ABSTRACT
OBJECTIVE: To determine praxis function in patients with Parkinson's disease (PD) and multiple system atrophy (MSA). METHODS: Nineteen patients with PD and 16 patients with probable MSA were recruited into study. Twenty-five age-matched, healthy subjects were included as controls. The Mayo Clinic praxis test battery was applied. Pantomime tasks, including oral/facial, trunk, and upper extremity movement, were used to evaluate ideomotor apraxia (IMA). Sequential tasks, including Luria test for ideational apraxia (IDA) and use of actual objects, were also tested. In addition, Standardized Mini Mental Test (MMSE), Hamilton Depression (HAM-D), and Anxiety (HAM-A) Scales were used. RESULTS: Mean ages of the study participants were 66 +/- 7, 68 +/- 5, and 65 +/- 7 years in PD, MSA, and control groups, respectively. Mean total praxis score was significantly lower for patients with PD (92.4 +/- 4) and MSA (75.9 +/- 18) than for controls (97.4 +/- 2) (P = 0.000). Transitive performances of upper extremities and sequential tasks were significantly impaired in patients with PD compared to control subjects (P < 0.05). There was no correlation between total praxis scores and sum scores of tremor, bradykinesia, and rigidity of both of the upper limbs of patients with PD. Subgroup praxis scores were substantially worse in MSA group (P < 0.0001). Compared to control subjects, mean scores for MMSE, HAM-D, and HAM-A tests were significantly worse in MSA group, but, for PD patient group, only HAM-A scores were worse. CONCLUSION: Our results indicate that although not a presenting symptom, IMA and IDA may be features of MSA and, to a lesser degree, of PD. Also, it seems to be unrelated to the motor features of patients with PD.
Subject(s)
Apraxias/complications , Multiple System Atrophy/complications , Parkinson Disease/complications , Aged , Apraxias/diagnosis , Case-Control Studies , Dyskinesias/complications , Dyskinesias/diagnosis , Female , Humans , Male , Middle Aged , Multiple System Atrophy/diagnosis , Neuropsychological Tests , Parkinson Disease/diagnosis , Psychiatric Status Rating Scales , Severity of Illness IndexABSTRACT
OBJECTIVE: To identify features related to the development of hallucinations in Parkinson's disease (PD). MATERIALS AND METHODS: Seventy PD patients with hallucinations (group 1) and 60 PD patients without hallucinations (group 2) were evaluated for disease severity, presence of motor complications, rapid eye movement (REM) behavior disorder (RBD), and antiparkinsonian drug profile. The ages at the emergence of hallucinations and duration of disease in group 1 were matched with the ages at the last visit of those in group 2. RESULTS: Disease severity and presence of motor complications were similar in both groups. RBD was more frequently encountered among hallucinators than among non-hallucinators (P = 0.007). The mean duration and daily doses of levodopa and other dopaminergic drugs did not differ in both groups; however, the usage of anticholinergics and amantadine were significantly more frequent in group 2, unexpectedly. CONCLUSIONS: The presence of RBD was significantly more common in hallucinators; however, severity of PD, duration and daily doses of dopaminergic drugs were not associated with the emergence of hallucinations.
Subject(s)
Antiparkinson Agents/administration & dosage , Brain/drug effects , Brain/physiopathology , Hallucinations/etiology , Parkinson Disease/complications , Parkinson Disease/drug therapy , Adult , Aged , Aged, 80 and over , Amantadine/administration & dosage , Amantadine/adverse effects , Antiparkinson Agents/adverse effects , Cholinergic Antagonists/administration & dosage , Cholinergic Antagonists/adverse effects , Dopamine Agents/administration & dosage , Dopamine Agents/adverse effects , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Hallucinations/physiopathology , Humans , Male , Middle Aged , Neurologic Examination , Ocular Motility Disorders/diagnosis , Ocular Motility Disorders/etiology , Ocular Motility Disorders/physiopathology , Parkinson Disease/physiopathology , Retrospective Studies , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology , Sleep Wake Disorders/physiopathologyABSTRACT
Penicillium chrysogenum was isolated from three subsequent cerebrospinal fluid (CSF) specimens of a 73-year-old male patient without immunological compromise. The isolated was tested against five antifungal agents according to the NCCLS M38-P macrodilution method. MICs were determined as follows: amphotericin B (AMB), 2 microg ml(-1); fluconazole (FLZ), 8 microg ml(-1); itraconazole (ITZ), 1 microg ml(-1); flucytosine (5FC), 0.125 microg ml(-1); and terbinafine (TRB), 0.06 microg ml(-1). The patient has been cured with FLZ.
Subject(s)
Central Nervous System Infections/microbiology , Penicillium chrysogenum/isolation & purification , Aged , Central Nervous System Infections/drug therapy , Cerebrospinal Fluid/microbiology , Humans , Male , Penicillium chrysogenum/drug effectsSubject(s)
Acetyl-CoA C-Acyltransferase/deficiency , Dystonia/enzymology , Dystonia/etiology , Brain Diseases/diagnosis , Brain Diseases/etiology , Child , Diabetic Ketoacidosis/complications , Disease Progression , Dystonia/diagnosis , Globus Pallidus/diagnostic imaging , Globus Pallidus/pathology , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed , Videotape RecordingSubject(s)
Antiparkinson Agents/administration & dosage , Fabaceae , Levodopa/administration & dosage , Parkinson Disease/drug therapy , Plant Proteins/administration & dosage , Plants, Medicinal , Adult , Combined Modality Therapy , Dose-Response Relationship, Drug , Drug Administration Schedule , Humans , Levodopa/adverse effects , Male , Middle Aged , Neurologic Examination/drug effects , Parkinson Disease/diagnosis , Seed Storage ProteinsABSTRACT
OBJECTIVES: We had noted cogwheel rigidity in a number of patients with rheumatoid arthritis (RA). Based on this finding, we aimed to investigate formally the presence of rigidity and cogwheeling in RA patients. Our secondary aim was to survey the co-existence of RA and Parkinson's disease (PD). METHODS: A total of 87 consecutive patients with a diagnosis of RA, 78 patients with PD and 67 otherwise healthy patients attending a dedicated headache clinic participated in the study. RESULTS: Rigidity was observed in 24% of RA, 60% of PD and 2% of headache patients. The frequency among the RA patients was significantly higher compared to that of patients with headache (chi 2 = 15.2; P = 0.00009). The frequency of PD among the RA patients was 2/87 (2.3%), while the frequency of RA among the PD patients was 6/78 (7.7%). CONCLUSION: Rigidity can be observed in approximately a quarter of patients with RA.
Subject(s)
Arthritis, Rheumatoid/complications , Basal Ganglia Diseases/etiology , Adult , Aged , Arthritis, Rheumatoid/physiopathology , Female , Humans , Male , Middle Aged , Muscle, Skeletal/physiopathology , Parkinson Disease/physiopathologyABSTRACT
Posthemiplegic focal limb or hemidystonias are rare movement disorders usually due to vascular lesions of the contralateral basal ganglia. The pathogenesis of posthemiplegic dystonia is unknown and its management is usually difficult. In this paper, we report two patients who suffered from a single limb dystonia and hemidystonia, respectively. In the latter patient, hemidystonia developed due to an ischaemic cerebrovascular accident 2 or 3 months after the recovery of hemiplegia. Computed tomography and magnetic resonance imaging scans showed evidence of contralateral putamen and thalamus infarcts.
