ISSN:0885-3185    

DOI:10.1002/mds.870060102

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

年代:1991

数据来源: WILEY

摘要:

AbstractTwo distinct neuronal inclusions occur in Parkinson's disease. The Lewy body is the diagnostic hallmark and is recognized by its eosinophilic body and unstained halo. It can be found in specific regions of the nervous system, where its frequency, size, shape, and structure differ. Large neurons of the dorsal vagal nucleus and sympathetic ganglia often contain particularly large quantities of Lewy‐body‐like matter. It consists of filament in the outer part and electron dense material in the core, the outer part staining with silver and with antibodies to neurofilament and tubulin. The pale body is restricted to the substantia nigra and locus ceruleus. It does not react with conventional stains, silver, or neurofilament antibodies, and has a homogeneous structure with a granular and vesicular surface texture. It contains sparse granular matter, vacuoles, and filaments, surrounded by melanin. The Lewy body and pale body may be juxtaposed or contiguous in some cells, but their distinct appearances and structures indicate that they are separate inclusi

ISSN:0885-3185    

DOI:10.1002/mds.870060103

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

年代:1991

数据来源: WILEY

摘要:

AbstractStiff‐person syndrome (SPS) is characterized by progressive, usually symmetric rigidity of the axial muscles with superimposed painful spasms precipitated by tactile stimuli, passive stretch, volitional movement of affected or unaffected muscles, startling noises, and emotional stimuli. Electromyography demonstrates continuous normal motor unit potentials in the affected muscles. Both the rigidity and the spasms are relieved by sleep, general anesthesia, myoneural blockade, peripheral nerve blockade, and partially by diazepam. Evidence for an autoimmune etiology of SPS includes its association with other autoimmune diseases and autoantibodies and the presence of antibodies against glutamic acid decarboxylase (GAD) in the cerebrospinal fluid (CSF) of many affected patients. We describe two patients with this syndrome who had GAD antibodies in both CSF and serum. Partial relief of the symptoms in these patients by corticosteroid therapy provides additional evidence of an autoimmune etiology of SPS and of the role of immunotherapy in its treatmen

ISSN:0885-3185    

DOI:10.1002/mds.870060104

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe hemodynamic effects of triglycyl‐lysine‐vasopressin (TGLVP) were investigated in a single‐blind study in seven patients with chronic orthostatic hypotension and parkinsonism. Blood pressure, heart rate, and stroke volume were measured in the supine position before and after bolus injection of either placebo or TGLVP (5.0, 7.5, or 10.0 μg/kg of body weight). After 40 min in the supine position, the patients were head‐up tilted to 45° for 20 min. All patients underwent four tilt studies with different medication. The TGLVP increased supine blood pressure by approximately 25% and total peripheral resistance by approximately 46%, and reduced heart rate by approximately 13%. No changes in supine stroke volume or cardiac output were seen. The TGLVP slightly reduced the relative fall in blood pressure and increased heart rate during the tilt. After TGLVP, blood pressure levels during tilt were similar to supine levels prior to medication. The TGLVP did not change the effects of tilt on stroke volume or cardiac output. Only few and mild side effects were experienced and no cardiotoxic effects were observed. In conclusion, TGLVP showed marked blood pressure effects of very small doses in this category of patients. The clinical effects of TGLVP and other vasopressor‐specific analogs of vasopressin should be tested in the

ISSN:0885-3185    

DOI:10.1002/mds.870060105

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to determine if patients with focal hand dystonia have any significant psychopathology. We studied 20 patients with hand cramps who were participating in a therapeutic trial of botulinum toxin injectins. Patients were interviewed and administered the Minnesota Multiphasic Personality Inventory (MMPI), Beck Depression Inventory, Spielberger State‐Trait Anxiety Scale, a finger tapping test, and a choice serial reaction time test. Behavioral ratings were also obtained. Group statistics indicated that all personality scale scores and performances on motor tasks were within normal limits. Four out of 20 patients demonstrated mild depression. Trait anxiety scores were higher than state anxiety scores, suggesting that receiving medical treatment had a beneficial effect on mood. The number of depressive symptoms endorsed on the MMPI was correlated with reaction time speed but not finger dexterity. None of the 20 patients reported a remarkable psychiatric history. These results indicate that hand cramps are not associated with serious psychopatholog

