Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 45
Filter
1.
Arq. neuropsiquiatr ; 78(8): 512-522, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131740

ABSTRACT

ABSTRACT Background: Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system. Objective: We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice. Methods: Non-systematic review of the literature published up to June 2019. Results: A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus. Conclusion: These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.


RESUMO Introdução: Os estudos neurofisiológicos são métodos auxiliares para compreender melhor as características e a natureza dos distúrbios do movimento. A eletromiografia (EMG), em associação com o eletroencefalograma (EEG) e o acelerômetro, podem ser utilizados para avaliar um espectro de movimentos hipo e hipercinéticos. Técnicas específicas podem ser aplicadas para melhor caracterizar a fenomenologia, ajudar a distinguir a origem psicogênica da orgânica e avaliar o local mais provável de geração do movimento no sistema nervoso. Objetivo: Pretendemos fornecer ao clínico uma atualização sobre ferramentas neurofisiológicas úteis para avaliar distúrbios do movimento na prática clínica. Métodos: Revisão não sistemática da literatura publicada até junho de 2019. Resultados: Uma diversidade de protocolos foi encontrada e descrita. Dentre eles, inclui-se o uso de EMG para a definição do padrão de distonia, mioclonia, mioquimia, miorritmia e painfull legs moving toes, além do uso de EMG em associação ao acelerômetro para avaliar tremor e, em associação ao EEG para avaliar mioclonia. Ademais, técnicas para medida indireta de excitabilidade cortical e do tronco encefálico ajudam a descrever e diagnosticar a fisiologia anormal da doença de Parkinson, parkinsonismo atípico, distonia e mioclonia. Conclusão: Esses estudos podem ser úteis para o diagnóstico e geralmente são subutilizados na prática neurológica.


Subject(s)
Humans , Dystonia , Movement Disorders/diagnosis , Myoclonus/diagnosis , Tremor/diagnosis , Electroencephalography , Electromyography , Neurophysiology
2.
CoDAS ; 32(4): e20190132, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1101097

ABSTRACT

RESUMO Objetivo Este estudo visou validar o Protocolo de Avaliação Miofuncional Orofacial MBGR para adultos com DTM. Método Participaram 30 adultos, sendo 15 com DTM (deslocamento de disco com redução segundo o Research Diagnostic Criteria for Temporomandibular Disorders) e 15 Controles. O processo de validação envolveu a validade de conteúdo, de critério e de construto, além da concordância inter e intra-avaliador, sensibilidade e especificidade. Considerou-se nível de significância de 5%. Resultados Foram confirmadas as validades de conteúdo, visto que o Protocolo MBGR abarca todas as questões funcionais presentes em indivíduos com DTM; de critério, com correlações significantes entre o MBGR e AMIOFE; e de construto, diferenciando indivíduos com e sem DMO quanto à dor à palpação e mobilidade mandibular, com correlação significante entre a avaliação clínica do MBGR e o uso do algômetro digital, bem como confirmação do exame instrumental para a classificação do modo respiratório. A força de concordância variou de pobre a muito boa para a análise interavaliador e de razoável a muito boa para intra-avaliador. Os valores de sensibilidade e especificidade foram elevados. Conclusão O Protocolo MBGR mostrou-se válido para aplicação em adultos com DTM com deslocamento de disco com redução e controles, contemplando todos os aspectos que possibilitam a análise das condições oromiofuncionais nesses indivíduos.


ABSTRACT Purpose This study aimed at validating the MBGR Orofacial Myofunctional Assessment Protocol (MBGR Protocol) for adults with Temporal Mandibular Disorders (TMD). Methods The study sample was composed of 30 adults: 15 with TMD (disc displacement with reduction according to the Research Diagnostic Criteria for Temporomandibular Disorders) and 15 control individuals. The validation process encompassed the content, criterion, and construct of the protocol, as well as its inter- and intra-rater agreement levels and sensitivity and specificity values, considering a 5% statistical significance level. Results The following validities were confirmed: of content, as the MBGR Protocol covers all functional issues present in patients with TMD; of criterion, with significant correlations between the MBGR and Orofacial Myofunctional Evaluation with Scores (OMES) protocols; of construct, differentiating individuals with and without Orofacial Myofunctional Disorders (OMD) as for pain on palpation and mandible range of motion, with significant correlation between the MBGR clinical evaluation and that using a digital algometer, as well as confirmation of the instrumental assessment for the breathing mode classification. Agreement ranged from poor to very good and from reasonable to very good for the inter- and intra-rater power analyses, respectively. High sensitivity and specificity values were observed. Conclusion The MBGR Protocol proved to be valid for use in adults presented with TMD with disc displacement with reduction and controls, covering all aspects that enable the analysis of OMD in these individuals.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Deglutition Disorders/diagnosis , Temporomandibular Joint Disorders/diagnosis , Mass Screening/instrumentation , Facial Muscles/physiopathology , Mandible/physiopathology , Pain Measurement , Deglutition Disorders/physiopathology , Temporomandibular Joint Disorders/physiopathology , Case-Control Studies , Mass Screening/statistics & numerical data , Sensitivity and Specificity , Movement Disorders/diagnosis , Movement Disorders/physiopathology
3.
Geriatr., Gerontol. Aging (Impr.) ; 13(2): 118-120, abr-jun.2019. ilus
Article in Portuguese | LILACS | ID: biblio-1096825

