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

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

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

Deep cerebral venous thrombosis is a rare condition associated with edema, infarction or hemorrhage in basal ganglia, thalamus and periventricular white matter. It presents nonspecific clinical manifestations such as altered consciousness, headache, focal neurological deficit, nausea and vomiting. Extrapyramidal signs are very rare in deep cerebral venous thrombosis. We report a patient who presented micrographia, hypophonia and bradykinesia as an early manifestation of deep cerebral venous thrombosis.
Basal Ganglia ; Consciousness ; Edema ; Headache ; Hemorrhage ; Humans ; Hypokinesia* ; Infarction ; Nausea ; Parkinsonian Disorders* ; Thalamus ; Venous Thrombosis* ; Vomiting

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

Valproate is one of the most popular conventional anti-epileptic drugs. It has many side effects and in rare cases, it may result in the development of parkinsonian syndromes. The parkinsonism with valproate shows insidious onset and reversible symptoms after drug withdrawal. We observed a 69-year-old woman with resting tremor, bradykinesia, cog-wheel rigidity after 2 months of valproate use. She had been suffering from epilepsy for 30 years. Her seizures were well controlled with valproate, but parkinsonian symptoms slowly progressed with doses of 1200 mg/day of valproate. After 4 months, we discontinued the doses of valproate which led to subjective and objective improvement of the parkinsonian features. The mechanism of this side effect is not well established, but GABAergic neurotransmission or mitochondrial respiratory chain may possibly be related.
Aged ; Electron Transport ; Epilepsy ; Female ; Humans ; Hypokinesia ; Parkinsonian Disorders* ; Seizures ; Synaptic Transmission ; Tremor ; Valproic Acid

OBJECTIVES: For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. METHODS: We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H and Y) staging, and neuropsychological examinations. RESULTS: Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H and Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. CONCLUSION: We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.
Drug Therapy ; Dysarthria ; Dyskinesias ; Humans ; Hypokinesia ; Levodopa ; Muscle Hypotonia ; Pallidotomy* ; Parkinson Disease ; Parkinsonian Disorders

Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) is a novel therapy developed to treat Parkinson's disease. We report a patient who underwent bilateral DBS of the PPN and subthalamic nucleus (STN). He suffered from freezing of gait (FOG), bradykinesia, rigidity and mild tremors. The patient underwent bilateral DBS of the PPN and STN. We compared the benefits of PPN-DBS and STN-DBS using motor and gait subscores. The PPN-DBS provided modest improvements in the gait disorder and freezing episodes, while the STN-DBS failed to improve the dominant problems. This special case suggests that PPN-DBS may have a unique role in ameliorating the locomotor symptoms and has the potential to provide improvement in FOG.
Deep Brain Stimulation* ; Freezing ; Gait ; Humans ; Hypokinesia ; Parkinson Disease* ; Subthalamic Nucleus ; Tremor ; Weather