ABSTRACT
We describe kinematics, kinetics and electromyographic patterns of a patient with spinal myoclonus of the left lower limb, during walking. Gait analysis was performed when the patient was OFF and ON his treatment with antiepileptic drugs. When OFF, we mainly observed clonic bursts and out-of-phase activations of m. tibialis anterior and m. rectus femoris, with increased hip flexion, reduction of knee flexion during swing and excessive ankle dorsal flexion. Furthermore, large oscillations of knee moment of force and power during stance phase were also observed. These abnormal patterns markedly recovered when ON drugs.
Subject(s)
Anticonvulsants/pharmacology , Gait Disorders, Neurologic/physiopathology , Leg/physiopathology , Muscle, Skeletal/physiopathology , Myoclonus/physiopathology , Spinal Cord Diseases/physiopathology , Anticonvulsants/therapeutic use , Biological Clocks/drug effects , Biological Clocks/physiology , Biomechanical Phenomena/methods , Gait Disorders, Neurologic/diagnosis , Gait Disorders, Neurologic/drug therapy , Humans , Knee/physiopathology , Leg/innervation , Male , Middle Aged , Muscle Contraction/drug effects , Muscle Contraction/physiology , Muscle, Skeletal/innervation , Myoclonus/diagnosis , Myoclonus/drug therapy , Neurologic Examination/methods , Predictive Value of Tests , Quadriceps Muscle/innervation , Quadriceps Muscle/physiopathology , Spinal Cord/drug effects , Spinal Cord/physiopathology , Spinal Cord Diseases/diagnosis , Spinal Cord Diseases/drug therapyABSTRACT
INTRODUCTION AND AIMS: 1) Evaluate the capacity of cabergoline to inhibit lactogenesis by the administration of a single dose of 1 mg within 24 h of birth, primary inhibition. 2) Evaluate the capacity of cabergoline to suppress lactopoiesis (lactation) by the administration of 0.25 mg twice a day for 2 days, secondary inhibition. 3) Evaluate the collateral effects of cabergoline at these two doses. 4) Evaluate the reduction rate of prolactin (PRL) at 4 and 14 days after cabergoline administration. EXPERIMENTAL PROTOCOL: A prospective study was performed from 1/2/1995 to 31/1/1996 in 100 puerperae with indications for lactation with follow-up at 4 and 14 days after drug administration. The study was performed in the Division of Gynecology and Obstetrics of Sanremo Hospital in collaboration with the Analysis Service. RESULTS: Cabergoline inhibited primary and secondary lactation in all the puerperae examined. In 92% of cases lactation was suppressed following a single dose whereas a second treatment cycle was required in 8%. Twenty-two cases reported slight collateral effects without the need to resort to additional treatment. In 4 cases the collateral effects were of moderate intensity and it was necessary to administer symptomatic treatment. Mean levels of serum PRL at 4 and 14 days after cabergoline administration were respectively 12.5 and 18.2 ng/ml. CONCLUSIONS: Cabergoline, a new dopaminergic drug with long-term inhibition of PRL production and secretion, can inhibit lactogenesis and lactopoies in 92% of cases at a dose of 1 mg; it can reduce long-term PRL levels (18.2 ng/ml) and in 4% it is necessary to resort to symptomatic treatment of the undesirable effects caused.
