ABSTRACT
Testing the reliability and usefulness of disability scales in Parkinson's disease has been the object of a study carried out by 4 neurologists on 48 patients using 2 rating scales--Hoehn and Yahr staging and Columbia University Rating Scale--and 2 disability scales--Northwestern University Disability Scale and Extensive Disability Scale, a new scale conceived for this purpose, which is more accurate in examining in a different way the physical incapacity and handicap of parkinsonian patients in their daily living. The examiners worked in pairs and did not discuss their rating scores before the end of the study. As far as interobserver agreement is concerned, the results of the disability scales are better than those of the rating scales. The Northwestern Disability Scale and the new scale are similar in reliability and consistency; however, the Extensive Disability Scale has proved to be a better indicator of the functional status. We suggest a more extensive employment of disability scales in clinical studies.
Subject(s)
Disability Evaluation , Parkinson Disease/physiopathology , Activities of Daily Living , Aged , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , WalkingABSTRACT
We report 8 cases of clinical idiopathic Parkinson disease in one kindred. None of the patients presented anomalous symptoms and all responded normally to routine L-Dopa therapy. On the basis of these findings we analyse the possible etiological role of heredity in Parkinson disease.
Subject(s)
Parkinson Disease/genetics , Aged , Aged, 80 and over , Female , Humans , Levodopa/therapeutic use , Male , Middle Aged , Parkinson Disease/drug therapy , Parkinson Disease/physiopathology , PedigreeABSTRACT
To study the possible damage of oculomotor structures we have studied 10 patients affected by idiopathic Parkinson's disease with a clear on-off phenomena. All the patients were subjected to an electro-oculographic examination observing qualitative and quantitative parameters in both on and off phases. The two exams were carried out in the same morning. We observed the well known electro-oculographic pattern of parkinsonian syndrome: multiple steps saccades, pursuit alterations, absence of spontaneous or evoked nystagmus. Moreover the most relevant finding consisted in an improvement of some electro-oculographic features during the off phase, contrary to clinical evidence. Such results seem to suggest that oculomotor system is functionally separate from that which controls arm movements.
Subject(s)
Electrooculography , Eye Movements , Parkinson Disease/physiopathology , Saccades , Aged , Female , Humans , Male , Middle Aged , Reflex, Vestibulo-OcularABSTRACT
The authors studied a group of 36 patients with idiopathic Parkinson's disease by electro-oculographic examination in order to evaluate the most frequent vestibular and oculomotor findings. Vestibular alterations were detected mainly in caloric nystagmus (82.9%). Hyperreflectivity was the most frequent evidence, but it does not necessarily represent the sign of a lesion. The occurrence of spontaneous and evoked nystagmus was not significant. Oculomotor findings were more interesting, as they were altered in two-thirds of the cases. Particularly, saccadic eye movements presented a "multiple step" morphology in 58.3% of the series. This saccadic disarrangement was scarcely found in neurological patients with brainstem and/or cerebellum pathology (7.7%). Moreover, in Parkinson's disease patients no other saccadic alterations typical of brainstem or cerebellum involvement were found. Such observations suggest a possible non-cerebellar origin of "multiple step". Vestibular and oculomotor findings were not significantly correlated with the clinical features of the patients.
Subject(s)
Electrooculography , Parkinson Disease, Secondary/diagnosis , Vestibule, Labyrinth/physiopathology , Adult , Age Factors , Aged , Caloric Tests , Humans , Middle Aged , Parkinson Disease, Secondary/physiopathology , Saccades , Tremor/physiopathologyABSTRACT
We studied the three most commonly used rating scales in Parkinson's Disease (Hoehn and Yahr Clinical Staging, Webster Rating Scale, Columbia University Rating Scale) in order to examine the agreement between observers. Six neurologists, experts at using such scales, evaluated 48 patients suffering from the idiopathic form of Parkinson's Disease. Reliability using the K index was moderate, although a slight superiority was found with the Columbia University Rating Scale. Analysis of the various items used has suggested that scales of disability could be a valid alternative to those examined.
Subject(s)
Disability Evaluation , Parkinson Disease/physiopathology , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Parkinson Disease/diagnosisABSTRACT
Lisuride was investigated for therapeutic effects in 19 patients with advanced Parkinson disease, no longer satisfactorily responding to routine L-Dopa therapy. The patients were treated with oral Lisuride (0.6-2.5 mg/die) and L-Dopa. The follow-up was at least 6 months. We noted a significant improvement on the Webster Rating Scale at 1st, 3rd and 6th months. Disability and on-off phenomen were reduced. Side effects were few. Lisuride is a valuable tool in this type of patient.
