1/14. A behavioral-educational alternative to drug control of hyperactive children.A behavioral procedure for controlling hyperactivity without inhibiting academic performance is described. Using a time-sample observational method, the hyperactivity displayed by three school children was recorded during math and reading classes. Concurrently, math and reading performances were measured. The study consisted of two baselines, one while the children were on medication and the second while they were off medication. A multiple-baseline design across the two academic subject matters was used to assess the behavioral intervention, which consisted of token reinforcement for correct academic responses in math and subsequently math and reading. Discontinuation of medication resulted in a gross increase in hyperactivity from 20% to about 80%, and a slight increase in math and reading performance. Introduction of a behavioral program for academic performance, during no medication, controlled the children's hyperactivity at a level comparable to that when they were on drugs (about 20%). At the same time, math and reading performance for the group jumped from about 12% during baseline to a level of over 85% correct. Each child performed behaviorally and academically in an optimal manner without medication. Contingency management techniques provided a feasible alternative to medication for controlling hyperactivity in the classroom while enabling the children to grow academically.- - - - - - - - - - ranking = 1keywords = drug (Clic here for more details about this article) |
2/14. Sequential withdrawal of stimulant drugs and use of behavior therapy with two hyperactive boys.The separate and combined effects of stimulant drugs, placebos, and behavior therapy were investigated with two hyperactive boys. In each case, sequential replacement of drugs (Ritalin and Dexedrine) with placebos demonstrated placebo effects of the drugs; behavior therapy, alone and in combination with drugs, was effective in controlling hyperactive behaviors. Implications in regard to drugs as treatment of choice are discussed.- - - - - - - - - - ranking = 1.8keywords = drug (Clic here for more details about this article) |
3/14. Unusual compulsive motor activity during treatment with clothiapine in a mentally retarded adolescent.Atypical antipsychotic agents, specifically those with a high hyposerotonergic activity such as clozapine and clothiapine, have been associated with de novo obsessive-compulsive symptoms. We report the case of a 16-year-old adolescent male with severe mental impairment and disruptive behaviour who developed a compulsive head and body turning disorder on clothiapine. Such a symptom had to be distinguished from epileptic partial seizures; it promptly disappeared with the drug discontinuation.- - - - - - - - - - ranking = 0.2keywords = drug (Clic here for more details about this article) |
4/14. Unusual ipsilateral hyperkinetic automatisms in SMA seizures.PURPOSE: To describe repetitive movements of the right arm possibly originating from the ipsilateral SMA area in two drug-resistant epileptic patients. methods: Two epileptic patients (one female, one male, 35 and 36 years old, respectively) were submitted to pre-surgical evaluation including history, neurological examination, long-term video-EEG monitoring, interictal and ictal SPET, MRI and fMRI, neuropsychological assessment. Invasive recordings (stereoelectroencephalography) were also performed. RESULTS: In both patients ictal semiology was characterized by very stereotyped repetitive right arm movements, i.e. tapping towards the thorax (movement rate of 6-7 Hz and 3-4 Hz for the two subjects, respectively). seizures in the first patient, whose epilepsy was cryptogenetic, originated from the right pre-SMA area, which was surgically removed. She is seizure free 2 years after the operation. In the second patient, in whom a right pre-frontal post-abscess porencephaly was disclosed, the epileptogenic zone included the lesion and surrounding areas, while the SMA area was involved less consistently. CONCLUSIONS: Even if, according to literature, SMA epilepsy is predominantly characterized by postural manifestations, ipsilateral repetitive movements could be a relevant sign in this kind of epilepsy, as showed in our first patient. The presence of similar semiology in the second patient, might suggest that the symptomatogenic zone involved SMA area.- - - - - - - - - - ranking = 0.2keywords = drug (Clic here for more details about this article) |
5/14. Intraputaminal infusion of nerve growth factor to support adrenal medullary autografts in Parkinson's disease. One-year follow-up of first clinical trial.Experimental studies in rodents show that beta-nerve growth factor can increase the survival, neurite outgrowth, and functional effect of grafts of adrenal chromaffin cells to the basal ganglia. We, therefore, have begun to investigate whether treatment with nerve growth factor might also increase the functional effect of autografts of adrenal medullary tissue in patients with Parkinson's disease. Previous studies have shown that stereotactic implantation of adrenal tissue pieces produces a transient functional improvement that lasts for a few months. This report describes a trial of grafting of adrenal chromaffin tissue into the putamen, supported by infusion