1/11. Intrathecal baclofen for generalized dystonia: a case report.Dystonia is an abnormal movement characterized by sustained muscle contractions, frequently causing twisting and repetitive movements or abnormal postures. Primary generalized dystonia usually evolves to a debilitating condition, often unresponsive to oral pharmacologic regimens or physical rehabilitation. We present the case of a patient with idiopathic adult-onset generalized dystonia who was recalcitrant to oral therapies. This patient was treated with intrathecal baclofen therapy and responded dramatically with improved functional abilities, resolution of chronic pain, and an improved rating on the dystonia scale.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. syringomyelia presenting as paroxysmal arm posturing resembling seizures.A 9-year-old female presented with daily episodes of medically refractory paroxysmal bilateral arm posturing, which had long been thought to be epileptic seizures. She also had other types of episodes, including daily staring spells and infrequent generalized tonic-clonic convulsions. neurologic examination was normal except for delayed cognitive development. The results of previous electroencephalograms (EEG) were normal, and magnetic resonance imaging of the head revealed a Chiari I malformation. Video EEG monitoring revealed no EEG changes during the attacks, and magnetic resonance imaging of the spine revealed a large cervical syrinx associated with the Chiari malformation. The episodes of paroxysmal bilateral dystonic arm posturing resolved after surgical intervention for the syrinx. This report illustrates that cervical cord disease is an unusual although potentially treatable condition to be considered in the differential diagnosis of paroxysmal episodes with dystonic movements of the arms, even in the absence of other physical findings of myelopathy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. Dystonic attacks related to sleep and exercise.Two unrelated children displayed attacks of paroxysmal jerky 'puppet-like' movements lasting 2-3 min. The attacks were not kinesigenic and occurred during wakefulness precipitated by physical exercise and during NREM sleep, spontaneous or upon arousal and awakenings. Paroxysmal dystonic choreoathetosis was excluded by the absent family history, and paroxysmal kinesigenic dystonia by the absence of triggering effects by sudden movements and efficacy of anticonvulsants. Pattern and duration of involuntary movements were not those typical of nocturnal paroxysmal dystonia. Our cases emphasize that overlap exists among the different clinical categories of paroxysmal dyskinesia.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/11. Treatment of inferior lateral pterygoid muscle dystonia with zolpidem tartrate, botulinum toxin injections, and physical self-regulation procedures: a case report.The following case report depicts the management of a patient suffering with a jaw opening oromandibular dystonia using a combination of botulinum toxin injections, zolpidem, and relaxation procedures. Eventually the botulinum toxin injections were eliminated, and the patient was maintained with only zolpidem and relaxation procedures.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
5/11. Tardive dystonia in Chinese.Three Chinese patients with the under-recognized condition of tardive dystonia are described. This is a physically and socially handicapping complication of neuroleptic treatment. A past history of acute dystonia does not appear to predict the future development of tardive dystonia. The need for judicious indication of neuroleptics is emphasised.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/11. Hypnogenic paroxysmal dystonia: a new type of parasomnia?Four cases of hypnogenic paroxysmal dystonia are described. The patients (three males and one female), aged between 12 and 39 were subjected to neurological, physical and psychological examination, and routine lab tests and brain CT scan were carried out within normal limits. One of the patients suffered from diurnal epileptic seizures. Repeated EEG recordings during wakefulness were normal. During polysomnographic and TV recordings the patients showed different types of dystonic fits occurring several times a night, always brief, and starting during NREM sleep. carbamazepine therapy proved to be relatively effective in three subjects.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/11. Neurologic symptoms in a depressed woman. A medical-psychiatric case conference.A 48-year-old woman with head and neck pain and upper extremity weakness demonstrated equivocal neurologic findings and otherwise essentially negative laboratory and x-ray evaluations. An interview at a case conference revealed significant depression, severe marital discord, and a poor self-image. The correlation of the onset of her physical symptoms with certain life events suggested that psychologic factors were important contributors to her disorder. Discussed here are an approach to understanding such problem patients and methods of ongoing management.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/11. Drug-induced dystonia in a patient with C4 quadriplegia. Case report.prochlorperazine, a piperazine phenothiazine, is a commonly used anti-emetic that blocks dopamine receptors in the central nervous system. prochlorperazine causes various extrapyramidal syndromes, with the incidence in the inpatient population estimated to be 0.5 to 0.8%. These side effects are typically manifested by motor dysfunction and easily observed on physical examination. We report the case of an 18-year-old male with C4 complete quadriplegia who developed an acute dystonic reaction isolated to the tongue during short-term treatment with prochlorperazine. This case demonstrates the importance of maintaining a high level of suspicion in the spinal cord population, considering that many key physical findings may be absent below the level of function.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
9/11. Dopa-responsive dystonia of childhood: a case report.A 5-year-old Chinese boy presented with difficulty in walking and weakness of his lower limbs for one year, especially towards the evening. Bilateral equinovarus posturing of the feet and tremors of the upper limbs were noted on physical examination. Dopa-responsive dystonia was diagnosed after a remarkable symptomatic response to levodopa. This disorder is reported here to highlight an often misdiagnosed condition is children which is important because it is treatable. Dopa-responsive dystonia should be considered in the differential diagnosis of gait disturbance in children.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/11. hypnosis and spasmodic torticollis--report of four cases: a brief communication.Dystonia and particularly spasmodic torticollis are neuromuscular disorders that are extremely resistant to most therapies (physical, medical, or surgical). torticollis is a unilateral spasm of the neck muscles, particularly of the sternocleidomastoid, that produces violent, tonic turning of the head to one side. The etiology remains uncertain, although the role of psychogenic factors has been emphasized. This article reviews the literature and reports four cases of spasmodic torticollis treated successfully with hypnosis. In all four cases, psychogenic causes were involved. Postural hypnosis (i.e., hypnosis in the standing position) was employed to counteract and minimize muscle spasms due to postural reflexes. A hypnobehavioral approach was adopted along with hypnotic strategies that included hierarchical desensitization, sensory-imaging conditioning, ego-boosting suggestions, and hypnosis-facilitated differential muscle retraining. In two cases, a combined hypnosis and electromyographic-biofeedback approach was used to equilibrate and retrain affected neck muscles. Although the hypnotherapeutic process took several months to induce and stabilize significant changes, outcome results were good to excellent in all cases, with marked reduction of the torticollis and the hypertrophy of the neck muscles as well as a reduced interference of symptoms in daily living.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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