ABSTRACT

O diabetes e suas complicações constituem as principais causas de mortalidade precoce na maioria dos países. O envelhecimento da população e a crescente prevalência da obesidade e do sedentarismo, além dos processos de urbanização, são considerados os principais fatores responsáveis pelo aumento da incidência e da prevalência do diabetes mellitus (DM) em todo o mundo. Este relato de caso objetiva descrever a presença de distúrbio do movimento em idoso por conta do estado hiperosmolar não cetótico. A combinação de hemicoreia-hemibalismo, hiperglicemia não cetótica e envolvimento dos gânglios da base em exames de imagem é considerada uma síndrome única. Os distúrbios do movimento em estado hiperosmolar não cetótico apresentam resposta terapêutica satisfatória com o uso de neurolépticos e controle glicêmico adequado. A escassez de trabalhos publicados proporciona subdiagnósticos clínico e laboratorial, interferindo no prognóstico e no acompanhamento dos pacientes.


Diabetes mellitus (DM) and its complications constitute the leading causes of early mortality in most countries. Population aging and the growing prevalence of obesity and sedentary lifestyles, in addition to spreading urbanization, are considered the main drivers of the increasing incidence and prevalence of DM worldwide. This case report describes the acute onset of movement disorder in an older woman secondary to hyperosmolar hyperglycemic state (HHS). The combination of hemichorea­hemiballismus, HHS, and evidence of basal ganglia involvement on neuroimaging is considered a unique syndrome. Movement disorders secondary to HHS respond satisfactorily to administration of neuroleptic agents and proper glycemic control. The lack of published studies on this pathologic entity may lead to clinical and laboratory underdiagnosis, with negative impacts on patient prognosis and follow-up.


Subject(s)
Humans , Female , Aged , Chorea/drug therapy , Chorea/diagnostic imaging , Hyperglycinemia, Nonketotic/complications , Dyskinesias/drug therapy , Dyskinesias/diagnostic imaging , Diabetes Complications , Psychotropic Drugs/therapeutic use , Diabetes Mellitus/physiopathology , Hypoglycemic Agents , Movement Disorders/diagnosis
4.
Arq. neuropsiquiatr ; 76(10): 716-719, Oct. 2018. graf
Article in English | LILACS | ID: biblio-973917

ABSTRACT

ABSTRACT Recognizing the semiologic importance of the second, and most famous, sign described by Joseph Babinski - the extension of the hallux after stimulation of the plantar region in order to differentiate organic from pithiatic paralysis- several authors have tried to find a comparable signal in the hand. After 122 years, no one has succeeded.


RESUMO Reconhecida a importância semiológica do segundo e mais famoso sinal descrito por Joseph Babinski - a extensão do hálux após estimulo plantar visando diferenciar a paralisia orgânica da pitiática - diversos autores vêm tentando encontrar um sinal equiparável na mão. Após 122 anos ninguém conseguiu obter sucesso.


