A Professional's Guide to Corticobasal Degeneration
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Hemimasticatory Spasm Treated with Botulinum Toxin
Arq Neuropsiquiatr 2002;60(2-A):288-289 HEMIMASTICATORY SPASM TREATED WITH BOTULINUM TOXIN Case report Hélio A.G. Teive1, Élcio J. Piovesan2, Francisco M.B. Germiniani3, Carlos Henrique A. Camargo3, Daniel Sá3, Rosana H. Scola4, Lineu C. Werneck5 ABSTRACT - We describe a female patient with hemimasticatory spasm, a rare movement disorder due to dysfunction of the motor trigeminal nerve of unknown origin. This patient had an excellent response to botulinum toxin therapy. KEY WORDS: hemimasticatory spasm, paroxysmal spasms, botulinum toxin. Espasmo hemimastigatório tratado com toxina botulínica: relato de caso RESUMO - Relatamos o caso de paciente feminina com espasmo hemimastigatório, distúrbio do movimento raro decorrente de disfunção da porção motora do nervo trigeminal, de etiologia desconhecida. A paciente teve excelente resposta clínica ao tratamento com toxina botulínica. PALAVRAS-CHAVE: espasmo hemimastigatório, espasmos paroxísticos, toxina botulínica. Hemimasticatory spasm (HMS) represents a rare spontaneously. She also complained of difficulty in talk- movement disorder due to a dysfunction of the mo- ing and swallowing when she had the spasms. tor trigeminal nerve of unknown origin. It is frequen- Neurological examination was normal except for in- tly misdiagnosed as hemifacial spasm, which is a tense contraction of the masseter and temporal muscles disorder due to dysfunction of the facial nerve1-3. on the right with severe facial pain when the patient had the spasms. Routine laboratory tests (WBC, biochemistry, The most striking features of HMS are the excruciat- VDRL, ERS) and ceruloplasmine were all normal. ing pain that accompanies the spasm itself and the The patient also had a previous history of irregular fact that initially masticatory movements act as a menstrual cycles and even amenorrhea for more than 1-3 trigger for the spasm . -
Perioral Twitching During Smiling - a Rare Form of Essential Tremor
Clinical Video Neurological Case Reports Published: 02 Dec, 2020 Perioral Twitching during Smiling - A Rare form of Essential Tremor Lea Pollak* Department of Neurology, Neurological Clinic, Kupat Cholim Macabi, Israel Abstract Involuntary movements of facial muscles such as jaw tremor, oromandibular dyskinesia, dystonia, facial myoclonus or hemifacial spasm are common in clinical practice. A 52-year old woman with a 15 year history of upper limb tremor complained of recent spread of the tremor to her face. On examination a moderate kinetic and action, mildly asymmetric tremor of the arms was present. On voluntary and spontaneous smiling bilateral twitching of the buccal muscles was observed. Keywords: Periorbital twitching; Essential tremor; Tardive dyskinesia Introduction Involuntary movements of facial muscles such as jaw tremor, oromandibular dyskinesia, dystonia, facial myoclonus or hemifacial spasm are common in clinical practice. Isolated tremor induced by mild contraction of smiling muscles smiling tremor is extremely rare and was reported by some authors to be associated with Parkinson disease while others related this condition to essential tremor [1-3]. Clinical Video A 52-year old woman with a 15 year history of upper limb tremor complained of recent spread of the tremor to her face. Her medical history comprised Crohn's disease treated with adalimumab and depression treated with sertraline and perphenazine during the last ten years. On examination a moderate kinetic and action, mildly asymmetric tremor of the arms was present. On voluntary and spontaneous smiling bilateral twitching of the buccal muscles was observed (video 1). The twitching disappeared on rest and forced smiling. There were no extra pyramidal signs or involuntary OPEN ACCESS movements of the jaw, lips or tongue (Figure 1). -
Isolated Corpus Callosal Infarction Secondary to Pericallosal Artery Disease Presenting As Alien Hand Syndrome N C Suwanwela, N Leelacheavasit
