-
Arquivos de Neuro-psiquiatria May 2022Parkinson's disease (PD) is a complex neurodegenerative condition. Treatment strategies through all stages of disease progression could affect quality of life and... (Review)
Review
BACKGROUND
Parkinson's disease (PD) is a complex neurodegenerative condition. Treatment strategies through all stages of disease progression could affect quality of life and influence the development of future complications, making it crucial for the clinician to be on top of the literature.
OBJECTIVE
This paper reviews the current treatment of PD, from early to advanced stages.
METHODS
A literature review was conducted focusing on the treatment of PD, in the different stages of progression.
RESULTS
Every individual with a new diagnosis of PD should be encouraged to start exercising regularly. In the early stage, treatment should focus on using the lowest dose of levodopa or combination therapy that provides maximum functional capacity, and does not increase the risk of complications, such as peak dose dyskinesias and impulse control disorders. At the moderate and advanced stages, motor fluctuations and complications of treatment dominate the picture, making quality of life one important issue. Rehabilitation programs can improve motor symptoms and should be offered to all patients at any stage of disease progression.
CONCLUSION
Many factors need to be considered when deciding on the best treatment strategy for PD, such as disease progression, presence of risk factors for motor and behavioral complications, potential side effects from dopaminergic therapy and phenotypical variabilities. Treatment should focus on functional capacity and quality of life throughout the whole disease course.
Topics: Antiparkinson Agents; Disease Progression; Dyskinesias; Humans; Levodopa; Parkinson Disease; Quality of Life
PubMed: 35976316
DOI: 10.1590/0004-282X-ANP-2022-S126 -
Neurology India 2023
Topics: Humans; Chorea; Dyskinesias; Hyperglycemic Hyperosmolar Nonketotic Coma
PubMed: 37635540
DOI: 10.4103/0028-3886.383864 -
Tidsskrift For Den Norske Laegeforening... Mar 2019
Topics: Aged, 80 and over; Cerebral Infarction; Chorea; Dyskinesias; Female; Humans
PubMed: 30872840
DOI: 10.4045/tidsskr.18.0779 -
Tremor and Other Hyperkinetic Movements... 2017Hemichorea-hemiballism is a syndrome secondary to different etiologies. Drug-induced hemichorea is a rare syndrome related to selective serotonin reuptake inhibitors. To...
BACKGROUND
Hemichorea-hemiballism is a syndrome secondary to different etiologies. Drug-induced hemichorea is a rare syndrome related to selective serotonin reuptake inhibitors. To the best of our knowledge, no previous cases of hemichorea associated with sertraline have been reported.
CASE REPORT
A 65-year-old female noticed hemichorea 1 week after initiation of sertraline. After extensive investigations, other causes of hemichorea were excluded. Hemichorea remitted after sertraline withdrawal.
DISCUSSION
In our patient, temporal association and the negative clinical assessment supported a diagnosis of likely drug-induced involuntary movement. We hypothesized that enhanced serotonergic transmission in the ventral tegmental area or nigrostriatum may be involved in sertraline-induced hemichorea.
Topics: Aged; Chorea; Depressive Disorder; Diagnosis, Differential; Dyskinesia, Drug-Induced; Dyskinesias; Female; Humans; Selective Serotonin Reuptake Inhibitors; Sertraline
PubMed: 29276648
DOI: 10.7916/D8XK999F -
Journal of Postgraduate Medicine 2003
-
The Western Journal of Medicine Nov 1990Tardive dyskinesia is a potentially irreversible syndrome of involuntary hyperkinetic movements that occur in predisposed persons receiving extended neuroleptic... (Review)
Review
Tardive dyskinesia is a potentially irreversible syndrome of involuntary hyperkinetic movements that occur in predisposed persons receiving extended neuroleptic (antipsychotic) drug therapy. It is usually characterized by choreoathetoid dyskinesias in the orofacial, limb, and truncal regions, but subtypes of this syndrome may include tardive dystonia and tardive akathisia. Although the mechanisms underlying the pathogenesis and pathophysiology of this disorder are unproven, altered dopaminergic functions will likely play a role in any explanation of it. Tardive dyskinesia develops in 20% of neuroleptic-treated patients, but high-risk groups such as the elderly have substantially higher rates. Risk factors include age, female sex, affective disorders, and probably those without psychotic diagnoses, including patients receiving drugs with antidopaminergic activity for nausea or gastrointestinal dysfunction for extended periods. Total drug exposure is positively correlated with tardive dyskinesia risk. Management strategies include a careful evaluation of both the psychiatric and neurologic states, a broad differential diagnosis, and adjustment of neuroleptic agents to the lowest effective dose that controls psychosis and minimizes motor side effects. No drug therapy is uniformly safe and effective for treating this disorder. A favorable long-term outcome of improvement or resolution correlates with younger age, early detection, lower drug exposure, and duration of follow-up.
