Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight patients are described with an unusual form of carotid transient ischemic attack, limb shaking. The basic features included a brief, involuntary, coarse, irregular, wavering movement or tremble involving arm-hand alone, or arm-hand and leg together. In 2 patients limb shaking was the initial manifestation of carotid occlusive disease, and all but one patient had other typical carotid transient ischemic attacks. Major atheromatous carotid occlusive disease was present in all patients on the side opposite the limb movements. Four patients had bilateral carotid occlusive disease. Cerebral ischemia from a carotid territory low-perfusion state may be the pathogenesis of these limb movements, an idea supported by the apparent benefit of surgical revascularization in abolishing or reducing the limb shaking in 6 patients. There was no clinical or EEG evidence to document an epileptiform etiology. Recognition of this uncommon form of carotid transient ischemic attack may be important in the early diagnosis and treatment of carotid occlusive disease.
Stroke
PMID:Limb shaking--a carotid TIA. 400 58

Dopexamine, a new compound with postjunctional dopamine receptor activating and beta adrenoceptor agonist properties, was given to 10 patients with chronic heart failure at diagnostic cardiac catheterisation to investigate its acute haemodynamic and metabolic effects. The drug was administered by intravenous infusion in three incremental doses and produced significant dose related increases in cardiac index, stroke volume index, and heart rate and falls in systemic vascular resistance and left ventricular end diastolic pressure; aortic and pulmonary artery pressures were unchanged. Isovolumic phase (max dP/dt and KVmax) and ejection phase (peak aortic blood velocity, maximum acceleration of blood, and maximum rate of change of power with time during ejection) indices of myocardial contractility were all increased by dopexamine but these changes were hard to interpret in the presence of an increase in heart rate. Myocardial efficiency and ejection fraction were both increased and left ventricular end diastolic and end systolic volumes fell. These largely beneficial changes were achieved without a statistically significant increase in myocardial oxygen consumption or disturbance of myocardial metabolic function. Dopexamine was well tolerated but tremor was reported by two patients at the intermediate dose and mild chest pain by two patients at the high dose.
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PMID:Acute haemodynamic and metabolic effects of dopexamine, a new dopaminergic receptor agonist, in patients with chronic heart failure. 404

Rubral tremor is characterized by a slow coarse tremor at rest that is exacerbated by postural adjustments and by guided voluntary movements. Some authorities have questioned whether it should be regarded as a distinct clinical entity. We observed three cases of rubral tremor following stroke and studied the movements by videotape recordings. The tremors were very similar in the three cases, and all showed plastic rigidity and dystonic posturing of the affected limbs. Rehabilitation difficulties out of proportion to the motor deficit were present, but all three patients responded favourably to treatment with levodopa-carbidopa. Lesions of the superior cerebellar peduncle, midbrain tegmentum or posterior part of the thalamus may cause this peculiar tremor, and it is probable that lesions of the red nucleus itself are not crucial for its production. The similarity of the clinical features and management problems of these cases suggests that it is valuable to regard rubral tremor as a specific clinical syndrome.
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PMID:Rubral tremor: clinical features and treatment of three cases. 656 36

Intermittent stimulation of the parvocellular portion of the nucleus ventralis posterolateralis (V.P.L.) by means of chronically implanted electrodes and stimulus generator was performed in 124 patients for the control of chronic intractable pain. Among these, 11 showed spontaneous abnormal movements within the painful area: 6 post amputation "jumping stumps"; 4 pseudothalamic syndromes and 1 Von Benedikt's syndrome following a cerebrovascular accident. Electrical stimulation of the V.P.L. was able to control both pain and abnormal movements in all cases. The technique was applied with an equally good result in a case of choreoathetotic syndrome without pain but with severe sensory disturbances following a demyelinating process. Attempts made to control action tremor, parkinsonism and other dyskinesias not associated with sensory deafferentation in 12 cases failed. The same mechanism seems to be responsible for pain and dyskinesia in cases of sensory deafferentation, and thalamic stimulation might work as a substitute for sensory information delivered to the nucleus ventralis posterolateralis.
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PMID:Control of dyskinesias due to sensory deafferentation by means of thalamic stimulation. 697 May 2