533 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.72.4.536 on 1 April 2002. Downloaded from SHORT REPORT Isolated corpus callosal infarction secondary to pericallosal artery disease presenting as alien hand syndrome N C Suwanwela, N Leelacheavasit ............................................................................................................................. J Neurol Neurosurg Psychiatry 2002;72:533–536 held a paper with both hands, the left hand would try to pull Two patients are described with the callosal type of alien the paper against the right. Some actions indicating mirror hand syndrome. Both presented with abnormal feelings in movement were also seen. For example, when he moved his the left upper limb and intermanual conflict without clinical right hand backwards, he felt that the left hand was pulled evidence of callosal apraxia or frontal lobe dysfunction back in the same manner. On examination, he was alert. such as motor deficit or reflexive grasping. Imaging studies Motor power of the arms and legs was full. There was no pin- disclosed subacute infarction in the body and splenium of prick sensory loss or inattention, on double simultaneous the corpus callosum due to pericallosal artery disease. stimulation test. Proprioceptive sense was normal. He could These patients were unique in their presentation as a not identify his left hand fingers or objects placed in his left callosal type of alien hand syndrome secondary to ischae- hand with his eyes closed, but was able to do so under visual mic stroke. observation. There was no apraxia of the left hand on verbal command, in imitation, and in actual object use. Frontal lobe releasing signs such as reflexive grasping, palmomental reflex, and snout reflex were absent. -
Criteria for the Diagnosis of Corticobasal Degeneration
VIEWS & REVIEWS Criteria for the diagnosis of corticobasal degeneration Melissa J. Armstrong, ABSTRACT MD Current criteria for the clinical diagnosis of pathologically confirmed corticobasal degeneration (CBD) Irene Litvan, MD no longer reflect the expanding understanding of this disease and its clinicopathologic correlations. An Anthony E. Lang, MD international consortium of behavioral neurology, neuropsychology, and movement disorders special- Thomas H. Bak, MD ists developed new criteria based on consensus and a systematic literature review. Clinical diagnoses Kailash P. Bhatia, MD (early or late) were identified for 267 nonoverlapping pathologically confirmed CBD cases from pub- Barbara Borroni, MD lished reports and brain banks. Combined with consensus, 4 CBD phenotypes emerged: corticobasal Adam L. Boxer, MD, syndrome (CBS), frontal behavioral-spatial syndrome (FBS), nonfluent/agrammatic variant of primary PhD progressive aphasia (naPPA), and progressive supranuclear palsy syndrome (PSPS). Clinical features Dennis W. Dickson, MD of CBD cases were extracted from descriptions of 209 brain bank and published patients, providing Murray Grossman, MD a comprehensive description of CBD and correcting common misconceptions. Clinical CBD pheno- Mark Hallett, MD types and features were combined to create 2 sets of criteria: more specific clinical research criteria Keith A. Josephs, MD for probable CBD and broader criteria for possibleCBDthataremoreinclusivebuthaveahigher Andrew Kertesz, MD chance to detect other tau-based pathologies. Probable CBD criteria require insidious onset and grad- Suzee E. Lee, MD ual progression for at least 1 year, age at onset $50 years, no similar family history or known tau Bruce L. Miller, MD mutations, and a clinical phenotype of probable CBS or either FBS or naPPA with at least 1 CBS Stephen G. -
Essential Tremor of the Voice Vs. Spasmodic Dysphonia by Michael M
Essential Tremor (ET) Essential Tremor of the Voice vs. Spasmodic Dysphonia By Michael M. Johns, MD (pictured below)- Director at Emory Voice Center, Emory University, Atlanta, GA and member of the IETF Medical Advisory Board, and Madeleine Pethan, MS, CCC-SLP - Speech Pathologist at Emory Voice Center Introduction box, is not the only structure which can cause essential tremor of the voice. Tremor of the voice can be caused Certain neurologic conditions can cause people to have when any of the structures in the speech system is problems with their voice. These voice problems can affected. Essential tremor of the voice may be caused often lead to more difficulty