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

There are a number of different relationships among aging, psychosis and movement disorders, most of which have been proposed to involve the neurotransmitter dopamine. Dopamine content and dopamine receptors have been shown to decrease with age, which may relate to the time of onset of different motor and psychotic disorders, as well as to the appearance of these disorders. For example, some so-called senile movement disorders, such as senile tremor and senile chorea, may relate to alterations in dopaminergic transmission with age, as might the general findings of increased slowing of movements and mildly increased rigidity with age, although it is not clear how common some of these changes are in the medically healthy elderly. Decrease in dopamine with age may also be associated with the findings that choreiform and psychotic disorders (which have been proposed to be related to excess dopaminergic activity) tend to predominate at younger ages, whereas parkinsonism is more common at later ages. Certain findings support this notion, such as the appearance of both dyskinesia and psychosis in patients treated with L-dopa, the finding that psychosis may be less common in patients with later-onset Huntington's disease, and the fact that neuroleptic-induced parkinsonism is often more severe in the elderly. However, the situation is more complicated than this, because there are a number of phenomena that do not fit the pattern, including the observation of an increased incidence of tardive dyskinesia in the elderly. Age-related changes in other transmitters are undoubtedly important in both movements disorders and psychosis, and even dopamine has been proposed to have both trophic and toxic properties over the aging process. In general, care is warranted in the use of any psychotropic medications in the elderly, because there can be widespread and often unpredictable effects of these drugs on both motor and mental function.
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PMID:Association of psychosis and movement disorders in the elderly. 289 37

Movement disorders other than cerebellar tremor are rare clinical manifestations of multiple sclerosis (MS). Two cases of parkinsonism and a case of chorea associated with MS are reported, and the literature is reviewed.
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PMID:Movement disorders in multiple sclerosis. 306 39

The large-scale mail questionnaire is a useful tool in epidemiological investigation and will probably come into wider use in the search for an environmental cause of Parkinson's disease (PD). To determine the validity of mail questionnaires in patients with PD, we administered a 17-item questionnaire by in-person interview, as a standard, to 68 patients (and/or a relative when necessary) and compared the results with the same questionnaire mailed at least 1 month before or after the interview. Questions in three formats requested recall of the clinical course and past environmental factors. Each patient also completed a multiple-choice physical self-assessment (a modification of four items on the Columbia Scale) immediately before seeing the neurologist, who completed the same form after the examination. Percent of patients with zero discordance between mail and interview responses averaged 52% for the nine fill-in-a-year items, 53% for the three list-generation items. Kappa statistics for the five multiple-choice items, which each offered four choices, averaged 0.67 (range 0.40-0.89). Kappa for the physical examination items, each rated on a 0-3 scale, was finger-tap 0.12, gait 0.34, tremor 0.35, and chorea 0.20. Patients' ratings tended to be more severe than neurologists' ratings. We conclude that mail surveys in PD should either be avoided or rigorously pretested for validity.
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PMID:Validity of a mailed epidemiological questionnaire and physical self-assessment in Parkinson's disease. 319 62

Tremor and drug-induced dyskinesia are major involuntary movements in Parkinson's disease. The rhythm of resting tremor is 4-6 cycles/s, driven by generators in the brain, and stabilized by reflex arcs involving the spinal cord, nerves and muscles. Its frequency is fixed: it is the same in proximal and distal muscles in each case and does not change in the course of amplitude reduction of tremor by levodopa injection. An approximate doubling of frequency occurs in action tremor which suggests a central mechanism liable to produce harmonics. In postural tremor as observed in the lower limbs while on standing, the frequency of grouped discharges falls into ranges of rhythm with either resting or action tremor. Levodopa-induced dyskinesia has a similar nature to chorea in both clinical observation and EMG. With EMG choreic discharges may appear concomitant with regular parkinsonian tremors in the same muscle, suggesting that the two are not opposites as expressions of dysfunction of the dopaminergic system.
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PMID:Pathophysiology of involuntary movements in Parkinson's disease. 355 88

