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)

Between 1984 and 1989, orthotopic cardiac transplantations were done in 90 patients from 10 to 65 years of age for end-stage, refractory congestive cardiomyopathy. Two patients had had ischemic strokes 5 months and 18 years, respectively, before transplantation. Six patients (7%) suffered acute neurologic events perioperatively. Three patients suffered cerebral infarctions. In 1 case this occurred 10 days before transplantation--probably as a result of systemic hypoperfusion--with the placement of ventricular assist devices. Two others suffered infarctions 5 and 21 days, respectively, after transplantation, each of probable embolic origin. Two patients had an acute intracerebral hemorrhage 21 and 36 days, respectively, after transplantation; both were located within the basal ganglia and subcortical regions. Both patients had moderate to severe hypertension, and in 1, renal failure and a coagulopathy developed before hemorrhage. Tremor, seizures, and an altered level of consciousness developed in 1 patient as an apparent toxic reaction to cyclosporine treatment. Only 1 patient died as a result of the neurologic complication--of an acute intracerebral hemorrhage. Three patients recovered fully, 2 partially. Only the case of drug toxicity could be directly attributed to the transplantation procedure itself. We conclude that the risk of an acute neurologic insult with orthotopic cardiac transplantation is low but may result from drug toxicity, cerebral ischemia, or hemorrhagic mechanisms.
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PMID:Neurologic complications of cardiac transplantation. 221 70

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.
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PMID:Limb shaking--a carotid TIA. 400 58

Diving deeper than 180 metres of seawater (msw) will impose neurological symptoms in most divers. Atactic signs and abnormal EEGs were found in five of 18 divers immediately after deep diving. Neuropsychological testing before and after deep diving in 64 divers revealed a reduction in autonomic reactivity (48%), increased hand tremor (27%) and impairment of spatial memory and reduced finger coordination (8%) after the dives. These results had not improved one year later. A follow-up study of 40 divers one to seven years after their last deep dive revealed that the divers experienced more problems of concentration and paresthesia in feet and hands than the controls. Two had had seizures, one had suffered episodes of transitory cerebral ischemia and one had experienced transitory global amnesia after the deep dives. In the future, oil installations at depths below 180 msw should be installed and maintained with remote control and robot technology.
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PMID:[Acute and chronic effects of deep diving on the nervous system]. 842 49

The clinical records of patients withdrawn from the UK-TIA Aspirin Trial after identification of a brain tumour were reviewed. Certain features of transient focal neurological dysfunction were associated with an underlying brain tumour rather than transient ischaemia: a) focal jerking or shaking; b) pure sensory phenomena; c) loss of consciousness; d) isolated aphasia or speech arrest. In several patients the misdiagnosis occurred because these features were interpreted as the sequelae of previous ischaemic damage. When a transient focal neurological attack is associated with any of these features, a brain tumour must be considered. If patients later develop epilepsy the diagnosis of cerebral ischaemia should be reviewed.
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PMID:Intracranial tumours that mimic transient cerebral ischaemia: lessons from a large multicentre trial. The UK TIA Study Group. 850 52

The identification of comorbid disorders in migraineurs is important since it may impose therapeutic challenges and limit treatment options. Moreover, the study of comorbidity might lead to improve our knowledge about causes and consequences of migraine. Comorbid neuropathologies in migraine may involve mood disorders (depression, mania, anxiety, panic attacks), epilepsy, essential tremor, stroke, and white matter abnormalities. Particularly, a complex bidirectional relation exists between migraine and stroke, including migraine as a risk factor for cerebral ischemia, migraine caused by cerebral ischemia, migraine as a cause of stroke, migraine mimicking cerebral ischemia, migraine and cerebral ischemia sharing a common cause, and migraine associated with subclinical vascular brain lesions.
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PMID:Comorbid neuropathologies in migraine. 1676 30