communicating throughout by tremor in the soft palate, tongue, pharynx, or even daily life. It is important that patients with neurological muscles of respiration. Extralaryngeal tremor (i.e., out- voice disorders are evaluated by an otolaryngologist, or side the voice box) has been reported in up to as many ENT doctor, in addition to their neurologist to determine as 93% of patients with diagnosed essential tremor of the diagnosis and discuss treatment options. Many the voice. Similarly, most patients with essential tremor patients with essential tremor also experience essential of the voice also have tremor affecting their hands, leg, tremor of the voice. Essential tremor of the voice can chin, or trunk. often be confused with another neurologic voice disor- der known as spasmodic dysphonia. Essential tremor seems to be associated with aging, al- though the reasons are still inconclusive. Most studies What is Essential Tremor? report average age of onset from the late 40s to early 50s. -
Review of Systems Reason for Visit Past Gynecologic
REVIEW OF SYSTEMS Patient Name Date DOB Height Weight REASON FOR VISIT Why are you seeing the doctor today? ________________________________________________________________________________________ Have you been treated for this problem in the past? Yes No If yes, please explain ______________________________________________________________________________________________________ Have you had any recent radiology or laboratory studies? Yes No If yes, please indicate where, when, and type of study __________________________________________________________________________ PAST GYNECOLOGIC HISTORY Please indicate if you have received treatment for the conditions below, or if you are currently receiving treatment. Yes No Yes No Abnormal Pap HPV (Human Papillomavirus) Other Gynecologic Problems _______________________________________________________________________________________________ Are there any other medical problems that we should be aware of? ______________________________________________________________ _________________________________________________________________________________________________________________________ Are you currently pregnant or could you possibly be pregnant? Yes No Date of Last Menstrual Period ____________________/ / Do you/have you taken female hormones? Yes No Oral contraceptives? Yes No Type of contraception: _____________________________ Total number of: Pregnancies ________ Term Births ________ Pre-Term Births ________ Elective Abortions ________ Miscarriages ________ C-sections ________ REVIEW OF -
History-Of-Movement-Disorders.Pdf
Comp. by: NJayamalathiProof0000876237 Date:20/11/08 Time:10:08:14 Stage:First Proof File Path://spiina1001z/Womat/Production/PRODENV/0000000001/0000011393/0000000016/ 0000876237.3D Proof by: QC by: ProjectAcronym:BS:FINGER Volume:02133 Handbook of Clinical Neurology, Vol. 95 (3rd series) History of Neurology S. Finger, F. Boller, K.L. Tyler, Editors # 2009 Elsevier B.V. All rights reserved Chapter 33 The history of movement disorders DOUGLAS J. LANSKA* Veterans Affairs Medical Center, Tomah, WI, USA, and University of Wisconsin School of Medicine and Public Health, Madison, WI, USA THE BASAL GANGLIA AND DISORDERS Eduard Hitzig (1838–1907) on the cerebral cortex of dogs OF MOVEMENT (Fritsch and Hitzig, 1870/1960), British physiologist Distinction between cortex, white matter, David Ferrier’s (1843–1928) stimulation and ablation and subcortical nuclei experiments on rabbits, cats, dogs and primates begun in 1873 (Ferrier, 1876), and Jackson’s careful clinical The distinction between cortex, white matter, and sub- and clinical-pathologic studies in people (late 1860s cortical nuclei was appreciated by Andreas Vesalius and early 1870s) that the role of the motor cortex was (1514–1564) and Francisco Piccolomini (1520–1604) in appreciated, so that by 1876 Jackson could consider the the 16th century (Vesalius, 1542; Piccolomini, 1630; “motor centers in Hitzig and Ferrier’s region ...higher Goetz et al., 2001a), and a century later British physician in degree of evolution that the corpus striatum” Thomas Willis (1621–1675) implicated the corpus -
Corticobasal Syndrome: Clinical, Neuropsychological, Imaging
