Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Parkinson’s Disease and Movement Disorders
TN Mehrotra, Kalyan B Bhattacharyya
1:
The Life and Works of James Parkinson
INTRODUCTION
The Early Years
His Political Inclinations and Social Activities
His Writings
His Magnum Opus
His Final Years
2:
The History of Evolution of Surgery for Movement Disorders
INTRODUCTION
ORIGIN
STEREOTACTIC SURGERY AND MOVEMENT DISORDERS
THE ASCENT OF STEREOTAXY
THE FALL AND RISE OF STEREOTACTIC SURGERY
PALLIDOTOMY REVISITED
THE IMPACT OF ADVANCED IMAGING AND COMPUTERIZATION
THE FUTURE
3:
Basal Ganglia: Structure and Function
4:
Epidemiology of Movement Disorders in India and in Other Countries
INTRODUCTION
DIFFICULTIES IN EPIDEMIOLOGICAL STUDIES OF MOVEMENT DISORDERS
OVERVIEW OF MOVEMENT DISORDERS IN INDIA
EPIDEMIOLOGY OF PD
DESCRIPTIVE EPIDEMIOLOGY
Prevalence Rate (Table 4.1)
Incidence (Table 4.1)
Age
Gender
Race
Time Trends
ANALYTICAL EPIDEMIOLOGY
Genetic Factors
Environmental Factors
The Indian Data
Mortality
Survival
Atypical Parkinsonism
EPIDEMIOLOGY OF DYSTONIA
Prevalence
Incidence
Age
Gender
Genetic Factors
Environmental Factors
Prognosis
Indian Scenario
EPIDEMIOLOGY OF ESSENTIAL TREMOR
Prevalence
Incidence
Age
Gender
Race
Genetic Factors
Environmental Factors
Prognosis
Indian Scenario
EPIDEMIOLOGY OF CHOREA—INDIAN PICTURE
EPIDEMIOLOGY OF HUNTINGTON'S DISEASE
Prevalence
Age at onset
Survival
EPIDEMIOLOGY OF WILSON'S DISEASE
Prevalence and Incidence
Age of Onset
Gender
EPIDEMIOLOGY OF TIC DISORDERS
Prevalence Study
Incidence Study
Natural History136
Risk Factors
TICS IN INDIA
CONCLUSION
ACKNOWLEDGEMENT
5:
Genetics of Parkinson's Disease
INTRODUCTION
Pathogenesis of PD
Autosomal Dominant Forms of Parkinsonism (ADPD)
PARK-1 Gene Mutation and Related PD
PARK–3
PARK–4
PARK–5
PARK–8
PARK–11
Autosomal Recessive Parkinsonism (ARPD)
PARK–2
PARK–6
PARK-7
PARK–10
PD in a Cuban Kindred
Parkinsonism and Mitochondrial Dysfunction
What is the Importance of Discovering Gene Linkage and Mutations in the Familial Forms of Parkinsonism?
Twin Studies and Familial Aggregation Studies in PD
Is Common Parkinsonism Etiologically a Multifactorial Disease with Gene-Environment or Gene-Gene Interaction or Both?
