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Neurology. Clinical Practice Dec 2023The objective of this study was to explore the clinical spectrum of movement disorders and associated neurologic findings in hypomagnesemia and challenges in diagnosis... (Review)
Review
PURPOSE OF REVIEW
The objective of this study was to explore the clinical spectrum of movement disorders and associated neurologic findings in hypomagnesemia and challenges in diagnosis and treatment.
RECENT FINDINGS
Sixty patients were identified in the literature for analysis. Movement disorders observed were postural tremor (23.3%, n = 14), resting tremor (8.3%, n = 5), intention tremor (10%, n = 6), ataxia involving the trunk (48.3%, n = 29) or limbs (25%, n = 15) and dysarthria (21.7%, n = 13), athetosis (8.3%, n = 5), myoclonus (6.7%, n = 4), and chorea (1.8%, n = 1). Symptoms may be accompanied by downbeat nystagmus, tetany, drowsiness, vertigo, and proximal muscle weakness. Residual deficits were noted in 16 (26.67%) patients. Serum magnesium was 1.3 mg/dL or lower in 53 patients (88.3%). Imaging findings include bilateral cerebellar (20%, n = 11) and vermis hyperintensities (9.09%, n = 5) and normal imaging. Proton pump inhibitors are the commonest etiology.
SUMMARY
The movement disorders linked with hypomagnesemia can be associated with varied neurologic symptoms. A high degree of suspicion will enable early diagnosis to prevent residual deficits.
PubMed: 37795503
DOI: 10.1212/CPJ.0000000000200202 -
Cureus Jul 2023Involuntary movement disorders include tremors, tics, myoclonus, athetosis, chorea, dystonia, and dyskinesia. Neuroleptic drugs have the propensity to cause...
Involuntary movement disorders include tremors, tics, myoclonus, athetosis, chorea, dystonia, and dyskinesia. Neuroleptic drugs have the propensity to cause extrapyramidal side effects. Lithium-induced coarse tremors are well documented and may occur at therapeutic serum concentrations (0.8-1.0 mEq/L) in the treatment of bipolar disorder. Treatment for coarse tremors due to lithium includes either dose reduction or non-selective beta-blockers. To our knowledge, there are only four case reports regarding the lithium-induced awakening of cell memory of involuntary movement disorders worldwide. In scientific literature, only two drugs have the propensity to reawaken past cell memory. These intriguing findings can have a wider application across fields such as past-life regression therapy, post-traumatic stress disorder, catharsis, or recall of sub-aural temporal high-frequency burst-erased memory-type of mind-altering techniques. We report a case of lithium-induced awakening of the cell memory of involuntary dyskinesia in a female who took treatment for bipolar disorder in the past.
PubMed: 37641744
DOI: 10.7759/cureus.42592 -
Clinics and Practice Aug 2023Drug-induced movement disorders affect a significant percentage of individuals, and they are commonly overlooked and underdiagnosed in clinical practice. Many... (Review)
Review
Drug-induced movement disorders affect a significant percentage of individuals, and they are commonly overlooked and underdiagnosed in clinical practice. Many comorbidities can affect these individuals, making the diagnosis even more challenging. Several variables, including genetics, environmental factors, and aging, can play a role in the pathophysiology of these conditions. The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD) are the most commonly used classification systems in categorizing drug-induced movement disorders. This literature review aims to describe the abnormal movements associated with some medications and illicit drugs. Myoclonus is probably the most poorly described movement disorder, in which most of the reports do not describe electrodiagnostic studies. Therefore, the information available is insufficient for the diagnosis of the neuroanatomical source of myoclonus. Drug-induced parkinsonism is rarely adequately evaluated but should be assessed with radiotracers when these techniques are available. Tardive dyskinesias and dyskinesias encompass various abnormal movements, including chorea, athetosis, and ballism. Some authors include a temporal relationship to define tardive syndromes for other movement disorders, such as dystonia, tremor, and ataxia. Antiseizure medications and antipsychotics are among the most thoroughly described drug classes associated with movement disorders.
PubMed: 37623268
DOI: 10.3390/clinpract13040087 -
Child's Nervous System : ChNS :... Oct 2023Non-spastic movement disorders in children are common, although true epidemiologic data is difficult to ascertain. Children are more likely than adults to have... (Review)
Review
BACKGROUND
Non-spastic movement disorders in children are common, although true epidemiologic data is difficult to ascertain. Children are more likely than adults to have hyperkinetic movement disorders defined as tics, dystonia, chorea/athetosis, or tremor. These conditions manifest from acquired or heredodegenerative etiologies and often severely limit function despite medical and surgical management paradigms. Neurosurgical management for these conditions is highlighted.
