Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0233565 (bradykinesia)
 2,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Striatonigral degeneration (SND) is difficult to diagnose in vivo. The purpose of this study was to detect the best indicators for an early and reliable diagnosis of the disease. Eighteen patients clinically diagnosed as having SND were selected with rigorous inclusion criteria and compared to 18 patients with Parkinson's disease (PD) matched for age and disease duration. Apart from dysautonomia, the principal discriminant clinical features that distinguished SND from PD were the early appearance of the following symptoms and signs: (a) severe and atypical progressive parkinsonism characterized by bilateral bradykinesia and rigidity, slowness of gait, postural instability, and falls, and poor or absent response to adequate levodopa treatment; (b) increased tendon reflexes associated or not with frank pyramidal signs, severe dysarthria, and less consistently, dysphagia, stridor, antecollis, and stimulus-sensitive myoclonus, which, when present, are highly suggestive of the disease.
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PMID:"Pure" striatonigral degeneration and Parkinson's disease: a comparative clinical study. 765 45

We report a 65-year-old male with progressive supranuclear palsy (PSP) who developed bilateral vocal cord abductor paralysis (VCAP). The patient was admitted to our hospital because of impaired gait. He was well until two years earlier, when he began to walk unsteadily. During the next two years, dysarthria and dysphagia developed and his gait worsened gradually. On admission, neurological examination showed impaired vertical and incomplete lateral gaze. His speech was slow and monotonous. Contractures were found in the neck muscles and elbows. The deep tendon reflexes were increased in the upper and decreased in the lower extremities. Babinski sign was negative. Snout and forced grasping reflexes were elicited. He showed marked bradykinesia. Magnetic resonance imaging revealed a midbrain tectum atrophy. Single photon emission tomography showed severe hypoper-fusion in the frontal cortex. No improvement was provided by the administration of levodopa-carbidopa, bromocriptine, droxydopa and amitriptyline. One month after admission, inspiratory stridor developed at night. The laryngofiberscopic examination demonstrated VCAP. An emergency tracheostomy relieved his respiratory distress. Although VCAP rarely occurs in neurodegenerative disorders other than multiple system atrophy, attention to VCAP should be required in PSP patients.
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PMID:[A case of progressive supranuclear palsy associated with bilateral vocal cord abductor paralysis]. 936 83

Bilateral vocal cord paralysis leading to stridor is a known but rare complication of Parkinson's disease (PD) and a recognised complication of multiple system atrophy (MSA). Tracheostomy is a commonly offered treatment, leading to substantial adaptations and lifestyle changes for the patient. Patients can struggle to manage a tracheostomy due to the tremor and bradykinesia associated with their parkinsonism. We report a case of bilateral vocal cord paralysis leading to significant stridor in a patient with atypical parkinsonism (probable MSA). To avoid tracheostomy, our patient underwent successful right-sided laser arytenoidectomy and posterior cordotomy as a day-case procedure. At follow-up, he had a weaker voice but complete recovery from the shortness of breath and stridor. He was very satisfied with the outcome. We conclude that, despite resulting in a weaker voice, this procedure offers an option to the patient that improves quality of life.
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PMID:Laser arytenoidectomy and posterior cordotomy in a patient with bilateral vocal cord paralysis due to multiple system atrophy. 2593 70