Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 59-year-old man, who was diagnosed as having Parkinson's disease and depression seven years ago and was on oral antiparkinsonian agents, antianxiety agents, and antidepressants, developed a high fever, disturbed consciousness, and marked muscle rigidity after discontinuation of etizolam and amitriptyline. He was admitted to a nearby hospital. Hypothyroidism had been noted two months before admission. Marked muscle rigidity and increased serum CK were observed. Since discontinuation of benzodiazepine has been known to rarely trigger a neuroleptic malignant syndrome (NMS), he was diagnosed as having NMS. After receiving dantrolene and bromocriptine, these symptoms temporarily improved but he again developed consciousness disturbance, and convulsive seizures associated with an elevated serum CK. He was transferred to our hospital. On admission, the CK level was normal at 168 IU/l, while free T4 was 0.6 ng/dl (normal range, 0.9-2.3) and TSH was 108.7 mU/ml (normal range, 0.2-4.2) in serum, indicating the presence of primary hypothyroidism. As an increase in thyroid hormone dosage improved the thyroid function to normal level, his disturbed consciousness and muscle rigidity gradually improved. Convulsive seizure and recurrence of NMS in a short interval are unusual in neuroleptic malignant syndrome. In this patient, hypothyroidism may have contributed to the development of malignant syndrome through metabolic changes of the central dopaminergic system, and discontinuation of etizolam, a kind of benzodiazepine, may have triggered NMS, since there has not been reported that discontinuation of antidepressants including amitriptyline triggers NMS.
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PMID:[A patient with Parkinson's disease complicated by hypothyroidism who developed malignant syndrome after discontinuation of etizolam]. 1242 63

Development of hypothyroidism may easily be overlooked when occurring together with Parkinson's disease (PD), because many of the symptoms of the two disorders are similar. We report on a case of a woman suffering from both PD and hypothyroidism and review the literature on the subject.
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PMID:Hypothyroidism and Parkinson's disease and the issue of diagnostic confusion. 1537 12

The objective of this study was to determine whether hypothyroidism is more common in Parkinson patients than in a control group without Parkinson, as suggested in the past. We performed a retrospective file review of all admissions to the geriatric ward during a 1-year period. Concentrations of thyroid stimulating hormone (TSH) and thyroxine (T4) from 92 Parkinson patients were compared with those of 225 randomly selected controls from the same ward. Hypothyroidism was not found to be more common in patients with Parkinson disease as previously suggested. Incidentally, we found an unexpected increase in the prevalence of abnormal thyroid laboratory tests in this group. Statistically significant differences were found in two subgroups, (1) men with Parkinson were more likely to have abnormal thyroid laboratory tests as compared with controls; and (2) 'subclinical' hyperthyroidism was found to be more prevalent in Parkinson patients than in controls. Further research in this field is warranted in non-hospitalized patients.
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PMID:Subclinical thyroid disease in patients with Parkinson's disease. 1537 26

"A propensity to bend the trunk forward" and "the chin is now almost immovably bent down upon the sternum" were described by James Parkinson in patients with Parkinson's disease (PD). The term "dropped head" was first reported in "Gerlier disease" in Switzerland and 'kubisagari' in Japan and since then also reported in myositis, myopathy, myasthenia gravis, amyotrophic lateral sclerosis, neuropathy, and hypothyroidism. Disproportionate antecollis occurs in about half cases of multiple system atrophy (MSA) and is considered dystonic in nature. Dropped head is considered rare in PD, both in advanced and early stages of PD. However, it is known to progress subacutely over a period of several days. In my experience, dropped head is relatively common in PD. The mechanism of dropped head in PD is either dystonia of flexor neck muscles or weakness of extensor neck muscles. The response of dropped head to various anti-parkinsonian medications is rather inconsistent. Levodopa is reported to induce amelioration in some patients while dopamine agonists can cause deterioration. Muscle afferent block with lidocaine and ethanol is reported to be effective, while the effect of botulinum toxin injection into the affected muscles is limited. The effect of stereotaxic neurosurgery on dropped head is controversial. Early diagnosis and prompt treatment is necessary to prevent muscle damage associated with longterm overstretch of extensor neck muscles.
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PMID:Dropped head in Parkinson's disease. 1713 Dec 24

