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)

Tremor can be categorized into three general types: resting, action, and intention, Each requires different therapy. Resting tremor is present when the hands are at rest; it disappears with movement. It is characteristic of Parkinson's disease and responds to treatment with L-dopa either alone or in combination with a decarboxylase inhibitor. Action tremor is maximal when the hands are outstretched to the front; it may persist during movement. It is not rare and is often misread as a sign of Parkinson's disease. Propranolol is beneficial. Intention tremor occurs with movement and is characteristic of cerebellar disease. Pharmacologic agents are not helpful. The only known effective treatment is stereotaxic surgery.
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PMID:The shaking patient. Diagnosis and management of tremor. 83 91

Six patients with Parkinson's disease, six patients with essential or intention tremor, and nine controls were tested on a step-tracking task using a joystick control and oscilloscope display. Tremor subjects resembled controls in making an initial ballistic movement followed by (defective) corrections, and took longer than the controls to reach the target with small amplitude jumps, but not with larger ones. The reverse was true for parkinsonian subjects, who acquired the target with slow corrective movements only. This suggests that two kinds of movement available to normal people are selectively impaired in these disorders; ballistic movements in Parkinson's disease and small amplitude corrective movements in the other disorders.
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PMID:Ballistic and corrective movements on an aiming task. Intention tremor and parkinsonian movement disorders compared. 116

Actual phenomena of various types of involuntary movements listed below were demonstrated by moving pictures, which were followed by comments on symptomatology, in particular the fundamental characteristics of an individual involuntary movement. These characteristics are the essence of each involuntary movement, and it is necessary to recognize both its phenomenon itself and its accumulated knowledge in order to realize and interpret the involuntary movement. The following involuntary movements are treated: (1) typical tremor-at-rest in paralysis agitans, (2) atypical parkinsonian tremor, (3) essential tremor, (4) chorea, (5) ballism, (6) athetosis, (7) choreoathetosis, (8) dystonia, (9) spontaneous myoclonus at rest, (10) intention or action myoclonus, (11) intention tremor and (12) hyperkinesis.
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PMID:[Symptomatology of the involuntary movement]. 201 97

Fourteen thalamotomies and five pallidotomies were performed in 19 patients with hereditary intention tremor or Parkinson's disease. The target coordinates were determined by a stereotactic computed tomography study using the Laitinen noninvasive stereoadapter. Surgery was done without ventriculography. The patients were assessed 3-12 months later. In a postoperative stereotactic computed tomography study, the positions of the thalamic and pallidal targets were marked, and the coordinates of the center of the lesion were measured in relation to these targets. The volume of the lesion was calculated. In 3 thalamic lesion patients, no lesion could be visualized. The size of the eleven visible thalamic lesions ranged from 4 to 75 mm3 (mean 26), and the size of the 5 pallidal lesions ranged from 28 to 150 mm3 (mean 67). On the average, the center of the lesion was 1.4 mm medial to the position of the anatomical target (p less than 0.002). Neither size nor site of the lesion correlated with the clinical outcome.
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PMID:Correlation between clinical outcome and size and site of the lesion in computed tomography guided thalamotomy and pallidotomy. 208 Mar 34

In this review, the authors present a critical overview of the historical development, indications, complications, operative techniques, and results of procedures for the alleviation of the major dyskinesias. Emphasis is placed upon recent refinement of technique, particularly stereotaxis, as well as neurophysiologic stimulation and recording, computerized tomographic scanning (CT) and magnetic resonance imaging (MRI). Specific disorders that may be amenable to surgical therapy include spasticity secondary to spinal cord pathology, cerebral palsy, and multiple sclerosis; the tremor and rigidity of Parkinson's disease; essential tremor; dystonia; spasmodic torticollis; post-traumatic and postinfarction intention tremor; cerebral palsy with tremor; hemiballismus; myoclonus; and dyskinesias induced by L-DOPA.
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PMID:Neurosurgical management of spasticity, rigidity, and tremor. 332 80

