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Query: UMLS:C0426980 (motor symptom)
 471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Freezing episodes and related phenomena (as a general term, motor blocks [MBs]) are poorly understood, particularly disabling, and a therapeutically frustrating problem in Parkinson's disease (PD). Epidemiologic and clinical characteristics of MBs, as well as risk factors to develop MBs, have never been fully addressed. Herein, we report our database survey on 990 PD patients, of whom 318 (32%) had MBs. The majority of MBs were linked to gait. Start hesitation occurred in 86%, blocking on turning in 45%, and blocking in narrow spaces in 25% of patients. Initial parkinsonian symptoms in the upper body and tremor as the initial motor symptom were less likely to be associated with the presence of MBs (odds ratios [OR] 0.6 and 0.7, respectively), while initial symptoms affecting gait or trunk had higher association with MBs (OR = 1.58). Longer disease duration, higher Hoehn and Yahr stage, and longer duration of levodopa treatment are all significantly associated with the presence of MBs. We observed significant association between the existence of MBs and levodopa-induced dyskinesias to suggest similar pathophysiology. We propose that MBs in PD are abnormal retrieval or execution of complex motor tasks that can occur as a result of disease progression or as short- or long-term side effects of levodopa treatment.
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PMID:Motor blocks in Parkinson's disease. 173 61

The French selegiline multicenter trial was conducted in 1990 to test the possibility to improve disability of de novo parkinsonian patients (P.P.) during the first three months of treatment with selegiline (S) (10 mg/day) monotherapy. 93 P.P. were included in this double-blind, randomized, placebo controlled, clinical trial, in which 13 centers participated. Both parallel groups were followed up from inclusion (D0) to D30, D60 and D90. Drug efficacy was judged with Hoehn and Yahr (HY), Hamilton Depression Rating Scale (HDRS), Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England scores, decision to introduce levodopa and selfassessment. Biological and clinical parameters (cardio- vascular, weight, side-effects reports) were assessed for tolerability. 84 P.P. (38 P, 46 S) were evaluable for efficacy at D90. When considering the main parameters, S appears superior to placebo: HY scores (p less than 0.001), global UPDRS scores (p less than 0.001) and UPDRS subscores: mental (p less than 0.001), daily living activities (p less than 0.01), motor activities (p less than 0.01). Depressive scores (HDRS) are significantly improved only at D90 (p = 0.005). Levodopa therapy was introduced in 45% of the cases in S groups versus 18.4% in P group. Global impression of efficacy was largely in favor of S; failure was noted in half of the cases in P group and only in 1/5th of the cases in S group. Side-effects were rare and minor. S 10 mg/day monotherapy is statistically superior to placebo in improving de novo P.P. during the first three months treatment. Motor symptoms rapidly improve; mood is only modified after 3 months. S appears to be well tolerated. S may be considered as a good candidate for the initial treatment of P.P.
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PMID:Selegiline in de novo parkinsonian patients: the French selegiline multicenter trial (FSMT). 180 41

A five year retrospective study was undertaken involving 87 patients admitted to the University College Hospital, Galway, with a confirmed diagnosis of multiple sclerosis (MS). The aim of this study was to consider aspects of this disease as it affected this population in the West of Ireland. Age, sex, and social characteristics of the population were examined. Disease characteristics studied included its remittent and progressive forms and the degree of disability it caused. Relapses of disease were considered in greater detail. It was found that: 1. The highest percentage of patients with MS was in the 40-45 year age group. 2. The mean age of onset of the disease was 37.7 years. 3. Females were in the majority (female: male ratio of 1.4:1) and most of these suffered from the progressive form of MS. 4. Males tended to experience the larger percentage of relapses and had a lower annual relapse rate than females. 5. Of the social groups investigated, those involved in the industry had the highest reported average annual relapse rate. 6. Motor symptoms played an important part in exacerbations, either alone or in combination with other symptoms. 7. Relapses occurred in a cyclical fashion with peaks over 2-3 months. 8. The number of relapses did not tend to vary throughout the year.
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PMID:A population of MS patients in the west of Ireland. 228 78

The authors applied Hayashi's quantification theory III, a mathematical approach for quantification of qualitative data to evaluate cervical myelopathy in 81 patients who had been surgically treated. More of these patients recovered from sensory disturbances than from motor disturbance. The size of the spinal canal was correlated with the severity of the preoperative symptoms of the myelopathy, but not with the surgical results. The surgical results were correlated with the duration of the disease but not with the age of the patient. The most predictable surgical result obtained by the use of multiple regression analysis was that of the leg motor symptom.
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PMID:Numerical evaluation of symptoms in cervical myelopathy by quantification theory III (Hayashi). 260 47

Among neural lesions of the arms, the most common one is the medianus lesion in the carpal tunnel, followed by the ulnar nerve lesion in the elbow, while the ulnar nerve compression in the Guyon tunnel is found rarely. Besides the history and the clinical picture, the electromyoneurographic analyses make an early and accurate diagnosis possible. The characteristics of the evoked muscle potential and distal latencies in the diagnosis of the carpal tunnel syndrome are of utmost importance. In diagnosing the cubital syndrome, the multisegmental determination of the motor conduction velocity of the ulnar nerve and the features of the M-potential obtained by means of stimulation above the compression are very important. Generally speaking, the slowing down of the motor conduction velocity remains localised to the entrapped segments. The neural potential over the compression in the elbow cannot be evoked, and it is hardly evoked in the wrist. Within the period of the last five years, the author examined 154 patients clinically and electrophysiologically. 132 had the carpal tunnel syndrome, 20 the ulnar groove syndrome, and 2 Guyon's canal syndrome. The patients were treated conservatively and operatively. The success in the conservative treatment of the carpal tunnel syndrome was evident in the first three months by the absence of sensory symptoms in more than 50% of cases. The constant effect was achieved after six months. In that period the EMG findings were not essentially changed, and motor symptoms were also stationary. With the operative treatment the unpleasant symptoms, pain and shudder, disappeared after a relatively short period. Definitive results were achieved after six months. Motor symptoms were less improved and the EMG findings were showing a tendency to improvement. The ulnar groove syndromes were not remarkably influenced by the conservative therapy. Half the operated patients lost their sensory symptoms. Within six months the other half remained with the same or even more trouble.
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PMID:[Nerve compression syndromes of the arm]. 262 73