Subject(s)
Humans , History, 19th Century , History, 20th Century , Reflex, Babinski , Movement Disorders/history , France , History , Movement Disorders/diagnosis
5.
Medicina (B.Aires) ; 78(supl.2): 52-56, set. 2018.
Article in Spanish | LILACS | ID: biblio-955015

ABSTRACT

Los trastornos paroxísticos no epilépticos son comunes en la población de niños pre-escolares. Estas condiciones incluyen una variedad de eventos cuyas manifestaciones y fisiopatología son muy distintas. Por esa razón, el diagnóstico puede representar un difícil reto. En algunas ocasiones, estudios como el EEG o la polisomnografía pueden ayudar a clarificar el diagnóstico y descartar un trastorno epiléptico. Sin embargo, la historia clínica y el examen físico suelen ser suficientes para llegar al diagnóstico correcto. En este artículo, presentamos información sobre los trastornos paroxísticos no epilépticos más comunes en la población de niños pre-escolares, incluyendo: tics, discinesias, eventos relacionados al sueño, etc. Además, discutimos estrategias para el diagnóstico y opciones de tratamiento.


Paroxysmal events are commonly encountered in toddlers. These events include a variety of conditions with different manifestations and pathophysiology. For that reason, the diagnosis of these events can be challenging. In some instances, studies such as EEG and polysomnogram may be useful to differentiate between epileptic and non-epileptic events. In the majority of cases, a complete clinical history is enough to make an appropriate diagnosis. In this article, we review some of the most common paroxysmal non-epileptic events affecting toddlers, such as: tics, dyskinesias, sleep related events, etc. We also discuss diagnostic strategies and treatment options.


Subject(s)
Humans , Child, Preschool , Dyskinesias/diagnosis , Epilepsy/diagnosis , Movement Disorders/diagnosis , Polysomnography , Dyskinesias/classification , Diagnosis, Differential , Electroencephalography , Movement Disorders/classification
6.
CoDAS ; 29(6): e20170042, 2017. tab
Article in English | LILACS | ID: biblio-890811

ABSTRACT

ABSTRACT Purpose To develop a comprehensive assessment protocol for identifying, classifying and grading changes in stomatognathic system components and functions of older people, to determine its psychometric properties and verify its association with oral health and age. Methods The content validity of the Orofacial Myofunctional Evaluation with Scores for Elders protocol (OMES-Elders) was established based on the literature. The protocol contains three domains: appearance/posture, mobility, and functions of the stomatognathic system. Eighty-two healthy elder volunteers (mean age 69±7.24 years) were evaluated using the OMES-Elders. A test-screening for orofacial disorders (reference) was used to analyze the concurrent validity (correlation test), sensitivity, specificity and accuracy (Receiver Operating Characteristic Curve: ROC curve) of the OMES-Elders. The association of the OMES-Elders scores with the Oral Health Index (OHX) and age in the sample was tested. Results There was a significant correlation between the OMES-Elders and the reference test (p < 0.001). Reliability coefficients ranged from good (0.89) to excellent (0.99). The OMES-Elders protocol had a sensitivity of 82.9%, specificity of 83.3% and accuracy of 0.83. The scores of the protocol were significantly lower in individuals with worse oral health (OHX ≤ 61%), although individuals with adequate oral health (OHX ≥ 90%) also had myofunctional impairments. The predictors OHX and age explained, respectively, 33% and 30% of the variance in the OMES-Elders total score. Conclusion As the first specific orofacial myofunctional evaluation of older people, the OMES-Elders protocol proved to be valid, reliable and its total score was associated with oral health and age.


RESUMO Objetivo Desenvolver um protocolo de avaliação abrangente para identificar, classificar e graduar as mudanças nos componentes e funções do sistema estomatognático em pessoas idosas, determinar suas propriedades psicométricas e verificar a associação com a saúde oral e a idade. Método A validade de conteúdo do protocolo de Avaliação Miofuncional Orofacial com Escores para Idosos (AMIOFE-I), que contém três domínios, aparência/postura, mobilidade e funções do sistema estomatognático, foi estabelecida com base na literatura. Oitenta e dois voluntários idosos (média de idade 69±7,24 anos) foram avaliados usando o AMIOFE-I. Um teste de triagem de distúrbios miofuncionais (referência) foi empregado para as análises de validade concorrente (teste de correlação), sensibilidade, especificidade e acurácia (Receiver Operating Characteristic Curve: curva ROC) do AMIOFE-I. Também foi analisada a associação dos escores do AMIOFE-I com o índice de saúde oral (ISO), determinado na amostra, e à idade. Resultados Houve uma significante correlação entre o AMIOFE e o teste de referência. Os coeficientes de confiabilidade variaram de bom a excelente. O AMIOFE apresentou sensibilidade de 82,9%, especificidade de 83,3% e acurácia de 0,83. Os escores do AMIOFE-I foram significantemente menores em indivíduos com piores ISO (≤ 61%), contudo aqueles com adequada saúde oral (ISO ≥ 90%) também tinha prejuízos miofuncionais. Os preditores ISO e idade explicaram respectivamente 33% e 30% da variância no escore total do AMIOFE-I. Conclusão O protocolo AMIOFE-I, o primeiro específico para a avaliação miofuncional de idosos, mostrou-se válido, confiável e seu escore total foi associado à saúde oral e à idade.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Deglutition Disorders/diagnosis , Clinical Protocols , Movement Disorders/diagnosis , Psychometrics , Oral Health , Reproducibility of Results , Sensitivity and Specificity , Age Factors , Myofunctional Therapy , Facial Muscles/physiopathology , Middle Aged
7.
J. pediatr. (Rio J.) ; 92(3,supl.1): 64-70, graf
Article in English | LILACS | ID: lil-787521