Invasive cardiac measurements were performed at rest and during exercise after i.v. infection of 0.7 mg/kg 2-[(2-methoxy-4-methylsulfinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) in 10 patients with heart failure in NYHA class II and III of various origins. At rest AR-L 115 BS increased the cardiac index by 0.74 l/min/m2 (p less than 0.01) and the heart rate by 10 beats/min (p less than 0.01). Mean arterial pressure and pressures in the pulmonary artery and in the pulmonary capillary bed were not changed significantly. Stroke work index remained unchanged. At the highest comparable workload AR-L 115 BS reduced the pulmonary capillary wedge pressure by 7 mm Hg (p less than 0.001) and the mean pulmonary arterial pressure by 8 mm Hg (p less than 0.001). The other parameters measured did not change significantly. In most of the patients there was a reduction in the pulmonary capillary pressure in parallel with a slight increase in the stroke work index, indicating an improvement in left ventricular pump function. Four patients reported bright vision immediately after injection which lasted for several hours in 1 patient and for about 5 min in the others. One patient developed muscle tremor which lasted for several hours. The results suggest that AR-L 115 BS exerts a vasodilating action on the capacitance vessels and a positive-inotropic effect on the heart.
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PMID:Study of the acute effect of AR-L 115 BS, a new positive-inotropic agent in patients with exercise-induced heart failure. 719 37

Microstimulation within and below the ventrocaudal nucleus (Vc) in the human thalamus typically evokes non-painful, paraesthetic cutaneous sensations. We now describe cases in which thalamic microstimulation evoked visceral pains. Data were obtained during stereotactic thalamotomy procedures. Patient 211 had a history of essential tremor. At a site 0.5 mm ventroposterior to Vc, microstimulation elicited pain described as 'deep, internal, in a straight line like my appendix pain years ago'. Patient 153 had a history of post-stroke hemibody pain. In each of two trajectories, at sites approximately 2 mm ventroposterior to Vc, microstimulation evoked pain in the groin. At one of these sites, the pain was described as 'like having a baby'. These and additional observations suggest that stimulation ventroposterior to Vc can evoke visceral pain and may trigger pain 'memories'.
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PMID:Visceral pain evoked by thalamic microstimulation in humans. 775 31

The aim of the present study was to evaluate the cardiac effects of the beta 3-adrenoceptor agonist BRL35135, and determine whether beta 3-receptors are involved in mediating chronotropic or inotropic responses in man. Eight normal males received single oral doses of BRL35135 8 mg (BRL) or the selective beta 2-adrenoceptor agonist salbutamol 8 mg (SAL), after pretreatment with either placebo (PL), bisoprolol 5 mg (B5) as a selective beta 1-adrenoceptor antagonist, or nadolol 20 mg (N20) to block beta 1- and beta 2- but not beta 3-receptors. Both BRL and SAL produced a significant increase in postural finger tremor in keeping with beta 2-adrenoceptor stimulation, and this response was totally abolished by pretreatment with N20. Significant increases in systolic blood pressure and Doppler stroke distance occurred with BRL and SAL which were unaffected by pretreatment with B5 and completely blocked by N20, in keeping with beta 2-mediated effects. BRL and SAL produced significant chronotropic and minute distance responses which were unaffected by beta 1-adrenoceptor blockade. However, whereas N20 blocked these responses to SAL, a small but significant response occurred with BRL in comparison with placebo despite complete blockade of co-existing beta 2-mediated effects. Compared with PL, the mean responses to N20/BRL, and the 95% confidence interval for the differences between the means were 7.4 beats min-1 [3.2 to 11.6] (P = 0.002) for heart rate, and 208.8 cm [38.3 to 379.3] (P = 0.02) for minute distance responses.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cardiac effects of the beta 3-adrenoceptor agonist BRL35135 in man. 791 39

