Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tremor and movement disorders in multiple sclerosis (MS) patients cause a severe functional impairment. The different types of tremor observed in MS are: cerebellor tremor with a dominant intention component, Holmes tremor characterized by the addition of rest and postural components and palatal tremor. When no medication can improve the functional status, it is acceptable to discuss the deep brain stimulation in the VIM thalamus, thus making possible a partial attenuation of the rest and postural component, mainly affecting the proximal part of the affected limb. Among the movement disorders, paroxysmal dyskinesias are not rare and a good therapeutic response is obtained with carbamazepine: dystonia and parkinsonism are usually coincidental features during MS.
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PMID:[Tremor and abnormal movement in multiple sclerosis: symptomatic therapeutic indications]. 1178 40

Paroxysmal dystonia (PD) is a usually painful, unilateral dystonic posture, precipitated by voluntary movement, tactile stimulation, startling noise or hyperventilation. We describe two cases of paroxysmal dystonia in multiple sclerosis, both with a critically localized lesion in the thalamus, contralateral to the paroxysmal symptoms. Only one other case of paroxysmal dystonia with a demyelinated lesion of the thalamus has been reported previously.
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PMID:Paroxysmal dystonia with thalamic lesion in multiple sclerosis. 1191 77

We studied the effect of cervical dystonia on quality of life in a cohort of 289 patients by using a generic health status measurement scale (SF36). Cervical dystonia had a significant negative impact on quality of life compared with age-matched general population data. This negative impact was comparable to that seen in multiple sclerosis, Parkinson's disease, and stroke.
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PMID:Impact of cervical dystonia on quality of life. 1221 Aug 91

Movement disorders associated with multiple sclerosis (MS) are uncommon, except for tremor. We report two patients with relapsing-remitting MS, who developed either dystonia or chorea during clinical exacerbation of their MS. The movement disorders resolved during treatment with adrenocorticotropin hormone (ACTH). Acute exacerbations of MS may be associated with transient movement disorders, which are responsive to ACTH.
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PMID:Transient movement disorders and multiple sclerosis. 1247 1

Movement disorders occurring in association with multiple sclerosis (MS) are rare. Among them paroxysmal dystonia is the most common, although chorea, ballism, palatal myoclonia, spasmodic torticollis, writer's cramp and generalized dystonia have been reported. We describe a 34-year old woman with MS who developed simple phonic tic characterized by throat-clearing sounds. Magnetic resonance imaging showed demyelinating lesions involving the thalamus and basal ganglia. This is the first report of tic disorder occurring as a manifestation of MS.
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PMID:Simple phonic tic in multiple sclerosis. 1247 93

Deep brain stimulation (DBS) of the central gray matter was an important component of the surgical management of chronic, drug-refractory, central neuropathic pain until only a decade ago. However, in the recent past, this technique has been increasingly neglected and has been largely replaced by motor cortex stimulation (MCS). The results of MCS, however, are far from uniform, and the best reports quote a range of 50% to 75% success in providing satisfactory pain relief. In recent years, there has been considerable success in treating various movement disorders, particularly in Parkinson's disease (PD) and dystonia, by chronic high-frequency DBS of nuclear structures in the basal ganglia. This technique has also been shown to be relatively effective in some selected cases of tremulous conditions like essential tremor and posttraumatic tremor. However, when the same techniques have been applied to patients with multiple sclerosis tremor (MST), the results have been mixed. As a result, DBS for MST has often been perceived as an unreliable and inconsistent therapeutic intervention. The authors present their experience with the application of DBS in these two relatively unpopular areas for neuromodulation in the current practice of functional stereotactic neurosurgery. The results demonstrate that with careful patient selection, DBS can offer significant functional benefit in both of these difficult clinical conditions.
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PMID:Deep brain stimulation in the management of neuropathic pain and multiple sclerosis tremor. 1509 92

Paroxysmal phenomena such as dystonia in multiple sclerosis (MS) have approximate incidence ranged between 3.8%-17%. These symptoms in MS may represent transient phenomena related to inflammation in acute plaques and probably are secondary to irritation of demyelinated axons by lymphokines. Paroxysmal dystonia can occur at any time during the course of MS, but usually is the initial manifestation of demyelinating disease. We present the case of 42-year old woman with paroxysmal dystonia as the initial symptom of MS. Further MRI studies and CSF analysis revealed findings typical for MS. Patient's neurological status improved temporary after methyloprednisolone therapy. Paroxysmal dystonia may be related to ectopic impulses, release of inflammatory soluble factors, dysfunction of ion channels and accumulation of extra-cellular potassium. Paroxysmal dystonia often causes diagnostic difficulties, especially when it is the only or the initial symptom of the disease. It requires differential diagnosis with other diseases of central nervous system such as epilepsy and neurodegenerative or inflammation pathology.
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PMID:[Paroxysmal focal dystonia as the initial manifestation of multiple sclerosis: case report]. 1509 39