6:
Pathology of Movement Disorders
INTRODUCTION
CLASSIFICATION OF MOVEMENT DISORDERS
AKINETIC/RIGID MOVEMENT DISORDERS
Parkinsonism
Causes of Parkinsonism
Common causes
Idiopathic Parkinson's Disease
Neuropathology
Guam-Parkinsonian Dementia
Neuropathology
Postencephalitic Parkinsonism
Neuropathology
Progressive Supranuclear Palsy (PSP)
Neuropathology
AREAS AFFECTED BY TAU PATHOLOGY IN PSP
Usually Severely Affected
Commonly but Variably Affected
Uncommonly Affected
Never Affected
DIAGNOSTIC CRITERIA FOR PSP
HYPERKINETIC MOVEMENT DISORDERS
Chorea
Causes of Chorea
Hereditary
Sporadic
Hungtington's Disease (HD)
Neuropathology
Neuroacanthocytosis
Neuropathology
Chorea Minor
Neuropathology
Wilson's Disease (WD)
Neuropathology
Neurodegeneration with Brain Iron Accumulation (Hallervorden-Spatz Disease)
Neuropathology
Hemiballismus and Ballismus
Myoclonus
Lafora Body Disease
Neuropathology
Neuronal Ceroid Lipofuscinosis (Batten's Disease)
Dystonia
Primary Inherited Dystonias and Dyskinesias
Neuropathology
Craniofacial Dystonia (Meige's Syndrome)
Tic Disorders
Gilles DE LA Tourette Syndrome
Neuropathology
ATAXIC MOVEMENT DISORDERS
Friedreich's Ataxia
Ataxia-Telangiectasia
Neuropathology
Autosomal Dominant Cerebellar Ataxia
ADCA I, SCA 1, SCA 2, SCA 3 and Machado-Joseph Disease (a form of SCA 3)
Dentatorubropallidoluysial Atrophy (DRPLA)
Mitochondrial Encephalopathy
Neuropathology
MOTOR NEURON DISORDERS
Motor Neuron Disease (Amyotrophic Lateral Sclerosis)
Neuropathology
Spinal Muscular Atrophy
7:
Immunology and Movement Disorders
INTRODUCTION
The Spectrum of Poststreptococcal Movement Disorders
Sydenham's Chorea (SC)
Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS)
Other Post-Streptococcal Movement Disorders
Pathophysiology of the Poststreptococcal Syndromes
Neuroimaging in PoststreptococcalSyndromes
Therapy in Poststreptococcal Syndromes
Autoimmune Connective Tissue/Vasculitic Diseases Associated Movement Disorders
SLE
Antiphospholipid Antibody Syndrome (Hughes’ Syndrome)
Hashimoto's Thyroiditis
Other Autoimmune Disorders
Paraneoplastic/Idiopathic Disorder Associated Movement Disorders
Opsoclonus Myoclonus Syndrome (OMS)
Neuromyotonia
Stiff Person Syndrome
Paraneoplastic Chorea
Paraneoplastic Myelitis
Demyelinating Disease Associated Movement Disorders
Multiple Sclerosis
ADEM
Demyelinating Neuropathy Associated Tremor
Classic Idiopathic/Degenerative Syndromes: “Immune Mechanisms Proposed”
Idiopathic Tic Disorder/Tourette Syndrome/OCD
Parkinson's Disease (PD)
CONCLUSION
8:
Major Symptoms and Signs of Parkinson's Disease
INTRODUCTION
Clinical Features
Motor Symptoms
Non-motor Symptoms
Assessment of Severity
Diagnostic Value of Clinical Features
DIFFERENTIAL DIAGNOSIS
CONCLUSION
9:
Less Common Features in Diagnosis of Parkinsonism
10:
A Clinical Approach to the Diagnosis of Akinetic-Rigid Syndrome: Parkinson's Disease and Parkinsonism Plus Syndromes
INTRODUCTION
EARLY DIAGNOSIS
THE NEXT STEP IN THE DIAGNOSIS
Posture and Gait
Facial Expression
Eye Movements
Tremor and Symmetry of Involvement
Rigidity and Bradykinesia
Autonomic Symptoms and Bulbar Involvement
Dementia and ARS
Borderlands of ARS
Dystonia, Ataxia and Pyramidal Involvement
Response to Levodopa and Other Drugs
INVESTIGATIONS IN ARS
CONCLUDING REMARKS
11:
Diagnosis of Parkinsonism
INTRODUCTION
DIAGNOSIS
SIGNS AND SYMPTOMS OF PARKINSON'S DISEASE
Step 1. Diagnosis of Parkinsonian Syndrome
Step 2. Exclusion Criteria for Parkinson's Disease
Step 3. Supportive Prospective Positive Criteria for Parkinson's Disease
INVESTIGATIONS
Computed Tomography Scan
Magnetic Resonance Imaging
Positron Emission Tomography
Diagnostic Difficulties
12:
Pitfalls in the Diagnosis of Parkinson's Disease
BACKGROUND
Pitfalls in the Diagnosis of PD
Previous Studies to Assess the Diagnostic Accuracy
Pharmacological Considerations
Neuroimaging
The Problems with Early Diagnosis—Impact on Neuroprotection Studies
Synthesis and Recommendations
13:
Nocturnal Disabilities in Parkinson's Disease and its Management
INTRODUCTION
THE IMPACT OF THE PROCESS OF PARKINSON'S DISEASE ON SLEEPINESS
INSTRUMENTS FOR ASSESSMENT OF SLEEP IN PD
