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)

Solitary extramedullary plasmacytomas are uncommon neoplasms. They occur most frequently in the upper aerodigestive tract and account for 4% of the nonepithelial tumors in this site. The evolution of a plasmacytoma is unsteady and symptoms at presentation have included dystonia, dysphagia, oral pain, cough, and dyspnea on exertion. Plasmacytoma of the upper aerodigestive tract has not been previously reported as a cause of obstructive sleep apnea.
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PMID:Plasmacytoma as a cause of obstructive sleep apnea. 876 30

We report the results of treatment of 16 patients (14 women, two men; 18-81 years old) with nonoccupational limb and trunk dystonia with botulinum toxin A (BTX; Dysport). A total of 18 clinical problems were identified. Outcomes were assessed in terms of pain relief and improvement in posture and function by the combined observations of the patient and physician. Patients' satisfaction with treatment was high--the benefit in 15 of 18 problems was rated as good to excellent. Reduction in pain was achieved in nine of 10 painful problems, with total relief in four cases. Some normalisation of posture was obtained in 17 of 18; it was complete in three cases. Functional improvement was less common (10 of 18). Excessive weakness was the most common side effect, affecting five patients, but it was disabling in only two. We conclude that BTX can provide substantial benefit with minimal side effects in the majority of patients with these conditions, particularly with pain relief and postural improvements.
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PMID:Treatment of nonoccupational limb and trunk dystonia with botulinum toxin. 881 16

Cervical spinal pain is frequently found in conjunction with idiopathic cervical dystonia (ICD), a focal dystonia characterized by sustained deviation of the head. Since the perception of noxious stimuli has never been studied in ICD, we performed a controlled study to obtain more insight into the psychophysics of dystonia-related muscle pain by evaluating pressure-induced pain levels. In nine ICD patients and five gender- and age-matched asymptomatic control subjects, pain-pressure thresholds (PPTs) were determined in the sternocleidomastoid and upper trapezius muscles, both at resting activity and at maximal voluntary contraction (MVC). The masseter muscles served as non-pathological control regions. To determine the accuracy of PPT values, pain intensity and unpleasantness were rated at threshold on 100-mm visual analogue scales. Four replication measurements were obtained. The data were analyzed by multilevel procedures. For all muscles under investigation, average PPTs of the ICD patients were about two times lower than those of the control subjects (P < 0.001-0.0005) and showed a smaller intra-subject variance. Further, average PPTs at MVC were about two times higher than those at resting activity (P < 0.005). These results provide psychophysical evidence to suggest that, at controlled levels of muscle contraction, the threshold of pain perception is decreased in ICD. In addition, ICD patients seem to be better able to establish their own PPTs than control subjects, which might be due to a different setting of the discriminative aspect of pain in ICD. Surprisingly, lower intensity and unpleasantness scores were found in ICD patients with coinciding painful and deviated sides than in ICD patients for whom the painful side was opposite to the deviated one (P < 0.05). This finding might be of clinical importance for defining functional disability and predicting treatment outcome.
Pain 1996 Oct
PMID:Pain perception in idiopathic cervical dystonia (spasmodic torticollis). 895 45

Seventy-six consecutive patients with cervical dystonia. (CD) treated with botulinum toxin were assessed with the Tsui rating scale, the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), and a global scale of improvement. Tsui, TWSTRS, and TWSTRS subscale scores all showed significant improvement. Tsui and TWSTRS score reduction rates correlated significantly with each other, and each correlated with the global scale. Analysis of these scales and TWSTRS subscales indicates that an objective scale of severity such as either the Tsui rating scale or TWSTRS severity subscale used in conjunction with the TWSTRS pain subscale adequately assesses improvement of CD following treatment with botulinum toxin.
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PMID:Comparison of clinical rating scales in treatment of cervical dystonia with botulinum toxin. 899 61

Botulinum toxin was introduced as a safe and effective treatment for strabismus and other disorders of the extraocular muscles in the early 1980s. Approved by the U.S. Food and Drug Administration for use in the treatment of strabismus, blepharospasm and seventh cranial nerve disorders, botulinum toxin has also been shown to be effective in the treatment of a wide range of disorders associated with involuntary muscle contraction and spasm, including focal dystonia, hemifacial spasm and spasmodic torticollis. Neurologic syndromes associated with excessive muscle contraction or involuntary movement, disturbances of sphincter function and musculoskeletal pain are other conditions that can be successfully treated with botulinum toxin.
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PMID:Therapeutic uses of botulinum toxin. 905 23

