- Status Dystonicus with Atypical Presentation in Developmentally Delay Child: A Case Report. [Journal Article]
- Status dystonicus is characterised by involuntary sustained or intermittent muscle contractions of muscles causing repetitive twisting movements, abnormal postures of the body, or both is a rare but life-threatening movement disorder. Early diagnosis and management of status dystonicus prevent serious complications. We report a 2 years old previously developmental delay diagnosed girl who present…
- PMC Free PDF
- StatPearls: Trihexyphenidyl [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Trihexyphenidyl works as an anticholinergic and is used for the treatment of tremors, spasms, stiffness, and weak muscle control seen in patients with Parkinson disease. It can also be used for the prevention or treatment of similar muscular conditions, which are caused by certain central nervous system (CNS) drugs such as fluphenazine, haloperidol, chlorpromazine. It was approved for the managem…
- Effects of trihexyphenidyl on prefrontal executive function and spontaneous neural activity in patients with tremor-dominant Parkinson's disease: An fNIRS study. [Journal Article]Parkinsonism Relat Disord. 2022 12; 105:96-102.PR
- CONCLUSIONS: These findings suggest that THP treatment may lead to prefrontal dysfunction in tdPD patients, attenuating brain activation in executive function and cognition-related spontaneous neural activity.
- Publisher Full Text (DOI)
- Trihexyphenidyl in young children with dystonic cerebral palsy: A single arm study. [Journal Article]J Pediatr Rehabil Med. 2022 Nov 07 [Online ahead of print]JP
- CONCLUSIONS: Trihexyphenidyl significantly improved dystonia, motor function and development in children with dystonic cerebral palsy in this study. Additional studies are needed to clarify its role in larger numbers of children with this condition.
- Publisher Full Text (DOI)
- Electrophysiological characterization of the striatal cholinergic interneurons in Dyt1 ΔGAG knock-in mice. [Journal Article]
- DYT1 dystonia is an inherited early-onset movement disorder characterized by sustained muscle contractions causing twisting, repetitive movements, and abnormal postures. Most DYT1 patients have a heterozygous trinucleotide GAG deletion mutation (ΔGAG) in DYT1/TOR1A, coding for torsinA. Dyt1 heterozygous ΔGAG knock-in (KI) mice show motor deficits and reduced striatal dopamine receptor 2 (D2R). St…
- PMC Free PDF
- Woodhouse-Sakati Syndrome Presenting With Psychotic Features After Starting Trihexyphenidyl: A Case Report. [Case Reports]
- Woodhouse-Sakati syndrome is a rare, autosomal recessive, multisystemic disorder first identified as a constellation of hypogonadism, mental retardation, diabetes, alopecia, deafness, and electrocardiogram abnormalities. We report a case of a 33-year-old woman who was born to consanguineous parents. She is suffering from hypergonadotropic hypogonadism, extrapyramidal symptoms, hypothyroidism, alo…
- PMC Free PDF
- Adrenocorticotropic Hormone Induced Status Dystonicus in a Child with West Syndrome. [Case Reports]
- Dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contraction causing repetitive twisting movements and abnormal postures. Status dystonicus (SD) is an enigmatic disease of cryptic etiology. We hereby report a child with West syndrome (WS) who went on to develop SD following intramuscular adrenocorticotropic hormone (ACTH) injection. An 11-month-old mal…
- PMC Free PDF
- Trihexyphenidyl increases delta activity in non-rapid eye movement sleep without impairing cognitive function in rodent models. [Journal Article]Neuropharmacology. 2022 11 01; 218:109217.N
- Both human and rodent studies suggest the link between non-rapid eye movement (NREM) sleep and cognition. Recent study indicated that selective activation of cholinergic neurons in basal forebrain inhibits electroencephalogram (EEG) delta power and shortens NREM sleep. In the current study, we aimed to test the pharmacological effect of trihexyphenidyl (THP), a selective muscarinic M1 receptor an…
- Publisher Full Text (DOI)
- Gabapentin as Add-on Therapy to Trihexyphenidyl in Children with Dyskinetic Cerebral Palsy: A Randomized, Controlled Trial. [Journal Article]
- CONCLUSIONS: Trihexyphenidyl alone is as effective as combination of gabapentin with trihexyphenidyl in decreasing the severity of dystonia at 12 wk. Hence, there is no added benefit of gabapentin as add-on therapy for dystonia among children with dyskinetic CP.