NOCTURNAL SYMPTOM COMPLEX OF PD
TREATMENT STRATEGIES
SUMMARY OF TREATMENT STRATEGIES FOR NOCTURNAL SYMPTOMS OF PD
CONCLUSION
ACKNOWLEDGEMENTS
14:
Sleep and Parkinson's Disease
HISTORICAL ASPECTS
CLINICAL MANIFESTATIONS
CLASSIFICATION
Effect of PD On Sleep
Classification
Effect of Drugs For PD On Sleep
Parasomnias
Effect of Sleep on Parkinson's Disease
Management
15:
Autonomic and Vegetative Functions in Parkinson's Disease
URINARY DYSFUNCTIONS
SEXUAL DYSFUNCTION
ORTHOSTATIC HYPOTENSION
SWEATING
DYSPNEA
CARDIAC ARRHYTHMIAS
CHRONIC CONSTIPATION
16:
Depression and Dementia in Parkinson's Disease
INTRODUCTION
DEPRESSION IN PARKINSON'S DISEASE
TREATMENT OF DEPRESSION IN PD
DEMENTIA IN PARKINSON'S DISEASE
CLINICAL PROFILE OF DEMENTIA IN PD
TREATMENT OF DEMENTIA IN PARKINSON'S DISEASE
CONCLUSION
17:
Psychosis in Parkinson's Disease
INTRODUCTION
Magnitude of the Problem
Clinical Features
Etiology and Risk Factors
Pathophysiology of Psychosis in PD
Management of Psychosis in PD
Newer Atypical Antipsychotic Drugs
Clozapine
Olanzapine
Risperidone
Quetiapine
Cholinesterase Inhibitors
Choice of Drug Therapy for Psychosis in PD
18:
Young Onset Parkinson's Disease: A Review
INTRODUCTION
REVIEW OF LITERATURE
INCIDENCE AND PREVALANCE
Familial Incidence
CLINICAL FEATURES
RESPONSE TO LEVODOPA
PROGRESS OF THE DISEASE
MORTALITY
ENVIRONMENTAL RISK FACTORS
GENETICS OF YOPD
NEUROPATHOLOGY
NEUROCHEMISTRY
QUALITY OF LIFE AND FINANCIAL BURDEN
SUMMARY
19:
Electrophysiological Evaluation of Movement Disorders: An Overview
INTRODUCTION
EVALUATION OF TREMOR
Recording Muscle Activity and Movement
Polymyography
Recording Movement
Protocol for Recording Tremor
Resetting of Tremor by Peripheral and Central Stimulation
Data Analysis
Differential Diagnosis of Tremors
Measurement of Ballistic Arm Movements
EVALUATION OF JERKS
Differential Diagnosis of Jerks
Organic Jerks
Psychogenic Jerks
EVALUATION OF DYSTONIAS AND SPASMS
Abnormalities of EMG and Kinematics Studies
Abnormalities of Spinal Cord Reflexes
Abnormalities of Brainstem Reflexes
Abnormalities of SEPs
Abnormalities of Premovement Potentials
(a) Bereitschafts Potential (BP)
(b) Contingent Negative Variation (CNV)
Abnormalities of Transcranial Magnetic Stimulation (TMS)
CONCLUSION
20:
Basic Principles in the Pharmacotherapy of Parkinson's Disease
SUBCLINICAL EARLY ASYMPTOMATIC PD
CLINICAL MILDLY SYMPTOMATIC PD
EARLY PD—SYMPTOMATIC DISEASE REQUIRING TREATMENT
Neuroprotective Therapy
Symptomatic Therapy
Anticholinergics
Amantadine
Levodopa
Dopamine Agonists (including bromocriptine, pergolide, pramipexole, ropinirole, lisuride, cabergoline, and apomorphine)
TREATMENT OF ADVANCED PARKINSON'S DISEASE
Medical
Motor Fluctuations in Advanced PD (Listed in Table 20.4)
Early Morning Akinesia
Wearing-off
On-off
Freezing
Off Period Dystonia
Peak-dose Dyskinesia
Diphasic Dyskinesia
Treatment of Motor Fluctuations and Dyskinesia
Plotting the Response
Medical Treatment of Fluctuations and Dyskinesia
Surgical Treatments of Advanced PD
Nonmotor Symptoms in Advanced PD
Mental Symptoms
Anxiety
Depression
Dementia
Sleep in PD
Autonomic Dysfunction
CONCLUSION
21:
Neuroprotective Drug Therapy in Parkinson's Disease
INTRODUCTION
NEED FOR NEUROPROTECTIVE THERAPY
APPROACHES FOR NEUROPROTECTION
PATHOGENESIS
DEFINITION OF NEUROPROTECTIVE THERAPY
NEUROPROTECTION IN PD
CLINICALLY AVAILABLE NEUROPROTECTIVE AGENTS
Dopamine Agonists
Monoamine Oxidase B Inhibitors
Vitamin E and Other Antioxidants
Agents that Enhance Mitochondrial Function
Agents That Reduce Excitotoxic Injury
Neurotrophic Agents and Other Neuroprotective Strategies
Problems in Evaluation of Neuroprotective Agents
Recommendations for Use of Neuroprotective Agents
CONCLUSION
22:
Levodopa in the Early Stages of Parkinson's Disease
INTRODUCTION
Age
Type of PD
The Dopamine Agonists and Levodopa
Neurotoxicity
Neuroprotection
CONCLUSION
23:
Role of Levodopa in Late Stage of Parkinson's Disease
24:
Therapeutic Challenges of Levodopa Therapy in Parkinson's Disease
INTRODUCTION
LEVODOPA THERAPY IN PD: THE STORY SO FAR
LEVODOPA THERAPY: CONTROVERSIES AND CHALLENGES
IS LEVODOPA TOXIC TO NIGRAL CELLS?