CORTICOBASAL SYNDROME: CLINICAL, NEUROPSYCHOLOGICAL, IMAGING, GENETIC AND PATHOLOGICAL FEATURES by Mario Masellis A thesis submitted in conformity with the requirements for the degree of Doctorate of Philosophy in the Graduate Department of Institute of Medical Sciences, University of Toronto © Copyright by Mario Masellis (2012) Library and Archives Bibliothèque et Canada Archives Canada Published Heritage Direction du Branch Patrimoine de l'édition 395 Wellington Street 395, rue Wellington Ottawa ON K1A 0N4 Ottawa ON K1A 0N4 Canada Canada Your file Votre référence ISBN: 978-0-494-97827-6 Our file Notre référence ISBN: 978-0-494-97827-6 NOTICE: AVIS: The author has granted a non- L'auteur a accordé une licence non exclusive exclusive license allowing Library and permettant à la Bibliothèque et Archives Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par télécommunication ou par l'Internet, prêter, telecommunication or on the Internet, distribuer et vendre des thèses partout dans le loan, distrbute and sell theses monde, à des fins commerciales ou autres, sur worldwide, for commercial or non- support microforme, papier, électronique et/ou commercial purposes, in microform, autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriété du droit d'auteur ownership and moral rights in this et des droits moraux qui protege cette thèse. Ni thesis. Neither the thesis nor la thèse ni des extraits substantiels de celle-ci substantial extracts from it may be ne doivent être imprimés ou autrement printed or otherwise reproduced reproduits sans son autorisation. -
What Every Social Worker Physical Therapist Occupational
What Every Social Worker Physical Therapist Occupational Therapist Speech-Language Pathologist Should Know About Progressive Supranuclear Palsy (PSP) Corticobasal Degeneration (CBD) Multiple System Atrophy (MSA) A Comprehensive Guide to Signs, Symptoms, and Management Strategies DISEASE SUMMARIES at a glance Progressive Supranuclear Palsy (PSP) • Rare neurodegenerative disease, the most common parkinsonian disorder after Parkinson’s disease (PD) • Originally described in 1964 as Steele-Richardson-Olszewski syndrome • Often mistakenly diagnosed as PD due to the similar early symptoms • Symptoms include early postural instability, supranuclear gaze palsy (paralysis of voluntary vertical gaze with preserved reflexive eye movements), and levodopa-nonresponsive parkinsonism • Onset of symptoms is typically symmetric • Pathologically classified as a tauopathy (abnormal accumulation in the brain of the protein tau) • Five to seven cases per 100,000 people • Slightly more common in men • Average age of onset is 60–65 years, but can occur as early as age 40 • Life expectancy is five to seven years following symptom onset • No cure or effective medication management Signs and Symptoms • Early onset gait and balance problems • Clumsy, slow, or shuffling gait 2 • Lack of coordination • Slowed or absent balance reactions and postural instability • Frequent falls (primarily backward) • Slowed movements • Rigidity (generally axial) • Vertical gaze palsy • Loss of downward gaze is usually first • Abnormal eyelid control • Decreased blinking with “staring” -
The Clinical Approach to Movement Disorders Wilson F
REVIEWS The clinical approach to movement disorders Wilson F. Abdo, Bart P. C. van de Warrenburg, David J. Burn, Niall P. Quinn and Bastiaan R. Bloem Abstract | Movement disorders are commonly encountered in the clinic. In this Review, aimed at trainees and general neurologists, we provide a practical step-by-step approach to help clinicians in their ‘pattern recognition’ of movement disorders, as part of a process that ultimately leads to the diagnosis. The key to success is establishing the phenomenology of the clinical syndrome, which is determined from the specific combination of the dominant movement disorder, other abnormal movements in patients presenting with a mixed movement disorder, and a set of associated neurological and non-neurological abnormalities. Definition of the clinical syndrome in this manner should, in turn, result in a differential diagnosis. Sometimes, simple pattern recognition will suffice and lead directly to the diagnosis, but often ancillary investigations, guided by the dominant movement disorder, are required. We illustrate this diagnostic process for the most common types of movement disorder, namely, akinetic –rigid syndromes and the various types of hyperkinetic disorders (myoclonus, chorea, tics, dystonia and tremor). Abdo, W. F. et al. Nat. Rev. Neurol. 