Muscle cramps are involuntary, painful, spasmodic contractions of the skeletal muscle. Although cramps are a common clinical complaint, their etiology and management have not been well established. Exercise-associated muscle cramps occur during or immediately following exercise, and they are associated with muscular fatigue and shortened muscle contraction. The main challenges for treating physicians are to identify whether the complaint represents a true muscle cramp as well as to rule out the presence of an underlying serious clinical condition. Muscle cramps may be a symptom of any of several conditions, including radiculopathies, Parkinson's disease, hypothyroidism, diabetes mellitus, vascular problems, electrolyte disorders, and metabolic myopathies. Cramps also may occur as a side effect of certain drugs (eg, lipid-lowering agents, antihypertensives, beta-agonists, insulin, oral contraceptives, alcohol). Most athletes who experience exercise-associated muscle cramps are healthy individuals without systemic illness. Therapy should focus on preventing premature fatigue by means of appropriate nutrition and adequate training.
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PMID:The athlete with muscular cramps: clinical approach. 1760 31

Fatigue without coincident depression may accompany many neurological disorders, including multiple sclerosis, Parkinson's disease, motor neuron disease, stroke and post-polio syndrome, and is frequently reported by patients as a predominant complaint. The pathophysiology of fatigue is unknown. The role of various mechanisms has been suggested, including the effect of proinflammatory cytokines (TNF-alpha, IL-1beta and IL-6) on glutaminergic transmission, hypothalamo-pituitary-adrenal (HPA) axis dysfunction, disturbances of astroglia metabolism and decreased levels of the neurotransmitters noradrenaline and serotonin. The diagnosis of fatigue syndrome is based on exclusion of depression and additional organic conditions (anaemia, cardiovascular disorders, kidney diseases or hypothyroidism). The treatment of fatigue syndrome is complex. Physical activity, rehabilitation, psychotherapy and avoidance of factors which may increase fatigue, such as fever, anxiety, depression, pain, sleep disturbances, as well as some drugs like opioids and benzodiazepines, are important. Pharmacological treatment leads to slight improvement. Amantadine, modafinil and pemoline are administered to such patients.
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PMID:[Fatigue syndrome in chronic neurological disorders]. 1787 43

Constipation has always been a common problem but recently it appears to be on the rise in the western world. Its prevalence in the general population is estimated at around 20% with reports suggesting significantly higher levels in the elderly, especially above the age of 65. There have also been reports of females being affected more then males, Higgins et al reporting a male to female ratio of 1: 2.2. Constipation can be classified as either primary or secondary. Primary constipation is either due to prolonged transient time through the colon (colonic inertia) or a disturbance in defecation with normal transient time. Secondary constipation is either due to medications or other medical diseases for example hypothyroidism, diabetes or Parkinson's disease. In the past several years advances have been made in understanding the physiological and pathophysiological processes of normal and abnormal defecation. This has led to the understanding of transient time, sensation and pressure build-up in the rectum and anus as well as the key role of synchronization between contraction and relaxation of the involved muscles and sphincters. Disturbance in any one of the above mentioned processes can lead to constipation. The obstructed defecation syndrome has been shown to be the result of an abnormal function of the muscles involved in defecation or an anatomical abnormality of the pelvic organs. Obstructed defecation syndrome is estimated to be prevalent in 7% of the adult population and is judged to be the cause of one third of all cases of constipation. Due to the fact that surgery is an emerging treatment of choice for these patients suffering from obstructed defecation syndrome, it is highly important that we should not only be able to diagnose the cause of constipation in patients but accurately identify those suffering specifically from obstructed defecation syndrome. Therefore, this paper reviews the definitions, symptoms, pathophysiology, diagnosis and treatments of obstructed defecation syndrome.
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PMID:[Obstructed defecation syndrome]. 1869 23

