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)

Isotonic muscle strength measured by a quantitative technique was decreased in early Parkinson's disease compared to age-matched controls. Weakness was present both on the affected and unaffected side in hemiparkinsonism. Similar degrees of weakness occurred in limbs with tremor or rigidity. Muscle weakness appears to be a primary symptom of Parkinson's disease which may relate to disturbed motor programming due to basal ganglia dysfunction.
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PMID:Muscle strength testing in Parkinson's disease. 394 87

The possibility of an 'organically' based depression intrinsic to the pathophysiology of Parkinson's disease (PD) and comparable to endogenous depression (Major Depressive Episode) has been raised. It has also been argued that signs of depression observed in PD are merely the natural reaction of the patients to their progressive and inevitable physical limitations and loss of independent function. Because conventional depression rating scales are limited in scope, a psychometric investigation of depression in PD was pursued. Based on the known impairment of short-term memory (STM) in endogenous depression, which was confirmed in a group of psychiatric patients in the present study, measures of STM were also obtained in groups of depressed and nondepressed PD patients and in 15 normal control subjects. Regardless of depression severity, PD patients performed as well as control subjects and both these groups consistently obtained scores significantly better than those of the endogenously depressed patients. A relative weakness in the PD patients on order-dependent STM tests was further explored and interpreted as an indication of mild frontal lobe dysfunction. It was concluded that PD patients are frequently depressed when confronted with their behavioural limitations and that this reaction may be exacerbated by a form of emotional liability related to pathophysiological processes which may involve prefrontal cortical areas.
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PMID:Parkinson's disease and depression. A critical re-evaluation. 395 35

Of 1322 patients with fractures of the proximal femur, 86 had muscular disturbances. Of these, 65 were suffering from paresis due to cerebrovascular stroke and 21 had Parkinson's disease. In the paretic patients, except for one case, the fracture occurred on the affected (paretic) side, and it was intertrochanteric in the majority of cases. In the patients with Parkinson's disease, cervical (intracapsular) fractures predominated. Muscle weakness or disturbance is a factor in the causation and location of hip fractures.
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PMID:Significance of muscular disturbances in the localization of fractures of the proximal femur. 674 20

Shy-Drager syndrome consists of progressive autonomic nervous system failure with Parkinson's disease-like symptoms and orthostatic hypotension. It can also result in airway compromise from bilateral vocal cord paralysis. Fewer than 30 cases of severe bilateral vocal cord paresis or paralysis associated with the Shy-Drager syndrome have been reported in the English literature. We present a case of a 72-year-old man who had a 2-year history of orthostatic hypotension, neurogenic bladder, impotence, anhydrosis, and extremity weakness and paresthesias. Hoarseness and dyspnea with stridor developed as a result of bilateral vocal cord paralysis in the median position and required an emergency tracheotomy. This combination of symptoms resulted in the diagnosis of Shy-Drager syndrome. We present the case along with literature review of bilateral vocal cord paralysis with the Shy-Drager syndrome.
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PMID:Bilateral vocal cord paralysis with Shy-Drager syndrome. 750 34

A 45-year-old woman with a history of probable perinatal craniocerebral trauma resulting in mild asymptomatic right hemiatrophy developed right leg weakness and hypotonia alternating with dystonia only after prolonged exertion at age 12. At age 27, she developed right-sided parkinsonism. Exertional paresis and dystonia and parkinsonism responded completely to levodopa; however, she developed a progressive reduction in the duration of action of levodopa over the first 4 years of treatment. Investigations including computed tomography, magnetic resonance imaging, [18F]fluorodopa, and [18F]fluorodeoxyglucose positron emission tomography scans suggested a static lesion involving the left substantia nigra. This unusual exertion-induced weakness and hypotonia alternating with hypertonia and dystonia has not been reported previously. The role of dopamine deficiency in dystonia and the role of levodopa in the development of fluctuations in Parkinson's disease are discussed. Review of the literature, including this patient, emphasizes the heterogeneity of the syndrome of hemiparkinsonism-hemiatrophy.
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PMID:Hemiatrophy, juvenile-onset exertional alternating leg paresis, hypotonia, and hemidystonia and adult-onset hemiparkinsonism: the spectrum of hemiparkinsonism-hemiatrophy syndrome. 756 31

An 81-year-old man with Parkinson's disease was admitted to our hospital with impaired function of all extremities. Four weeks before his symptoms developed, he had tripped on the steps, fallen and bruised his jaw. Following this episode he experienced a few more falls inside his house. On examination his greatest weakness was in the hands and wrists. He was hyper-reflexic in all extremities and had bilateral Babinski's sign. He could not walk and needed physical assistance in most of his daily living activities. X-ray films of the cervical spine showed significant degenerative changes. The magnetic resonance images suggested central cervical cord damage at the level of the C6 vertebral body. After three months' rehabilitation treatment, he became able to walk with a cane and became independent in all the basic activities of daily living except for bathing. He never regained skillful function of his hands despite later levodopa treatment of Parkinson's disease. His clinical features were consistent with the central cervical cord syndrome, described by Schnneider and co-workers in 1954. This syndrome may occur as a result of hyperextension neck injury, occasionally associated with an accidental fall in the elderly with cervical spondylosis. Thirteen patients with cervical spinal cord injury above 65 of age were admitted to our department from 1983 to 1993. Six of them presented with the central cervical cord syndrome, and all patients had a history of accidental injuries related to falling.
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PMID:[Central cervical cord syndrome: a case report on rehabilitation, with special references to accidental falls in the elderly]. 759 63

