ABSTRACT
OBJECTIVE: Sensory symptoms are common in patients with Parkinson disease (PD), although its exact prevalence and causes are not well known. We aimed to investigate whether peripheral pathology contribute to chronic sensory symptoms in patients with PD by nerve conduction test. METHODS: We recruited consecutively 34 patients with clinically probable PD (Hoehn-Yahr stage, 1–3) who developed persistent sensory symptoms in their lower extremities during optimal dopamine replacement therapy. Twenty-five patients who are above age of 70 or have other possible causes of neuropathy as determined by laboratory testing or medical record were excluded. Age- and gender-matched PD patients with same disease severity who have never developed sensory symptom during the same period were allocated to paired controls. Total 18 subjects participated in this study. Nerve conduction tests on peroneal motor nerve and sural sensory nerve were performed in all subjects. Amplitude and conduction velocity were compared between the paired subjects using Wilcoxon signed rank test. RESULTS: Subjective sensory symptoms of the 9 patients were variable: pain (4/9), chilling (3/9), burning (1/9), and tingling sense (1/9). There were no significant difference of mean values of compound muscle action potential/sensory nerve action potential amplitude and conduction velocity between patients and their paired controls. CONCLUSION: This study supports the hypothesis that the origin of chronic sensory symptoms in PD patients is more central than peripheral.
Subject(s)
Humans , Action Potentials , Burns , Dopamine , Levodopa , Lower Extremity , Medical Records , Neural Conduction , Parkinson Disease , Pathology , PrevalenceABSTRACT
BACKGROUND: Cardiovascular autonomic dysfunction is one of the most frequent non-motor symptoms in idiopathic Parkinson disease (IPD). Several cardiovascular autonomic indexes (CAIs) have been reported to represent the degree of autonomic dysfunction in various neurodegenerative diseases. However, quantitative assessment by autonomic function tests in IPD has not been fully evaluated yet. The aim of this study is to investigate the usefulness of the quantitative autonomic test for detecting subclinical cardiovascular autonomic dysfunction and their correlation to the clinical severity of motor symptoms in IPD. METHODS: Four parasympathetic and sympathetic indexes during cardiovascular autonomic tests were compared between patients with IPD (n=31, age=65.8+/-9.14, Hoen&Yahr (H&Y) stage=2.1+/-0.68) and age matched healthy controls (n=30, age=63.2+/-7.56). Parasympathetic indexes include expiration:inspiration ratio (E:I ratio), valsalva ratio, 30:15 ratio, and vagal barosensitivity. Sympathetic indexes are pressure recovery time, sympathetic index 1, sympathetic index 3 and adrenergic baroseneitivity. To demonstrate the correlation between severity of clinical motor symptoms and the autonomic abnormality, we also compared the H&Y stage and the abnormalities of those CAIs. RESULTS: E:I ratio (p=0.009) and Valsalva ratio (VR) (p<0.001) were significantly different between IPD and control groups. Among the parameters, E:I ratio (r=-0.466, p=0.005) showed significant negative correlation with severity of clinical motor symptoms in IPD (H&Y< or =3). CONCLUSIONS: Among the CAIs, E:I ratio, VR are useful in detecting subclinical autonomic cardiovascular dysfunction in IPD. E:I ratio may be the possible evaluation method revealing the severity of clinical motor symptoms in IPD.
Subject(s)
Humans , Neurodegenerative Diseases , Parkinson DiseaseABSTRACT
Creutzfeldt-Jakob disease (CJD) is a human prion disease with rapidly progressive neurodegeneration. The major clinical manifestations of CJD include mental deterioration, myoclonus, cerebellar dysfunction, and neuro-ophthalmic symptoms and signs. However, abnormal eye movements as an early sign of CJD are rare. We report a 49-year-old man with periodic alternating nystagmus in early disease course.
Subject(s)
Humans , Middle Aged , Cerebellar Diseases , Creutzfeldt-Jakob Syndrome , Eye Movements , Fixation, Ocular , Myoclonus , Nystagmus, Pathologic , Prion DiseasesABSTRACT
A 54-year-old man presented with primary position upbeat nystagmus and wall-eyed bilateral internuclear ophthalmoplegia. He also showed bilateral limb ataxia and impaired horizontal gaze. Upbeat nystagmus obeyed Alexander's law and attenuated by visual fixation and disappeared by convergence. Brain magnetic resonance imaging showed acute infarction in the bilateral paramedian midbrain involving the crossing of brachium conjunctivum. Multiple mechanisms including the interruption of central vestibulo-ocular projections from anterior canal may be postulated in upbeat nystagmus of this patient.
Subject(s)
Humans , Middle Aged , Ataxia , Brain , Cerebral Infarction , Infarction , Jurisprudence , Magnetic Resonance Imaging , Mesencephalon , Ocular Motility Disorders , OphthalmoplegiaABSTRACT
No abstract available.