No abstract available.
Animals ; Hypokinesia* ; Immobilization* ; Muscle, Skeletal* ; Rats*

Whilst rare, the acute development of involuntary movements with characteristic lesions of the bilateral basal ganglia in a diabetic uremic patient is a well-demarcated clinical syndrome. Most patients with this syndrome present with either parkinsonism or chorea; however, concurrent chorea with bradykinesia or parkinsonism is rarely reported. We report herein two diabetic uremic patients who developed acute chorea and bradykinesia with characteristic MR images.
Basal Ganglia ; Chorea ; Dyskinesias ; Humans ; Hypokinesia ; Parkinsonian Disorders

Changes in the individual symptomatology were analyzed on twenty-nine patients with Parkinson's disease who underwent thirty-five stereotaxic thalamotomies to evaluate the influence of each symptom on the surgical results. The thalamotomy could obviously improve and prevent progression of tremor and rigidity but not bradykinesia and axial symptoms. Long-term follow-up wtudy with statistical analysis suggested that progressive worsening after surgery was due not to recurrence of tremor and rigidity but aggravation of bradykinesia and axial symptoms in the natural course of the disease. We believe that timely surgical treatment should be encouraged in patients presenting symptoms of tremor and rigidity.
Follow-Up Studies ; Humans ; Hypokinesia ; Parkinson Disease* ; Recurrence ; Tremor

Parkinsonism is a very rare complication of phenytoin. The authors experienced a 71-year-old man who presented progressive cognitive decline, postural tremor, bradykinesia and gait disturbance. Laboratory test and brain imaging revealed no abnormality that commonly causes parkinsonism. The only abnormal finding was elevation of serum phenytoin above the therapeutic level. The patient showed marked improvement of symptoms by reduction of phenytoin dosage. Here we report a case of phenytoin induced parkinsonism.
Aged ; Gait ; Humans ; Hypokinesia ; Neuroimaging ; Parkinsonian Disorders ; Phenytoin ; Tremor

Stereotactic thalamotomy has traditionally provided good relief of tremor for patients with intractable tremor dominant in Parkinson's disease. However bradykinesia, dyskinesia and rigidity are less reliably treated with this technique. Although posteroventral pallidotomy(PVP) can alleviate dyskinesias appendicular bradykinesia and rigidity, tremor may not be completely ameliorated. Between January 1993 and May 1997, the authors performed posteroventral pallidotomy(PVP) on 69 patients with Parkinson's disease who had bradikinesia, rigidity, drug induced dyskinesia and tremor. Of these patients who had only PVPs 17(25%) patients had severe tremor, 20(29%) patients moderate tremor and 32(46 %) patients mild or no tremor after the surgery. We have combined ventrolateral thalamotomy(VLT ) and PVP in 37 patients with moderate to severe tremor. Of the 37 patients, who had both PVP and VLT, 27(73%) patients showed good improvement, and fair improve-ment in 10(27%). Except for 6 cases with transient dysarthria we did not encounter any other operative complications from the ipsilateral combined PVP and VLT. The combination of the two procedures appear to provide excellent relief for the majority of symptoms in patients suffering from advanced Parkinsons disease with rigidity bradykinesia, dyskinesia and tremor.
Dysarthria ; Dyskinesias ; Humans ; Hypokinesia ; Pallidotomy* ; Parkinson Disease* ; Tremor

BACKGROUND: The role of coronary collateral circulation has been a subject of great interest and controversy. The functional significance of collateral circulation was evaluated in 125 patients with total coronary occlusion of left anterior descending artery(LAD) or right coronary artery(RCA). METHOD: Patients were classified into two groups. Group 1:patients with angina pectoris(AP), Group 2:patients with a first transmural myocardial infarction(MI) within 3 months of symptom onset, Clinical variables, resting and exercise electrocardiogram(EKG) were analyzed with angiographic findings. Collateral fillings were graded from 0 to 3 : 0=none ; 1=filling of side branches only ; 2=partial filling of the epicardial segment ; 3=complete filling of epicardial segment. The wall motion of each segment was scored from 1 to 5:1=normal ; 2=mild to moderate hypokinesia ; 3=severe hypokinesia ; 4=akinesia ; 5=dyskinesia. The score of the 5 segments were added to yield a total LV score. RESULT: There is a higher prevalence of good collaterals and multivessel disease in group 1 than in group 2(83% vs 53%, 54% vs 30%, respectively, p<0.05). The left ventricular ejection fraction(LVEF), left ventricular end-diastolic pressure(LVEDP) and segmental wall motion score were significantly better in group 1 than group 2(68.9+/-13.4% vs 50.5+/-12.6%, 15.0+/-7.3 vs 20.3+/-8.8mmHg, 6.5+/-2.2 vs 9.6+/-2.3, respectively, p<0.05). In spite of total coronary occlusion, 61% of AP patients had normal resting EKG but 96% of patients who underwent treadmill test proved to be positive. The proportions of well-developed collaterals in 3 groups divided according to the interval between onset of MI and angiography(within 1 day, 2 to 14 days, 15 days to 3 months)were 13%, 54% and 60%. There were no significant difference in LVEF, segmental wall motion score and LVEDP in MI patients with poorly-developed collaterals and well-developed collaterals(49.1+/-15.7 vs 46.4+/-10.1%, 11.1+/-2.2 vs 10.9+/-1.4 and 24.3+/-9.7 vs 20.3+/-7.0mmHg, p=NS). The degree of collateral development is higher in MI with RCA occlusion compared with that of LAD occlusion(1.1+/-1.0 vs 2.0+/-1.0, p<0.05). CONCLUSION: Collateral circulation can prevent myocardial ischemia and preserve myocardial function in a significant number of patients with AP but do not provide protection against exercise-induced myocardial ischemia in a majority of patients with AP. Well-developed collaterals are uncommonly present within 1 day after MI, but subsequently develop and are generally demonstrable after 2 weeks. Collateral vessels in patients with MI have no beneficial effects on preserving myocardial function.
Collateral Circulation* ; Coronary Occlusion* ; Electrocardiography ; Exercise Test ; Humans ; Hypokinesia ; Myocardial Ischemia ; Prevalence