of nerve growth factor. The patient is a 63-year-old woman with a 19-year history of Parkinson's disease, now complicated by on-off phenomena and drug-induced hyperkinesia, despite optimized medical management. The left adrenal gland was removed, and the medulla was dissected into 1- to 2-mm3 pieces in a solution containing nerve growth factor purified from mouse submandibular gland. Pieces were implanted in six tracts 3 to 4 mm from a previously placed cannula in the left putamen. Through the cannula, nerve growth factor was infused for 23 days for a total dose of 3.3 mg. Clinical assessment consisted of global ratings for rigidity and/or hypokinesia and for drug-induced hyperkinesia. Measures of gait and fine-motor control were also made. The motor readiness potential and auditory evoked potentials were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.4keywords = drug (Clic here for more details about this article) |
6/14. The effect of central nervous system stimulants on tourette syndrome.A survey of patients with tourette syndrome uncovered 32 who had been exposed to central nervous system stimulants. In 17 (53%) of these patients, symptoms were markedly accentuated by the drugs. Two patients whose tourette syndrome developed suddenly when methylphenidate was administered are also reported.- - - - - - - - - - ranking = 0.2keywords = drug (Clic here for more details about this article) |
7/14. Nutrient intake and stimulant drugs in hyperactive children.Recent studies have demonstrated suppressed growth of height and weight in children receiving stimulant drugs for hyperactivity. For approximately twelve months, growth data and food records were collected on two subjects receiving different types and dosages of stimulant drugs. The two cases demonstrated that dextroamphetamine levels of 10 mg. or more and methylphenidate levels of 30 mg. or more decreased caloric intake significantly. This decrease may be limiting for long-term growth. Both subjects had a variety of feeding problems due to poor appetite. Careful nutritional evaluation and planning are important to insure optimal energy and nutrient intake in these children receiving stimulant drugs.- - - - - - - - - - ranking = 1.4keywords = drug (Clic here for more details about this article) |
8/14. Transient hyperkinesia after a single intravenous perfusion of diphenylhydantoin. Report of a case associated with nontoxic plasma levels of diphenylhydantoin.Transient hyperkinesia was observed in a 16-year-old epileptic and mentally retarded patient after a single intravenous perfusion of diphenylhydantoin (DPH). No clinical signs of DPH intoxication were associated with the movement disorder. Repeated plasma anticonvulsant level determinations never showed toxic concentrations of DPH. Since a few spontaneous episodes of hyperkinesia had been observed before, the DPH intravenous perfusion could have unmasked a preexisting latent movement disorder in our patient. However, neuroradiological investigations failed to demonstrate the existence of any anatomical damage of the basal ganglia, and HVA as well as 5-HIAA levels measured in the CSF with the probenecid technique were within the normal range 2 months after cessation of hyperkinesia. HVA and 5-HIAA levels have also been measured in the CSF during the period with hyperkinesia; the results are discussed with reference to previously published data concerning cerebral monoamine metabolism in drug-treated epileptic patients.- - - - - - - - - - ranking = 0.2keywords = drug (Clic here for more details about this article) |
9/14. Effects of the Feingold diet on seizures and hyperactivity: a single-subject analysis.The effects of a dietary manipulation on seizure frequency and activity level of a 3 1/2-year-old male with tuberous sclerosis, mental retardation, and uncontrolled seizures were assessed. Using a reversal design, the Feingold (K-P) diet was presented and withdrawn three times, while the medication regimen remained unaltered. Every application of the K-P diet resulted in substantial reductions in seizure frequency. During a 21-week follow-up, seizure frequency remained low despite the phasing out of one drug, and seizures were reportedly eliminated 1 year later. Brief objective measures of hyperactivity failed to show any effect due to the diet changes.- - - - - - - - - - ranking = 0.2keywords = drug (Clic here for more details about this article) |
10/14. methylphenidate-induced chorea: case report and pharmacologic implications.In a child with minimal brain dysfunction, we found that chorea was related to the major central effect of methylphenidate and probably to the effect of the drug on central catecholaminergic systems. Also, after 3 weeks of treatment with methylphenidate, guinea pigs showed a hypersensitive response to apomorphine, suggesting that chronic administration of methylphenidate leads to hypersensitivity of receptor sites. chorea beginning shortly after initiation of methylphenidate therapy probably is related to the central dopaminergic effect of the drug; when choreic movements appear after chronic methylphenidate administration, altered responsiveness of striatal dopamine receptor sites may be responsible.- - - - - - - - - - ranking = 0.4keywords = drug (Clic here for more details about this article) |
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