Thirty-one patients with Wilson's disease were evaluated with detailed neurologic and medical examinations. Mean age (+/- SD) at onset was 21 +/- 5 years and at examination was 28 +/- 6 years. Of the 90% of patients who were first treated with penicillamine, 31% deteriorated initially despite therapy, and half never recovered to pretherapy baseline. At the time of our evaluations, the most common neurologic findings were dysarthria (97%), dystonia (65%), dysdiadochokinesia (58%), rigidity (52%), gait and postural abnormalities (42%), and tremor (32%). Chorea and dementia were rare. Twenty-two patients underwent magnetic resonance imaging. All but one of the 19 symptomatic patients had abnormal scans. The three asymptomatic patients had normal scans. Most lesions were seen in the caudate, putamen, subcortical white matter, midbrain, and pons. Generalized brain atrophy was also common. Lesions were less common in the thalamus, cerebellar vermis, midbrain tegmentum, globus pallidus, red nucleus, and dentate nucleus. Dystonia and bradykinesia correlated with putamen lesions, and dysarthria correlated with both putamen and caudate lesions.
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PMID:Clinical assessment of 31 patients with Wilson's disease. Correlations with structural changes on magnetic resonance imaging. 382 91

A 58-year-old woman was receiving chemotherapy for carcinoma of the breast. She was given 1,700 mg metoclopramide IV for 2 months to prevent nausea and vomiting. Within hours after metoclopramide was given, she had hand tremor, akathisia, and truncal and orofacial dyskinesia. These symptoms resolved, but she was left with persistent shoulder stump chorea, the perception of the phantom left arm involuntarily adducted at the shoulder and flexed at the elbow, and dystonic pronation and extension of the hand away from her body. The motor aspects of the phantom dyskinesia will be emphasized.
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PMID:Metoclopramide-induced phantom dyskinesia. 397 6

Two patients with movement disorders are described and neurochemically studied. The first subject concerns a central anticholinergic syndrome in a 83 years old man treated with l-dopa and amantadine for red nucleus tremor. The second one is an association of parkinsonism and chorea in a 76 years old woman presenting with FAHR's syndrome. In both cases, CSF HVA levels were measured before and after oral probenecid load. The observations confirm the usefulness of this neurochemical strategy in order to classify aging patients with parkinsonism into dopasensitive and doparesistant groups.
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PMID:Further observations showing the impact of the probenecid test in movement disorders. 401 57

Monkeys inflicted with specific unilateral electrolytic lesions in the upper brain stem developed extrapyramidal disorders. Hypokinesia of the limbs was associated contralaterally with a lesion of the substantia nigra and depletion of striatal dopamine. Choreiform movements were observed in animals that had, contralaterally, a lesion severing the most dorsomedial fibres of the cerebral peduncle and the rubro-tegmentospinal tract, associated with depletion of striatal serotonin. Monkeys showing sustained postural tremor and hypokinesia had lesions affecting these three tracts contralaterally and loss of striatal dopamine and serotonin on the lesion side. Of many drugs tested, only harmaline and harmine affected the dyskinesias. The nigrostriatal fibres appear to be dopaminergic; the cerebral peduncular (dorsomedial) fibres, serotoninergic. The role of striatal dopamine and serotonin in the control of normal movements and posture of the limbs represents the first directly demonstrated function of these amines in the central nervous system.
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PMID:Neurochemical bases of tremor and other disorders of movement. 438 Mar 39

Excluding surgical procedures, this article focuses on clinical pharmacotherapeutic approaches to treatment of parkinsonism and tremor, chorea, dystonia, tic, and tardive dyskinesia.
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PMID:Involuntary movement disorders. 623 89

This review concentrated on the more recent findings of investigations into the functional anatomy and pathophysiology of movement disorders. Attempts were made to provide explanations for rigidity, bradykinesia, and tremor. What little is known of the pathophysiology of chorea, tics, and dystonia is discussed. Greater information is available to allow pathophysiologic classification of different types of myoclonus.
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PMID:The pathophysiology of movement disorders. 624 55


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