1/7. Psychogenic palatal tremor.Recent criteria for the classification of palatal tremor use clinical, imaging, and electrophysiological features to differentiate essential and symptomatic forms. A case of probable psychogenic palatal tremor (PPT) is described within the context of these criteria, which lack clear guidelines for diagnosing PPT. The heterogenous nature of essential palatal tremor and its relationship with PPT, voluntary palatal movements, and tics is discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/7. Isolated tongue tremor after gamma knife radiosurgery for acoustic schwannoma.We describe a patient who had an isolated tongue tremor with an audible click after gamma knife radiosurgery for acoustic schwannoma. The nature of the tongue tremor was clearly demonstrated by videofluoroscopy. The possible pathogenic mechanisms are discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/7. Neuroleptic-induced parkinsonism and Parkinson's disease: differential diagnosis and treatment.Although Parkinson's disease can occur in individuals with psychosis, a patient on antipsychotic medication who develops parkinsonian signs may more readily be diagnosed as and treated for neuroleptic-induced parkinsonism. There are several clinically significant criteria that may aid in proper diagnosis, including clinical course, time and age of onset, nature of tremor, unilaterality of signs, and response to anticholinergic medication. Appropriate diagnosis is essential, as treatment approaches differ for the two disorders. Four case studies are presented to highlight the diagnostic criteria and therapeutic ramifications.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/7. Brief communication: electromagnetic fields improve visuospatial performance and reverse agraphia in a parkinsonian patient.A 73 year old right-handed man, diagnosed with Parkinson's disease (PD) in 1982, presented with chief complaints of disabling resting and postural tremors in the right hand, generalized bradykinesia and rigidity, difficulties with the initiation of gait, freezing of gait, and mild dementia despite being fully medicated. On neuropsychological testing the Bicycle Drawing Test showed cognitive impairment compatible with bitemporal and frontal lobe dysfunction and on attempts to sign his name he exhibited agraphia. After receiving two successive treatments, each of 20 minutes duration, with AC pulsed electromagnetic fields (EMFs) of 7.5 picotesla intensity and 5 Hz frequency sinusoidal wave, his drawing to command showed improvement in visuospatial performance and his signature became legible. One week later, after receiving two additional successive treatments with these EMFs each of 20 minutes duration with a 7 Hz frequency sinusoidal wave, he drew a much larger, detailed and visuospatially organized bicycle and his signature had normalized. Simultaneously, there was marked improvement in Parkinsonian motor symptoms with almost complete resolution of the tremors, start hesitation and freezing of gait. This case demonstrates the dramatic beneficial effects of AC pulsed picotesla EMFs on neurocognitive processes subserved by the temporal and frontal lobes in Parkinsonism and suggest that the dementia of Parkinsonism may be partly reversible.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
5/7. dystonia secondary to electrical injury: surface electromyographic evaluation and implications for the organicity of the condition.We describe a patient who developed right arm dystonia following an electrical injury. The patient's arm remained adducted, and flexed at the elbow and wrist, with all movement resulting in pain and tremor. Surface electromyographic evaluation revealed constant tonic activity of multiple upper and lower arm muscles at rest, that was not distractible. Voluntary and passive movement of the elbow or wrist resulted in high amplitude EMG activity, with motor grouping at 11 Hz at the elbow and 8 Hz at the wrist. Although a diagnosis of psychogenic dystonia was entertained, the stereotyped nature of the movement disorder and lack of variability on clinical and surface EMG evaluation support an organic disorder that was temporally-related to an electrical injury.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/7. Electrophysiological aids in distinguishing organic from psychogenic tremor.The clinical differentiation of tremors of organic and psychogenic origin can be difficult. We describe a patient with unilateral upper limb tremor that was initially considered to have a psychogenic cause, but subsequent frequency analysis of EMG signals and accelerometer recordings indicated that the tremor was organic in nature. An ischemic lesion in the contralateral lentiform nucleus found on MRI supported this conclusion. Quantitative electrophysiologic studies may thus be useful in distinguishing organic from psychogenic tremor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/7. Shuddering attacks in children: an early clinical manifestation of essential tremor.Six infants and children presenting with shuddering attacks had evidence and a family history of essential tremor. Although this association had not been recognized, the shuddering spells caused considerable concern and led to a wide range of diagnoses. The attacks start in infancy or early childhood, are brief, often associated with some posturing, and may be very frequent. They are benign and tend to become less frequent or to remit during the latter part of the first decade. The recognition of this syndrome should avoid unnecessary investigation and concern. The pathophysiology of shuddering attacks seems to represent an expression of the mechanism of essential tremor in the immature brain. The ultimate nature of these attacks will undoubtedly be clarified when a neurochemical basis for essential tremor is found.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |