Periodic limb movements in sleep (PLMS) have been diagnosed easily by nocturnal polysomnography (NPSG) and treated effectively with dopamine receptor agonist, benzodiazepine and opioid. However, few reports have objectively assessed the treatment responses. We treated a PLMS patient with clonazepam and pramipexole, and evaluated their efficacy with actigraphy. Clonazepam improved sleep quality without reducing frequency of limb movements, and pramipexole reduced frequency of limb movements without improving sleep quality, results which are consistent with previous study findings. Actigraphy proved useful in evaluation of treatment response of PLMS.
Actigraphy ; Benzodiazepines ; Clonazepam ; Dopamine Agonists ; Extremities* ; Humans ; Polysomnography

Segmental myoclonus can be seen in variable lesions of the brainstem or spinal cord, but the pathophysiology of the segmental myoclonus is not fully defined yet. We describe three patients with delayed developed and chronically persisted involuntary movement restricted to one arm after mild cervical injury. Myoclonus developed 1 month later in 2 patients and the other 5 months later after the injury. They suffered from myoclonus for more than 2 months, 1 year, and 25 years, respectively. Clonazepam and phenytoin were tried, but not satisfactory.
Arm ; Brain Stem ; Clonazepam ; Dyskinesias ; Humans ; Myoclonus* ; Phenytoin ; Spinal Cord

Segmental myoclonus can be seen in variable lesions of the brainstem or spinal cord, but the pathophysiology of the segmental myoclonus is not fully defined yet. We describe three patients with delayed developed and chronically persisted involuntary movement restricted to one arm after mild cervical injury. Myoclonus developed 1 month later in 2 patients and the other 5 months later after the injury. They suffered from myoclonus for more than 2 months, 1 year, and 25 years, respectively. Clonazepam and phenytoin were tried, but not satisfactory.
Arm ; Brain Stem ; Clonazepam ; Dyskinesias ; Humans ; Myoclonus* ; Phenytoin ; Spinal Cord

Orthostatic tremor is characterized by tremor of legs on standing that disappears on siting down or walking, We have recently seen a 68 year-old woman who showed typical orthostatic tremor, EMG bursts of 4-5 Hz were recorded in the leg muscles only when she was standing, Alprazolam, propranolol and clonazepam were ineffective in the alleviation of her tremor. We believe this to be the first Korean case in the literature.
Aged ; Alprazolam ; Clonazepam ; Female ; Humans ; Leg ; Muscles ; Propranolol ; Tremor* ; Walking

PURPOSE: To describe clinical features of cyclic vomiting syndrome(CVS), managements during episodes, prophylactic drugs as long term therapy and to investigate the disease course and prognostic factors of CVS. METHODS: Thirty two children who fulfilled the diagnostic criteria of CVS and who presented to Seoul National University Children's Hospital from March 1989 to December 2000, were included. Data were obtained from chart review and telephone interview. RESULTS: All had recurrent, self-limited episodes and were free of symptoms between episodes. During the acute phase of episodes, lorazepam and ondansetron were effective in some patients. Various prophylactic drugs were tried and some patients recovered after the use of clobazam, clonazepam, erythromycin and imipramine. Among 32 patients, 18 had recovered from CVS. The age at recovery was 9.4 +/- 4.0 years. It took 3.4 +/- 2.2 years from the onset to the recovery. The age at onset was later in the recovery group than in the non-recovery group(6.1 +/- 3.2 vs 1.7 +/- 1.8 years; P=0.015) and the duration of episodes was longer in the recovery group(5.2 +/- 1.6 vs 2.3 +/- 1.2 days; P=0.003). CONCLUSION: Many patients recovered from CVS spontaneously. The prognosis in patients with later onset of the disease and the longer duration of episodes seemed to be better. Prophylactic drugs such as clobazam, clonazepam, erythromycin and imipramine may be beneficial. A total approach including trials of prophylactic drugs, removal of the triggering factor and psychiatric support is needed in the management of CVS.
Child ; Clonazepam ; Erythromycin ; Humans ; Imipramine ; Interviews as Topic ; Lorazepam ; Ondansetron ; Prognosis* ; Seoul ; Vomiting*

OBJECTIVES: Many chronic schizophrenics are suffered from treatment-refractory hallucinations. As a countermeasure, the combined use of neuroleptics and benzodiazepines has been studied. In this context, the authors tried to evaluate the anti-hallucinatory effect of neuroleptics-clonazepam combination therapy. METHODS: At first, the authors described 3 cases of chronic schizophrenics who reported alleviation of hallucinations, which are resistant to neuroleptic treatment, after adding clonazepam. And then, prospective open study including 6 female chronic schizophrenic inpatients having neuroleptic-refractory hallucinations was done. In addition to existing psychiatric medication, these patients were treated with clonazepam 1.5 mg for 6weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 6 weeks of treatment. The psychopathology was assessed by the items of hallucinatory behavior and anxiety/tension of PANSS and BPRS. Clinical improvement was defined by fall-off of the hallucinatory behavior below the moderate level. The side effects were assessed by UKU Side Effect Rating Scale. RESULTS: All patients completed 6 weeks' trial. At the end of 6 weeks, 2 (33.3%) of 6 patients showed decrement of the hallucinatory behavior below the moderate level, when evaluated by PANSS and BPRS. However, the courses of anti-hallucinatory effect were different in these 2 patients. Another one patient showed that the hallucinatory behavior assessed by BPRS fell to the moderate level, but not when assessed by PANSS. The item of anxiety/tension was unchanged in all 6 patients. Except very mild sedation in one patient, there was no side effect. CONCLUSION: This study suggests that neuroleptics-clonazepam combination therapy is effective against treatment-refractory hallucinations in some schizophrenics and generally safe.
Antipsychotic Agents ; Benzodiazepines ; Clonazepam* ; Female ; Hallucinations* ; Humans ; Inpatients ; Prospective Studies ; Psychopathology ; Schizophrenia