ABSTRACT

Abstract Objectives: To describe fidgety movements (FMs), i.e., the spontaneous movement pattern that typically occurs at 3–5 months after term age, and discuss its clinical relevance. Sources: A comprehensive literature search was performed using the following databases: MEDLINE/PubMed, CINAHL, The Cochrane Library, Science Direct, PsycINFO, and EMBASE. The search strategy included the MeSH terms and search strings (‘fidgety movement*’) OR [(‘general movement*’) AND (‘three month*’) OR (‘3 month*’)], as well as studies published on the General Movements Trust website (www.general-movements-trust.info). Summary of the data: Virtually all infants develop normally if FMs are present and normal, even if their brain ultrasound findings and/or clinical histories indicate a disposition to later neurological deficits. Conversely, almost all infants who never develop FMs have a high risk for neurological deficits such as cerebral palsy, and for genetic disorders with a late onset. If FMs are normal but concurrent postural patterns are not age-adequate or the overall movement character is monotonous, cognitive and/or language skills at school age will be suboptimal. Abnormal FMs are unspecific and have a low predictive power, but occur exceedingly in infants later diagnosed with autism. Conclusions: Abnormal, absent, or sporadic FMs indicate an increased risk for later neurological dysfunction, whereas normal FMs are highly predictive of normal development, especially if they co-occur with other smooth and fluent movements. Early recognition of neurological signs facilitates early intervention. It is important to re-assure parents of infants with clinical risk factors that the neurological outcome will be adequate if FMs develop normally.


Resumo Objetivos: Descrever os movimentos irregulares (FMs), ou seja, o padrão de movimentos espontâneos que normalmente ocorrem entre três e cinco meses após o nascimento e discutir sua relevância clínica. Fontes: Uma pesquisa abrangente na literatura foi feita nas seguintes bases de dados: Medline/PubMed, Cinahl, The Cochrane Library, Science Direct, PsycINFO e Embase. A estratégia de busca incluiu os termos e cadeias de pesquisa do MeSH [(“fidgety movement*”) OU [(“general movement*”) E (“three month*”) OU (“3 month*”)], bem como estudos publicados no website da General Movements Trust (www.general-movements-trust.info). Resumo dos dados: Praticamente todos os neonatos se desenvolveram normalmente se os FMs estiveram presentes e foram normais, mesmo se seus resultados do ultrassom do cérebro e/ou históricos clínicos indicassem tendência a déficits neurológicos posteriores. Por outro lado, quase todos os neonatos que nunca desenvolveram FMs apresentaram maior risco de déficits neurológicos, como paralisia cerebral, e doenças genéticas de início tardio. Caso os FMs fossem normais, porém simultâneos a padrões posturais não adequados para a idade, ou o caráter geral dos movimentos fosse monótono, as capacidades cognitivas e/ou de linguagem na idade escolar seriam abaixo do ideal. Os FMs anormais não são específicos e têm baixo poder preditivo, porém ocorrem em grande parte em neonatos posteriormente diagnosticados com autismo. Conclusões: FMs anormais, ausentes ou esporádicos indicam um risco maior de disfunções neurológicas posteriores, ao passo que FMs normais são altamente preditivos de desenvolvimento normal, principalmente se forem simultâneos a outros movimentos suaves e fluentes. O reconhecimento precoce de sinais neurológicos facilita a intervenção antecipada. É importante garantir aos pais de neonatos com fatores de risco clínicos que o resultado neurológico será adequado se os FMs se desenvolverem normalmente.