Thalamic targets in the treatment of involuntary movements include the lateral and usually the intermediary ventral nuclei. Destruction of their afferents in Forel's fields provides the same therapeutic result but the size of the lesion must then be very small due to the proximity of essential structures, particularly corpus Luysi. Efficacy of treatment depends partly on the aetiology of the involuntary movement (and thus from the indication for surgery) and also on the technical possibilities of electrophysiologic mapping. The true dystonic element of the involuntary movement is usually little improved whereas tremors of all types are improved or suppressed. Essential tremor, familial or not, of large amplitude and very disabling, is an ideal indication for stereotaxic surgery when it presents as intention tremor. In Parkinson's disease, the treatment is effective against tremor and rigidity but akinesia is unaltered and the progressive course of the disease uninterrupted. Indications for surgery have become rare since the availability of L-dopa, perhaps too rare for the slowly progressive forms with predominant tremor poorly relieved by dopa-therapy, surgery has a curative and probably preventive effect on the involuntary movements of limbs induced by this treatment. Suppression of post-traumatic tremor and that due to multiple sclerosis is dependent on various factors: electrophysiologic precise mapping of the target since "electrical silences or holes" exist that disturb or prevent collection of evoked potentials or spike activity; multiple neurologic lesions that may be worsened by an additional thalamic lesion; finally residual cerebellar disturbance unmasked by the suppression of tremor, a poor "functional" result despite a good operative result.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of abnormal movements by thalamic lesions]. 353 89

In 58 patients with progressive supranuclear palsy (PSP), 19 (32.8%) had CT, MRI, or autopsy evidence of a multi-infarct (MI) state. The clinical findings in the infarct syndrome were similar to idiopathic PSP. Five MI-PSP patients had had a stroke, four had focal dystonia, two had hemiparesis, and one had an intention tremor of recent onset. In contrast, only 5.9% (12.9% of those with CT or MRI) of 426 Parkinson's disease patients had evidence of strokes. One case of PSP studied pathologically was attributed to cerebral amyloid angiopathy.
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PMID:Progressive supranuclear palsy and a multi-infarct state. 356 71

Cerebrospinal fluid from patients with Parkinson's disease and Huntington's chorea has been investigated with regard to the concentration of choline. In Parkinson's disease the choline concentration of lumbar spinal fluid was not different from that of a control group, nor was it related to medication, duration of illness, or severity of symptoms. A comparison between choline in ventricular cerebrospinal fluid from patients with Parkinson's disease and with intention tremor showed no significant differences. Patients with Huntington's chorea had a lower concentration of choline in lumbar spinal fluid as compared with a control group. The results are discussed in relation to the possible sources of cerebrospinal fluid choline.
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PMID:Cerebrospinal fluid choline in extrapyramidal disorders. 426 43

Most disorders of motor activity including disturbances of muscle tone and of locomotor activity observed in patients with neurological disorders have been reproduced experimentally in animals. Most motor disorders of the extrapyramidal type including those associated with Parkinson's disease and choreiform and athetoid involuntary movements, have been reproduced exclusively in primates. This is most likely related to the highly complex organization of the extrapyramidal and related nervous mechanisms subserving the corresponding peculiar type of motor control in the primate brain. Other types of motor disturbances including cervical and trunkal dystonias, ataxia, hypotonicity, spasticity and intention tremor, however, have been successfully induced in various mammalian species. The latter types of motor disorders are related to disturbances of central nervous mechanisms which show similar patterns in the brains of different animal species. Histopathological and neurochemical changes associated with extrapyramidal disorders have been discovered and more precisely determined as a consequence of the development of new technical approaches. Therefore numerous morphological, physiological and neurochemical data concerning the extrapyramidal system are now available but a better knowledge of their precise and subtle interrelationship is greatly needed in order to develop more efficient therapeutic procedures.
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PMID:Behaviour correlates of neurotransmitter activity. 614 9

The effect of nadolol, a peripherally acting beta-adrenergic blocker, on resting tremor was examined in eight patients with idiopathic Parkinson's disease. With the use of a double-blind, placebo-controlled study of crossover design, patients received 80 to 320 mg of nadolol for 6 weeks while continuing their previous treatment regimen. Accelerometer readings showed a progressive reduction in tremor amplitude, but no change in tremor frequency, with increasing nadolol dosage. Maximum benefit was achieved at 240 mg, when resting tremor improved 50% (p less than 0.01). Physician ratings confirmed these findings. The results suggest that response to beta-adrenergic blockade may not be limited to postural or intention tremor and that such agents may not reliably differentiate between the tremor of Parkinson's disease and essential tremor.
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PMID:Treatment of resting tremor by beta-adrenergic blockade. 614 81


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