Neurogenic orthostatic hypotension is a severely disabling condition due to deficient peripheral vasoconstrictor tone in response to the upright position and is characterized by a decrease in blood pressure upon standing associated with symptoms of lightheadedness, dizziness, visual "white-out", weakness, lack of energy, near syncope or even syncope. Previous pharmacologic treatment of neurogenic orthostatic hypotension has been problematic. Midodrine, a new specific alpha-1-agonist has been shown to produce arteriolar constriction and decrease in venous pooling via a constriction of venous capacitance vessels. Therefore, a recent multicenter study evaluated the safety and efficacy of midodrine therapy in 97 patients with neurogenic orthostatic hypotension due to various etiologies: Shy Drager syndrome (No. 18); Bradbury Eggleston syndrome (idiopathic orthostatic hypotension) (No. 20); diabetic autonomic neuropathy (No. 27); Parkinson's disease (No. 22); and miscellaneous (No. 10). Following one week of placebo therapy, the patients were randomized into 4 groups for a 4 week period of time; placebo, 2.5 mg, 5 mg, or 10 mg three times daily. The BE/SDS subgroup demonstrated a 27 +/- 8% (22 mmHg) increase in standing systolic blood pressure for the 10 mg dose. Diabetics achieved a significant increase at 5 mg. Similar increases were observed for the entire group on the 10 mg dose (p < 0.001). Symptoms or fainting, blurred vision, improved energy level, standing time, and depressed feelings were also significantly improved even at lower doses (p < 0.05 or less). Side effects were mild. Therefore, midodrine is an effective and safe agent for the treatment of neurogenic orthostatic hypotension.
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PMID:Midodrine in neurogenic orthostatic hypotension. A new treatment. 769 Mar 83

We conducted an open-label study to determine the utility of treating severe hand tremors with intramuscular injections of botulinum toxin (BTX) in forearm and arm muscles in 26 patients, 12 with Parkinson's disease (PD) and 14 with essential tremor (ET). The effect after 6 weeks for each patient was evaluated using two clinical rating scales, subjective evaluations of functional improvement and global disability, measures of weakness, and computer-assisted quantitative assessments of tremor. Although none of the clinical scores averaged > 3/4 point change, statistical significance was found on comparison of pre- and postinjection scores in the Webster Tremor and Global Disability Scales in the ET patients. Similarly, although average tremor amplitudes decreased by no more than 25% by quantitative analysis, amplitude decrease significantly correlated with patient subjective assessment in ET. In only two of 12 PD (17%) and three of 14 ET patients (21%) were major quantitative changes in tremor amplitude (> 50% reduction) found after BTX injections. Nevertheless, 10 patients (38%; five PD and five ET) reported moderate to marked subjective improvement in functional benefit after BTX. These findings suggest that although there were no major changes in clinical ratings or objective measurements, BTX injections may subjectively improve tremor in some patients, particularly those with ET.
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PMID:Botulinum toxin A injections for the treatment of hand tremors. 784 99

The decision to stop driving leads to severe contraction of independence, and most localities do not curtail driving privileges in impaired elders. In a population of community-based, ambulatory individuals 70-96 years old, annual medical screening showed that 276 of 1,656 (16.7 +/- 1.8%) who reported driving regularly in the past do not currently drive. The cessation of driving behavior was examined in terms of specific medical conditions occurring within the past 5 years. Retired drivers were disproportionately female, and driving cessation risk rose with age. Age-sex-adjusted logistic regression found that six conditions explained about 50 percent of the decisions to stop driving: macular degeneration; retinal hemorrhage; any deficit in Activities of Daily Living; Parkinson's disease; stroke-related residual paralysis or weakness; and syncope. Strikingly, only 1.8 percent of those who stopped driving had ever had a license revoked; 58.7 percent reported voluntarily stopping; 31.9 percent gave health or medical reasons. Clearly, the decision to cede driving privileges is complex and not dependent solely on medical problems.
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PMID:Medical conditions associated with driving cessation in community-dwelling, ambulatory elders. 831 47

A case of familial juvenile parkinsonism with dementia, orthostatic hypotension, neurogenic bladder and constipation was reported. He had been in a good health until the age of 28 when a finger tremor occurred on effort to hold hands in a definite position, and disturbances in gait and speech were noted. These symptoms were relieved by levodopa treatment followed by dyskinesia and motor fluctuations. Three years later, he complained of faintness, constipation and urinary frequency. The neurological examination revealed mentally sound male with masked face, tremor and rigidity in his extremities, and short step gait with lateropulsion. Urodynamic study showed uninhibited bladder. In the following years, orthostatic hypotension, dysuria and urinary retention developed gradually. He became mentally loose and was unable to take medicines appropriately. When in the Nishiojiya Byoin National Sanatorium, he tried to snake out the hospital many times. His parents and a brother suffered from Parkinson's disease and juvenile parkinsonism, respectively, suggesting an autosomal dominant inheritance. On admission to our hospital, he was apathetic. He had masked face, bilateral postural tremor, frozen gait and dyskinesia in the right lower extremity. Little bradykinesia or rigidity was noted. His muscle tone and deep tendon reflexes were decreased but neither muscular wasting, weakness, ataxia nor sensory disturbance was observed. Laboratory data including ceruloplasmin, copper, dopamine-beta-hydroxylase and lysosomal enzyme activities were normal except for mild anemia. A cranial CT scan revealed mild cortical atrophy in the frontal and temporal lobes, but nerve conduction study and cortical evoked potentials showed no abnormality. While in the hospital, his mental functions deteriorated to the state of dementia and orthostatic hypotension became apparent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Familial juvenile parkinsonism with dementia and autonomic failure--a case report]. 833 79


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