- Publisher Full Text (DOI)
- Pharmacological Management of Nightmares Associated with Posttraumatic Stress Disorder. [Review]
- Posttraumatic stress disorder (PTSD) can be a chronic and disabling condition. Post-traumatic nightmares (PTNs) form a core component of PTSD and are highly prevalent in this patient population. Nightmares in PTSD have been associated with significant distress, functional impairment, poor health outcomes, and decreased quality of life. Nightmares in PTSD are also an independent risk factor for su…
- Publisher Full Text (DOI)
- Type 1 neurodegeneration with brain iron accumulation: a case report. [Case Reports]
- CONCLUSIONS: The diagnosis can be made based on the presence of clinical and imaging features. The presence of "eye-of-the-tiger" sign on magnetic resonance imaging must be considered a nearly pathognomonic sign of neurodegeneration with brain iron accumulation presence. Treatment after high-severity presentation remains directed toward symptomatic findings. Both dopamine agonists and anticholinergic agents are useful to treat motor symptoms, but there is not yet an effective treatment to stop the underlying degeneration. New therapeutic approaches are needed to counteract late stages of the disease and improve prognosis.
- PMC Free PDF
- Evolving Concepts in Our Understanding and Treatment of Holmes Tremor, Over 100 Years in the Making. [Review]
- Holmes Tremor (HT) is an irregular, slow-frequency (<4.5 Hz) tremor characterized by a combination of resting, postural, and action tremors mostly of the upper extremities. Symptoms of HT typically emerge 4 weeks to 2 years after a brain injury caused by a spectrum of etiologies. HT pathophysiology is thought to result from aberrant collateral axonal sprouting and synaptic dysfunction following n…
- PMC Free PDF
- Anticholinergic treatment for sialorrhea in children: A systematic review. [Journal Article]
- CONCLUSIONS: Glycopyrrolate, scopolamine/hyoscine, trihexyphenidyl/benzhexol, benztropine, and atropine have all shown efficacy in the treatment of sialorrhea in children. The small number of reports and the variability in study design precluded a meta-analysis. More studies are needed with uniformity in outcome measures to help guide evidence-based decision making. A guidance table is presented.
- PMC Free PDF
- Antipsychotic Drug Utilization and Adverse Drug Reaction Profiling in Patients With Schizophrenia at a Tertiary Care Hospital in Western India. [Journal Article]
- Introduction Prescription pattern studies conducted in patients with schizophrenia have shown variability in the utilization of antipsychotics based on the geographical location of the study setting. Moreover, there is only a sparse number of studies specifically related to adverse drug reactions (ADRs) in schizophrenia. Hence, a need was felt to study the antipsychotic utilization pattern and ad…
- PMC Free PDF
- KMT2B-Related Dystonia: Challenges in Diagnosis and Treatment. [Case Reports]
- In this study, we report the first known Turkish case of a novel nonsense mutation c.2453dupT (p.M818fs*28) in the KMT2B (NM_014727.2) gene diagnosed in a male patient with KMT2B-related dystonia (DYT-KMT2B, DYT-28, Dystonia*-28), which is a complex, childhood-onset, progressive, hereditary dystonia. The patient, who is followed up from 9 to 13 years of age, had dysmorphic features, developmental…
- PMC Free PDF
- Blockade of M4 muscarinic receptors on striatal cholinergic interneurons normalizes striatal dopamine release in a mouse model of TOR1A dystonia. [Journal Article]
- Trihexyphenidyl (THP), a non-selective muscarinic receptor (mAChR) antagonist, is commonly used for the treatment of dystonia associated with TOR1A, otherwise known as DYT1 dystonia. A better understanding of the mechanism of action of THP is a critical step in the development of better therapeutics with fewer side effects. We previously found that THP normalizes the deficit in striatal dopamine …
- Publisher Full Text (DOI)
- Drugs of Abuse among In-Patients Receiving Treatment for Substance Use Disorders in a Tertiary Health Care Center in South-South Nigeria: An Exploratory Qualitative Study. [Journal Article]West Afr J Med. 2022 Feb 28; 39(2):147-153.WA
- CONCLUSIONS: Newer substances of abuse in their various combinations are abused by Nigerian youth. More studies are needed to elucidate further the chemical composition of these drugs/mixtures and their mechanism of action.
- Status Dystonicus in Children: A Cross-Sectional Study and Review of Literature. [Review]
- Background: Status dystonicus is a life-threatening, underrecognized movement disorder emergency. We aimed to ascertain the etiology, clinical presentation, complications, and outcomes of status dystonicus in children and reviewed the literature for similar studies. Methods: Records of all children aged <14 years admitted to a single center with status dystonicus between 2014 and 2018 were review…
- Publisher Full Text (DOI)
- Pharmacophore-Based Discovery of Substrates of a Novel Drug/Proton-Antiporter in the Human Brain Endothelial hCMEC/D3 Cell Line. [Journal Article]
- A drug/proton-antiporter, whose the molecular structure is still unknown, was previously evidenced at the blood-brain barrier (BBB) by functional experiments. The computational method could help in the identification of substrates of this solute carrier (SLC) transporter. Two pharmacophore models for substrates of this transporter using the FLAPpharm approach were developed. The trans-stimulation…
- PMC Free PDF
- Misuse of Anticholinergic Medications: A Systematic Review. [Review]
- (1) Background: Over the last decade, misuse and diversion of medications has appeared to be increasingly concerning phenomena, including a range of different molecules. As current knowledge on the abuse of centrally acting anticholinergics is limited, the aim of the present study is to review the relevant published data, focusing on the following molecules: benztropine, biperiden, scopolamine, o…
- PMC Free PDF
- The Clinical Characteristics, Putative Drugs, and Optimal Management of 62 Patients With Stevens-Johnson Syndrome and/or Toxic Epidermal Necrolysis: A Retrospective Observational Study. [Journal Article]
- CONCLUSIONS: Aromatic anticonvulsants, allopurinol, nevirapine, cotrimoxazole, paracetamol, and diclofenac remain the most implicated drugs. Sulfasalazine, leflunomide, ethambutol, and trihexyphenidyl were uncommon additions. A short course of high-dose dexamethasone in the early stage was useful. Addition of BT or IVIg provided rapid relief. Preexisting HIV disease, kidney disease, and sepsis remain important for in-hospital deaths. Retrospective study design and small number of cases remain major limitations.
