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

Long-term experience with clozapine has shown that the agent has a motor and mental side effect profile that is distinct in many ways from classical neuroleptics. It can produce a parkinsonian-like bradykinesia and mild akathisia, but no rigidity and rarely tremor. In patients with tardive dyskinesia induced by other neuroleptics, clozapine permits the dyskinesia to disappear in about half the cases. That clozapine may induce tardive dyskinesia in extremely rare cases cannot be excluded, but it seems more likely that this tardive dyskinesia in clozapine-treated patients is due to previous treatment with classical neuroleptics. The earlier clozapine is started, the less chance for development of tardive dyskinesia. As do other neuroleptics, clozapine can elicit sedation and asthenia, but corresponding to the motoric extrapyramidal syndrome, clozapine causes emotional indifference ("mental parkinsonism"), depression, and restlessness to a significantly lesser degree, which may be of importance in the higher compliance seen with this drug.
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PMID:Motor and mental side effects of clozapine. 796 51

This paper reports a study that examines the relations between Dyskinesia Identification System: Condensed User Scale (DISCUS) scores and a battery of postural and movement kinematic measures in a group of adults diagnosed as being developmentally disabled and screened as having tardive dyskinesia. The results showed that finger tremor measures correlated with the tongue tremor and pill rolling items of DISCUS, whereas the postural stability scores correlated with the toe movement item of DISCUS and the total DISCUS score. There was also a high stability in subject kinematic performance from trial to trial over the postural and movement tests. The pattern of correlations between the DISCUS items and movement kinematic measures is consistent with the proposition that tremor is a centrally rather than peripherally driven phenomenon, although many factors contribute to emergent tremors. These findings provide construct and content validity for the DISCUS as a screening device for tardive dyskinesia and suggest that certain posture and movement kinematic measures could be sensitive measuring methods for tardive dyskinesia in developmentally disabled populations.
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PMID:Correlations between kinematic and rating scale measures of tardive dyskinesia in a developmentally disabled population. 809 76

Clinical characteristics of 15 consecutively referred patients with tardive dystonia are reported. The onset of tardive dystonia occurred in all age groups and in both sexes, with some preponderance in men. There was considerable overlap with tardive dyskinesia and tardive akathisia. Six subjects reported past acute dystonia, and four had histories of essential tremor, suggesting a vulnerability to the development of dystonia.
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PMID:Clinical characteristics of 15 patients with tardive dystonia. 809

The arm tremor of adults diagnosed as having mental retardation and/or tardive dyskinesia was examined through an analysis of the acceleration properties of several arm postures. The degree of arm acceleration was increased in all groups compared to a control group without mental retardation. The tardive dyskinesia and/or mentally retarded groups also showed a shift to a lower modal frequency of physiological tremor. Results showed that both time domain and frequency properties of the tremor acceleration signal are necessary to distinguish between groups. The neuroleptic medication appears to engender a dual and opposing influence on performance in the arm tremor task for the mentally retarded group. The medication reduces behavioral variability as indexed by analyses of arm acceleration over time (time domain) but lowers the modal frequency of physiological tremor.
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PMID:Arm tremor, tardive dyskinesia, and mental retardation. 810 99

The objective of this study was to determine the putative risk factors for the development of tardive dystonia (TDt) in contrast with tardive dyskinesia (TD). Fifteen TDt patients seen in the Movement Disorders Clinic were compared with 2 groups of 15 TD controls each. The first control group was drawn from the Clinic and matched with the TDt cases for severity, using degree of dysfunction as the matching variable. The second control group comprised mild TD cases drawn from a separate study of drug-induced movement disorders in chronic schizophrenia and were matched for age and sex with the TDt cases. A number of demographic, treatment-related, diagnosis-related and historical variables suggested in the literature were examined. Most risk factors for TDt that have been suggested by previous studies were not supported. The first control group was significantly older than the TDt cases. The TDt patients had a more frequent past history of acute drug-induced dystonia and of postural tremor prior to the onset of the mental illness, although only the former reached statistical significance. The results suggested that TDt and TD do not differ in most putative risk factors, although the small sample size increases the likelihood of a type II error. It is inconclusive on the role of young age and male sex as risk factors. TDt cases may, however, be individuals vulnerable to the development of dystonia, with neuroleptics probably bringing out such a vulnerability. This finding needs to be examined in larger studies.
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PMID:Risk factors for tardive dystonia: a case-control comparison with tardive dyskinesia. 810 38

Extrapyramidal side effects of neuroleptics are important in clinical practice. Study of extra-pyramidal side effects is also of importance for researchers who test new antipsychotic agents or study tardive dyskinesia. A french translation of the Simpson-Angus Rating Scale of extra-pyramidal side effects thus appeared useful. This scale contains 10 items: Gait, Arm dropping, Shoulder shaking. Elbow rigidity, Wrist rigidity, Leg pendulousness, Head dropping, Glabella Tap, Tremor, Salivation. Each item is rated between 0 and 4. A total score is obtained by adding the items and dividing by 10. Scores of up to 0.3 are considered within the normal range. The scale original has been validated in a population of fourteen psychotic inpatients taking, in a double-blind procedure, placebo, haloperidol 6 mg/day or haloperidol 30 mg/day. Patients receiving haloperidol 30 mg/day presented more extrapyramidal symptoms than patients under placebo. The Simpson Angus rating scale has also been shown to have clinical validity and high inter-rater reliability. It can be routinely used in clinical drug evaluation. The french version was used in a population of 30 psychotic inpatients fulfilling the DSM III-R criteria of schizophrenic disorder. Patients were treated for at least two weeks, orally, either with a phenothiazine (chlorpromazine 350 mg) or a butyrophenone (haloperidol 15 mg). 10 of the 30 patients received, in addition, anticholinergic agents (trihexiphenidyl, 5 mg). The french version of The Simpson Angus Rating Scale appeared to be easy to use and not time-consuming. Interraters correlation was high. Patients receiving butyrophenones or phenothiazines had no significantly different ages and sociodemographic characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Translation and application of the Simpson and Angus Scale of Extrapyramidal Symptoms]. 827 89