METHODS
We performed a focused review of the literature by searching PubMed on 16 May 2023 using key terms related to our review. No temporal filter was applied, but only English articles were considered. We searched for the terms (("Pallidotomy"[Mesh]) OR "Rhizotomy"[Mesh]) OR "Deep Brain Stimulation"[Mesh], dystonia, children, adolescent, pediatric, globus pallidus, in combination. All articles were reviewed for inclusion in the final reference list.
RESULTS
Our search terms returned 37 articles from 2004 to 2023. Articles covering deep brain stimulation were the most common (n = 34) followed by pallidotomy (n = 3); there were no articles on rhizotomy.
DISCUSSION
Non-spastic movement disorders are common in children and difficult to treat. Most of these patients are referred to neurosurgery for the management of dystonia, with modern neurosurgical management including pallidotomy, rhizotomy, and deep brain stimulation. Historically, pallidotomy has been effective and may still be preferred in subpopulations presenting either in status dystonicus or with high risk for hardware complications. Superiority of DBS over pallidotomy for secondary dystonia has not been determined. Rhizotomy is an underutilized surgical tool and more study characterizing efficacy and risk profile is indicated.
Topics: Adult; Adolescent; Humans; Child; Dystonia; Movement Disorders; Tremor; Dystonic Disorders; Neurosurgical Procedures; Globus Pallidus; Deep Brain Stimulation; Treatment Outcome
PubMed: 37522933
DOI: 10.1007/s00381-023-06100-1 -
American Journal of Physical Medicine &... Apr 2024We analyzed the retrospective performance of para powerlifters over 8 yrs considering sex, the origin of impairment, and sport classification of para powerlifting.
OBJECTIVE
We analyzed the retrospective performance of para powerlifters over 8 yrs considering sex, the origin of impairment, and sport classification of para powerlifting.
DESIGN
This retrospective study analyzed data from 6791 (4613 and 2178 for male and female, respectively) individual results from 1634 athletes' performances. We collected absolute load (in kilograms), relative load (in kilogram/body mass), chronological age and origin of impairment (acquired or congenital), and sport classification (leg length difference, limb deficiency, range of movement, impaired muscle power, hypertonia, ataxia, athetosis, and short stature of para powerlifters.
RESULTS
Males were stronger than females thorough the years with acquired impairment being stronger than congenital impairment. Para powerlifters with acquired impairment were older compared with congenital impairment over the years. Acquired impairment males won 60% more medals than the congenital group. There was a significant association between competition achievement and sports class classification, with a higher number of medals for limb deficiency than other sports classes.
CONCLUSIONS
These results demonstrate that the sex, origin of impairment, and sports classification influence performance of athletes in para powerlifting. Thus, this information can help athletes, coaches, sport managers, and sport institutions involved in the sport of para powerlifting.
Topics: Humans; Male; Female; Retrospective Studies; Weight Lifting; Athletic Performance; Athletes; Muscle Hypertonia
PubMed: 37405959
DOI: 10.1097/PHM.0000000000002307 -
European Child & Adolescent Psychiatry Oct 2023Salla disease (SD) is a rare lysosomal storage disorder characterised by intellectual disability ataxia, athetosis, nystagmus, and central nervous system demyelination.... (Review)
Review
Salla disease (SD) is a rare lysosomal storage disorder characterised by intellectual disability ataxia, athetosis, nystagmus, and central nervous system demyelination. Although the neurological spectrum of SD's clinical phenotype is well defined, psychotic symptoms in SD remain unreported. We reviewed the presence of psychiatric symptoms in patients diagnosed with SD. Medical records of all SD patients at Oulu University Hospital during the years 1982-2015 were systematically reviewed to evaluate the presence of psychiatric symptoms. Psychiatric symptoms were frequently associated with SD (10/24, 42%), and two patients were described as developing psychosis as adolescents. We reported their clinical characteristics in detail and assessed the prevalence of psychiatric symptoms in a cohort of 24 patients. Other psychiatric factors associated with SD were sleeping disorders (8/24, 32%), aggressive behaviour disorders or restlessness (6/24, 25%), and off-label antipsychotic medication (4/24, 17%). This report expands the knowledge of the phenotypic spectrum of SD and demonstrates the importance of recognising the possibility of psychiatric symptoms, including psychosis, in persons with SD.
Topics: Adolescent; Humans; Sialic Acid Storage Disease; Mental Disorders; Psychotic Disorders; Antipsychotic Agents; Phenotype
PubMed: 35796883
DOI: 10.1007/s00787-022-02031-5