More than 8,000 researchers, clinicians and exhibitors from around the world gathered in San Francisco for the American Academy of Neurology 56th Annual Meeting, April 24 to May 1, 2004. Of the 1,300 studies at the conference, researchers presented more than 200 abstracts each on multiple sclerosis, stroke and dementia, 145 on epilepsy, 159 on Parkinson's disease, 132 on pain and about 50 each on tremor and dystonia. The use of brain imaging technology also figured strongly in the program, with 300 abstracts that mentioned magnetic resonance imaging and 50 that included positron emission tomography. Highlights included promising Parkinson's disease studies involving gene therapy and treatments using glial-cell-derived neurotrophic factor, but also new evidence of cardiac valve regurgitation associated with pergolide. Other highlights included studies on neural repair, new guidelines for the treatment of epilepsy and important studies comparing the thrombin inhibitor ximelagatran to warfarin for the prevention of stroke.
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PMID:New developments in the treatment of neurological diseases. 1533 92

Spasticity results in a resistance to passive movement and decrease of passive mobility of the involved joints and is defined as a state of hypertonicity with exaggeration of tendon reflexes mediated by a loss of inhibitory control of upper motor neurons. In patients with severe stages of multiple sclerosis (MS) spasticity of the lower limbs often leeds to a spastic pattern with hip adduction resulting in decreased range-of-motion (ROM), increased pain, spasms, and functional disability (disturbed gait and sitting position) as well as difficulties with perineal hygiene. Local botulinum toxin type A (Btx-A) injections in spastic muscles offer a new treatment approach for managing spasticity and associated problems. Up to now Btx-A is approved for the treatment of blepharospasm and cervical dystonia and the treatment of equinous gait in children with cerebral palsy in Austria and Germany. Up to now only in Switzerland Botox is licensed for the treatment of focal spasticity. Btx-A is a neurotoxin derived from Clostridium botulinum. In most european countries Btx-A is available as Dysport (vial = 500 units) and Botox (vial = 100 units). In prospective studies a ratio of 1 unit Botox to 3-4 units Dysport was found. Following intramuscular injection Btx-A blocks the release of acetylcholine at the neuromuscular junctions, thereby inhibiting muscle contraction, and decreases spastic muscle tone and muscle spindles afferent information to the spinal cord. The spectrum of side effects includes local weakening of the injected and adjacent muscles as well as pain and haematoma at the injection site. At therapeutic doses side effects are local and transient. According to a double blind, placebo controlled, dose ranging study published by Hyman et al. (2000, Dysport in a dose of 500, 1000 and 1500 units reduced the degree of hip adductor spasticity associated with MS, and this benefit was evident despite concomitant use of oral antispasticity medication. According to the results of the study there was a clear trend towards greater efficacy and duration of effects with higher doses of Dysport. Taking efficacy and adverse events into account (incidence of muscle weakness was higher for the 1500 units group than for placebo) the optimal dose for hip adductor spasticity seems to be 1000 units Dysport divided between the adductor magnus, longus and brevis muscles and between both legs. To increase Btx-A effects following injection of hip adductors additional physiotherapy and casting or orthosis to increase passive hip-abduction is recommended. According to the literature anatomical localisation of the adductor muscles for injection and aspiration following insertion of the needle, to avoid injection of the toxin into a vessel, should be performed. A maximum dose of 1500 units Dysport (400 units Botox) per treatment session and 250 units Dysport (50 units Botox) per injection site is recommended. See table for dose-range of Dysport, and Botox in the treatment of adult patients with hip-adductor spasticity. For evaluation of treatment effects in hip adductor spasticity clinical examination with specific scales and measurements (see Appendix) at baseline, 4 and 12 weeks following BtxA injection is recommended:--Global rating of severity (0-4; patient's self assessment and physician's rating) --Global rating of response (-4 - +4; patient's self assessment and physician's rating)--Visual Analogue Scale (patient's self assessment of pain)--Active and passive ROM (manual goniometer)--Distance between the medial femur condyles in thigh extension (distance in cm)--Modified Ashworth scale (0-4)--Ten meter walking time (seconds)--Functional Ambulation Categories (0-5)--Score of perineal hygiene (0-5).
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PMID:[Botulinum toxin treatment of hip adductor spasticity in multiple sclerosis]. 1550 48

We report a patient who developed relapsing-remitting multiple sclerosis (MS) at 8 years old, and then had a progressive clinical course and dystonia. Dystonia of the patient is probably due to a lesion of the basal ganglia. Abnormal posture or movement disorder is very rarely found in MS, and progressive clinical course is also rare in childhood. The patient is worthy of attention because of his childhood onset, progressive clinical course and dystonia.
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PMID:Dystonia in a 13-year-old boy with secondary progressive multiple sclerosis. 1631 May 95


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