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)

Clinically relevant movement disorders are identified in 3% of patients with HIV infection seen at tertiary referral centres. In the same setting, prospective follow-up shows that 50% of patients with AIDS develop tremor, parkinsonism or other extrapyramidal features. Hemiballism-hemichorea and tremor are the most common hyperkinesias seen in patients who are HIV positive, but other movement disorders diagnosed in these patients include dystonia, chorea, myoclonus, tics, paroxysmal dyskinesias and parkinsonism. Patients with movement disorders usually present with other clinical features such as peripheral neuropathy, seizures, myelopathy and dementia. In the vast majority of patients, hyperkinesias result from lesions caused by opportunistic infections, particularly toxoplasmosis, which damage the basal ganglia connections. On the other hand, parkinsonism and tremor can result from dopaminergic dysfunction resulting from HIV itself or the use of antidopaminergic drugs. The management of patients who are HIV positive who present with movement disorders involves recognition and treatment of opportunistic infections, symptomatic treatment of the movement disorder and the use of highly active antiretroviral therapy (HAART). The most effective treatment of cerebral toxoplasmosis in patients with HIV infection is the combination of sulfadiazine and pyrimethamine. Symptomatic treatment of the movement disorder is often disappointing: hemiballism improves with antipsychotics, but tremor, parkinsonism and other phenomena usually fail to respond to available therapies. Preliminary data suggest that HAART may be helpful in the symptomatic control as well as prevention of movement disorders in patients who are HIV positive.
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PMID:HIV-related movement disorders: epidemiology, pathogenesis and management. 1226 60

X-linked dystonia-parkinsonism (XDP), or Lubag syndrome, is known to cause progressive dystonia, with or without parkinsonism, among Filipino male adults with maternal roots from the Philippine island of Panay. We present cinematographic material of 11 cases of Lubag carrying the XDP haplotypes who manifest with a wide spectrum of movement disorders, including dystonia, tremor, parkinsonism, myoclonus, chorea, and myorhythmia. Because of overlapping features, Lubag patients are commonly misdiagnosed as idiopathic dystonia, essential tremor, Parkinson's disease, or Parkinson's-plus syndromes. Thus, it is imperative to elicit an exhaustive family history in any Filipino male adult who presents with a movement disorder.
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PMID:Phenomenology of "Lubag" or X-linked dystonia-parkinsonism. 1246 67

Movement disorders associated with multiple sclerosis (MS) are uncommon, except for tremor. We report two patients with relapsing-remitting MS, who developed either dystonia or chorea during clinical exacerbation of their MS. The movement disorders resolved during treatment with adrenocorticotropin hormone (ACTH). Acute exacerbations of MS may be associated with transient movement disorders, which are responsive to ACTH.
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PMID:Transient movement disorders and multiple sclerosis. 1247 1

An 8-year-old boy developed tremor, unsteadiness, chorea, and eye movement abnormalities on starting lamotrigine for myoclonic jerks. Investigations for a neurodegenerative disorder were negative. Symptoms and signs resolved on stopping lamotrigine. He was well and asymptomatic on follow-up after 4 years. Another 7-year-old boy who started on lamotrigine for suspected absence seizures developed abnormalities of eye movement with associated cognitive decline, which also resolved on discontinuing the medication. Eye movement abnormalities, involuntary movements, and behavioral changes appear to be unusual side effects of lamotrigine therapy.
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PMID:Unusual side effects of lamotrigine therapy. 1690 Sep 38

For children whose spasticity and movement disorders are inadequately treated by oral medications and botulinum toxins, neurosurgical procedures are now available to effectively treat spasticity, tremor, and many cases of dystonia. Spastic diplegia can be treated with selective lumbar rhizotomies, which significantly decrease spasticity, increase range of motion, and improve Gross Motor Function Measure scores. Children with spastic quadriparesis and those with secondary dystonia can be treated with intrathecal baclofen, which diminishes both spasticity and dystonia and is associated with improved function and quality of life. Children with primary dystonia and those with tremor can be treated with deep brain stimulation of the internal globus pallidus and thalamus, respectively. Some children with chorea respond to deep brain stimulation. There are no effective neurosurgical treatments for athetosis or ataxia. The effectiveness of neurosurgical treatments of pediatric movement disorders has increased significantly in the past 15 years.
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PMID:Neurosurgical treatment of spasticity and other pediatric movement disorders. 1367 72

