Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Meige Syndrome ; therapy

Acupuncture Therapy ; Humans ; Male ; Meige Syndrome ; therapy ; Middle Aged

Acupuncture Points ; Acupuncture Therapy ; Humans ; Male ; Meige Syndrome ; therapy ; Middle Aged

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Meige Syndrome ; therapy ; Middle Aged

Herein, a rare case of ovarian granulosa cell tumor, presenting as Meigs' syndrome, with elevated carbohydrate antigen 125 (CA125), is reported. A 69-year-old woman was admitted for the investigation of abdominal fullness and dyspnea. A preoperative examination revealed a huge pelvic tumor and an abdominopelvic magnetic resonance image (MRI) assumed ovarian cancer. A chest computed tomography (CT) scan revealed pleural effusion. A laparotomy confirmed the huge mass to be an ovarian tumor. A total abdominal hysterectomy (TAH), with a bilateral salpingo-oophorectomy (BSO) and partial omentectomy, was performed. Although short-term intrathoracic drainage was required, the hydrothorax and ascites rapidly resolved in the postoperative period.
Aged ; CA-125 Antigen/*blood ; Diagnosis, Differential ; Female ; Granulosa Cell Tumor/*diagnosis ; Humans ; Meige Syndrome/*diagnosis ; Ovarian Neoplasms/*diagnosis

OBJECTIVE: Meige syndrome is the combination of blepharospasm and oromandibular dystonia. We assessed the surgical results of bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) in patients with medically refractory Meige syndrome. METHODS: Eleven patients were retrospectively analyzed with follow-ups of more than 12 months. The mean follow-up period was 23.1 +/- 6.4 months. The mean age at time of surgery was 58.0 +/- 7.8 years. The mean duration of symptoms was 8.7 +/- 7.6 years. DBS electrodes were placed under local anesthesia using microelectrode recording and stimulation. After 2.4 +/- 1.3 days of trial tests, the stimulation device was implanted under general anesthesia. Patients were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). RESULTS: BFMDRS total movement scores improved by 59.8%, 63.5%, 74.1%, 74.5%, and 85.5% during the immediate postoperative period of test stimulation, 3, 6, 12, and 24 months (n = 5) after surgery, respectively. The BFMDRS total movement scores were reduced gradually and the results reached statistical significance in the postoperative period (test period, p < 0.001; 3 months, p < 0.001; 6 months, p = 0.003; 12 months, p < 0.001; 24 months, p = 0.042). There was no statistical difference between 12 months and 24 months. BFM subscores improved by 63.3% for the eyes, 80.9% for the mouth, 68.4% for speech/swallowing, and 87.9% for the neck at 12 months after surgery. The adverse effects were insignificant. CONCLUSION: The bilateral GPi-DBS can be effective for the treatment of intractable Meige syndrome without significant side effects.
Anesthesia, General ; Anesthesia, Local ; Blepharospasm ; Deep Brain Stimulation ; Dystonia ; Electrodes ; Eye ; Follow-Up Studies ; Globus Pallidus ; Humans ; Meige Syndrome ; Microelectrodes ; Mouth ; Neck ; Postoperative Period ; Retrospective Studies

Sulpiride, a selective antagonist for adenylate cyclase-independent dopamine receptors, was administrated to 25 patients with blepharospasm and oromandibular dystonia(Meige's syndrome). Of the 25, 7 patients (28%) exhibited marked and lasting improvement with sulpiride and 12 patients (48%) showed mild or transient improvement. This favorable therapeutic response to sulpiride suggests that striatal glutamate underactivity may play a role in the pathophysiology of Meige's syndrome as a primary or secondary defect.
Adult ; Aged ; Basal Ganglia Diseases/*drug therapy ; Corpus Striatum/metabolism ; Dopamine/metabolism ; Female ; Glutamates/metabolism ; Glutamic Acid ; Human ; Male ; Meige Syndrome/*drug therapy/metabolism ; Middle Age ; Sulpiride/*therapeutic use

OBJECTIVE[corrected] To evaluate efficacy and safety of botulinum toxin type B (BTX-B) in treatment of movement disorders including blepharospasm, oromandibular dystonia, hemifacial spasm, tremor, tics, and hypersecretory disorders such as sialorrhea and hyperhidrosis.

METHODSA retrospective study of BTX-B injections in treatment of 58 patients with various neurological disorders was performed. The mean follow-up time was 0.9 +/- 0.8 years. Results of the first and last treatment of patients with at least 3 injection sessions were compared.

RESULTSThe response of 58 patients to a total of 157 BTX-B treatment sessions was analyzed. Of the 157 treatment sessions, 120 sessions (76.4%) resulted in moderate or marked improvement while 17 sessions (10.8%) had no response. The clinical benefits after BTX-B treatment lasted an average of 14 weeks. Of the 41 patients with at least 3 injection sessions (mean 10 +/- 8.6), most patients needed increased dosage upon the last session compared to the first session. Nineteen patients (32.8%) with 27 sessions (17.2%) reported adverse effects with BTX-B treatment.

CONCLUSIONSThough most patients require increased dosage to maintain effective response after repeated injections, BTX-B is an effective and safe treatment drug for a variety of movement disorders, as well as drooling and hyperhidrosis.

Anti-Dyskinesia Agents ; administration & dosage ; therapeutic use ; Blepharospasm ; drug therapy ; Botulinum Toxins ; administration & dosage ; therapeutic use ; Botulinum Toxins, Type A ; Follow-Up Studies ; Humans ; Hyperhidrosis ; drug therapy ; Injections ; Meige Syndrome ; drug therapy ; Movement Disorders ; drug therapy ; Retrospective Studies ; Sialorrhea ; drug therapy ; Torticollis ; drug therapy