Clinical Reasoning: A demure teenager and her dystonic foot

A 13-year-old girl presented with a 4-year history of abnormal gait. At age 9, her parents noticed that she would run awkwardly "on the balls of her feet" and subsequently, that the rhythm of her running would break down with sustained exercise. There was no diurnal variation in her symptoms. There was no history of perinatal insults and early development was normal. There was no significant medical or psychiatric comorbidity and her family history was unremarkable. Examination of the patient's gait is demonstrated in video 1 at
Source: Neurology - Category: Neurology Authors: Tags: Dystonia, Parkinson's disease/Parkinsonism, All Pediatric, All Genetics RESIDENT AND FELLOW SECTION Source Type: research

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ConclusionsDifferent patterns of sleep disturbances are observed in HD patients: insomnia, difficulties in falling asleep, frequent nocturnal awakenings, and excessive daytime sleepiness are the most common sleep problems reported by patients with HD. In several HD studies, specific changes in sleep architecture and in circadian melatonin secretion were identified in laboratory testing.Sleep disorders in HD have diverse and complex determinants, the most significant of which includes damage to brain areas that are responsible for the proper sleep pattern and circadian rhythm regulation. Sleep and circadian rhythm disorders...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study underscores the importance of chronic stimulation in the modulation of sensorimotor integration and proprioception. The authors considered two possible mechanisms underlying SAI modulation by STN DBS. High-frequency DBS of the STN might normalize synchronization between basal ganglia structures, which might restore the ability of thalamocortical relay cells to respond to depolarizing inputs involved in sensorimotor integration (Brown et al., 2001; Rubin and Terman, 2004). Alternatively, STN DBS might have a direct effect on cortical structures through antidromic stimulation of the cortico-subthalamic pathway. I...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
AbstractTime perception is an essential element of conscious and subconscious experience, coordinating our perception and interaction with the surrounding environment. In recent years, major technological advances in the field of neuroscience have helped foster new insights into the processing of temporal information, including extending our knowledge of the role of the cerebellum as one of the key nodes in the brain for this function. This consensus paper provides a state-of-the-art picture from the experts in the field of the cerebellar research on a variety of crucial issues related to temporal processing, drawing on re...
Source: The Cerebellum - Category: Neurology Source Type: research
The field of spinal cord stimulation is expanding rapidly, with new waveform paradigms asserting supraspinal sites of action. The scope of treatment applications is also broadening from chronic pain to include cerebral ischemia, dystonia, tremor, multiple sclerosis, Parkinson disease, neuropsychiatric disorders, memory, addiction, cognitive function, and other neurologic diseases. The role of neurostimulation as an alternative strategy to opioids for chronic pain treatment is under robust discussion in both scientific and public forums. An understanding of the supraspinal mechanisms underlying the beneficial effects of spi...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Abstract Deep brain stimulation (DBS) is a well-established therapy for patients with advanced Parkinson's disease (PD), dystonia, and other movement disorders. In contrast to the strong positive effects that have been documented for motor symptoms, the effects of DBS on nonmotor symptoms have not been fully elucidated. Some reports suggest that stimulation of the subthalamic nucleus may improve lower urinary tract symptoms in patients with PD; however, reports of the effects of globus pallidus internus (GPi) DBS on urinary symptoms are limited. The authors present the case of a 49-year-old woman with PD who devel...
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
Discussion Head banging and body rocking are common habits that young children exhibit that can be worrisome or frustrating for parents but that do not cause harm to the child. In a normally developing child they occur around 6-9 months age, and generally resolve around 2-3 years with most behaviors gone by 6-8 years. Children usually do not cause harm to themselves, but it can cause furniture to move causing noise, or potentially the child could lose balance and fall off a bed, or strike an object unintentionally and hurt themself (hit edge of a bed just right in a way that causes a small bruise). The behaviors appear to ...
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Boston Scientific is releasing its Vercise Primary Cell (PC) and Vercise Gevia deep brain stimulation (DBS) systems in the U.S. Both have received recent FDA approval to be used in managing symptoms of Parkinson’s, as well as European regu...
Source: Medgadget - Category: Medical Devices Authors: Tags: Neurology Neurosurgery Rehab Source Type: blogs
Medtronic continues to develop products for deep brain stimulation (DBS) for the treatment of movement disorders including Parkinson ’s disease (PD), essential tremor (ET), dystonia, and other neurological disorders such as epilepsy and obsessive-compulsive disorder (OCD). As part of the development process, the effectiveness and safety of new products must be evaluated before initiation of clinical trials. While some evaluatio ns can be performed with bench testing and simulation, regulatory agencies often require in vivo testing in preclinical animal models.
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Source Type: research
Conclusions: In PD, ILS provided benefits for dyskinesias and parkinsonism, with minimal improvement of other adverse effects. In tremor and dystonia, marginal effects in terms of mitigation of adverse effects and improvement of clinical outcomes were evident.Stereotact Funct Neurosurg
Source: Stereotactic and Functional Neurosurgery - Category: Neurosurgery Source Type: research
This article provides the reader with an overview of the most important groups of genetic movement disorders. Genetic Parkinson syndromes, dystonia, essential tremor, genetic chorea, cerebellar ataxia and hereditary spastic paraplegia are dealt with in detail. For a better understanding individual genetic terms are explained and differences in molecular genetic diagnostics are presented. PMID: 30645659 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - Category: Neurology Authors: Tags: Nervenarzt Source Type: research
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