Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 2-year-old boy with Leigh disease, spasticity, dysarthria, and optic atrophy gradually developed. Computed tomography and magnetic resonance imaging disclosed progressive, symmetric basal ganglia lesions. In muscle tissue, a defect of pyruvate dehydrogenase complex was found. Magnetic resonance volume selective proton spectroscopy (MRVS) of the basal ganglia demonstrated an abnormal lactate peak. A ketonemic diet coincided with clinical stabilization and arrest of progressive brain lesions. Lactate could no longer be demonstrated by MRVS. It reappeared with a new brain lesion coinciding with discontinuation of the diet. MRVS, therefore, appears to be a sensitive tool to evaluate pathologic lactate production in metabolic brain disease with disturbed energy metabolism and allows noninvasive therapy monitoring.
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PMID:Assessment and therapy monitoring of Leigh disease by MRI and proton spectroscopy. 155 78

A patient with severe pyruvate carboxylase deficiency presented at age 11 weeks with metabolic decompensation after routine immunization. She was comatose, had severe lactic acidemia (22 mM) and ketosis, low aspartate and glutamate, elevated citrulline and proline, and mild hyperammonemia. Head magnetic resonance imaging showed subdural hematomas and mild generalized brain atrophy. Biotin-unresponsive pyruvate carboxylase deficiency was diagnosed. To provide oxaloacetate, she was treated with high-dose citrate (7.5 mol/kg(-1)/day(-1)), aspartate (10 mmol/kg(-1)/day(-1)), and continuous drip feeding. Lactate and ketones diminished dramatically, and plasma amino acids normalized, except for arginine, which required supplementation. In the cerebrospinal fluid (CSF), glutamine remained low and lysine elevated, showing the treatment had not normalized brain chemistry. Metabolic decompensations, triggered by infections or fasting, diminished after the first year. They were characterized by severe lactic and ketoacidosis, hypernatremia, and a tendency to hypoglycemia. At age 3(1/2) years she has profound mental retardation, spasticity, and grand mal and myoclonic seizures only partially controlled by anticonvulsants. The new treatment regimen has helped maintain metabolic control, but the neurological outcome is still poor.
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PMID:Treatment of pyruvate carboxylase deficiency with high doses of citrate and aspartate. 1058 40

Lower limb muscle chronic hyperactivity in hereditary spastic paraplegia (HSP) is the consequence of motor corticospinal tract involvement, which in turn has been hypothesized to be of mitochondrial origin. In order to assess skeletal muscle aerobic metabolism and sympathetic response during exercise in 10 HSP patients, we evaluated their blood lactate and catecholamine levels during an incremental workload bicycle exercise. Lactate, but not epinephrine or norepinephrine, levels were significantly higher in the HSP patients than in control subjects, in both resting conditions and during exercise. In the patients, the anaerobic lactate threshold was reached prematurely (at 50% of the predicted normal maximal power output) when compared to normal controls. This finding was not related to any specific muscle morphology or histochemical activity. Although other factors, including chronic spasticity and muscle deconditioning, have to be considered in the interpretation of our data, our results suggest the possible involvement of a mitochondrial mechanism, independently of sympathetic system overactivation, in exercising skeletal muscle of HSP patients.
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PMID:The relationship between anaerobic lactate threshold and plasma catecholamines during incremental exercise in hereditary spastic paraplegia. 1291 Nov 38