- PMC Free PDF
- Treatment strategies for clozapine-induced nocturnal enuresis and urinary incontinence: a systematic review. [Review]
- CONCLUSIONS: Following assessment of urological, psychiatric, pharmacological, and common comorbid medical issues, first-line treatments should be nonpharmacological, including bathroom alarms, voiding before bedtime, and nocturnal fluid restriction. If these interventions do not provide adequate relief, aripiprazole should be trialed. Desmopressin may be considered for severe refractory cases, but monitoring for hyponatremia is essential.
- Publisher Full Text (DOI)
- Bilateral Hypertrophic Olivary Degeneration after Pontine Hemorrhage: A Case Report. [Case Reports]
- CONCLUSIONS: Bilateral HOD is a rare phenomenon after pontine hemorrhage. The key to diagnosis lies in the clinical manifestations and MRI results.
- PMC Free PDF
- Serum short-chain fatty acids and its correlation with motor and non-motor symptoms in Parkinson's disease patients. [Journal Article]
- CONCLUSIONS: Serum SCFAs are altered in PD patients, and the decrease of serum propionic acid level is correlated with motor symptoms, cognitive ability and non-depressed state. Thus, the gut microbial-derived SCFAs potentially affect Parkinson's symptoms through the blood circulation. Propionic acid supplementation might ameliorate motor and non-motor symptoms of PD patients, although clinical trials are needed to test this hypothesis.
- PMC Free PDF
- Catatonia: A rare presentation of Wilson's disease. [Case Reports]
- Wilson's disease (WD) or hepatolenticular degeneration is a rare inherited disorder of copper metabolism affecting both the liver and the central nervous system. Psychiatric manifestations may precede neurological signs in the early stages of WD, but catatonia is a rare presentation. Here, we report a case of an 18-year-old girl who presented to the psychiatry outpatient department with catatonia…
- PMC Free PDF
- Pediatric Dystonic Storm: A Hospital-Based Study. [Journal Article]
- CONCLUSIONS: Dystonic storm is a medical emergency mandating aggressive multimodal management. Supportive care, antidystonic drugs, and early elective ventilation alongside adequate sedation with benzodiazepines ameliorate complications. Relapses of dystonic storm are not uncommon.
- PMC Free PDF
- Non-Motor Symptoms and Associated Factors in Parkinson's Disease Patients in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study. [Multicenter Study]
- CONCLUSIONS: The prevalence of NMS was high among PD patients in Ethiopia. Constipation was the commonest NMS. Longer duration of illness was associated with frequent occurrence of NMSs. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness.
- PMC Free PDF
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury: Parkinson Disease Agents [BOOK]LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases: Bethesda (MD)BOOK
- Parkinson disease is a progressive neurological condition characterized by slowness and paucity of movement (bradykinesia), muscle rigidity, resting tremors, and disordered posture. The onset is typically in the 6th or 7th decade of life with slow progression to akinesia, severe tremors, physical disability and death within 10 to 25 years of initial symptoms. Parkinson disease is common and affec…
- Carbamazepine-Responsive Chorea in a Toddler with Semilobar Holoprosencephaly: Case Report. [Case Reports]
- Holoprosencephaly (HPE) is a central nervous system malformation defined by incomplete separation of the prosencephalon in two hemispheres and determines a broad spectrum of clinical presentations based on extension of non-separation.
- PMC Free PDF
- Drugs and Lactation Database (LactMed): Flavoxate [BOOK]Drugs and Lactation Database (LactMed). National Library of Medicine (US): Bethesda (MD)BOOK
- No information is available on the use of flavoxate during breastfeeding. Long-term use of trihexyphenidyl might reduce milk production or milk letdown, but a single dose is not likely to interfere with breastfeeding. During long-term use, observe for signs of decreased lactation (e.g., insatiety, poor weight gain).