Post-stroke involuntary movements are often noted but time-locked myoclonus has not yet been reported. A 53-year-old man was admitted with mild left side weakness and ataxia. He also had involuntary jerky movement of limbs from the onset, which occurred exactly at 11: 00 PM everyday. Symptoms lasted for 30 minutes and were relieved by clonazepam. Brain MRI showed high signal lesion on right pontine tegmentum. We suggest that this time-locked phenomenon may be related with reticular structures containing the so called, "human biological clock".
Ataxia ; Brain ; Clonazepam ; Dyskinesias ; Extremities ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Myoclonus* ; Stroke

OBJECTIVE: The purpose of this study was to examine the pharmacological treatment patterns and clinical responses in inpatients and/or outpatients with obsessive compulsive disorder (OCD) at a university hospital. METHODS: A total of 71 OCD patients were included and followed during the first 4 months, first year and second year from 1998. The patterns of medication use and clinical responses according to the Yale-Brown obsessive-compulsive scale (Y-BOCS) were analyzed descriptively in this period. RESULTS: During the first 4 months, 26.7% of the patients underwent monotherapy in which most of the drugs were serotonin reuptake inhibitors (SRIs). Therapy with two or more drugs was administered in 66.6% of the patients and combination drugs with SRIs were atypical antipsychotics and clonazepam. The clinical response rate using Y-BOCS was 24.0% compared with baseline score. During the first year, the frequency of the monotherapy decreased to 6.5%, while that of therapy with two or more drugs increased to 80.6% (two and three drug frequencies were 35.3%, and 32.3%, respectively). The clinical response rate was 26.4% during this period. During the second year, the frequency of the monotherapy was 25% and that of multidrug therapy was 70.8% (two and three drug frequencies were 20.8%, and 45.8%, respectively). The clinical response rate was 39.3% compared with baseline score. CONCLUSIONS: In this study, the frequency of the combination therapy was relatively high compared with SRI monotherapy during the first 4 months and it increased further during the first year. The combination therapy was maintained without change of SRI dosage during the second year. Most of the drugs used in the combination therapy were atypical antipsychotics and clonazepam.
Antipsychotic Agents ; Clonazepam ; Drug Therapy* ; Humans ; Inpatients ; Obsessive-Compulsive Disorder* ; Outpatients ; Serotonin Uptake Inhibitors

Stiff-man syndrome is a rare disorder characterized by intermittent spasms and stiffness of the axial and limb muscles, associated with an electromyographic pattern of continuous motor unit activity in affected muscles. The cause of this disorder is unknown, but it has been associated with autoimmune disease and with endocrine disorder. We present a 49 year old female patient with clinical and electrophysiologic features of stiff-man syndrome and postoperative panhypopituitarism, whose muscle stiffness and spasm resolved with diazepam, clonazepam and prednisolonereplacement therapy.
Autoimmune Diseases ; Clonazepam ; Diazepam ; Extremities ; Female ; Humans ; Middle Aged ; Muscles ; Spasm ; Stiff-Person Syndrome*

PURPOSE: This is a clinical study to evaluate the efficacy and adverse reactions of deflazacort as adjunctive therapy in childhood intractable atonic seizure including Lennox- Gastaut syndrome. METHODS: This is a clinical prospective, add-on, and open-label study performed for 6 months from Jun. 2000 to Dec. 2000 at the pediatric neurology clinic of Severance Hospital. Subjects were selected according to the following criteria, 1) Patients were diagosed as refractory atonic seizure disorder including Lennox-Gastaut syndrome during more than 6 months, 2) Patients had been on maximal doses of at least 2 anticonvulants including sodium valproate and clonazepam or clobazam. We observed seizure frequency of 4 weeks and 24 week medication period as well as adverse reactions every 4 weeks. Those data were analysed primarily for median seizure frequency reduction rate and other efficacy variables such as responder rate with frequency reduction more than 50% and seizure free rate. We also compared the clinical aspects between responder and non responder group. RESULTS: 48 patients were evaluated for efficacy and adverse reactions. Median seizure frequency reduction rate was 42.7%, responders were 22 patients(45.8%) and seizure free patients were 4(8.3%). In Lennox-Gastaut syndrome, median seizure frequency reduction rate was 48.9% and in atonic seizure only 39.3%. However, there were no statistically significant differences in efficacy. We compared clinical aspects between respoder and non responder groups, but couldn't find any difference. The number of patients manifesting adverse reactions was 20(41.6%) in an descending order of frequency, weight gain in 16 patients(33.3%), and irritability in 4 patients(8.3%). CONCLUSION: Deflazacort is believed to be an effective and safe anticonvulsant when used as adjunctive therapy for atonic seizure including Lennox-Gastaut syndrome. However, long term follow up is required to evaluate relapse rate and its adverse reactions.
Clonazepam ; Epilepsy ; Follow-Up Studies ; Humans ; Neurology ; Prospective Studies ; Recurrence ; Seizures* ; Valproic Acid ; Weight Gain