There has been a major resurgence in stereotactic neurosurgery for the treatment
of Parkinson’s disease and tremor in the past several years. More recently,
interest has also been rekindled in stereotactic neurosurgery for the treatment of
dystonia and other movement disorders.
In writing An Atlas of Parkinson’s Disease and
Related Disorders, I have been conscious of the
need to find an appropriate match between the
text and the illustrative material. The text is
designed to provide a basic overview of the conditions
discussed, inevitably concentrating on those
areas which lend themselves best to photographic
illustration. Some movement disorders, by their
very nature, do not lend themselves to still
photography whereas others, characterized by
sustained postures, are ideally suited to the technique.
The field of movement disorders is relatively broad, encompassing disorders of increased
movement, such as tremors, dystonia, and tics, to disorders characterized by a
paucity of movement, such as Parkinson’s disease. Our understanding of the pathogenic
mechanisms and our treatment options are expanding at a rapid pace. This expansion
ranges from the medical and surgical advances in treating Parkinson’s disease to the flood
of genetic abnormalities that have now been found to cause various movement disorders.
Over the past few decades the field of neurology has seen spectacular developments in diagnostic techniques, most vividly
exemplified by modern neuroimaging and molecular genetics. Although not always at the same speed this evolution has
gone hand in hand with an enlarging armentarium of effective therapies to treat neurological disease.
The ability to walk safely, easily, and in an aesthetically pleasing manner is
a skill learned early and highly prized. Although it is typically taken for
granted, gait is key to mobility and functional independence and at the
core of our ability to carry out many activities of daily living. In older adults
and patients with neurological deficits, ease and safety in walking may
become compromised, and gait is often viewed as abnormal, i.e., as a disorder.
While not an inevitable part of aging, gait disorders are common
among older adults and in patients with neurological disease.
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Evaluating movement disorders in pediatric patients receiving risperidone: a comparison of spontaneous reports and research criteria for TD...
Movement disorders represent major causes of neurological disability and
eventual mortality affecting millions of people across the globe. From
Parkinson’s disease to spasticity, these neurological disorders devastate
young and old worldwide. While progress continues to be made toward
effective treatment, many limitations remain.
The combination of the limitation of medical therapy and surgical
technological advances have, however, led to an exponential growth in functional
neurosurgery in the last 5 years.
As part of our clinical and research activities in neurology and psychiatry,
we had the chance to examine hundreds of patients with Parkinson’s disease
(PD). The Movement Disorders Unit kept us abreast of the new developments
in the management of the clinical complications of PD, and made us
aware of the emotional, behavioral, and cognitive complications of the
disease. These problems have been speciWcally studied at the Departments
of Neuropsychiatry of our Institutes, where we carry out most of our clinical
and research activities in the interface between neurology and psychiatry....
Bone pain is the most common symptom in myeloma, affecting nearly 70% of patients. The pain usually involves the back and ribs, and unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement. Persistent localized pain in a patient with myeloma usually signifies a pathologic fracture. The bone lesions of myeloma are caused by the proliferation of tumor cells, activation of osteoclasts that destroy bone, and suppression of osteoblasts that form new bone.
.Treatment of Pediatric Neurologic Disorders
.NEUROLOGICAL DISEASE AND THERAPY Advisory Board Louis R. Caplan, M.D.
Professor of Neurology Harvard University School of Medicine Beth Israel Deaconess Medical Center Boston, Massachusetts
William C. Koller, M.D.
Mount Sinai School of Medicine New York, New York
John C. Morris, M.D.
Friedman Professor of Neurology Co-Director, Alzheimer’s Disease Research Center Washington University School of Medicine St. Louis, Missouri
Bruce Ransom, M.D., Ph.D.
The history of sleep medicine and sleep research can be
summarized as a history of remarkable progress and, at
the same time, a history of remarkable ignorance. Since
the publication of the second edition in 1999 enormous
progress has been made in all aspects of sleep science
and sleep medicine. I am pleased to see these rapid
advances in sleep medicine and growing awareness about
the importance of sleep and its dysfunction amongst the
public and the profession.
Studies of human movement have proliferated in recent years, and there have been many studies of spinal pathways in humans, their role in movement, and their dysfunction in neurological disorders. This comprehensive reference surveys the literature related to the control of spinal cor
Restless Legs Syndrome (RLS)
Patients with this sensory-motor disorder report an irresistible urge to move the legs, or sometimes the upper extremities, that is often associated with a creepycrawling or aching dysesthesias deep within the affected limbs. For most patients with RLS, the dysesthesias and restlessness are much worse in the evening or night compared to the daytime and frequently interfere with the ability to fall asleep. The symptoms appear with inactivity and are temporarily relieved by movement.
Insomnia Associated with Neurologic Disorders
A variety of neurologic diseases result in sleep disruption through both indirect, nonspecific mechanisms (e.g., pain in cervical spondylosis or low back pain) or by impairment of central neural structures involved in the generation and control of sleep itself. For example, dementia from any cause has long been associated with disturbances in the timing of the sleep-wake cycle, often characterized by nocturnal wandering and an exacerbation of symptomatology at night (so-called sundowning).
Treatment is justified if it has significantly improved their wellbeing and function. A combination of medication with psychological techniques is likely to be most beneficial, especially for resistant cases.
Humans spend about a third of the time asleep but why we sleep is not yet fully understood. Sleep is a state of inactivity accompanied by loss of awareness and a markedly reduced responsiveness to environmental stimuli.
After the publication of Emergency Neurology: Principles and Practice, many emergency
medicine residents inquired whether a handbook based on the main text
would be available. As a result, we developed a handbook to be carried by emergency
physicians, extending our initial goal of disseminaing the principles of
emergency neurology to emergency physicians and providing a ready resource
in caring for patients with neurological emergencies. As we embarked upon the
handbook project, we realized that this is a daunting challenge.
Myogenic Ptosis The causes of myogenic ptosis include myasthenia gravis (Chap. 381) and a number of rare myopathies that manifest with ptosis. The term chronic progressive external ophthalmoplegia refers to a spectrum of systemic diseases caused by mutations of mitochondrial DNA. As the name implies, the most prominent findings are symmetric, slowly progressive ptosis and limitation of eye movements. In general, diplopia is a late symptom because all eye movements are reduced equally. In the Kearns-Sayre variant, retinal pigmentary changes and abnormalities of cardiac conduction develop.
Dystonia is a neurologic disorder characterized by involuntary, sustained, patterned, and often repetitive muscle
contractions of opposing muscles that cause twisting movements, abnormal postures, or both (1). One of the earliest
descriptions of dystonia was provided in 1888 by Gowers, who used the term “tetanoid chorea” to describe
the movement disorder in two siblings who were later diagnosed to have Wilson’s disease.
Both cross-border and domestic bank credit are (generally) denominated in multiple
currencies. The BIS international banking statistics in combination with domestic bank credit
data from the IMF’s International Financial Statistics, along with some assumptions, yield an
estimate of the currency breakdown of total credit to non-banks (either including or excluding
bank credit to governments) in a particular country. This breakdown allows us to express
credit stocks at constant exchange rates (in this particular case, end-Q2 2011 rates).