LEVODOPA THERAPY: EARLY OR DELAYED?
EARLY COMBINATION OF LEVODOPA AND AN AGONIST
LEVODOPA ASSOCIATED MOTOR COMPLICATIONS: NEW INSIGHTS
MOTOR FLUCTUATIONS: STRATEGIES FOR MANAGEMENT
DYSKINESIAS: MANAGEMENT STRATEGIES
SURGERY AND PD
SUMMARY
25:
Dopamine Agonists in Parkinson's Disease
INTRODUCTION
Side Effects
The ‘Sleep Attack’ Phenomenon
Dopamine Agonists as Monotherapy in Early PD
Dopamine Agonist in Early Combination with Levodopa in PD
Dopamine Agonist in Late Combination with Levodopa
26:
Dopamine Agonists
PHARMCO-PHYSIOLOGY OF DOPAMINE AGONISTS
DOPAMINE AGONISTS
SIDE EFFECTS OF DOPAMINE AGONISTS (DA) IN GENERAL
SLEEP ATTACK PHENOMENON
BROMOCRIPTINE
LONG-TERM EFFECTS OF BC THERAPY
BROMOCRIPTINE—PLACE IN THE THERAPY OF PD
LERGOTRILE
PERGOLIDE
LISURIDE
MESULAGINE
OVERHAUL EXPERIENCE
OTHER AGENTS
AMANTIDINES
CABERGOLINE
SELEGILINE
PIRIBEDIL
PRAMIPEXOLE
ROPINIROLE
HOW TO CHOOSE A DOPAMINE AGONISTS
IDEAL DA
FUTURE ADVANCES
HOW TO CHOOSE A DOPAMINERGIC AGONISTS?
AS MONOTHERAPY
SAFETY PROFILE
NEUROPSYCHIATRIC PROBLEMS
CONCLUSION
27:
The Use of Dopamine Agonists in Parkinson's Disease: A Review
INTRODUCTION
ADVANTAGES OF DOPAMINE AGONISTS
PITFALLS OF DOPAMINE AGONISTS
DOPAMINE RECEPTORS
PHYSIOLOGY OF DOPAMINE RECEPTORS
AFFINITY OF DA TO RECEPTOR SUB-TYPES
ERGOT DOPAMINE RECEPTOR AGONISTS
Bromocriptine
Pergolide
Cabergoline
Lisuride
NON-ERGOT DOPAMINE RECEPTOR AGONISTS
Apomorphine
Pramipexole
Ropinirole
FUTURE AGENTS
CONCLUSION
28:
Dopaminergic Therapy for Parkinson's Disease: Current Status
INTRODUCTION
MANAGEMENT OF PARKINSON'S DISEASE
Symptomatic Drug Therapy
LEVODOPA
History
Metabolism
Formulations
Efficacy Data
Status of Levodopa
COMT Inhibitors
Merits
Demerits
DOPAMINE AGONISTS (DA)
Background
Pharmacodynamic Issues
Common Side Effects of DA
Pharmacokinetic Data
Clinical Data
For Symptomatic Therapy of PD as Monotherapy: DA vis-à-vis Levodopa
Use of DA as Early Combination Therapy with Levodopa
Use of DA with Levodopa as Late Combination Therapy
Neuroprotection
Neuroprotection and DA
Background
Evidence
Autoreceptor Effect
DA SUMMARY
Merits
Demerits
ALGORITHM FOR MANAGEMENT
CONCLUSION
29:
Non-pharmacological Treatment in Parkinson's Disease
INTRODUCTION
PARAMEDICAL THERAPY
Physical Therapy
Occupational Therapy
Speech and Language Therapy
Effect of Visual Cues on Gait Freezing
ALTERNATIVE THERAPIES
Acupuncture
DIETARY SUPPLEMENTS AND PARKINSON'S DISEASE
Alpha-tocopherol
Coenzyme Q10
Music Therapy
CONCLUSION
30:
Stereotactic Surgery for Parkinson's Disease in India: Current Status
INTRODUCTION
MATERIAL AND METHODS
SURGICAL TECHNIQUE
RESULTS
STN Stimulation
Pallidotomy
Thalamotomy/Thalamic Stimulation
COMPLICATIONS
STN Stimulation
Pallidotomy
Thalamotomy/Thalamic Stimulation
DISCUSSION
CONCLUSION
31:
Future Directions in the Medical Therapy of Parkinson's Disease
INTRODUCTION
