Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Flunarizine hydrochloride (FZ), a calcium entry blockade, has been used nationwide in Japan as a cerebral active vasodilator since October, 1984. The present paper reports 31 cases of FZ-induced Parkinsonism, depression and akathisia, referred to our hospital between October 1986 and September 1988. Out of the 31 patients, four including two with Parkinson's disease and one each with progressive supranuclear palsy and olivopontocerebellar atrophy showed worsening of their parkinsonian symptoms within a few months after FZ administration. The remaining 27 patients (7 males and 20 females) newly developed Parkinsonism after treatment with FZ. Symptoms appeared one week to two years (mean: 6.1 months) after starting FZ of a daily dose of 10 mg. FZ had been used in 6 patients for cerebrovascular episodes confirmed by clinical history or brain CT, and in the remainder, for dizziness, light-headedness, hypertension, amnesia or hypochondric neurotic complaints. Akinesia and bradykinesia progressed rather rapidly after onset, and patients became unambulatory within several months. Symptoms had worsened, and L-dopa, anticholinergic drugs, and bromocriptine had been ineffective until FZ was discontinued. Their Parkinsonism was characterized by marked akinesia, bradykinesia, and moderate rigidity. Masked face was seen in most of them. Tremor was absent at rest, and induced in 12 patients by posture and/or action. Sixteen patients were accompanied by depression, and five, by akathisia. Improvement began several weeks after withdrawal of FZ, and most patients recovered almost completely within a few months although mild rigidity and bradykinesia remained in some.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Parkinsonism, depression and akathisia induced by flunarizine, a calcium entry blockade--report of 31 cases]. 258 81

Stress thallium imaging with intravenous dipyridamole permits assessment of coronary artery disease (CAD) without the need for exercise. However, intravenous dipyridamole is available in the United States only on an experimental basis. To study the use of oral dipyridamole as a clinically available alternative to intravenous dipyridamole for this purpose, 100 patients underwent thallium imaging with oral dipyridamole. Each patient received 300 mg of pulverized tablets in a 30-ml suspension. Maximal increase in mean heart rate and decrease in mean blood pressure occurred 30 minutes after ingestion. At 45 minutes, 2 mCi of thallium was given intravenously and serial imaging was begun within 7 minutes. The serum dipyridamole level (mean +/- standard deviation) 45 minutes after 300 mg was administered orally (3.7 +/- 2.2 micrograms/ml) was similar to that 5 minutes after 0.56 mg/kg was given intravenously (4.6 +/- 1.3 micrograms/ml). Fifty-five patients had some adverse effects between 15 and 75 minutes after oral ingestion, including nausea, headache, dizziness, chest pain (25 patients) and electrocardiographic changes (14 patients). Intravenous aminophylline was used to resolve these adverse effects in 21 patients. There were no severe arrhythmias, myocardial infarctions or deaths. Of the 43 patients with angiographically documented CAD, 39 had an initial perfusion defect that redistributed on the delayed images. When the results in patients who had undergone catheterization were analyzed by individual segment, the presence of thallium redistribution was associated with normal or hypokinetic contrast left ventriculographic wall motion of that segment, whereas the presence of a persistent defect was associated with akinesia or dyskinesia (Fisher's standardized Z = 9.14).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Usefulness of oral dipyridamole suspension for stress thallium imaging without exercise in the detection of coronary artery disease. 395 32

Parkinsonian patients with orthostatic hypotension and dizziness due to usual antiparkinson therapy have been treated with the precursor amino-acid of noradrenaline, DL-3,4-threo-dihydroxyphenylserine (DL-3,4-threo-DOPS). Oral and intravenous administration improved these side effects significantly. A combined treatment of L-dopa, peripheral decarboxylase inhibitor and DL-3,4-threo-DOPS seems to be of benefit with respect to akinesia and orthostatic hypotension.
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PMID:DL-3,4-threo-DOPS in Parkinson's disease: effects on orthostatic hypotension and dizziness. 642 May 17

From our investigations, we are tempted to assume that all types of akinesia, including "freezing", off-phases, Yo-Yoing and akinetic crises, are primarily symptoms of PD, while hyperkinesia, stretch spasms and pharmacotoxic psychosis are "side-effects". Therefore side-effects can be triggered by antiparkinsonian therapy while they will disappear after withdrawal of the drugs inducing them. Antiparkinson drugs alleviate major symptoms like akinesia and rigidity but sometimes and especially as reflection of advanced parkinsonism, might amplify minor symptoms (freezing, off-phases, Yo-Yoing), which then predominantly at high drug doses occur earlier and more intensively. Therefore, minor symptoms can be observed more frequently in the advanced stages of PD. Depressed phases belong to the symptom complex as is bradyphrenia and dizziness. Bradyphrenia is the psychic correlate to akinesia. Dementia, if at all is a symptom, but more likely this disease occurs occasionally in combination with parkinsonism.
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PMID:Symptoms and side effects in the course of Parkinson's disease. 658 6

