Movement disorders

Abnormal postures of the trunk are a typical feature of Parkinson's disease (PD). These include Pisa syndrome (PS), a tonic lateral flexion of the trunk associated with slight rotation along the sagittal plane. In this study we describe clinical, electromyographic (EMG), and radiological features of PS in a group of 20 PD patients. All patients with trunk deviation underwent EMG and radiological (RX and CT scan) investigation. Clinical characteristics of patients with PS were compared with a control group of PD patients without trunk deviation. PD patients with PS showed a significantly higher score of disease asymmetry compared with the control group. In the majority of patients with PS, trunk bending was contralateral to the side of symptom onset. EMG showed abnormal tonic hyperactivity on the side of the deviation in the paravertebral thoracic muscles and in the abdominal oblique muscles. CT of the lumbar paraspinal muscles showed muscular atrophy more marked on the side of ...

Developmental delay (DD) in infants and children is one of the chief complaints of parents. It has been established that the concerns of parents are as accurate as quality screening tests. Some kinds of concerns are particularly useful in the early detection of associated developmental problems. The purpose of this study was to investigate the relationship between the main parental concerns and the final diagnosis based on professional assessment of children who are suspected to have DD. One-hundred and 1 infants or children were recruited into this study. The major concerns of parents were elicited and categorized by various developmental domains: speech, motor, behavioral, cognitive, global, and non-specific developmental problems. All children underwent comprehensive combined assessments by professionals in the hospital, and were classified into 6 subtypes: speech, motor, behavioral, cognitive, and global DD, and normal development. Our results revealed that parental concerns abo...

Studying the clinical effects induced by electrical stimulation of the subthalamic nucleus (STN) area in a parkinsonian patient under local anesthesia is a mandatory step to determine the precise location of the final chronic electrode. Using multiple microelectrodes, preferably in a concentric parallel array allows a precise mapping of the STN region. The most reliable features to determine the suitable target are stimulation-induced dyskinesias and rigidity decrease at a low intensity without adverse effects or only at far higher intensities. New skills are needed to assess all stimulation-induced effects and interpret them in anatomo-functional terms. © 2002 Movement Disorder Society

We tested the hypothesis that vibratory thresholds in the elderly are related to mobility. In all, 629 older persons without dementia underwent testing including 11 lower extremity performance measures and modified United Parkinson's Disease Rating Scale (UPDRS), summarized as composite mobility and global parkinsonian signs. Vibratory thresholds were measured at the ankle and toes bilaterally using the graduated Rydel–Seiffer tuning fork. In linear regression models adjusted for age, sex, and education, vibratory threshold was associated with composite mobility (estimate, 0.047, SE = 0.011, P < 0.001) and global parkinsonian signs score (estimate, −0.252, SE = 0.126, P = 0.047). These findings were primarily due to the association of vibratory threshold with gait and balance components of composite mobility and parkinsonian gait. These results were unchanged when we controlled for body mass index, physical activity, cognition, depression, vascular risk factors, vascular disease burden, joint pain, and falls. Vibratory thresholds are associated with mobility, supporting the link between peripheral sensory nerve function and mobility in the elderly. Muscle Nerve, 2009

Mercury toxicity causes postural tremors, commonly referred to as “mercurial tremors,” and cerebellar dysfunction. A 23-year woman, 2 years after injecting herself with elemental mercury developed disabling generalized myoclonus and ataxia. Electrophysiological studies confirmed the myoclonus was probably of cortical origin. Her deficits progressed over 2 years and improved after subcutaneous mercury deposits at the injection site were surgically cleared. Myoclonus of cortical origin has never been described in mercury poisoning. It is important to ask patients presenting with jerks about exposure to elemental mercury even if they have a progressive illness, as it is a potentially reversible condition as in our patient. © 2007 Movement Disorder Society