Parkinson's disease patients are frequently impaired in a variety of neuropsychological tasks involving memory, perceptual motor performance and cognitive flexibility. Although various theories have been forwarded to explain specific impairments, few attempts have been made to account for all the deficits within a single theoretical framework. Furthermore, the frequent occurrence of dementia, the adverse side effects of medication and the motor symptoms of the disease tend to interfere with neuropsychological performance. This has hindered the clear delineation of the neuropsychological profile of Parkinsonian patients. The present paper examines the evidence for intellectual deficits in non-demented Parkinson's disease patients. A number of problems inherent in cognitive research on Parkinson's disease are discussed. The contribution of dementia, motor symptom severity and medication in the expression of these intellectual impairments is examined. It is suggested that many of the neuropsychological deficits described in Parkinson's disease may result from a common underlying deficit in some aspect of information processing. Although it is not possible to pinpoint the precise mechanism(s) involved on the basis of the available evidence, several possibilities are suggested by cognitive and electrophysiological data.
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PMID:Parkinson's disease: a conceptualization of neuropsychological deficits within an information-processing framework. 269 79

Ophthalmologic symptoms are often not sufficiently accounted for by organic pathology. The complaints of these patients have been labeled hysterical, psychogenic, non-organic, or functional. The psychiatric nosology in this area may be the most confusing in the whole field of clinical medicine. The Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) offers a classification designed to reduce non-empirical concepts and ideology to a minimum. On this background, we discuss the hysterical symptoms encountered in clinical ophthalmology with special emphasis on psychogenic amblyopia and blepharospasm. Motor symptoms are commonly not of psychogenic origin. It is suggested that ophthalmologists are most likely to treat patients with psychogenic symptoms, using suggestion, patience, and reassurance. Few patients require psychiatric consultation and a specific psychiatric therapy. The association of hysteria with organic brain disease and the issue of symptom lateralization are briefly discussed. Eventually, we reject the psychoanalytic approach and suggest that the concept of abnormal illness behavior and the neurobiological models involving corticofugal inhibition, primitive reflex mechanisms, and an attention disturbance, serve best to understand the nature of the phenomenon hysteria.
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PMID:Hysterical symptoms in ophthalmology. 269 34

Thirty eight cases of childhood hysteria admitted to a rural medical college hospital, were studied for epidemiological characteristics, clinical presentation, precipitating factors and psychosocial environment and behaviour. Hysteria was commonly seen during adolescence (73.2%) and in males (63.2%). It was more common in the lower socio-economic status (60.5%) and in children for nuclear (94.7%) and large size families (81.6%). Eldest or youngest siblings of the families were found to be more prone to develop hysteria. Motor symptoms were most frequently observed (71.1%) and 55.3% cases had more than one symptom at the time of presentation. In a majority of cases hysteria was acute in onset. Precipitating psychological event was identified in 81.6% cases; scolding (26.3%) being the commonest followed by school avoidance (13.2%), examination fear (10.5%) and quarrel with peers (10.5%). Past history of 52.6% of patients of hysteria and 18.4% of their parents revealed subtle behavioural abnormalities. All patients improved with psychotherapy and modification of the psychosocial environment.
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PMID:Hysteria in children and adolescents. 275 54

MPTP induces parkinsonism in monkeys by destruction of the substantia nigra, pars compacta. It can also damage ventral tegmental dopamine neurones and the noradrenergic locus coeruleus, both of which may be affected in Parkinson's disease. Motor symptoms in MPTP-treated monkeys respond readily to levodopa or dopamine agonist therapy. Administration of levodopa over 4-8 weeks leads to the emergence of "peak-dose" dyskinesia. Such abnormal movements are not seen following challenge doses of levodopa in animals not on long-term therapy. Radioligand studies reveal a 40-180% increase in D2 receptor binding in the striatum of parkinsonian monkeys. 2-deoxyglucose studies of regional brain metabolism indicate that MPTP-induced parkinsonism is characterised by abnormally increased activity of medial pallidal neurones which project to the thalamus and pedunculopontine nucleus and reduced activity of subthalamic nucleus neurones.
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PMID:MPTP-induced parkinsonism in the monkey: neurochemical pathology, complications of treatment and pathophysiological mechanisms. 311 80

Incontinentia pigmenti (IP) has been associated with CNS involvement, including seizures, retardation, motor abnormalities, and malformations in greater than 30% of patients. Motor symptoms include spasticity and hyperreflexia; however, weakness and flaccidity have also been described. Peripheral nervous system neuropathology in patients with IP has not previously been reported. The infant with IP in this report showed generalized weakness due to anterior horn cell degeneration. The neuropathologic findings in both the central and peripheral nervous systems will be reviewed and contrasted to previous reports. Patients with IP and weakness should undergo neurodiagnostic evaluation of peripheral nervous system function.
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PMID:Incontinentia pigmenti: association with anterior horn cell degeneration. 382 37


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