A woman developed a slowly progressive speech disturbance at age 51. Three years latter she showed difficulty in calculation, reading and writing. At age 57, she complained of right shoulder pain. At age 58, neurological examination revealed rigidity, bradykinesia and ideomotor apraxia in the right upper extremity. This case demonstrats a clinical overlap between progressive nonfluent aphasia and corticobasal degeneration.
Apraxia, Ideomotor ; Female ; Humans ; Hypokinesia ; Neurologic Examination ; Primary Progressive Nonfluent Aphasia ; Shoulder Pain ; Upper Extremity ; Writing

We report adult-onset sleep terrors in a patient with idiopathic Parkinson's disease. A 42-year-old woman presented with abnormal behaviors during sleep. Neurologic examination revealed mild hypomimia, resting tremor and bradykinesia in her right upper limb indicating early Parkinson's disease. An episode would consist of sitting up in bed, screaming, then clapping her hands and more talking, shouting, screaming, and appearing frightened. Polysomnography documented 2 episodes of parasomnia which occurred in slow wave sleep indicating sleep terrors.
Adult ; Female ; Hand ; Humans ; Hypokinesia ; Neurologic Examination ; Night Terrors* ; Parasomnias ; Parkinson Disease* ; Polysomnography ; Tremor ; Upper Extremity

BACKGROUND: Drug-induced Parkinsonism(DIP) is the second commonest cause of Parkinsonism, after idiopathic Parkinson's disease(IPD). DIP is frequently produced by antipsychotic drugs. But the clinical characteristics of DIP did not get attention by neurologist. So we studied the clinical profiles of DIP patients. METHODS: We studied the clinical profiles of thirthone patients who showed parkinsonism after antipsychotic drug treatment. We compared the score of motor part of the Unified Parkinson's Disease Rating Scale(UPDRS) between trihexyphenidyl(n=15) & amantadine(n=16) monotherapy group(initial & 4 week after treatment). RESULTS: The mean age of patients was 45 years. Bradykinesia was the 1st symptom in 26 patients(94%), tremor in 5 patients(6%). In 25 patients(81%), the first symptom appeared within 1 week after sntipsychotic treatment. There was a statistical significant negative correlation between the dosage of antipsychotic drug and the symptom-onset interval following treatment with antipsychotic drugs(simple correlation analysis, p>0.01). Bradykinesia and rigidity were appeared in all DIP patients, symmetric distribution was more common(94%, 87%) Tremor occurred in 27 patients (87%). In patients with tremor, postural or action tremor was dominant in 15 patients(56%) asymmetric distribution was more common(16/27, 59%). There are no statistical difference in motor score of UPDRS between trihexyphenidyl & amantadine monotherapy group(student t-test, p<0.05) CONCLUSIONS: Bradykinesia was the most common 1st symptom in DIP patients. Asymmertrical postural or action tremor was relativelly common in DIP. Amantadine showed the same efficacy in the treatment of DIP compared to anticholinergics.
Amantadine ; Antipsychotic Agents ; Cholinergic Antagonists ; Humans ; Hypokinesia ; Parkinson Disease ; Parkinsonian Disorders* ; Tremor ; Trihexyphenidyl

BACKGROUND: The pathophysiology of resting tremor in Parkinsons disease (PD) remains unclear. Dopaminergic treatment provides variable effects on resting tremor in PD. We aimed to evaluate the predictable clinical factors for the levodopa responsiveness of resting tremor in patients with PD. METHODS: Eighty-five PD patients with prominent resting tremor who visited Asan Medical Center between June 2004 and June 2005 were included. The prominent resting tremor was defined as tremor scoring more than 3 in at least one limb in the Unified Parkinsons Disease Rating Scale (UPDRS). Subjects were divided into the responsive group (RG) or non-responsive group (NRG) according to the responsiveness of resting tremor to dopaminergic treatment. Responsiveness was defined as a minimum 2 points reduction of UPDRS score for the resting tremor after dopaminergic treatment for more than 3 months. RESULTS: Among the 85 patients, there were 35 men and 50 women ages 34-87 years (mean age, 67 years). Thirty-six patients (42.4%) were grouped into RG and 49 (57.6%) into NRG. Mean age of RG was significantly younger than that of NRG. RG showed significantly higher initial UPDRS part III subtotal score (p=0.015) and more severe Hoehn & Yahr stage (p=0.010) than those of NRG. UPDRS subscores for rigidity (p=0.012), bradykinesia (p=0.021) and postural impairment (p=0.018) were correlated with the responsiveness of dopaminergic treatment. CONCLUSIONS: Resting tremor in PD patients more favorably responded to dopaminergic treatment when it presented in combination with bradykinesia and rigidity suggesting dopaminergic role in the genesis of resting tremor in those PD patients.
Chungcheongnam-do ; Extremities ; Female ; Humans ; Hypokinesia ; Levodopa* ; Male ; Parkinson Disease* ; Tremor*