and have failed to take into consideration the natural history of the disorder and age of the subjects. The incidence of PHN 1 month following herpes zoster has been estimated at 9 to 14.3% (1–3). A steady, slower decline in this number has been noted over ensuing months so that at 3 months as few as 7% (1) and at 12 months only 2% of all patients (2) continued to suffer severely. Thus, any therapy for pain at the onset of the rash will be favorably influenced by this trend. Despite this overall low risk, a direct relationship of incidence at 1 month to age has been described so that 50% of patients at age 60 and 75% at age 70 will continue to suffer significantly (4). Any study of the treatment of PHN must allow for these facts and thus optimally be randomized, controlled, and double-blind. This article will review the more significant contributions to the literature on the management of this subject. Therapeutic approaches have been divided into (a) the prevention of PHN by treatment instituted at the onset of zoster and (b) the treatment of PHN of at least 1 month's duration.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Summary:Treatment of migraine with ergot alkaloids may produce systemic vasospasm in patients, especially as a result of automedication and overconsumption but also due to individual hypersensitivity. Peripheral vasoconstriction may lead to gangrene of the extremities, necessitating amputation. Various treatments have been tried against ischemic complications during ergotism with varied and unpredictable results. We report two recent cases of severe acute peripheral ischemia due to ergotamine abuse successfully treated with continuous systemic sodium nitroprusside infusion. The doses used during intraarterial injection are well below those known to be toxic. Consequently, the adverse effects of cyanide toxicity can be avoided. We think that intraarterial infusion of sodium nitroprusside, associated with forced diuresis and the administration of hydroxycobalamin, constitutes the treatment of choice of extreme peripheral ischemia of ergotism.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Summary:Experimental and human data in young volunteers suggest that tuberoinfundibular dopaminergic systems physiologically inhibit pituitary secretion of β-endorphin. This hypothesis was verified in patients with Parkinson's disease, a human model of a selective deficit of dopamine. Both previously untreated patients and patients who had been without chronic treatment for 1 week showed plasma β-endorphin levels significantly higher than those of healthy age-matched controls. Plasma β-lipotropin levels of patients and of controls were similar. There was no correlation between plasma opioid levels and age, severity, or duration of the disease. In five patients retested during chronic treatment, plasma levels both of β-endorphin and of β-lipotropin significantly decreased. This decrease approximately paralleled clinical improvement. The finding that in Parkinson's disease there is a reversible disinhibition of pituitary secretion of β-endorphin confirms that this secretion is physiologically inhibited by tuberoinfundibular dopaminergic systems.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Summary:Buspirone, an anxiolytic unrelated to benzodiazepines that may act at the presynaptic dopamine receptor, was given to 11 patients with Parkinson's disease in an open label study. Seven patients completed the initial 10 week study achieving doses of 50–70 mg/day without any significant change in their clinical status. Six patients continued for an additional 3–11 weeks with increases in dose to 65–100 mg/day. Two of the three most severely affected patients had mild worsening of parkinsonian symptoms. Buspirone is ineffective in the treatment of Parkinson's disease, but at anxiolytic doses (<40 mg/day) does not adversely affect parkinsonian disability.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Erythema multiforme is a serious condition that may occur in response to treatment with drugs, including anticonvulsant agents (1,2). The syndrome has been reported to recur with subsequent readministration of a known precipitating drug (2), but erythema multiforme occurring twice in the same individual in response to two different chemically unrelated anticonvulsant drugs does not appear to have been reported previously.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Electroconvulsive treatment (ECT) is an effective form of treatment for severe depression, acute mania, and certain schizophrenic syndromes (1). In this report we present a patient in whom ECT instituted for depression resulted in relief not only of the depression but also of coexisting akathisia. A literature survey revealed one other case in which akathisia, in association with parkinsonism and tardive dyskinesia, was relieved by ECT (2).Akathisia develops in ∼20% of patients who receive neuroleptic drugs (3). Because akathisia is often very distressing and drug treatment disappointing, the beneficial effect of ECT on akathisia may be of therapeutic interest.

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0362-5664    

出版商:OVID    

年代:1986

数据来源: OVID