This chapter reports the clinical and neuropathological findings of eight cases of "diffuse Lewy body disease" verified by autopsy. The age at onset was between 60 and 82 years; the age at death was between 75 and 92 years. The initial symptoms were amnesia in three cases, orthostatic dizziness in three, visual hallucination in two, but parkinsonism in none. The cardinal clinical symptoms included dementia in all cases, hallucinatory-delusional state in six, akinesia and rigidity in five, and orthostatic hypotension in five. Antemortem diagnoses were senile dementia in five, and hallucinatory-delusional state, Parkinson's disease and Shy-Drager syndrome in one each. Despite the clinical symptoms differences from each other, neuropathological findings were alike. Abundant Lewy bodies were present in the neurons of the cerebral cortex as well as in the brainstem nuclei and diencephalon. Concomitant senile changes including senile plaques and Alzheimer's neurofibrillary tangles (NFTs) were also present in varying degree. Immunocytochemical study with anti-ubiquitin for Lewy body, anti-tau protein for NFT, and beta-protein of amyloid for senile plaque suggested that dementia of DLBD might have resulted not from a single pathology but from the complex of Lewy bodies, NFTs and senile plaques.
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PMID:Clinical and neuropathological aspects of diffuse Lewy body disease in the elderly. 842 Jan 71

Pramipexole (SND 919), a potent non-ergot dopamine agonist, or placebo, was administered to 69 patients with advanced Parkinson's disease (33 received placebo, 36 received pramipexole) in a double-blind, randomized, multi-center study in which individually optimized doses of L-dopa plus a dopa decarboxylase inhibitor were associated with dyskinesia, "on-off" fluctuation, dystonia, akinesia, or end-of-dose deterioration. Study medication was titrated over 7 weeks to the maximal tolerated dose or to the maximal dose allowed by the study (5 mg/day in four divided doses). Dosing was maintained for 4 weeks and then tapered during the final week. Total score on the Unified Parkinson's Disease Rating Scale (UPDRS) for the intent-to-treat population was significantly improved in the pramipexole-treated group compared with the placebo-treated group (16.9 +/- 14.9 vs 9.0 +/- 16.1; p = 0.0184). By the end of maintenance, the mean reduction in L-dopa requirement was -150.7 mg for pramipexole-treated patients compared to -10.6 for placebo-treated patients. The most common adverse events (< 10%) were dizziness, insomnia, nausea, and postural hypotension. Aggravated parkinsonism occurred only after withdrawal of the study medication. Treatment with pramipexole in doses up to 5 mg/day was safe and well tolerated by patients with advanced Parkinson's disease.Copyright Lippincott-Raven Publishers
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PMID:A double-blind, placebo-controlled, randomized, multi-center study of pramipexole in advanced Parkinson's disease. 1021 Aug 37

We report a case of 68-year-old woman who was diagnosed spinocerebellar ataxia type 6 (SCA 6) by genomic testing. She presented hypochondriasis, parkinsonism, and ataxia. Since the age of 60, she noted difficulty in walking due to dizziness, and MRI showed minimal cerebellar atrophy. She became unable to walk without assistance at the age 67. She was referred to us when she was 68 years old. She had no family history of cerebellar ataxia, and her general physical examination was normal. Her speech was fluent, with neither slurring nor scanning, and she complained of much anxiety regarding her physical condition and was diagnosed as having hypochondriasis. Neurological examination revealed parkinsonism consisting of small steppage gait, mask-like face, akinesia, rigidity of neck and limbs, and postural instability. She also showed cerebellar signs such as saccadic smooth pursuit, ataxia of upper and lower limbs, and increased tendon reflexes. Her parkinsonism had developed slowly and symmetrically yet she showed a lack of response to levodopa. Our results suggest that the genomic testing is useful for differential diagnosis for the diseases presenting ataxia and parkinsonism, even if the family history is negative.
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PMID:[A case of spinocerebellar ataxia type 6 with hypochondriasis and severe parkinsonism]. 1180 19

Takotsubo cardiomyopathy (TTC) is a cardiomyopathy associated with emotional and physiological stress which can be recurrent. We report a case of recurrent TTC (total 3 times) induced by emotional stress, which was diagnosed accurately by coronary angiography (CAG) and left ventriculography (LVG). A 77-year-old female was referred to our institute because of stomach ache, nausea, dizziness, and vomiting. She had developed TTC associated with emotional stress twice, and she took an angiotensin receptor blocker for preventing recurrence. She was admitted for treatment of electrolyte imbalance. After the admission, she suddenly suffered from chest pain with ST segment elevation in II, III, aVF, V3, V4, V5, and V6 leads in electrocardiography. Emergency CAG showed normal coronary arteries, while LVG revealed apical akinesia and basal hyperkinesia. These findings were compatible with TTC. Follow-up ultrasonic cardiogram showed left ventricular contractile normalization in a week. She was discharged in 22 days. A few cases of repeated recurrence have been reported, but they were not diagnosed by cardiac catheterization. In the present case, 3 episodes of TTC were all diagnosed in CAG and LVG. We suggest that antianxiety drugs have potential to prevent the recurrence of TTC in a case induced by emotional stress. <Learning objective: Takotsubo cardiomyopathy (TTC) is a cardiomyopathy associated with emotional and physiological stress which can be recurrent. A few cases of repeated recurrence have been reported, but they were not diagnosed by cardiac catheterization. We report a case of recurrent TTC (total 3 times) induced by emotional stress, which was diagnosed accurately by coronary angiography and left ventriculography.>.
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PMID:A case of Takotsubo cardiomyopathy that was confirmed by cardiac catheterization at all three times of onset. 3054 82