Reports of 62 cases with a movement disorder associated with a focal lesion in the thalamus and/or subthalamic region were analyzed. Thirty-three cases had a lesion confined to the thalamus. Sixteen cases had a thalamic lesion extending into the subthalamic region and/or midbrain. Thirteen cases had a lesion in the subthalamic region or a subthalamic lesion extending into the midbrain. Nineteen cases with dystonia, 18 with asterixis, 17 with ballism-chorea, three with paroxysmal dystonia, and five with clonic or myorhythmic movements have been described. No case with isolated tremor has been described. In 53 cases with unilateral thalamic or subthalamic lesions, all but one with bilateral blepharospasm (associated with right posterior thalamic, pontomesencephalic, and bilateral cerebellar lesions) had dyskinesias in the limbs contralateral to the lesion. The other nine cases had bilateral paramedian thalamic lesions; seven developed bilateral dyskinesias, and the remaining two had unilateral dyskinesias. Regarding the 19 patients with dystonia, the two with bilateral blepharospasm had thalamic and upper brainstem lesions, and one with hemidystonia and torticollis had a subthalamic lesion. The other 16 patients all had a unilateral thalamic lesion with contralateral dystonia (10 hemidystonia, five focal dystonia affecting a hand and/or and one segmental dystonia involving face, arm, and hand). The exact location of the thalamic lesion was mentioned in 10 cases; the posterior or posterolateral thalamus was involved in six and the paramedian thalamus in four. These areas are more posterior or medial to the ventrolateral and ventroanterior thalamic nuclei, which receive pallido-thalamic and nigro-thalamic afferents. Two cases developed dystonia immediately after thalamotomy, and one case developed it 4 days after head trauma. The others initially had a hemiplegia and developed dystonia 1-9 months after the acute insult. Fifteen of the 17 patients with chorea had a unilateral lesion in the subthalamic nucleus or subthalamic region (eight due to infarcts, one to hemorrhage, five to mass lesions, and one to multiple sclerosis). All had contralateral hemichorea or hemiballism. One other case had bilateral chorea of the hands and tongue due to paramedian thalamic infarction. Another case with generalized chorea and thalamic atrophy was complicated by stereotaxic surgery. Thirteen of the 18 cases with asterixis had lesions confined to the thalamus. Eight were associated with thalamotomy, and five others had a stroke (four infarction and one hemorrhage) affecting the contralateral thalamus.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Movement disorders following lesions of the thalamus or subthalamic region. 799 Aug 45

We described two types of involuntary movement accompanied with a well-located thalmaic lesion shown by MR imaging in five patients. All patients had the involuntary movements of an upper limb contralateral to the thalamic lesion. Two patients (1 and 2) had choreoathetosis that became most prominent when their index finger approached their nose, where irregular and dysynchronous oscillation occasionally superimposed. This choreoathetosis was differentiated from pseudoathetosis caused by disturbance of proprioceptive sensations. The MRI lesion was located at the middle level of thalamus including nucleus centromedianus. The other three patients (3, 4 and 5) had a regular and rhythmic oscillation in their forearm. The oscillation began to appear after their index finger reached their nose on finger-to-nose test. We considered the oscillation as a postural tremor based on its rhythmicity and regularity. Patient 4 had additional tremor in movement. Their postural tremor continued while the arm kept the position. Surface electromyogram showed the reciprocal discharges between the forearm extensor and flexor muscles with a frequency of 3 to 4 Hz. This tremor was not accentuated during limb movement toward the nose nor was coarse, and was distinguished from intention tremor described by Charcot and Dejerine. This tremor was also different from hyperkinesis volitionnelle and movement oppositionist. The "rubral tremor" differed from the tremor shown in our cases for a lack of resting tremor. The responsible lesion shown by MRI located at caudal posterior thalamus including pulvinar in patient 3, or located at the upper level of thalamus in patient 4 and case 5 that was more rostral than the lesion of the choreoathetosis cases. In cases of cerebrovascular accidents, both types of involuntary movement appeared after several months from the stroke. This delayed appearance suggests that these involuntary movements were the result not only of functional disturbance of thalamus, but of secondary repairing mechanism occurring at the lesion.
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PMID:[Involuntary movements caused by thalamic lesion]. 799 88

'Arteriosclerotic' parkinsonism is still a subject of debate. The aim of this study was to investigate whether parkinsonism associated with basal ganglia lacunes possesses peculiar clinical features and a clinical course which enables its distinction from idiopathic Parkinson's disease (IPD). 106 consecutive ambulatory patients with the clinical diagnosis of parkinsonism were referred for CT examination. Patients in whom isolated basal ganglia lacunes were found were interviewed and examined, and their clinical characteristics were compared to those of patients suffering from IPD without lacunes (controls). In 20 patients, isolated basal ganglia lacunes were detected; all had risk factors for stroke (significantly more than controls) and 7 of them had had clinically diagnosed strokes. The extrapyramidal disability evolved slowly in all. The clinical picture was indistinguishable from IPD in individual patients. However, tremor was significantly less frequent in this group. Lower body parkinsonism was not observed. Extra-pyramidal signs were frequently asymmetrical (55%), with no consistent relationship to the side of the lacune. Asymmetrical pyramidal signs were present in 30% of those with unilateral lacunes, always on the appropriate side. Only 1 patient was an L-dopa nonresponder. Patients with parkinsonism associated with basal ganglia lacunes showed tremor less frequently than other IPD patients; otherwise, clinical features and course of the disease were indistinguishable from IPD. In these cases, parkinsonism and basal ganglia lacunes might have occurred independently of each other and tremor might have been prevented by ischemic events.
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PMID:Basal ganglia lacunes and parkinsonism. 801 63


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