Topics: Antipsychotic Agents; Child; Diagnosis, Differential; Dyskinesia, Drug-Induced; Humans; Movement Disorders; Prognosis; Risk Factors
PubMed: 1979705
DOI: No ID Found -
Experimental Neurology May 2022Gamma oscillations comprise a loosely defined, heterogeneous group of functionally different activities between 30 and 100 Hz in the cortical and subcortical local... (Review)
Review
Gamma oscillations comprise a loosely defined, heterogeneous group of functionally different activities between 30 and 100 Hz in the cortical and subcortical local field potential (LFP) of the motor network. Two distinct patterns seem to emerge which are easily conflated: Finely-tuned gamma (FTG) oscillations - a narrowband activity with peaks between 60 and 90 Hz - have been observed in multiple movement disorders and are induced by dopaminergic medication or deep brain stimulation (DBS). FTG has been linked with levodopa or DBS-induced dyskinesias, which makes it a putative biomarker for adaptive DBS. On the other hand, gamma activity can also present as a broad phenomenon (30-100 Hz) in the context of motor activation and dynamic processing. Here, we contrast FTG, either levodopa-induced or DBS-induced, from movement-related broadband gamma synchronisation and further elaborate on the functional role of FTG and its potential implications for adaptive DBS. Given the unclear distinction of FTG and broad gamma in literature, we appeal for more careful separation of the two. To better characterise cortical and subcortical FTG as biomarkers for dyskinesia, their sensitivity and specificity need to be investigated in a large clinical trial.
Topics: Deep Brain Stimulation; Dyskinesias; Humans; Levodopa
PubMed: 35143832
DOI: 10.1016/j.expneurol.2022.113999 -
Revista de Neurologia Jan 2009Paroxysmal dyskinesias are uncommon movements disorders that consist on recurrent brief episodes characterized by attacks with any combination of dystonia, chorea,... (Review)
Review
INTRODUCTION
Paroxysmal dyskinesias are uncommon movements disorders that consist on recurrent brief episodes characterized by attacks with any combination of dystonia, chorea, athetosis or ballismus.
DEVELOPMENT AND CONCLUSIONS
The pathophysiology of paroxysmal dyskinesias is unclear at the present time. An epileptic mechanism and basal ganglia disorders have been proposed although channelopathy due to ion channel mutations have been recently suggested. These disorders were classified by Demirkiran and Jankovic into two main groups: paroxysmal kinesigenic dyskinesia if the attacks were induced by sudden movement and paroxysmal nonkinesigenic dyskinesia if they were not. In addition to these groups, two more types have been known, namely paroxysmal exercise-induced dyskinesia and hypnogenic paroxysmal dyskinesia. As well association between benign infantile familial convulsions and paroxysmal choreoathetosis, or rolandic epilepsy, episodes of exercise induced dystonia, and writers' cramp have been described. Also others paroxysmal movements disorders have been known, we mention below. Paroxysmal dyskinesias can further be divided into idiopathic (familiar in most of the cases) or secondary cases depending on underlying cause.
Topics: Anticonvulsants; Chorea; Humans
PubMed: 19222019
DOI: No ID Found -
Pediatrics in Review Mar 2015On the basis of some research evidence and consensus, identification of acute opsoclonus, ataxia, or myoclonus should prompt consideration of an underlying...
On the basis of some research evidence and consensus, identification of acute opsoclonus, ataxia, or myoclonus should prompt consideration of an underlying neuroblastoma. On the basis of some research evidence and consensus, surgical treatment options should be considered for children with dystonia, including secondary dystonias, such as those related to cerebral palsy, and include intrathecal baclofen pumps and deep brain stimulation. On the basis of some research evidence and clinical experience, tetrabenazine may be effective in treating chorea. On the basis of strong research evidence, although seldom inherently dangerous, tics may be uncomfortable for affected children and interfere with academic achievement and social development. On the basis of some research evidence and clinical experience, topiramate may be an effective treatment for tic disorders.
Topics: Adolescent; Child; Developmental Disabilities; Dyskinesias; Humans; Male; Movement Disorders; Pediatrics
PubMed: 25733762
DOI: 10.1542/pir.36-3-104 -
Neurology India 2018
Topics: Adenylyl Cyclases; Child; DNA Mutational Analysis; Dyskinesias; Humans; Male; Mutation, Missense
PubMed: 29503338
DOI: 10.4103/0028-3886.226449