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Neurology India 2023
Topics: Humans; Dyskinesias; Chorea; Diabetes Mellitus
PubMed: 37148098
DOI: 10.4103/0028-3886.375388 -
Journal of Postgraduate Medicine 2016Asterixis is a type of negative myoclonus characterized by irregular lapses of posture of various body parts. It is an uncommon but important sign in clinical neurology.... (Review)
Review
Asterixis is a type of negative myoclonus characterized by irregular lapses of posture of various body parts. It is an uncommon but important sign in clinical neurology. Initially described as a "liver flap," its utility encompasses a galaxy of neurological and nonneurological situations. Asterixis has a rich history. Despite being described over 70 years ago, its exact pathogenesis remains unknown. Its significance as a tool for the evaluation and prognosis of encephalopathies has been suggested. This review presents its history, clinical implications and its significance.
Topics: Brain; Dyskinesias; Humans; Movement Disorders; Myoclonus
PubMed: 27089111
DOI: 10.4103/0022-3859.180572 -
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 -
Neurology India 2021Lamotrigine (LMT) is a phenyltriazine derivative that was originally described as an antiepileptic drug. (Review)
Review
BACKGROUND
Lamotrigine (LMT) is a phenyltriazine derivative that was originally described as an antiepileptic drug.
OBJECTIVE
This literature review aims to evaluate the clinical epidemiological profile, pathological mechanisms, and management of lamotrigine-associated movement disorders.
METHODS
Relevant reports in six databases were identified and assessed by two reviewers without language restriction. Reports that the individuals only developed tremor or ataxia after LMT use were not included.
RESULTS
In total 48 reports of 108 cases from 19 countries were assessed. The movement disorders associated with LMT found were 29 tics, 21 dyskinesias, 14 myoclonus, 13 parkinsonism, 10 dystonia, and 1 stuttering. The not clearly defined cases included 10 akathisia, 4 myoclonus, 4 cerebellar syndromes, 1 hypertonia, 1 dyskinesia, and an unknown number of dystonia cases. The mean reported age was 33.34 years (range: 1.574 years). The male was the predominant sex and the most common LMT indication was epilepsy. The mean LMT-dose at the movement disorder onset was 228 mg. The time from LMT start to the onset of movement disorder was within 6 months in 81%. The time from LMT withdrawal to complete recovery was within 1 month in 83%. The most common management was LMT withdrawal.
CONCLUSIONS
In the literature, the majority of the cases did not give a clear picture of the individual, and the times of movement disorder onset and recovery are not described. We believe that before withdrawal LMT, a dose adjustment based on the benefits and adverse events with careful evaluation case-by-case can be done.
Topics: Anticonvulsants; Ataxia; Epilepsy; Humans; Infant; Lamotrigine; Male; Movement Disorders
PubMed: 34979637
DOI: 10.4103/0028-3886.333440 -
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 -
The Journal of Clinical Psychiatry 2017What risk factors suggest that patients are more likely to develop tardive dyskinesia (TD)? Can TD symptoms be prevented? Read this CME activity to learn about the... (Review)
Review
What risk factors suggest that patients are more likely to develop tardive dyskinesia (TD)? Can TD symptoms be prevented? Read this CME activity to learn about the prevalence, epidemiology, and prevention of these abnormal movements from an expert.
Topics: Humans; Tardive Dyskinesia
PubMed: 29345874
DOI: 10.4088/JCP.tv17016tx1c -
Ugeskrift For Laeger Jul 2021This is a case report of a patient, who was diagnosed with epilepsy (atypical infantile convulsions) at the age of one year and unspecific myopathy at the age of three...
This is a case report of a patient, who was diagnosed with epilepsy (atypical infantile convulsions) at the age of one year and unspecific myopathy at the age of three years. At the age of 25 years, the patient was referred to a neuromuscular clinic due to myopathy, but the diagnose was changed to atypical infantile convulsions with seizures in adulthood and paroxysmal choreoathetosis due to a pathogenic variant c.970G>A, p. (Gly324Arg) in the PRRT2 gene.
Topics: Adult; Dyskinesias; Epilepsy, Benign Neonatal; Humans; Infant; Membrane Proteins; Mutation; Nerve Tissue Proteins; Pedigree
PubMed: 34356019
DOI: No ID Found -
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 -
Journal of Neurochemistry Aug 2014Dopamine replacement therapy in Parkinson's disease is associated with several unwanted effects, of which dyskinesia is the most disabling. The development of new... (Review)
Review
Dopamine replacement therapy in Parkinson's disease is associated with several unwanted effects, of which dyskinesia is the most disabling. The development of new therapeutic interventions to reduce the impact of dyskinesia in Parkinson's disease is therefore a priority need. This review summarizes the key molecular mechanisms that underlie dyskinesia. The role of dopamine receptors and their associated signaling mechanisms including dopamine-cAMP-regulated neuronal phosphoprotein, extracellular signal-regulated kinase, mammalian target of rapamycin, mitogen and stress-activated kinase-1 and Histone H3 are summarized, along with an evaluation of the role of cannabinoid and nicotinic acetylcholine receptors. The role of synaptic plasticity and animal behavioral results on dyskinesia are also evaluated. The most recent therapeutic advances to treat Parkinson's disease are discussed, with emphasis on the possibilities and limitations of non-pharmacological interventions such as physical activity, deep brain stimulation, transcranial magnetic field stimulation and cell replacement therapy. The review suggests new prospects for the management of Parkinson's disease-associated motor symptoms, especially the development of dyskinesia. This review aims at summarizing the key molecular mechanisms underlying dyskinesia and the most recent therapeutic advances to treat Parkinson's disease with emphasis on non-pharmacological interventions such as physical activity, deep brain stimulation (DBS), transcranial magnetic field stimulation (TMS) and cell replacement therapy. These new interventions are discussed from both the experimental and clinical point of view, describing their current strength and limitations.
Topics: Animals; Cannabinoids; Cell Transplantation; Chromatin; Deep Brain Stimulation; Dopamine Agents; Dopamine and cAMP-Regulated Phosphoprotein 32; Dyskinesias; Histones; Humans; Levodopa; Motor Activity; Parkinson Disease; Phosphorylation; Psychomotor Performance; Receptors, Dopamine D1; Signal Transduction; Transcranial Magnetic Stimulation
PubMed: 24773031
DOI: 10.1111/jnc.12751 -
Neurology India 2023
Topics: Humans; Chorea; Dyskinesias; Hyperglycemic Hyperosmolar Nonketotic Coma
PubMed: 37635540
DOI: 10.4103/0028-3886.383864