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

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

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 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

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

A variety of toxins cause parkinsonism and the lesions are primarily in the pallidostriatum. It usually does not respond to levodopa. We experienced a patient whose parkinsonian features developed after accidental acetone ingestion. She had rigidity, bradykinesia, gait disturbance and her speech was sluggish. Brain MRI showed bilateral basal ganglionic lesions. She was treated with levodopa and her neurological symptoms improved. To our knowledge, there has not been any previous reports of acetone causing parkinsonism. Acetone may cause parkinsonism by damaging the basal ganglia.
Acetone* ; Basal Ganglia ; Brain ; Eating ; Gait ; Ganglion Cysts ; Humans ; Hypokinesia ; Levodopa ; Magnetic Resonance Imaging ; Parkinsonian Disorders*

We studied to investigate the predictive values of gated SPECT for the improvement of wall motion after bypass surgery. As we compared postoperative SPECT with preoperative ones, we defined viability as wall motion improvement. We performed rest 71-201/stress Tc-99m-MIBI gated SPECT in 25 patients before and 3 months after bypass surgery. Myocardial wall motion was graded as normal, hypokinesia, akinesia, and dyskinesia by pair-wise visual analysis of gated pre and postoperative SPECT's on the same monitor screen. Myocardial wall thickening was determined good or poor Among 92 segments with wall motion abnormalities before operation, 69 (75%) improved and 23 did not. Before operation, we could find segments with good systolic thickening in 64 segments among total 92. Thickening of the remaining 28 was poor. Wall motion improved postoperatively in 45 segments (70%) among 64 with good thickening. Twenty four(86%) among 28 segments with poor thickening had also improved. We grouped segments into mild(hypokinetic) and severe(akinetic/dyskinetic) ones. Among 33 segments with severe motion abnormalities, 14 had good thickening and 19 did not. Nine(60%) improved out of 14 segments having severe abnormality with good thickening. However, 16(84%) segments out of 19 having severe abnormality with poor thickening also improved. Neither degree of perfusion decrease nor severity of wall motion abnormalities could explain the high rate of false negatives. In conclusion, as we defined viability as wall motion improvement by comparing pre and postoperative SPECT, systolic thickening observed by gated Tc-99m-MIBI SPECT in myocardial segments with wall motion abnormalities predicted wall motion improvement after bypass surgery. However, poor thickening could not be referred as evidence of nonviable myocardium both in mild and severe contractile dysfunction, so that we might need stimulation study such as dobutamine echocardiography or dobutamine gated SPECT.
Dobutamine ; Dyskinesias ; Echocardiography ; Humans ; Hypokinesia ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

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