NEUROPROTECTIVE THERAPIES
Caffeine
Coenzyme Q10
Rasagiline
Zydis Selegiline
GPI-1485
CEP-1347
SYMPTOMATIC THERAPY
Apomorphin
Moclobemide
Rotigotine (spm-962)
TV-1203 (Levodopa Ethyl Ester)
S-32504
Intraduodenal Infusion of Levodopa (Duodopa)
Dihydroergocryptine
TREATING DYSKINESIAS
Levetiracetam
GDNF
Alpha-2 Adrenergic Receptor Antagonists
Rimantidine
Talampanel
KW-6002
32:
Rehabilitative Management in Parkinson's Disease
INTRODUCTION
DEFINITION
ASSESSMENT AND EVALUATION
Subjective Examination
SIGNS
Posture
GRADING
Balance9
Learnt and Voluntary Movement
Automatic Movements
Rigidity
Tremor
Gait
Finger Dexterity
Speech
Cough and Swallowing
Reflexes and Sensory Changes
DISABILITY GRADING
The Hoehn and Yahr Staging11,13
Functional Assessment
Cognition Assessment16
Additional Assessments
TREATMENT PROGRAM
Goals
General Principles of Treatment
Analysis of Functional Difficulties
Routine for ADL
Movement Facilitation
Motor Learning
Postural Awareness
Gait
Visual Cueing
Relaxation
Adaptive Technique
Learning New Tasks
Long-Term Care
Home Exercises
Patient and Family Education
Vocational Rehabilitation
CONCLUSION
33:
Progressive Supranuclear Palsy
INTRODUCTION
CLINICAL FEATURES
Postural Instability, Falls and Extrapyramidal Features
Neuro-ophthalmological Features
Frontal Lobe Features
Other Features
CLINICAL DIAGNOSTIC CRITERIA
Possible PSP—Mandatory Inclusion Criteria
Probable PSP—Mandatory Inclusion Criteria
For both, Probable and Possible PSP— Mandatory Exclusion Criteria
Definite PSP
NATURAL HISTORY
DIFFERENTIAL DIAGNOSIS
Parkinson's Disease
Corticobasal Degeneration
Multiple System Atrophy
Other Diagnoses in the Differential
NEUROPATHOLOGY
ETIOLOGY
LAB STUDIES
Magnetic Resonance Imaging
Functional Neuroimaging
PET
SPECT
Evoked Potentials
Electro-oculography
Polysomnography
Other Brainstem Reflexes
Anal Sphincter Electromyography and Urodynamic Studies
TREATMENT
34:
Chorea
INTRODUCTION
Pathophysiology
Post-infectitious/infectitious/autoimmune
Endocrinological
Drug-Induced Chorea
Vascular
Others
Chorea and Neuroacanthocytosis (NA)
Benign Hereditary Chorea
Senile Chorea
Paroxysmal Kinesogenic Chorea
Chorea in Wilson's Disease (WD)
Diagnosis
Treatment
Fahr's Syndrome (Synonym: Familial Idiopathic Basal Ganglia Calcification)
Hallervorden-Spatz Syndrome
Chorea in Autoimmune Disorders
Sydenham's Chorea
Clinical
Etiopathogenesis
Neuroimaging
Pathophysiology
Treatment
SLE
APL Syndromes
Chorea Gravidarum
Drug-Induced Chorea
CHOREA IN CEREBROVASCULAR DISEASES
CHOREA IN MITOTIC DISEASES
CHOREA METABOLIC
Diabetes Mellitus
Summary
35:
Huntington's Disease
INTRODUCTION
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
PATHOLOGICAL CHANGES
GENETIC AND MOLECULAR STUDIES
EPIDEMIOLOGY
INDIAN STUDIES
CLINICAL FEATURES OF AN INDIAN COHORT
NEUROLOGICAL STATUS
RADIOLOGY
TRINUCLEOTIDE REPEATS
SPREAD OF HD IN INDIA