Subject(s)
Humans , Infant, Newborn , Infant , Infant Behavior/physiology , Motor Activity/physiology , Movement Disorders/physiopathology , Time Factors , Cerebral Palsy/diagnosis , Cerebral Palsy/physiopathology , Predictive Value of Tests , Risk Factors , Age Factors , Movement Disorders/diagnosis , Movement Disorders/etiology , Neurologic Examination
8.
Iatreia ; 27(3): 290-298, jul.-set. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-720251

ABSTRACT

Introducción: la prueba 8 foot up & go evalúa el balance dinámico y la agilidad del adulto mayor. Aunque se ha evaluado su reproducibilidad en población norteamericana, se desconoce si funciona de manera similar en una población diferente como la colombiana. Objetivo: evaluar la reproducibilidad prueba-reprueba y el nivel de acuerdo de la prueba 8 foot up & go para la evaluación funcional del balance dinámico y la agilidad en una muestra de adultos mayores de Bucaramanga. Materiales y métodos: se llevó a cabo un estudio de evaluación de pruebas diagnósticas en 114 adultos mayores. Se evaluó la reproducibilidad prueba-reprueba mediante el coeficiente de correlación intraclase (CCI [2,1]) con sus respectivos intervalos de confianza del 95% (IC95%). El nivel de acuerdo se estableció mediante el método de Bland y Altman. Resultados: la reproducibilidad prueba-reprueba fue muy buena (CCI: 0,98; IC95%: 0,98-0,99); se encontró buen nivel de acuerdo para las mujeres (promedio de las diferencias [PD] = 0,04 segundos y límites de acuerdo [LA]: -1,27; 1,36 segundos) y los individuos institucionalizados (PD = 0,04 segundos [LA]: -3,18; 3,27 segundos). Conclusión: la prueba 8 foot up & go tiene muy buena reproducibilidad y buen nivel de acuerdo en población adulta mayor local colombiana.


Background: The 8 foot up & go test assesses the dynamic balance and agility in elderly people. Its reproducibility has been evaluated in American population, but it is unknown whether it would work similarly in a different population like the Colombian. Objective: To evaluate the test-retest reliability and agreement level of the 8 foot up & go test in a sample of older adults from Bucaramanga, Colombia. Materials and methods: An evaluation of diagnostic tests was done in 114 elderly individuals. In the analysis, we assessed the test-retest reliability of the 8 foot up & go test by the Intraclass Correlation Coefficient (ICC 2.1) with their respective confidence intervals at 95% (95% CI). The agreement level was established by the Bland-Altman method. Results: The test-retest reliability of the 8 foot up & go test was very good (ICC: 0.98; 95% CI: 0.98- 0.99). The agreement was good in females (mean difference [MD] = 0.04 seconds and limits of agreement [LA]: -1.27; 1.36 seconds), and in elderly institutionalized (MD = 0.04 seconds [LA]: -3.18; 3.27 seconds). Conclusion: The 8 foot up & go test has very good reliability and good agreement in Colombian local elderly population.


Subject(s)
Middle Aged , Aged, 80 and over , Aged/physiology , Movement Disorders/diagnosis
9.
CoDAS ; 26(4): 322-327, July-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-720824

ABSTRACT

PURPOSE: To test the usability of Computerized Orofacial Myofunctional Evaluation (OMES) protocol and analyze its validity. METHODS: The study was divided into three stages: the first stage, production of the computerized version of OMES. The second stage was the validation of the user's interface, in which 100 OMES protocols of a database, filled in printed version, were transferred using the computerized instrument. Necessary changes to the system have occurred at this stage. In the third stage, usability of the OMES protocol in multimedia version, three evaluators transferred data from other 25 printed protocols from database for the computerized version, and the time to transfer the data of each protocol was computed and compared between examiners by one-way ANOVA. Moreover, these evaluators analyzed the usability of computerized protocol according to the "Ten principles of Heuristics usability" as described in the literature. RESULTS: The computerized protocol satisfied the principles of heuristics usability, according to the evaluation of the three Speech-Language Pathology evaluators, and the average time spent by the evaluators to transpose the data of each protocol to the software ranged from 3.1±0.75 to 3.83±0.91 minutes. CONCLUSION: The Computerized AMIOFE protocol is valid and had its usability/functionality confirmed. .


