Management Of Movement Disorders Research Articles

SURGICAL MANAGEMENT OF MOVEMENT DISORDERS

SURGICAL MANAGEMENT OF MOVEMENT DISORDERS edited by Gordon Baltuch and Matthew Stern , 328 pp., Informa Healthcare, $199.95 (hardback), $99.95 (paperback) I’ve always agreed with the maxim stating that “good things often come in small packages.” This is particularly apt for Gordon Baltuch’s and Matthew Stern’s Surgical Management of Movement Disorders : appealing for its compactness, not only in size, but, more importantly, for its careful condensation of a large body of complex information. The book is divided into seven sections. Section I concerns Parkinson disease and comprises five chapters devoted to various aspects of this disease. The last chapter entitled “Novel Surgical Strategies” is particularly well written, …

Clinical value of botulinum toxin in neurological indications

Botulinum toxin type-A (BoNT-A) prevents the release of acetylcholine at cholinergic junctions, thereby causing temporary muscle weakness lasting 3-4 months. It is now widely used to treat a broad range of clinical disorders characterized by muscle hyperactivity. BoNT-A has proved effective in the management of several neurological conditions and, in particular, in the management of movement disorders (e.g. blepharospasm, cervical dystonia, laryngeal dystonia, limb dystonia, hemifacial spasm, focal tics, tremor and other hyperkinetic disorders). As a treatment of spasticity, BoNT-A can improve mobility and dexterity as well as preventing the development of distressing and costly secondary complications. In cerebral palsy, BoNT-A is of value, being able to delay or even avoid surgery until motion patterns have become established.

Management of movement disorders in glutaryl‐CoA dehydrogenase deficiency: Anticholinergic drugs and botulinum toxin as additional therapeutic options

Glutaric aciduria type I is an inborn error of metabolism due to the deficiency of glutaryl-CoA dehydrogenase, an enzyme responsible for the catabolism of lysine, hydroxylysine and tryptophan. The most important neurological symptoms include dyskinesia and dystonia, which can be focal, segmental or generalized. Treatment of the extrapyramidal syndrome is often unsatisfactory. We report our experience in the treatment of generalized and focal dystonia with anticholinergic drugs and botulinum toxin type A, respectively. Both therapies proved beneficial.

Tratamiento neuroquirúrgico en la enfermedad de Parkinson y el temblor esencial

Recent technological advances along with new neuroimaging techniques and progress in neuro-monitoring have provided us with new therapeutical options from the neurosurgical point of view in the management of movement disorders. Deep brain stimulators become more and more frequently used in the last few years since they have reversible effects, are easily implantable and have shown good initial results. However, only now we start knowing the clinical effects in the middle run.To review the main neurosurgical options in Parkinson's disease and tremor.We reviewed the articles considering ablative or stimulating neurosurgical treatments in these diseases, and we grouped the results according to the technique performed and the time of follow-up.Clinical results are often similar despite the use of different techniques. However, the side-effects are critical in deciding which technique should be used once medical therapy has been considered insufficient.

Schuster atlas of gastrointestinal motility in health and disease, second editionedited by Marvin M. Schuster, Michael D. Crowell, and Kenneth L. Koch. 472 pp. $149.00. B.C. Decker Inc, Hamilton, London, 2002. ISBN 1-55009-104-2. Web address for ordering: www.bcdecker.com

Schuster atlas of gastrointestinal motility in health and disease, second editionedited by Marvin M. Schuster, Michael D. Crowell, and Kenneth L. Koch. 472 pp. $149.00. B.C. Decker Inc, Hamilton, London, 2002. ISBN 1-55009-104-2. Web address for ordering: www.bcdecker.com

Case study: Pharmacologic management of movement disorder after midbrain haemorrhage

Movement disorders following midbrain haemorrhage are infrequently encountered in rehabilitation, and are uncommonly corrected by pharmacologic means. This report describes a 20 year-old male with a prior history of cocaine abuse who presented with a 4 day history of dysarthria and blurred vision following methamphetamine abuse. Physical examination demonstrated hypertension, left facial hemispasm, bilateral upward gaze paresis and ataxic gait. Magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) showed multifocal parenchymal haematomas in the mesencephalic tegmentum, subcortical left front region and right anterior thalamus consistent with cavernous angiomas. The patient was transferred to rehabilitation on hospital day 5. The following day, he developed choreoathetoid movements, dystonia, and aphasia, secondary to an extension of the midbrain haemorrhage. Cogentin was initiated with slight improvement in choreoathetoid movements. The patient began intensive multidisciplinary rehabilitation therapy but after 18 days of therapy, the patient remained totally dependent in activities of daily living (ADLs), transfers, mobility and was unable to communicate in any manner. A trial of Sinemet was initiated, with resultant steady improvement in functional ability over the next month. By discharge, the patient was independent in ADLs and ambulation. By 9 months post discharge follow-up, the patient was fully independent with normal cognition, and had self tapered all medications without ill effect. Dopamine agonist trials of appropriate duration appear indicated in cases of movement disorder (paucity or excess) following midbrain lesions.

Prisms in the Medical and Surgical Management of Strabismus

This is a complete reference about the use of prisms for diagnosis, treatment, and assistance in surgical planning and therapy of strabismus. The author, Dr Veronneau-Troutman, is an accomplished practitioner and innovator in the management of motility disorders, particularly in the use of prisms. Her experience is translated in a concise and usable form. The text begins with a discussion of optical principles and conventions of using and prescribing prisms. Alone, this segment provides a complete review of clinical optics, but as a bonus, there are additional valuable pearls such as the use of prisms in toric contact lenses to provide ballast. A significant portion of the text is devoted to discussing the advantages of Fresnel membrane prisms, their effect on vision, binocularity, care and handling, and their use in motility disorders. As a testament of the versatility of Fresnel prisms in transcending all aspects of ophthalmologic practice, their use

THERAPEUTIC STRATEGIES FOR MOTILITY DISORDERS: Medications, Nutrition, Biofeedback, and Hypnotherapy

Gastrointestinal motility is regulated by a complex balance of inhibitory and excitatory neuronal, humoral, and mechanical factors. The goal in the management of motility disorders is to maintain adequate nutrition while decreasing symptoms. This can be accomplished by medications and support of nutrition and biofeedback; the application of these therapeutic strategies to patients with gut motility disorders is reviewed.

Management of Movement Disorders: An Overview

Functional neurosurgery has been involved with management of movement disorders since the first days of stereotactic surgery. Those movement disorders that can be managed surgically are reviewed, along with general criteria for patient selection. A flow sheet of surgically managed movement disorders is supplemented by descriptions of how patients are assigned to various treatment categories and the various treatments available.

Current concepts in the management of movement disorders.

Current concepts in the management of movement disorders.