ISSN:0885-3185    

DOI:10.1002/mds.870060106

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe study was conducted on 120 patients (76 men and 44 women) affected by idiopathic Parkinson's disease (IPD) responsive to L‐dopa and observed for many years. Sixty had clinical onset between the ages of 20–40, representing 10.2% of our PD population; in the others the symptoms began after the 40th birthday. The two groups were matched for sex and length of illness. In all patients a diagnosis of IPD depended on history and clinical and neuroradiological findings. Clinical, pharmacological, evolutive, and epidemiological data were collected on all patients. Thirty‐six patients from each group performed motor dexterity tests (reaction time to expected and unexpected stimuli) and cognitive tests (Wechsler Adult Intelligence Scale, Benton, Short tale, and Zazzo's speed and accuracy test). To assess the prevalence of dementia and the severity of psychiatric side effects of L‐dopa administration, the 60 patients with early‐onset PD were compared with 134 consecutive unselected PD patients. Five percent of early‐onset PD patients had a family history of the disorder. Our study showed that early‐onset PD does not differ fundamentally from the late‐onset form except that the former is characterized by a more rapid establishment of the full‐blown parkinsonian clinical picture and deterioration of the therapeutic efficacy of L‐dopa, with an earlier appearance of side effects. The results of our neuropsychological investigation suggest that early‐onset PD may be a “pure” form of extrapyramidal compromise with exclusi

ISSN:0885-3185    

DOI:10.1002/mds.870060107

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

年代:1991

数据来源: WILEY

摘要:

AbstractA 55‐year‐old man with a 4½‐year history of paroxysmal bouts of involuntary large‐amplitude flexion jerks of the trunk and a 1‐year history of persistent rhythmic small‐amplitude movements of the anterior abdominal wall is described. Clinical and electrophysiological evidence suggested that the paroxysmal myoclonus arose in propriospinal systems intrinsic to the

ISSN:0885-3185    

DOI:10.1002/mds.870060108

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

年代:1991

数据来源: WILEY

摘要:

AbstractMotor potentials evoked in the biceps, thenar, and tibialis anterior muscles by electrical stimulation of the scalp and of the spinal regions were recorded in 12 patients with progressive supranuclear palsy (PSP) and in a control group. Abnormalities of central motor conduction for at least one muscle were present in five patients (41.7%), characterized by a long illness duration. The central sensory conduction time of the median nerve was normal, but five patients showed a depressed frontal N30 wave. These findings support the possible occurrence of functional damage to the corticospinal tracts and to the supplementary motor area in PSP.

ISSN:0885-3185    

DOI:10.1002/mds.870060109

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

年代:1991

数据来源: WILEY

摘要:

AbstractTwelve patients with writer's cramp were treated with injections of botulinum toxin. The overactive muscles were identified by clinical observation of the subjects while they were writing. Repeated injections were given at 2‐week intervals until the optimal response was obtained. Eleven patients reported some benefit, which was considered by seven to be significant. Eight of the 10 patients who had pain reported moderate to significant relief. Five patients had local complications, consisting of disabling weakness of target or neighbouring muscles. These preliminary results suggest that this treatment can be successfully applied to many patients with writer's cramp without performing complex electromyographic recordings while the patients are writin

ISSN:0885-3185    

DOI:10.1002/mds.870060110

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

年代:1991

数据来源: WILEY

摘要:

AbstractOrthostatic tremor is characterized by tremor of the trunk and legs while standing. Rapid frequency has been emphasized as an important criterion for the diagnosis of this tremor. We observed five patients who had the typical findings of orthostatic tremor but had a wide range of frequencies. All five also had postural hand tremor and a family history of essential tremor, suggesting a relationship between orthostatic tremor and essential tremor. This report also emphasizes the association of orthostatic tremor with painful cramps and a relatively consistent improvement with clonazepam.

ISSN:0885-3185    

DOI:10.1002/mds.870060111

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

年代:1991

数据来源: WILEY