In this paper the authors describe two patients with recurrent hemiparesis and limb shaking that gradually progressed to hemichorea. Cerebral angiography confirmed severe unilateral internal carotid artery stenosis (95%) contralateral to the hemichorea. The cerebral blood flow, assessed using N-isopropyl-p-(iodine-123) iodoamphetamine single-photon emission computed tomography (SPECT), disclosed markedly decreased vascular reserves in both patients. After carotid endarterectomy was performed, the hemichorea gradually subsided and SPECT confirmed increased cerebral perfusion. The results in these cases indicate that surgical revascularization is effective for hemichorea due to cerebral ischemia with reduced vascular reserve.
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PMID:Hemichorea due to hemodynamic ischemia associated with extracranial carotid artery stenosis. Report of two cases. 1687 90

We report four cases of cerebral hemodynamic compromise identified over a five year period. Cerebral hemodynamic compromise is characterized by reversible attacks of regional cerebral ischemia affecting patients with occlusive disease of main arteries supplying blood to the brain. All four of our patients had occlusion of one internal carotid artery (ICA) often associated with high grade stenosis or occlusion of the contralateral internal carotid artery and/or major intracranial arteries. All patients developed likely limb shaking transient ischemic attacks (TIAs) which occur during acute exacerbation of regional cerebral hypoperfusion. These events often trigger EEG testing because of suspicion of seizures. Each patient also had focal delta EEG slowing without evidence of noteworthy structural lesions on imaging scans. A discrepancy or mismatch between these testing results occurred. The patients' focal delta EEG slowing was attributed primarily to resting regional cerebral hypoperfusion. Diagnosis of cerebral hemodynamic compromise may be delayed when limb shaking TIA is misdiagnosed as a seizure disorder or when regional cerebral hypoperfusion is not considered as a potential cause of focal delta EEG slowing in older patients that have normal structural imaging studies. Our cases are discussed in light of the relevant EEG and clinical characteristics that have been described in reports of limb shaking TIA and structural imaging/focal delta EEG slowing mismatches.
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PMID:Cerebral hemodynamic compromise associated with limb shaking TIA and focal EEG slowing. 1989 15

Unilateral limb shaking has been described as brief, repetitive jerking movements of arm and leg, resembling seizures and attributed to transient cerebral ischemia. We report a patient with numerous episodes of whole body shaking in the setting of bilateral carotid occlusions as well as vertebral stenoocclusive disease. These episodes of whole body shaking occurred in the presence of bilateral intracranial blood flow steal phenomenon. After angioplasty of the vertebral artery and initiation of aggressive medical therapy and non-invasive ventilatory correction, intracranial blood flow improved and whole body shaking episodes were resolved during 6-months follow-up.
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PMID:Whole body shaking due to intracranial blood flow steal. 2142 22

We describe the clinical course of a young female Caucasian patient with bilateral moyamoya disease in whom we could diagnose the simultaneous occurrence of cerebral ischemia, TIAs, limb shaking TIAs and focal Jacksonian seizures. It is the second clinical communication in the literature elaborating limb shaking TIAs in moyamoya disease.
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PMID:Differential diagnosis between cerebral ischemia, focal seizures and limb shaking TIAs in moyamoya disease. 2274 64

Holmes' tremor is a low-frequency rest and intentional tremor secondary to various insults, including cerebral ischemia, hemorrhage, trauma, or neoplasm. Pharmacologic treatment is usually unsuccessful, and some cases require surgical intervention. We report a rare case of Holmes' tremor secondary to left pontine hemorrhage in a 29-year-old Asian male patient who developed 1.6-Hz postural and rest tremor of the right hand. He responded markedly to ultrasonography-guided botulinum toxin type A injection. To our knowledge, this is the first report of Homes' tremor treated with ultrasonography-guided botulinum toxin type A injection with favorable results.
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PMID:Effect of ultrasonography-guided botulinum toxin type a injection in holmes' tremor secondary to pontine hemorrhage: case report. 2537


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