OBJETIVO: Testar a usabilidade do protocolo de Avaliação Miofuncional Orofacial com Escores (AMIOFE) Informatizado e analisar a validade do mesmo. MÉTODOS: Estudo dividido em três etapas: a primeira, produção da versão informatizada do AMIOFE. A segunda etapa consistiu na validação da interface do usuário, na qual 100 protocolos AMIOFE de um banco de dados, preenchidos em versão impressa, foram transferidos empregando o instrumento informatizado. Alterações necessárias no sistema ocorreram nessa etapa. Na terceira etapa, usabilidade da versão multimídia do protocolo AMIOFE, três avaliadoras transferiram os dados de outros 25 protocolos do banco de dados para a versão informatizada, sendo que o tempo para a transferência dos dados de cada protocolo foi computado e comparado entre os examinadores pelo teste ANOVA one-way. Além disso, essas avaliadoras analisaram a usabilidade do protocolo informatizado de acordo com os "Dez princípios de usabilidade Heurística", como descritos na literatura. RESULTADOS: O protocolo informatizado satisfez aos princípios de usabilidade heurística, de acordo com a avaliação das três avaliadoras fonoaudiólogas, e o tempo médio despendido pelas avaliadoras para a transposição dos dados de cada protocolo para o software variou de 3,1±0,75 a 3,83±0,91 minutos. CONCLUSÃO: O protocolo AMIOFE Informatizado é válido e teve sua usabilidade/funcionalidade confirmada. .


Subject(s)
Humans , Deglutition Disorders/diagnosis , Malocclusion/diagnosis , Movement Disorders/diagnosis , Clinical Protocols , Diagnosis, Computer-Assisted , Facial Muscles/physiopathology , Mastication/physiology , Movement Disorders/physiopathology , Reproducibility of Results , Severity of Illness Index , User-Computer Interface
10.
Arq. neuropsiquiatr ; 72(5): 373-377, 05/2014. tab, graf
Article in English | LILACS | ID: lil-709360

ABSTRACT

Bizarre, purposeless movements and inconsistent findings are typical of conversive gaits. The objective of the present paper is to review some phenomenological aspects of twenty-five consecutive conversive gait disorder patients. Some variants are typical – knees give way-and-recover presentation, monoparetic, tremulous, and slow motion – allowing clinical diagnosis with high precision.


Movimentos bizarros, sem finalidade e inconsistentes são típicos das marchas conversivas. O objetivo deste artigo é descrever os aspectos fenomenológicos de vinte e cinco pacientes com distúrbio conversivo da marcha, salientando que algumas variantes são tão típicas – dobrando os joelhos e recuperando, monoparética, trêmula e em câmara lenta – que praticamente não possuem diagnóstico diferencial.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Conversion Disorder/diagnosis , Gait Disorders, Neurologic/diagnosis , Movement Disorders/diagnosis , Conversion Disorder/physiopathology , Gait Disorders, Neurologic/physiopathology , Medical Illustration , Movement Disorders/physiopathology , Time Factors , Walking/physiology
11.
Rev. bras. psiquiatr ; 36(supl.1): 65-68, 2014.
Article in English | LILACS | ID: lil-727710

ABSTRACT

According to current proposals for ICD-11, stereotyped movement disorder will be classified in the grouping of neurodevelopmental disorders, with a qualifier to indicate whether self-injury is present, similar to the classification of stereotypic movement disorder in DSM-5. At the same time, the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders has proposed a grouping of body-focused repetitive behavior disorders within the obsessive-compulsive and related disorders (OCRD) cluster to include trichotillomania and skin-picking disorder. DSM-5 has taken a slightly different approach: trichotillomania and excoriation (skin picking) disorder are included in the OCRD grouping, while body-focused repetitive behavior disorder is listed under other specified forms of OCRD. DSM-5 also includes a separate category of nonsuicidal self-injury in the section on “conditions for further study.” There are a number of unresolved nosological questions regarding the relationships among stereotyped movement disorder, body-focused repetitive behavior disorders, and nonsuicidal self-injury. In this article, we attempt to provide preliminary answers to some of these questions as they relate to the ICD-11 classification of mental and behavioral disorders.