THERAPY OF HD
36:
Unusual Tremors
INTRODUCTION
Orthostatic Tremor
Task and Position—Specific Tremors
Primary Writing Tremor
Dystonic Tremor Syndrome
Dystonic Tremor
Tremor Associated with Dystonia
Dystonia Gene Associated Tremor
Midbrain or Holmes Tremor
Neuropathic Tremor
37:
Wilson's Disease
INTRODUCTION
PATHOGENESIS
PATHOLOGY
GENETICS
CLINICAL PRESENTATION
Guidelines for Screening
KF Ring
Serum Ceruloplasmin (Cp)
24 Hours Urinary Copper
Serum Copper
Radioactive Copper Incorporation Test
Liver Biopsy
Magnetic Resonance Imaging (MRI)
THERAPEUTIC AGENTS IN WD
CONCLUSION
38:
Dystonia
INTRODUCTION
THE PHENOMENON OF DYSTONIC MOVEMENTS
EPIDEMIOLOGY
PATHOPHYSIOLOGY OF DYSTONIA
DYSTONIA RATING SCALES
Treatment
Oral Medications
Chemical Denervation
Rationale for Functional Neurosurgery in Dystonia
SURGICAL THERAPY
Ablative Surgery
Patient Selection for CNS Surgery
Pallidotomy: Our Experience
Thalamotomy
Role of Deep Brain Stimulation and Treatment of Dystonia
Intrathecal Baclofen for the Treatment of Dystonia
CONCLUSION
39:
Cerebral Palsy and Movement Disorders
INTRODUCTION
Epidemiology
Classification
Movement Disorders in Cerebral Palsy
Choreoathetotic Cerebral Palsy
Dystonic Cerebral Palsy
Pathophysiology
Pathology
IMAGING TECHNIQUES
Radionuclide Scanning
Computed Tomography
Magnetic Resonance Imaging
Treatment
AN ANALYSIS OF 32 PATIENTS WITH EXTRAPYRAMIDAL CEREBRAL PALSY
Neurological Examination
Movement Disorders
Neuroimaging
Therapy
CONCLUSION
40:
Tourette's Syndrome
INTRODUCTION
PREVALENCE
DIAGNOSIS
CLINICAL FEATURES
GENETICS
NEUROBIOLOGY
IMMUNOLOGY
IMAGING
CO-MORBIDITY
TREATMENT
41:
Restless Legs Syndrome
INTRODUCTION
PATHOPHYSIOLOGY
Genetics
Neurochemistry
Iron and RLS
Alterations in the Sensory Nervous System
RLS, Systemic Diseases and Miscellaneous Agents
RLS and Other Sleep Disorders
CLINICAL FEATURES AND DIAGNOSIS OF RLS
POLYSOMNOGRAPHIC STUDIES IN RLS
MANAGEMENT
Benzodiazepines
Opiates
Dopamine and the Dopaminergic Agents
CONCLUSION
42:
Clinical Conundrum of Neuroleptic Malignant Syndrome
INTRODUCTION
HISTORICAL PERSPECTIVES
Pre-neuroleptic Era
Neuroleptic Era
Initial Recognition and Definition of the Syndrome
Refinement of the Clinical Definition and Criteria
Incidence and Risk Factors
Age and Sex
Affective Disorders
Patients at Risk of Neuroleptic Malignant Syndrome
Ambient Temperature
Organic Brain Syndromes
Other Disorders and Medication
Neuroleptic Agents
Role of Lithium
Withdrawal of Dopaminergic Agents
Pathogenetic Mechanisms and the Role of Hypodopaminergic Status
Skeletal Muscle Studies
Hyperadrenergic State
Other Potential Mechanisms
Autopsy Findings
Diagnostic Criteria and Clinical Features
Levenson's Criteria
Clinical Course
Mortality in NMS
Differential Diagnosis
Lethal Catatonia
Neuroleptic-induced Catatonia
Malignant Hyperthermia (MH)
Heatstroke
Serotonin Syndrome