6, 29–37 (2010); doi:10.1038/nrneurol.2009.196 1 Continuing Medical Education online 85 years. The prevalence of essential tremor—the most common form of tremor—is 4% in people aged over This activity has been planned and implemented in accordance 40 years, increasing to 14% in people over 65 years of with the Essential Areas and policies of the Accreditation Council age.2,3 The prevalence of tics in school-age children and for Continuing Medical Education through the joint sponsorship of 4 MedscapeCME and Nature Publishing Group. -
Porro NEWORK NEWS
International Polio Network SAINT LOUIS, MISSOURIUSA Winter 2003 .Vol. 19, No. 1 Porro NEWORKNEWS Straight Answers to Your "Cramped" Questions Holly H. Wise, P7; PhD, and Kerri A. Kolehma, MS, MD, Coastal Post-Polio Clinic, Charleston, South Carolina Tired in the morning? Is it diffi- Cramps can occur throughout origins anywhere in the central cult to get comfortable for a good the day but more often occur at and peripheral nervous systems night of sleep? A complaint often night or when a person is resting. and may explain the wide range reported at the Coastal Post-Polio Although it is not known exactly of conditions in which the Clinic in Charleston, South why cramps happen mostly at cramping occurs (Bentley, 1996). Carolina, is the inability to get these times, it is thought that to sleep at night due to leg pain, the resting muscle is not being Seeking Answers twitching, or cramping. stretched and is therefore more A thorough history and possibly easily excited. Muscle cramping is a relatively a referral for screening labs will common, painful, and bother- The basis for the theory that help determine the causes for some complaint among generally I cramps occur more at rest, due to I leg pain and cramping. Polio healthy adults, and is more com- I the muscle not being stretched, I survivors can provide a descrip- mon in women than men. Some I is that passive stretching can I tion of their muscle cramps, studies estimate as many as 50- 1 relieve muscle cramping. Pain I identification of the time and 70% of older adults may experi- I associated with cramping is likely I place when they occur, and an ence nocturnal leg and foot I caused by the demand of the I activity log of the 24-48 hours cramps (Abdulla, et. -
Muscle Spasms and Strains
MUSCULOSKELETAL HEALTH Muscle spasms may have many possible causes, including, Muscle spasms but not limited to: • Poor blood circulation and strains • Overexertion of the muscles while exercising • Insufficient stretching before exercise • Excessive exercise in the heat Lynn Lambert, BPharm • Muscle fatigue Amayeza Info Centre • Dehydration • A magnesium and/or potassium deficiency • A side-effect of medication. Introduction A muscle locked in spasm produces a sudden, tight and Muscles are the “powerhouse” of the human body as their main intense pain. The pain can range in intensity from slight to agonising. A muscle in spasm may feel hard to the touch, function is to produce motion. Skeletal muscle is responsible and/or appear visibly distorted. A twitch beneath the skin can for the movement of external areas of the body, for example, be seen in some cases. A spasm can last a few seconds to the limbs. Most people experience a muscular injury, such as a 15 minutes or longer, and may recur a few times before it goes spasm or a strain, at some time during their lives. Such injuries away. can occur during sport or exercise, but can also take place while sitting, walking, or even during sleep. Muscle spasms Treatment and prevention and strains are a common complaint with which patients Muscle spasms usually resolve with self-care measures present at a pharmacy. Therefore, the pharmacist’s assistant without the need to see a doctor. It is important that the patient is in an ideal position to provide practical advice, combined stops the activity which triggered the spasm.