Subject(s)
Carotid Artery, Internal, Dissection/complications , Horner Syndrome/etiology , Hypoglossal Nerve Diseases/etiology , Anticoagulants/therapeutic use , Carotid Artery, Internal, Dissection/diagnosis , Carotid Artery, Internal, Dissection/diagnostic imaging , Carotid Artery, Internal, Dissection/drug therapy , Horner Syndrome/diagnosis , Humans , Hypoglossal Nerve/diagnostic imaging , Hypoglossal Nerve Diseases/diagnosis , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Lingual movement disorders are a rare but serious manifestation of neurologic disease, which have the potential to cause significant morbidity. Traditionally, these disorders were treated with pharmacotherapy achieving only limited results. Several case series have demonstrated the effectiveness of Botulinum toxin injection for the management of focal lingual movement disorders; however, apprehension persists regarding intralingual injections due to the risk of dysphagia. Here, we report seven patients with lingual movement disorders treated with intralingual Botox (Allergan product) injections via a novel superior approach into the genioglossus over a period of 3 to 72 months. All patients experienced a marked improvement in their abnormal tongue movements with no substantial bleeding or dysphagia. Lingual Botulinum toxin injection should be considered a safe and viable treatment option for a variety of disorders affecting the tongue.
Subject(s)
Anti-Dyskinesia Agents/therapeutic use , Botulinum Toxins/therapeutic use , Movement Disorders/drug therapy , Tongue Diseases/drug therapy , Aged , Antiparkinson Agents/adverse effects , Female , Humans , Levodopa/adverse effects , Male , Middle Aged , Movement Disorders/complications , Movement Disorders/etiology , Parkinson Disease , Retrospective Studies , Time Factors , Tongue Diseases/chemically induced , Tongue Diseases/complicationsABSTRACT
Sleepiness is often neurophysiologically assessed using the multiple sleep latency test (MSLT) or the maintenance of wakefulness test (MWT). We examined the frequency of incidental intersession napping during MSLT and MWT testing to see if there was a relationship between intersession napping, mean sleep latency and subjective sleepiness on the Epworth Sleepiness Scale (ESS). We conducted a retrospective analysis of 24 studies of subjects who underwent either a MSLT or a MWT as a component of their clinical assessment and had coincidental wireless telemetry recording of their sleep in between scheduled naps. We found that 17.6% of the MSLT patients and 28.6% of the MWT patients slept inadvertently between test sessions. The group of patients who napped between sessions had shorter sleep latencies on the MSLT. No statistically significant group-wise difference between the sleep latencies of those who napped between MWT sessions and those who did not was found. There was no significant difference between the ESS of those who did and those who did not sleep between sessions. We found that brief inadvertent intersession napping was common during the MSLT and MWT, but there was no evidence to suggest that this significantly alters clinical test results.
Subject(s)
Reaction Time/physiology , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep/physiology , Wakefulness/physiology , Female , Humans , Male , Probability , Retrospective Studies , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/physiopathologyABSTRACT
The synthesis of a variety of alkylidene benzoxacycles via a domino palladium-catalyzed ortho-alkylation/intramolecular Heck reaction is described. Under the optimized conditions [Pd(OAc)2 (10 mol %), P(2-Furyl)3 (20 mol %), norbornene (4 equiv), Cs2CO3 (2 equiv), CH3CN, 80 degrees C], aryl iodides with oxygen-tethered Heck acceptors are coupled with alkyl bromides (5 equiv) to generate a variety of six- and seven-membered-ring benzoxacyclic products.
