- Predictors of alcohol responsiveness in dystonia. [Journal Article]
- NeurNeurology 2018 Oct 19
- CONCLUSIONS: The association of alcohol responsiveness with a positive family history for movement disorders, generalized dystonia, and an earlier age at onset suggests that patients with dystonia who have an underlying genetic contribution may be more likely to respond beneficially to alcohol. The fact that dystonic tremor may respond to alcohol is in keeping with the observation that the intake of GABAergic drugs may have a beneficial effect in a proportion of patients.
- Deep brain stimulation of the ventralis intermedius nucleus of the thalamus and posterior subthalamic area for Holmes' tremor secondary to brainstem hemorrhage: A case report. [Journal Article]
- JCJ Clin Neurosci 2018 Oct 16
- Holmes' tremor is a rare but severely disabling movement disorder characterized by a combination of resting, action, and intention tremor. Because Holmes' tremor is usually resistant to pharmacothera...
Holmes' tremor is a rare but severely disabling movement disorder characterized by a combination of resting, action, and intention tremor. Because Holmes' tremor is usually resistant to pharmacotherapy, surgical treatment is required for symptom control in most cases. We report the case of a 56-year-old man who was diagnosed with Holmes' tremor and treated with stimulation of the ventralis intermedius nucleus of the thalamus and posterior subthalamic area. Deep brain stimulation alleviated the patient's tremor over a 3-year follow-up period.
- H1/H2 MAPT haplotype and Parkinson's Disease in Mexican mestizo population. [Journal Article]
- NLNeurosci Lett 2018 Oct 16
- Parkinson's disease (PD) is characterized by bradykinesia, resting tremor, rigidity and disequilibrium as well as early symptoms. Previous studies that evaluated the association between H1/H2 MAPT ha...
Parkinson's disease (PD) is characterized by bradykinesia, resting tremor, rigidity and disequilibrium as well as early symptoms. Previous studies that evaluated the association between H1/H2 MAPT haplotype and PD were mostly conducted in European populations in which the H1 haplotype was a reported risk factor for PD. Despite those findings, some studies have suggested that the association may be ethnically dependent. Since studies conducted in Latin American population have been scarce, we genotyped the H1/H2 MAPT haplotype in Mexican mestizo population as part of a PD case-control study. DNA was extracted from peripheral blood leucocytes in 108 cases and 108 controls and detection of the H1/H2 haplotypes was achieved by determining the MAPT_238bp deletion/insertion variant at intron 9 through end-point PCR followed by visual 3% agarose gel electrophoresis interpretation. We observed no-association between genotypes and PD risk [OR/CI (Odds ratio/95% Confidence Interval) of 1.60 (0.78-3.29) for H1/H2 genotype and 2.26 (0.20-25.78) for H2/H2]. No-association was maintained when stratifying our groups by central (p = 0.27) and northern regions (p = 0.70). Our data suggest that H1/H2 MAPT haplotype is not a risk factor to PD in our population.
- Procedural Variables Influencing Stereotactic Accuracy and Efficiency in Deep Brain Stimulation Surgery. [Journal Article]
- ONOper Neurosurg (Hagerstown) 2018 Oct 18
- CONCLUSIONS: Distinct procedural variables in DBS surgery are associated with reduced case times and improved stereotactic accuracy.
- Movement disorders associated with neuronal antibodies. [Review]
- ANActa Neurol Scand 2018 Oct 18
- Movement disorders are one of the common clinical feature of neurological disease associated with neuronal antibodies. which is a group of potentially reversible disorder. They can present with hypok...
Movement disorders are one of the common clinical feature of neurological disease associated with neuronal antibodies. which is a group of potentially reversible disorder. They can present with hypokinetic or hyperkinetic types of involuntary movements and may have other associated neurological symptoms. The spectrum of abnormal movements associated with neuronal antibodies is widening. Some specific phenomenology of movement disorders are likely to give clue about the type of antibody, for instance presence of paroxysmal dystonia (facio-brachial dystonic seizures) are a pointer towards presence of LGI-1 antibodies, and orofacial lingual dyskinesia is associated with NMDAR associated encephalitis. The presence of specific type of movement disorder allows high suspicion of testing of certain specific type of antibodies. In this review, we have discussed the various antibodies and the spectrum of movement disorder associated with them, highlighting if any distinct movement disorder allows the clinician to suspect type of antibody in a certain clinical context. We have also reviewed the treatment of the movement disorder associated with the neuronal antibodies. Physicians should have high index of suspicion of these disorders, as early institution of treatment options can lead to better outcome. This article is protected by copyright. All rights reserved.
- Pseudo-orthostatic tremor in idiopathic Parkinson's disease: could it be re-emergent tremor? [Letter]
- NSNeurol Sci 2018 Oct 18
- Parkinson's Disease Motor Subtypes Show Different Responses to Long-Term Subthalamic Nucleus Stimulation. [Journal Article]
- FHFront Hum Neurosci 2018; 12:365
- Background and purpose: Subthalamic nucleus deep brain stimulation (STN DBS) is well established for the treatment of advanced Parkinson's disease (PD), substantially improving motor symptoms, qualit...
