Parkinsonism & related disorders
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Parkinsonism Relat. Disord. · Sep 2005
Clinical TrialQuality of life in Essential Tremor Questionnaire (QUEST): development and initial validation.
Essential tremor (ET) can diminish functioning and quality of life (QOL) but generic QOL measures may be relatively insensitive to ET and its therapies. We sought to develop an ET-specific measure that might be more sensitive, acceptable to patients, relatively brief, and easily used. ⋯ A brief, 30-item, ET-specific QOL scale with excellent reliability was developed. Preliminary validity data are encouraging. The Quality of Life in Essential Tremor Questionnaire (QUEST) promises to facilitate QOL measurement in ET.
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Parkinsonism Relat. Disord. · Sep 2005
Case ReportsElectroconvulsive therapy for depression in a Parkinson's disease patient with bilateral subthalamic nucleus deep brain stimulators.
We report a patient with advanced Parkinson's disease (PD) who developed a recurrence of major depression with psychotic features after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. Electroconvulsive therapy (ECT) dramatically improved the depression without shifting electrode position or damaging the DBS hardware. This case suggests that ECT can be a safe and effective option for severe depression in PD patients treated with STN DBS.
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Parkinsonism Relat. Disord. · Mar 2005
Letter Clinical TrialLimited efficacy of levetiracetam on myoclonus of different etiologies.
Levetiracetam is a relatively new antiepileptic drug, which has been reported to have promising antimyoclonic properties, especially in posthypoxic myoclonus, progressive myoclonic epilepsy (PME) and spinal myoclonus. Eight patients with intractable myoclonus of various etiologies were given levetiracetam as add-on therapy in an open-label trial. ⋯ All other forms of myoclonus either did not improve or worsened (1 essential myoclonus, 2 myoclonus-dystonia, 2 PME, 2 mitochondrial disease). Levetiracetam has promising but selective antimyoclonic potential, which should be the subject of further study.
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Parkinsonism Relat. Disord. · Jan 2003
Comparative StudyAre electrophysiological autonomic tests useful in the assessment of dysautonomia in Parkinson's disease?
To assess the autonomic system in Parkinson's disease (PD), the sympathetic skin response (SSR) and the R-R interval variation (RRIV) tests were studied in 26 PD patients and in 24 healthy controls. The aim of the study was to evaluate the sympathetic and parasympathetic system function in PD, to define the pattern of autonomic abnormalities found in SSR and RRIV in parkinsonian patients as well as to analyze the usefulness of both tests in paraclinical assessment of the dysautonomia, compared with clinical symptoms and signs of the autonomic nervous system involvement. The corrrelations between both autonomic tests results were also studied. ⋯ Clinical and paraclinical signs of dysautonomia occurred in a similar proportion of patients (i.e. in about 62%). A weak correlation was found between the latency of SSR from upper limbs and the value of RRIV during deep breathing (p=0.063). Our results show that SSR and RRIV are non-invasive paraclinical electrophysiological tests that confirm clinical dysautonomia in PD and can supplement the clinical differentiation of Parkinsonian syndromes.
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Parkinsonism Relat. Disord. · Mar 2002
Case ReportsProgressive encephalomyelitis with rigidity presenting as a stiff-person syndrome.
Diagnosis criteria of stiff-person syndrome (SPS) include progressive, fluctuating muscular rigidity and spasms with normal neurological examination. The presence of unusual features such as prominent limb rigidity with segmental signs and contracture, evidence of brainstem dysfunction, profound autonomic disturbances, CSF pleiocytosis or MRI abnormalities in patients with SPS presentation allows to classify these patients as progressive encephalomyelitis with rigidity (PER). We report a 50 year-old woman suffering from severe painful spasms of abdominal wall and limb muscles. ⋯ The initial clinical presentation mimicking a SPS with subsequent diffuse involvement of the central nervous system and a striking localisation of a severe rigidity to one arm allowed to suspect the diagnosis of PER. The relationship between SPS and PER remains unclear because of the rarity of these disorders. The observation reported in this paper gives evidence that both the disorders are probably two clinical presentations of the same pathogenic process.