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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two postmortem case of multiple sclerosis treated by sterotactic operations for the intention shaking of limbs, trunk, and head, and for the action myoclonus are analyzed to determine the location of the substrate of myoclonic and ballistic movements, the location of the coagulations for relief of these movements, and whether fresh demyelinating foci are elicited by intracerebral interventions. In the first case of a clinically typical multiple sclerosis, the foci responsible for the severe action myoclonus and intention ataxia of the trunk are demyelinations in the right and left red nucleus resulting in nerve cell damage and loss and an almost complete destruction of myelinated fibers. The restricted foci in the white matter of the cerebellum which do not involve the cerebellar nuclei are not extensive enough or old enough to be the cause of the action myoclonus but may, perhaps, sustain the pathogenesis. - In the second case of cerebral palsy and combined multiple sclerosis (detected post mortem), the combination of the severe damage of putamen and caudate nucleus by status marmoratus and the extensive nerve cell and fiber damage due to demyelinating foci in the substantia nigra are probably the substrate of the jactitation and intention myoclonus of the left limbs. The stereotactic coagulation of the dentatothalamic and pallidothalamic fibers in the base of V. o.p. and V.o.a. at the point where they pass through the zona incerta (location confirmed post mortem) resulted in a nearly complete relief of hyperkinetic movements. In the first case, fresh demyelinating foci are present in both hemispheres with stereotactic interventions; these foci are located, amongother places, around the coagulation and the electrode track. In the second case, post mortem serial brain sections demonstrate that stereotactic operations even in subacute multiple sclerosis can be carried out without eliciting any exacerbation of demyelination foci. Therefore, the danger exists that stereotactic intervention in cases of multiple sclerosis may precipitate fresh demyelinating foci. As our clinical experience [Riechert and Richter, 1972a, b] indicates, however, this occurred in markedly less than 10% of the cases.
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PMID:Pathologic-anatomical findings and cerebral localization in stereotactic treatment of extrapyramidal motor disturbances in multiple sclerosis. 109 87

The clinical pattern and etiology of 544 cases of cerebral palsy were studied retrospectively. Of these cases, 354 (65.1%) were males. Four hundred and ninety seven (91.4%) cases were of spastic type. Hypotonic, ataxic and athetoid cerebral palsy were observed in 5.5, 1.5 and 1.3% cases, respectively. There was one case each of tremor and mixed type. In the spastic group, quadriplegia comprised the maximum number of cases (34.9%). Hemiplegia (28.7%) and diplegia (21.9) were also common. Mental retardation was found in 47.2%, while speech impairment was observed in 37% cases. Other handicaps included visual (9%), seizures (8.8%), and auditory handicap (2.9%). The etiological factors were prenatal in 7.7% cases, natal in 43.8% cases and postnatal in 26.1% cases. More than one etiological factor was observed in 14.5% cases, while in 7.9% cases, no apparent cause could be found.
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PMID:Cerebral palsy. 807 18

The results of stereotactic surgery in 38 patients with cerebral palsy are reviewed. A total of 67 nuclei were approached and 109 stereotactic lesions performed. The motor disorders were spasticity, athetosis, dystonia and tremor. The targets were chosen according to the motor disorder, and included the pulvinar, ventrolateral (VL), sub-VL and cerebellar dentate, and a combination of 2 or 3 of these. The results of the surgery were evaluated on the basis of objective functional improvement using a scale for task achievement. Varying degrees of overall improvement were found in over 80% of the patients; these are discussed in detail.
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PMID:Stereotactic surgery for cerebral palsy. 208 Mar 27

A retrospective study was performed on a group of 28 patients with cerebral palsy, who had undergone a stereotactic encephalotomy for hyperkinesia or dystonia. The mean postoperative follow up period was 21 years (range: 12-27). Eighteen patients were available for follow up, nine had died, and one could not be traced. A positive result was obtained in eight of the 18 reassessed patients. Determining factors for the outcome were the degree of preoperative disability, side effects of the operation, and ageing since operation. The more favourable results were obtained in patients with hyperkinesia, tremor, and predominantly unilateral dystonia.
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PMID:Cerebral palsy and stereotactic neurosurgery: long term results. 265 66

Precise radiographical measurement of the third ventricle in the first and essential procedure in stereotaxic surgery in order to determine the target point. This is done while referring to an available standard brain atlas such as Schaltenbrand & Bailey. However there have been no criteria established for determining the deviation of the coordinates of the thalamic nuclei, especially in their lateral coordinates when the third ventricle is highly dilated. Therefore, in 109 cases encountered recently (81 parkinsonism, 11 essential tremor, 10 cerebral palsy, 3 thalamic pain, 1 Benedikt's syndrome, 1 torticollis, 1 oral dyskinesia, 1 striato-nigral degeneration), we studied the correlation between the width of the third ventricle and the lateral coordinate of the thalamic point where kinesthetic neurons or tremor-synchronously discharging neurons were detected. These neurons were especially related to the arm. According to the width of the third ventricle, we classified the cases into three types: 18 cases with large ventricles (more than 10 mm), 37 cases with medium-sized ventricles (4-10 mm) and 16 cases with small ventricles (less than 4 mm). By plotting the lateral coordinate of the thalamic point where kinesthetic neuron of the upper extremity was recorded in reference to the radiogram of anteroposterior view, we found that the lateral coordinates of large ventricular cases generally tended to show more lateral displacement than cases where the ventricles were narrower. Their mean lateral coordinate was 16.9 mm from midline in contrast ot 14.0 mm in cases with small ventricular width. There was a linear correlation between the width of the third ventricle and the lateral coordinate of the kinesthetic neuron of the Vim nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lateral coordinate of the thalamic Vim neurons in the cases with dilated third ventricle]. 320 65