Background and purpose: Subthalamic nucleus deep brain stimulation (STN DBS) is well established for the treatment of advanced Parkinson's disease (PD), substantially improving motor symptoms, quality of life, and reducing the long-term need for dopaminergic medication. However, whether chronic STN DBS produces different effects on PD motor subtypes is unknown. This retrospective study aimed to evaluate the long-term effects of STN DBS on the PD motor subtypes. Methods: Eighty patients undergoing STN DBS were included. The Unified Parkinson's Disease Rating Scale (UPDRS) analysis was performed in "On" and "Off" medication/"On" and "Off" stimulation conditions. The patients were classified as akinetic-rigid type (ART), tremor-dominant type (TDT), and mixed type (MT) based on the preoperative UPDRS III subscores in the "Off" medication state. Preoperative and postoperative comparisons were performed. Results: After 4.9 years, STN DBS produced significant improvement in the UPDRS III total scores and subscores of tremor, rigidity, and bradykinesia in the "Off" medication state in the ART group, less improvement in the MT group, and the least improvement in the TDT group. The UPDRS II and III total scores and other subscores failed to improve during the "On" medication state. However, all groups improved substantially, and the improvement in tremor was sustained for both the "On" and "Off" medication states after years. Long-term STN DBS failed to improve swallowing and speech in all the subtypes. Conclusion: The data confirms that PD is heterogeneous. Long-term STN DBS produced the best effects on bradykinesia/rigidity in the "Off" medication state and on tremor in the "On" and "Off" medication states. There were differences in the response by each group, but some of the differences could be explained by the fact that more severe symptoms at baseline tend to have greater improvement. The findings support the idea that ART mainly involves the basal ganglia-thalamo-cortical pathway, whereas TDT involves a different circuit, likely the cerebellar-thalamo-cortical pathway.
- Outcomes from stereotactic surgery for essential tremor. [Journal Article]
- JNJ Neurol Neurosurg Psychiatry 2018 Oct 18
- There are several different surgical procedures that are used to treat essential tremor (ET), including deep brain stimulation (DBS) and thalamotomy procedures with radiofrequency (RF), radiosurgery ...
There are several different surgical procedures that are used to treat essential tremor (ET), including deep brain stimulation (DBS) and thalamotomy procedures with radiofrequency (RF), radiosurgery (RS) and most recently, focused ultrasound (FUS). Choosing a surgical treatment requires a careful presentation and discussion of the benefits and drawbacks of each. We conducted a literature review to compare the attributes and make an appraisal of these various procedures. DBS was the most commonly reported treatment for ET. One-year tremor reductions ranged from 53% to 63% with unilateral Vim DBS. Similar improvements were demonstrated with RF (range, 74%-90%), RS (range, 48%-63%) and FUS thalamotomy (range, 35%-75%). Overall, bilateral Vim DBS demonstrated more improvement in tremor reduction since both upper extremities were treated (range, 66%-78%). Several studies show continued beneficial effects from DBS up to five years. Long-term follow-up data also support RF and gamma knife radiosurgical thalamotomy treatments. Quality of life measures were similarly improved among patients who received all treatments. Paraesthesias, dysarthria and ataxia were commonly reported adverse effects in all treatment modalities and were more common with bilateral DBS surgery. Many of the neurological complications were transient and resolved after surgery. DBS surgery had the added benefit of programming adjustments to minimise stimulation-related complications. Permanent neurological complications were most commonly reported for RF thalamotomy. Thalamic DBS is an effective, safe treatment with a long history. For patients who are medically unfit or reluctant to undergo DBS, several thalamic lesioning methods have parallel benefits to unilateral DBS surgery. Each of these surgical modalities has its own nuance for treatment and patient selection. These factors should be carefully considered by both neurosurgeons and patients when selecting an appropriate treatment for ET.
- Thomas Mann and Neurology. [Journal Article]
- FNFront Neurol Neurosci 2018; 43:76-84
- Thomas Mann (1875-1955) is considered one of the most influential writers of the late nineteenth and early twentieth century. In addition to his novels and essays, he was well known for his criticism...
Thomas Mann (1875-1955) is considered one of the most influential writers of the late nineteenth and early twentieth century. In addition to his novels and essays, he was well known for his criticisms of the Nazi party, and particularly against the racial nationalism promoted by Adolf Hitler after the First World War, as well as for his depiction of diseases. Here, we provide a quick sketch of Mann's life and his relationship with nineteenth to twentieth century German society. We then proceed to describe how Mann became interested in diseases, how he used the diseases as metaphors, and his specific contribution to the field of neurology. We describe some of the neurological cases portrayed in Mann's work, and particularly epilepsy described in The Buddenbrooks, Felix Krull and The Magic Mountain, meningitis, neurosyphilis and migraines depicted in Doctor Faustus, and essential tremor described in The Magic Mountain and Doctor Faustus. We conclude with reflections about Mann's interest in diseases and particularly in neurology.
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- [123I]Ioflupane imaging in Caucasians and non-Caucasians: Are there any differences? [Journal Article]
- JNJ Neurol Sci 2018 Oct 03; 395:159-163
- CONCLUSIONS: In this study, the diagnostic performance of [123I]ioflupane SPECT imaging was comparable between Caucasians and non-Caucasians.