Six cases representing the most commonly encountered movement disorders-restless legs syndrome with periodic limb movements, tics, myoclonus, chorea, essential tremor, and cervical dystonia-are presented. Discussion of each case focuses on a practical approach to recognizing the important clinical features of each movement disorder as well as the current therapeutic options. A detailed discussion of botulinum toxin follows the case on cervical dystonia, focusing on its mechanism of action, clinical indications, side effects, and dosing.
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PMID:Case studies in movement disorders. 1472 23

Gait disorders, postural instability and movement disorders, such as tremor, chorea or dystonia, are common complaints in day-to-day neurological practice. These conditions are quite difficult to appreciate objectively when relying on clinical observation only, yet a correct assessment of their phenomenology and an accurate measurement of their main characteristics are required to address the questions of both the underlying diagnosis and the functional impairment they may generate. By contrast, kinesiological analyses allow qualitative and quantitative studies of gait, posture and movements and may lead to specific therapeutic interventions. kinesiological analyses, which requires a high-technology laboratory conducted by a trained staff, is based on the sequential or simultaneous use of various and complementary measurement methods, whose choice is problem-oriented. Hence, the use of specific observational analysis, three-dimensional kinematic recordings, poly-electromyography and electro goniometry for the analysis of gait, the use of force plate for the analysis of postural stability and the use of electromyography and multiaxial accelerometers or gyroscopes for the analysis of movement disorders. In the present article, we review the particular features of these measurement tools and the clinical usefulness of their routine use illustrated by case reports.
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PMID:[Kinesiologic analysis of gait and abnormal movements]. 1509 18

Upon clinical examination of involuntary movement, its correct diagnosis and classification is most important for choosing its most appropriate treatment. Correct diagnosis of involuntary movements should be based on their clinical characteristics rather than laboratory data. First attention should be paid to the way of its occurrence; whether it repeats itself at a relatively regular period or it occurs irregularly. Among irregular movements, chorea and ballism (us) belong to the same category clinically as well as neuropharmacologically; both respond to benzodiazepine and D2 receptor blockers. Dyskinesia and akathisia are often drug-induced. Athetosis often overlaps chorea and dystonia. Dystonia is characterized by excessive muscle contraction in terms of strength, spread and duration. Recently involvement of the sensori-motor cortex is emphasized in generation of focal dystonia. Myoclonus is usually caused by abrupt muscle contraction but also by sudden cessation of muscle contraction (negative myoclonus). Myoclonus and tics are usually irregular, but they can be rhythmic or quasiperiodic. Tremor is often associated with dysfunction of basal ganglia, cerebellum or thalamus, but recently an increasing attention has been paid to involvement of the sensori-motor cortex. Some involuntary movement could show features of two or more kinds of involuntary movements or it may shift among different kinds of involuntary movements or among different subgroups of that particular involuntary movement. Therefore, it is not advisable to feel obliged to classify every single involuntary movement into any pre-existing category. Instead a more flexible approach is warranted.
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PMID:[How to clinically approach involuntary movements]. 1515 56

The main clinical characteristics and aetiology of drug-induced tremor and acute movement disorders (myoclonus, chorea, athetosis, dyskinesia, dystonia, tics) are reviewed and discussed in this article. Tremor is the most frequent drug-induced acute movement disorder. Drug intake (and, initially, true or 'hidden' neuroleptic or psychoactive drugs) should be suspected as the cause of every abnormal movement. Drug-induced acute movement disorders usually disappear spontaneously after withdrawal of the suspected drug without any drug treatment. Drug-induced tremor and movement disorders are often poorly described in the Summary of Products Characteristics (SPC).
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PMID:[Drug-induced tremor and acute movement disorders]. 1520 22

Head injury can cause extrapyramidal movement disorders such as tremors, parkinsonism, dystonia, chorea, myoclonus, and tics. Pure adventitious movements are rare, but combinations with paresis, spasticity, apraxia, or ataxia occur in approximately 20% of cases of severe head injury, in many cases appearing or evolving in the months following the injury. Tremors may improve in time but many of the other syndromes tend to persist. Reversible causes such as medications or metabolic derangements are occasionally identifiable. Some of these adventitious movements can be improved using neuroactive drugs, botulinum toxin injections, or stereotactic brain surgery.
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PMID:Movement disorders after head injury: diagnosis and management. 1526 58


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