Management
Supportive Treatment
Drug Therapy in MS
Dantrolene
Bromocriptine
Amantidine
Levodopa
Benzodiazepines
Electroconvulsive Therapy (ECT)
Re-Institution of Neuroleptics in Post-NMS Patients
43:
The Paroxysmal Dyskinesias
INTRODUCTION
Paroxysmal Dyskinesias
Paroxysmal Kinesigenic Choreoathetosis (PKC)
Paroxysmal Dystonic Choreoathetosis (PDC)
Paroxysmal Exercise-induced Dystonia (PED)
Paroxysmal Nocturnal HypnogenicDyskinesias (PNHD)
Secondary Paroxysmal Dyskinesias
Management of Paroxysmal Dyskinesias
44:
Myoclonic Epilepsy: The Borderzone Between Epilepsy and Movement Disorders
INTRODUCTION
TREATMENT CONSIDERATIONS
45:
Psychogenic Movement Disorders
INTRODUCTION
HISTORICAL SURVEY
PSYCHOPATHOLOGICAL BASIS OF PMD
EPIDEMIOLOGY
GENERAL CLUES REGARDING PMD7,10,11
Historical
Clinical
Therapeutic Response
REVIEW OF PSYCHIATRIC DIAGNOSIS
Somatoform Disorders
Conversion Disorder
Pathophysiology of Conversion Disorder
Diagnostic Criteria of Conversion Disorder12,13
Factitious Disorders
Malingering
PSYCHOGENIC DYSTONIA
PSYCHOGENIC TREMORS
PSYCHOGENIC GAIT DISORDERS
PSYCHOGENIC MYOCLONUS
APPROACH TO A PATIENT WITH PMD
APPROACH TO THERAPY
CONSULTATION
PROGNOSIS
CONCLUSION
46:
Movement Disorders in Children
INTRODUCTION
Spasticity
Dystonia
Choreoathetosis
Myoclonus
Tics
Tremor
47:
The Eye in Movement Disorders
INTRODUCTION
The Basics
Saccades
Smooth Pursuit
Vestibulo-ocular Reflex (VOR)
Vergence
Optokinetic Eye Movements
The Eye in Parkinson's Diseaseand Related Conditions
Oculomotor Abnormalities
Visual Sensory Abnormalities
Ocular Motor Abnormalities inParkinsonian Syndromes
Progressive Supranuclear Palsy (PSP)
Cortico-basal Ganglia Degeneration
Multiple System Atrophy (MSA)
Huntington's Disease (HD)
Wilson's Disease
Gilles De La Tourette Syndrome
Niemann-Pick's Disease Type C (Juvenile Dystonic Lipidosis)
Ataxia Telangiectasia (AT)
Neuroacanthocytosis
Focal Primary Dystonias
CONCLUSION
48:
Movement Disorders in Infectious Diseases
INTRODUCTION
MENINGITIS
Septic Meningitis
Tuberculous Meningitis
STREPTOCOCCUS RELATED MOVEMENT DISORDERS: SYDENHAM'S CHOREA AND PANDA
Sydenham's Chorea (SC)
Pathogenesis
Management
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS)
Post-streptococcal Autoimmune Dystonia with Isolated Striatal Necrosis (IBSN)
Encephalitis
Von Econono's Encephalitis (Encephalitis Lethargica)
General Clinical Presentation
Japanese Encephalitis
Slow Viral Diseases
Subacute Sclerosing Panencephalitis
Creutzfeldt-Jakob Disease
Acquired Immunodeficiency Syndrome (AIDS)Related Movement Disorders
49:
Drug Induced Acute Dystonia
INTRODUCTION
ACUTE DYSTONIA
CLINICAL FEATURES
PREVALENCE AND RISK FACTORS
DRUGS CAUSING DYSTONIA
PATHOPHYSIOLOGY
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
Prophylaxis
Drug Management
CONCLUSION
INDEX
TOC
Index
×
Chapter Notes
Save
Clear
