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

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

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

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

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 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*

Tremor is defined as involuntary, rhythmic, and sinusoidal movement. The rate, location, amplitude, and constancy vary depending on the specific type of tremor and its severity. Etiologies and treatment of tremors differ according to the type of tremor. It is helpful to determine whether the tremor is present at rest, with posture-holding, with action or with intention maneuvers. Rest tremor is most typically present in patients with Parkinson's disease. Physiologic tremors and essential tremors are common forms of postural tremor. Intention tremor is typically present in cerebellar lesions. Associated neurological symptoms and signs are also helpful for differential diagnosis. Not all patients with hand tremor have Parkinson's disease. Rest tremor, bradykinesia, rigidity, and loss of postural reflex are cardinal signs of Parkinson's disease. Careful observation of the patient is the key point of diagnosis in patients with tremor.
Diagnosis ; Diagnosis, Differential ; Essential Tremor ; Hand* ; Humans ; Hypokinesia ; Intention ; Parkinson Disease* ; Reflex ; 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

PURPOSE: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. METHODS: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. RESULTS: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echocardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patientswere discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were 2.53+/-2.29 and 2.19+/-2.12, respectively (p=0.860). CONCLUSION: Cardiovascular manifestations occurafter acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant initself in the clinical course, and the short-term prognosis of cardiac toxicityis unlikely to be unfavorable in acute CO poisoning.
Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Echocardiography ; Electrocardiography ; Emergencies ; Humans ; Hypokinesia ; Hypotension ; Prognosis ; Retrospective Studies