We reviewed the medical records and videotapes of 100 patients with tardive dyskinesia (TD) referred to our movement disorders clinic to characterize the spectrum of hyperkinetic movement disorders caused by dopamine receptor blocking drugs (DRBD). Tardive stereotypy, present in 78 patients, was the most common type of TD, followed by tardive dystonia, akathisia, tremor, chorea, and myoclonus. Sixty-four had a combination of these hyperkinesias. In a second study, a "blind" review of videotapes of patients with a variety of movement disorders found that DRBD were the cause of stereotypic movements in 89.3% of patients, and 96.1% of patients with TD had stereotypy. We conclude that stereotypy can be readily differentiated from other hyperkinetic movement disorders and that its presence in an adult is highly suggestive of prior exposure to DRBD.
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PMID:Tardive stereotypy and other movement disorders in tardive dyskinesias. 849 49

Although there is a consensus that orofacial and limbtruncal subtypes of tardive dyskinesia (TD) exist and may represent distinct pathophysiologic entities, few studies have examined the incidence of and risk factors associated with the development of these TD subtypes. Two hundred and sixty-six middle-aged and elderly outpatients with a median duration of 21 days of total lifetime neuroleptic exposure at study entry were evaluated at 1- to 3-month intervals. Using "mild" dyskinesia in any part of the body for diagnosis of TD, the cumulative incidence of orofacial TD was 38.5 and 65.7% after 1 and 2 years, respectively, whereas that of limbtruncal TD was 18.6 and 32.6% after 1 and 2 years. Preclinical dyskinesia was predictive of both orofacial and limbtruncal TD. History of alcohol abuse or dependence was a significant predictor of orofacial TD only whereas tremor was a significant predictor of limbtruncal TD only. Findings support suggestions that orofacial and limbtruncal TD may represent specific subsyndromes with different risk factors.
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PMID:Risk factors for orofacial and limbtruncal tardive dyskinesia in older patients: a prospective longitudinal study. 886 68

Schizophrenic patients in long-term neuroleptic monotherapy with clozapine (n = 100) and perphenazine, flupenthixol or zuclopentixol (controls, n = 100) were evaluated for extrapyramidal side effects (EPS) (blind) as well as other side effects and mental condition (non-blind). In both groups the patients had received neuroleptic treatment for a total of 14 years (median) and the present antipsychotic (clozapine or control drug) for 5 years. Thus the clozapine-treated patients had previously received traditional neuroleptics for 9 years (median). The study was both retrospective (0.3-19 years for clozapine, 0.3-24 years for control drug, by means of chart information) and prospective (1 year, with video-controlled evaluation of EPS). There was a significantly lower prevalence of tardive dyskinesia (TD) in clozapine treated patients than control patients, although prior to this treatment there were more TD patients in the clozapine group (P < 0.05). This lower level of TD in the clozapine group was related to a lower induction of new cases (P < 0.001) and a tendency towards greater disappearance of TD in the clozapine than in the control group (P = 0.07). Clozapine treated patients without TD had started clozapine and ceased traditional neuroleptics at an earlier age than those with TD. Parkinsonian signs were seen in 33% of the clozapine patients versus 61% of the control patients, mainly as hypokinesia; tremor in 3% versus 11% and rigidity in 0 versus 19%. Psychic akathisia was found in 14% versus 40% and motor akathisia in 7% versus 29% of the patients, all differences significantly in favor of clozapine. Clozapine treated patients also had less neuroleptic-induced emotional indifference and depression, but more autonomic side effects than controls.
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PMID:Clozapine versus typical antipsychotics. A retro- and prospective study of extrapyramidal side effects. 893 15

Stereotypies are patterned, repetitive, purposeless movements that are performed the same way each time. They are commonly seen in individuals with autism, schizophrenia, or mental retardation, and also occur as a feature of tardive dyskinesia and as movements in those with akathisia. We studied 10 children who had stereotypies but were not autistic or mentally retarded. Although most had an uneventful delivery, seven had mild to moderately delayed developmental milestones. Five had hyperactive behavior or attention-deficit problems. All appeared to be of normal intelligence. The median age of onset of stereotypies was 12 months. The stereotypies including arm flapping, arm and hand posturing, finger wiggling, body rocking, leg shaking, facial grimacing, involuntary noises, neck extension, and eye blinking. Of the 10 children, only two stopped having stereotypies eventually without medications.
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PMID:The characterization and outcome of stereotypical movements in nonautistic children. 899 53


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