Subject(s)
Humans , Trichotillomania/diagnosis , International Classification of Diseases , Self-Injurious Behavior/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Movement Disorders/diagnosis , Obsessive-Compulsive Disorder/diagnosis , Stereotyping , Diagnosis, Differential , Movement Disorders/classification
14.
Arq. neuropsiquiatr ; 70(6): 453-461, June 2012. tab
Article in English | LILACS | ID: lil-626287

ABSTRACT

Movement disorders (MD) encompass acute and chronic diseases characterized by involuntary movements and/or loss of control or efficiency in voluntary movements. In this review, we covered situations in which the main manifestations are MDs that pose significant risks for acute morbidity and mortality. The authors examine literature data on the most relevant MD emergencies, including those related to Parkinson's disease, acute drug reactions (acute dystonia, neuroleptic malignant syndrome, serotonergic syndrome and malignant hyperthermia), acute exacerbation of chronic MD (status dystonicus), hemiballism and stiff-person syndrome, highlighting clinical presentation, demographics, diagnosis and management.


Os distúrbios do movimento (DM) englobam doenças agudas e crônicas caracterizadas por movimentos involuntários e/ou perda do controle ou eficiência em movimentos voluntários. Nesta revisão, incluímos situações nas quais as principais manifestações são DM que representam risco devido à alta morbidade e mortalidade. Os autores revisaram aspectos relacionados às principais emergências em DM, incluindo aquelas relacionadas a doença de Parkinson; reações causadas por drogas (distonia aguda, síndrome neuroléptica maligna, síndrome serotoninérgica, hipertermia maligna); exacerbação aguda de DM crônicos (status distonicus); hemibalismo e síndrome da pessoa rígida. São destacados a apresentação clínica, os dados demográficos, o diagnóstico e o tratamento.


Subject(s)
Humans , Emergency Treatment , Movement Disorders/diagnosis , Movement Disorders/therapy , Acute Disease
16.
Rev. méd. Chile ; 139(8): 1032-1038, ago. 2011. ilus
Article in Spanish | LILACS | ID: lil-612218

ABSTRACT

Background: Non-motor symptoms are common among patients with Parkinson disease and include cognitive, psychiatric, sleep and autonomic dysfunctions. Aim: To determine if the detection of non-motor symptoms along with the appropriate referral to an specialist has an impact on their prevalence after one year follow-up. Material and Methods: We included 60 patients diagnosed with Parkinson´ s disease attending to the Movement Disorder Clinic. The presence of non-motor symptoms was determined by the non-motor symptom questionnaire (NMSQuest). Results: The mean NMSQuest scores at baseline and at one year follow up were 12.6 ± 6.2 and 9.9 ± 5.6, respectively (p < 0.01). The non-motor symptoms that showed a statistically significant differences in frequency between baseline and the final assessment, were constipation (p = 0.04), urinary urgency (p = 0.02), hallucinations (p = 0.04), dizziness (p = 0.02) and vivid dreams (p = 0.04). Conclusions: Intentional search for non-motor symptoms in patients with Parkinson´ s disease along with a multidisciplinary approach has an impact on their prevalence. The change in specific symptoms is probably related to adjustments in dopaminergic management.


Subject(s)
Aged , Female , Humans , Male , Dopamine Agents/administration & dosage , Dopamine/administration & dosage , Motor Activity , Movement Disorders/epidemiology , Parkinson Disease/complications , Follow-Up Studies , Motor Activity/drug effects , Movement Disorders/diagnosis , Parkinson Disease/drug therapy , Surveys and Questionnaires/standards
17.
Rev. Esc. Enferm. USP ; 44(3): 753-758, sept. 2010. tab
Article in Portuguese | LILACS, BDENF | ID: lil-561413

ABSTRACT

O estudo teve como objetivo investigar a ocorrência do diagnóstico de enfermagem Mobilidade Física Prejudicada em pacientes com AVE. Estudo exploratório, desenvolvido em unidades de reabilitação, de novembro de 2007 a março de 2008, por meio de entrevista e exame físico. A Taxonomia II da NANDA foi utilizada para a identificação do diagnóstico. Foram avaliados 121 indivíduos, com idade média de 62,1 anos, 52,3 por cento homens, com média de 1,5 episódio de AVE em 3,4 anos. O diagnóstico esteve presente em 90 por cento, com média de 5,8 características definidoras. Dificuldade para virar-se foi a característica mais presente, e 3,4 fatores foram relacionados por paciente, com destaque para a Força muscular diminuída, além de Prejuízos neuromusculares (100 por cento). Destaca-se a necessidade de enfocar-se esse diagnóstico no planejamento das intervenções após o AVE, com vistas à promoção da saúde desses pacientes.