Hypothyroidism in the developing brain results in progressive intraneuronal accumulation of neurofilament (NF) proteins in the proximal hillock regions of axons, analogous to the pathological intraneuronal accumulation of NF in common neurodegenerative diseases like Alzheimer's disease, Parkinson's disease and Amyotrophic lateral sclerosis. A preferential decline in the expression of the light chain of NF occurs in all the three diseases leading to an absolute change in stoichiometry of the NF subunits. Using the developing hypothyroid rat cerebra as a model, we have tried to elucidate if age or hypothyroidism causes a change in the stoichiometry or molar ratio of the NF subunits which could be responsible for their aberrant intraneuronal accumulation. Western blotting and chemiluminescence assay of cytoskeletal preparations from normal and hypothyroid developing rats at postnatal days 5 (PND5), PND15 and PND25 shows that in the normal cerebra, the expression of NFL and NFM were abundant during the first 2 weeks, corresponding to the onset of axonal outgrowth and synaptogenesis, whereas that of NFH was predominant during the second and third weeks corresponding to the period of maturation of synapses, axonal caliber and transport processes. These results show that consistent with the requirement for neuronal differentiation during synaptogenesis, the molar ratios NFH:NFM:NFL changed significantly from 1:3:9 at PND5 to 1:2:6 at PND25. Hypothyroidism caused a 40-60% decline in the expression of all three subunits. However, at all three ages examined, differences in the molar ratios of the NF subunits between normal and hypothyroid cerebra were insignificant suggesting that factors other than alteration in the stoichiometry of NF subunits are associated with their aberrant intraneuronal aggregation.
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PMID:Age related and hypothyroidism related changes on the stoichiometry of neurofilament subunits in the developing rat brain. 1916 77

Abnormal tonic-motor activity is a key component in pathogenesis of many digestive disorders. Secondary disturbance of tonic-motor activity of digestive organs and the accompanying symptoms are known to develop in conjunction with diseases of other organs and systems, diabetes mellitus, Parkinson's disease, myotonic muscular dystrophy, amyloidosis, hyper- and hypothyroidism, hypoparathyroidism, etc. Disturbed motor activity in the gastro-duodenal region most frequently underlies functional dyspepsia, i.e. a group of symptoms unrelated to organic, systemic and metabolic diseases. Prokinetics are an important class of medicinal products for the treatment of all clinical forms of dyspepsia. One of the new ones is itopride hdrochloride having combined mechanism of action. Clinical studies of this drug revealed its high efficiency in patients with functional dyspepsia, chronic gastritis, and diabetic gastroparesis. It is well tolerated by the patients and produces no serious side effects. Inclusion of this drug in therapy improves the outcome of the treatment of disturbed motor activity of the gastrointestinal tract.
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PMID:[The use of prokinetics for the correction of motor and tonic digestive disorders]. 1946 57

A diagnosis of hypothyroidism in the elderly can easily be overlooked if we rely exclusively on its clinical presentation because this may be highly non-specific, since the signs and symptoms of the disease are common to other diseases typical of old age, and even to the normal aging process. Imaging diagnostics (ultrasound or CT), when considered alone, are also of little use for the purpose of clarifying thyroid gland function. We report here on a case of primary hypothyroidism that was diagnosed late because the correlated signs and symptoms (asthenia, bradycardia, pleural effusions, hyponatremia, worsening renal and respiratory insufficiency, hoarseness) had previously been attributed to the normal aging process and to the patient's other health conditions (Parkinson's disease, PD; chronic obstructive pulmonary disease, COPD). After a couple of weeks of treatment with levothyroxine and liothyronine, there were clinical and laboratory evidences of an improvement in the patient's condition. She became more reactive, with a shriller voice. The pleural effusion disappeared, and so did the bradycardia. Laboratory tests showed normal sodium levels, and the renal insufficiency had improved. The lack of specificity of the clinical presentation of hypothyroidism in the elderly might justify the routine measurement of thyroid-stimulating hormone in these patients.
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PMID:Hypothyroidism in the elderly: diagnostic pitfalls illustrated by a case report. 2164 Mar 96


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