Spasmodic torticollis (cervical dystonia) is frequently a painful condition but little is known of the characteristics of the pain. We assessed 39 patients with spasmodic torticollis for the presence or absence, location, and quality of pain, as well as its correlation to postural abnormality. Muscle tenderness was evaluated by manual palpation and pressure algometry. Measurements were made on muscles either actively maintaining or opposing abnormal head posture, as well as on muscles not contributing to it. Control measurements were made in 18 healthy subjects. Two-thirds of patients reported continuous or intermittent recurrent pain. Pain was reported widespread and diffuse over the neck and shoulders, with some radiation, predominantly on the side toward which the head was twisted. There were no differences between study groups when compared for pressure algometry and only moderate differences when compared for manual palpation. No correlation was found between the severity of motor signs and pain. Degenerative changes seen on X-rays were similar in painful and pain-free patients. These findings suggest that pain associated with spasmodic torticollis does not arise in muscles alone, and we hypothesise that central mechanisms are also involved.
Pain 1997 Feb
PMID:Pain in spasmodic torticollis. 908 2

Sleep disorders occur in 74-98% of patients with idiopathic Parkinson's disease (PD), adversely affecting their quality of life. Sleep disruption takes the form of sleep fragmentation with frequent and prolonged awakenings and daytime sleepiness. Nocturia, difficulty in turning over in bed, painful leg cramps, vivid dreams/nightmares, back pain, limb/facial dystonia and leg jerks are the main causes of nocturnal awakening in PD patients. Sleep disturbance gradually worsens with disease progression, suggesting that it is related to the severity of the disease. Sleep disturbances may be generally considered as part of the normal aging process, being more common in the elderly. However, no significant associations between sleep disturbances and either age or disease duration was found in a survey of 100 PD patients. Disturbed sleep maintenance in PD patients was more severe than in age-matched controls, and nocturnal awakening was frequently caused by nocturia, pain, stiffness and difficulty in turning over in bed. Sleep disturbance is also a complication of chronic levodopa therapy. Recent data suggest that controlled-release levodopa is less likely to cause nocturnal symptoms than standard levodopa, particularly in mild-to-moderate disease. Depression, which is common in PD patients, contributes to sleep disturbance but has a lesser influence than the disease process itself. Hypnotic and sedative agents, as well as anti-depressants if required, are useful in ameliorating sleep disturbances in PD patients; intranasal desmopressin appears to be effective in reducing nocturia.
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PMID:Sleep disorder related to Parkinson's disease. 911 82

We describe a patient who developed right arm dystonia following an electrical injury. The patient's arm remained adducted, and flexed at the elbow and wrist, with all movement resulting in pain and tremor. Surface electromyographic evaluation revealed constant tonic activity of multiple upper and lower arm muscles at rest, that was not distractible. Voluntary and passive movement of the elbow or wrist resulted in high amplitude EMG activity, with motor grouping at 11 Hz at the elbow and 8 Hz at the wrist. Although a diagnosis of psychogenic dystonia was entertained, the stereotyped nature of the movement disorder and lack of variability on clinical and surface EMG evaluation support an organic disorder that was temporally-related to an electrical injury.
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PMID:Dystonia secondary to electrical injury: surface electromyographic evaluation and implications for the organicity of the condition. 912 15

This is a multicentric double blind comparison of the effects of standard and slow release levodopa + carbidopa formulations in patients with Parkinson's disease. Sixty four patients with simple fluctuations were included and 43 finished the study. The study had three phases: a) optimal dose findings phase with standard levodopa + carbidopa; b) open label, cross over study with the two formulations, and c) double blind, parallel investigation. The following results were obtained. There was not a difference in the severity of disability according to UPDRS, part 3, scores though the subjective impressions of patients were in favor of standard formulations. The Sustained release levodopa + carbidopa produced significant improvement of dystonia in off period, pain due to akinesia in off and the number of hours in off and the quality and latency of sleep. In addition there was a tendency in favor of slow release compounds for early morning akinesia, global effect and impression of the examining physician. Low protein diet improved the kinetics of levodopa and the clinical response with both formulations. The clinical usefulness of standard and slow release levodopa + carbidopa formulation should be weighted according to individual problems of patients with Parkinson's disease.
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PMID:[The effect of controlled release of DOPA and carbidopa on clinical response and plasma pharmacokinetics of DOPA in parkinsonian patients]. 923 23

Treatment of tardive dystonia with oral baclofen produces ambivalent and overall disappointing results. However, because only a small proportion of the baclofen penetrates into the central nervous system when administered orally, we tested whether it is possible to increase the efficacy of treatment by continuous intrathecal infusion of baclofen (CITB) in a patient with severe tardive axial dystonia unresponsive to conventional therapy. A dose of 100 micrograms/day improved muscle tone, head control, posture, and walking distance; electromyography showed a marked decrease of dystonic muscle activity with fully preserved voluntary muscle activity, and the patient reported substantial reduction of pain. Apart from some minor discomfort at the site of operation, no side effects were noted. Further studies should be encouraged to evaluate the usefulness of CITB for other patients with severe and otherwise untreatable tardive dystonia.
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PMID:Severe tardive dystonia: treatment with continuous intrathecal baclofen administration. 925 Oct 78


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