The study aimed to investigate the occurrence of Nursing Diagnosis Impaired Physical Mobility in patients with stroke. This exploratory study was developed at rehabilitation units from November 2007 to march 2008, through an interview and physical examination. Nursing diagnoses were made using NANDA Taxonomy II. A total 121 patients were evaluated. Subjects' average age was 62.1 years, 52.3 percent were males with an average 1.5 stroke events in 3.4 years. The diagnosis was present in 90 percent, with an average of 5.8 defining characteristic. Difficulty turning was the most present characteristic and there were 3.4 related factors per patient, and most reported decreased strength and endurance besides neuromuscular impairment (100 percent). There should be a closer look towards this diagnosis when planning interventions after a stroke with aiming at health promotion for these patients.


El estudio tuvo como objetivo investigar la ocurrencia del diagnóstico de enfermería Movilidad física disminuida en pacientes con AVE. Estudio exploratorio, desarrollado en unidades de rehabilitación, desde noviembre de 2007 a marzo de 2008, a través de entrevistas y exámenes físicos. Para la identificación del diagnóstico se utilizó la Taxonomía II de la NANDA. Fueron evaluados 121 individuos, con edad media de 63,1 años, 52,3 por ciento hombres, con un promedio de 1,5 episodios de AVE en 3,4 años. El diagnóstico se verificó en el 90 por ciento, con una media de 5,8 características distintivas. La dificultad para darse vuelta fue la característica más presente, con 3,4 factores relacionados por paciente, con relevancia de la fuerza muscular disminuida, además de trastornos neuromusculares (100 por ciento). Se destaca la necesidad de enfocarse ese diagnóstico en el planeamiento de las intervenciones posteriores al AVE, en vistas a la mejoría de la salud de dichos pacientes.


Subject(s)
Female , Humans , Male , Middle Aged , Movement Disorders/diagnosis , Movement Disorders/etiology , Nursing Diagnosis , Stroke/complications , Cross-Sectional Studies
19.
Indian J Pediatr ; 2009 May; 76(5): 531-536
Article in English | IMSEAR | ID: sea-142201

ABSTRACT

In recent years there has been a growing interest towards pediatric movement disorders (PMD). The data derived from the synthesis of clinical observation, neuroimaging, biochemical and, molecular genetics studies have allowed for the identification of a significant number of pediatric diseases featuring movement disorders. The purpose of this review is to outline an approach to the advances in management of dystonia, neurotransmitter disorders, tics, and paroxysmal dyskinetic syndromes starting in children younger than 18 yr of age.


Subject(s)
Age Distribution , Age of Onset , Baclofen/therapeutic use , Benzodiazepines/therapeutic use , Child , Child, Preschool , Cholinergic Antagonists/therapeutic use , Dopamine Agents/therapeutic use , Drug Therapy, Combination , Dyskinesias/diagnosis , Dyskinesias/drug therapy , Dyskinesias/epidemiology , Early Diagnosis , Electromyography , Female , Humans , Incidence , Infant , Levodopa/therapeutic use , Male , Movement Disorders/diagnosis , Movement Disorders/drug therapy , Movement Disorders/epidemiology , Physical Examination , Prognosis , Risk Assessment , Severity of Illness Index , Sex Distribution , Spain , Treatment Outcome
20.
Rev. Hosp. Clin. Univ. Chile ; 20(1): 5-13, 2009. ilus, tab
Article in Spanish | LILACS | ID: lil-545862

ABSTRACT

Introduction: Parkinson disease diagnosis is based on physical neurologic exam, however sometimes ancillary tests could be needed. Transcranial sonography is a useful tool to perform Parkinson disease and others movement disorders diagnosis, showing pathologic hyperecogenicities of nigra substance and basal ganglia. Objective and methods: The objective of this study is to report the first 39 patients in whom transcranial sonography was performed. We recruit patients consulting to movement disorders unit at University of Chile hospital. Two independent investigators (PVF and GMG) blinded to clinical diagnosis performed transcranial sonography by temporal window. Considering clinical diagnosis as gold standard we calculated specificity and sensibility. Concordance between investigators was estimated too. Results: Concordance between investigators was 100 percent. Sensibility was 85.71 percent and specificity was 100 percent. Conclusion: According our report, transcranial sonography performed at University of Chile Hospital, is a high sensibility and specificity tool to support Parkinson disease and others movement disorders.


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Parkinson Disease/diagnosis , Movement Disorders/diagnosis , Ultrasonography, Doppler, Transcranial/statistics & numerical data
SELECTION OF CITATIONS
SEARCH DETAIL