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

There is a paucity of trained neurologists in developing countries. We designed a questionnaire to rapidly screen a community of 851 people (Parsis living in a colony in Bombay, India) for possible neurologic diseases. This questionnaire was pretested and found to have a sensitivity of 100 percent for detecting epilepsy, febrile seizures (only in children), completed stroke, peripheral neuropathy, movement disorders, cerebral palsy, mental retardation, and severe dementia. The screening questionnaire was administered by trained lay health workers. One hundred and sixty-three people were identified by this questionnaire as possibly having neurologic disease. Neurologists later examined these 163 people and found that 80 of them actually suffered from at least one of the neurologic diseases of interest (positive predictive value = 48 percent). The most common neurologic disorders were peripheral neuropathy (32 cases), essential tremor (13 cases), stroke (12 cases), Parkinson's disease (six cases), and epilepsy (four cases).
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PMID:Pilot survey of the prevalence of neurologic disorders in the Parsi community of Bombay. 333 Jun 62

To determine the prevalence of frequently occurring neurologic disorders in a biracial population, a survey of households and chronic care institutions was carried out for all residents of Copiah County, Mississippi. Along with a complete census, interviews were held using extensive questions about diagnoses, signs, and symptoms of neurologic disorders. More than 97% of eligible households participated, comprising 23,842 persons (49% black, 50% white, 1% other). Persons with responses suggesting one or more of these disorders were examined by a neurologist who used defined diagnostic criteria. Age-adjusted prevalence ratios for cerebral palsy, epilepsy, stroke, and severe dementia were somewhat higher in blacks than in whites, while the age-adjusted prevalence ratio for essential tremor was slightly higher in whites. For Parkinson's disease, there was no difference in age-adjusted prevalence ratios between the races.
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PMID:Survey of major neurologic disorders in a biracial United States population: the Copiah County Study. 382 20

In 1983, approximately 40 000 patients in France and 5 760 patients in Switzerland suffered from cerebral palsy, representing more than 0.1% of their respective populations. The functional disability of these patients is particularly impressive and emphasizes the medical, social and economic importance of this problem. The term cerebral palsy is restricted to non-progressive disorders of motor function, already observed at an early age and due to cerebral lesions. These motor disorders can be of paretic, dystonic and dyskinetic nature. Their epidemiology, classification, etiology, pathology, early diagnosis and evolution are extensively reviewed by Th. Deonna. The difficulty in evaluation of treatment is the absence of a generally accepted rating scale. G. Broggi has proposed one on the basis of a large experience which could serve in the future for more objective evaluation. This monograph is devoted to the functional neurosurgical treatment of cerebral palsy. Physiotherapy and rehabilitation are part of the basic treatment of cerebral palsy, and must be continued after any neurosurgical treatment. Various conservative methods of treatment and their neurophysiological rationale are mentioned by P. Claverie. Some technical devices which improve the neurological deficits and facilitate rehabilitation are presented. Radiculotomies and neurotomies are probably the oldest neurosurgical operations for the treatment of spasticity. The neurophysiological and neuroanatomical basis of this therapeutic approach are treated in the review of the material from the neurosurgical department of Montpellier. Sixty cases were collected and the results analysed according to the type of operation (posterior radiculotomy, anterior radiculotomy, mixed) performed. Stereotactic thalamotomies and subthalamotomies are believed to be the best neurosurgical method to treat the tremor and improve other dyskinesias and hyperkinesias. The technique and a personal review of 49 cases of cerebral palsy are presented. The long-term follow-up in this study demonstrates that this type of operation markedly improves the functional disability of patients with moderate hyperkinesias, moderately improves patients severely affected, but also demonstrates that possible side effects cannot be ignored. Review of the literature indicates the difficulty in interpretation of results due to a lack of objective evaluation. Nevertheless, stereotactic thalamotomy can still be recommended when tremor and rigidity are the most prominent symptoms. Stereotactic dentatotomies in the treatment of spasticity were very popular 20 years ago, but have been largely forgotten for nearly a decade.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Functional neurosurgery of cerebral palsy]. 390 55

Twenty-one children born 1970-76, selected from 103 children of 30 alcoholic women, were paired to controls matched for sex, age, birth weight and gestational age. The sample (10 girls, 11 boys) was representative of the whole group with regard to weight, length and head circumference at birth. At follow-up (mean age 70 months) the study group was significantly leaner, shorter and had smaller mean head circumference than the control group. The controls had significant catch-up growth from birth to follow-up of weight, height and head circumference to the mean for Swedish children. The study group had no catch-up growth. Compared to controls the study group had significantly lower fine and gross motor age test scores and inferior coordination. One child had cerebral palsy (spastic hemiplegia) and in 6 other children slight tremor and ataxia were observed. Malformations and/or other signs of the fetal alcohol syndrome (FAS) were found in 10 cases. Study group children with FAS had significantly slower growth of head circumference than others without FAS. Children placed in foster home care (n = 11) were found to have significantly (p less than 0.05) lower birth weight, birth length and head circumference than children raised at home (n = 10). There were no significant differences at follow up between study group children raised in foster homes or in homes of their biological mother.
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PMID:Children of alcoholic mothers. Growth and motor performance compared to matched controls. 398 23


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