Hyperkinetic Movement Disorders: Tremor and Myoclonus

2021 ◽  
pp. 593-601
Author(s):  
Farwa Ali ◽  
Jeremy K. Cutsforth-Gregory
Keyword(s):  
Movement Disorders ◽  
Signs And Symptoms ◽  
Body Part ◽  
Underlying Disease ◽  
Metabolic State ◽  
Oscillatory Movement ◽  
Underlying Causes

Hyperkinetic movement disorders are characterized by excess movement. Tremor and myoclonus are the most common hyperkinetic movement disorders and signify various possible underlying causes or diagnoses. Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It can be distinguished from myoclonus by its regular frequency and from chorea by its stereotyped nature. The subtypes of tremor vary in frequency, conditions of activation and relief, and associated signs and symptoms. Tremor can be primary, being the only manifestation of a condition, or secondary, being symptomatic of a metabolic state or other underlying disease.

Drug-Induced Movement Disorders

2015 ◽  
Vol 25 (2) ◽  
pp. 70-77
Author(s):  
Amy Lustig ◽  
Cesar Ruiz
Keyword(s):  
Movement Disorders ◽  
Medical Management ◽  
Disease Process ◽  
Underlying Disease ◽  
Extrapyramidal Symptoms ◽  
Drug Induced ◽  
General Overview ◽  
Management Approaches ◽  
Broad Understanding ◽  
Underlying Disease Process

The purpose of this article is to present a general overview of the features of drug-induced movement disorders (DIMDs) comprised by Parkinsonism and extrapyramidal symptoms. Speech-language pathologists (SLPs) who work with patients presenting with these issues must have a broad understanding of the underlying disease process. This article will provide a brief introduction to the neuropathophysiology of DIMDs, a discussion of the associated symptomatology, the pharmacology implicated in causing DIMDs, and the medical management approaches currently in use.

scholarly journals Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis

2017 ◽  
Vol 45 (3) ◽  
pp. 248-256 ◽  
Author(s):  
Fernanda Payan Schober ◽  
Meghan A. Jobson ◽  
Caroline J. Poulton ◽  
Harsharan K. Singh ◽  
Volker Nickeleit ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Disease Process ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Underlying Disease ◽  
Fibrillary Glomerulonephritis ◽  
Black Patients ◽  
End Stage ◽  
20 Nm ◽  
The University

Background: Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. Methods: The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. Results: Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. Conclusion: According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.

scholarly journals Asthenia and fatigue in hyperammonemia: etiopathogenesis and methods of correction

2022 ◽  
pp. 95-104
Author(s):  
E. Yu. Plotnikova ◽  
M. N. Sinkova ◽  
L. K. Isakov
Keyword(s):  
Liver Disease ◽  
Liver Diseases ◽  
Signs And Symptoms ◽  
Chronic Liver ◽  
Blood Levels ◽  
Chronic Liver Diseases ◽  
Life Threatening ◽  
Underlying Causes ◽  
Principles Of Treatment ◽  
The Brain

Asthenia and fatigue are the most common syndromes in patients with liver disease, which significantly affects their quality of life. The prevalence of fatigue in chronic liver diseases is from 50% to 85%. While some progress has been made in understanding the processes that can cause fatigue in general, the underlying causes of fatigue associated with liver disease remain not well understood. In particular, many data suggest that fatigue associated with liver disease likely results from changes in neurotransmission in the brain against the background of hyperammonemia. Hyperammonemia is a metabolic state characterized by an increased level of  ammonia, a  nitrogen-containing compound. The  present review describes hyperammonemia, which is likely important in the pathogenesis of fatigue associated with liver disease. Ammonia is a potent neurotoxin, its elevated blood levels can cause neurological signs and symptoms that can be acute or chronic, depending on the  underlying pathology. Hyperammonemia should be recognized early, and immediately treated to prevent the development of life-threatening complications, such as, swelling of the brain and coma. The article gives pathophysiological mechanisms of influence of hyperammonemia on state of psychovegetative status of patients with liver diseases, also lists basic principles of treatment. A significant part of the article is devoted to L-ornithine-L-aspartate, which is effective in asthenia and fatigue to reduce the level of hyperammonemia through a variety of well-studied mechanisms in chronic liver diseases.

Tremor and other abnormal movements

2018 ◽  
Author(s):  
Susanne Schneider ◽  
Alexander Schmidt ◽  
Kailash P. Bhatia ◽  
Peter G. Bain
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Tests ◽  
Body Part ◽  
Body Parts ◽  
Abnormal Movements ◽  
Oscillatory Movement

Tremor is a rhythmic involuntary oscillatory movement of a body part, most commonly affecting the hands and arms but other body parts can also be affected including the legs, head, jaw, chin, palate, voice, and trunk. This chapter covers the differential diagnosis of tremor, the approach to diagnosis (including key diagnostic tests), therapies, and prognosis.

scholarly journals The State of the Art of Traditional Arab Herbal Medicine in the Eastern Region of the Mediterranean: A Review

2006 ◽  
Vol 3 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Hassan Azaizeh ◽  
Bashar Saad ◽  
Khalid Khalil ◽  
Omar Said
Keyword(s):  
Herbal Medicine ◽  
State Of The Art ◽  
Signs And Symptoms ◽  
Underlying Disease ◽  
The State ◽  
Complementary Alternative Medicine ◽  
Eastern Region ◽  
Know How ◽  
The Status ◽  
The Mediterranean

Historical and current studies indicate that the Eastern region of the Mediterranean has been distinguished from other regions by a rich inventory of complementary alternative medicine (CAM), in particular herbal medicine. Data collected from several surveys and studies indicate that there is a flourishing and well-developed trade of herbs. These surveys also reveal that 200–250 herbs are used in treating human diseases and are sold or traded in market places in the Mediterranean region or internationally. In addition, some of these herbs are rare or even endangered species. In regard to the status of the know-how of herbalists, unfortunately, herbal medicine in our region is mostly prescribed by ethnopharmacologists symptomatically—based on signs and symptoms alone, rather than as a result of a full understanding of the underlying disease. In some cases, herbs used today may not even correspond to the plants described originally in the old literature, as the former are cultivated from herbs that went through different breeding procedures throughout several centuries. This article presents a systematic review of both the state of the art of traditional Arab herbal medicine and the status of the know-how of Arab herbalists.

Theoretical Development and Experimental Validation of an Adaptive Controller for Tremor Suppression at Musculoskeletal Level

2013 ◽  
Author(s):  
Behzad Taheri ◽  
David Case ◽  
Edmond Richer
Keyword(s):  
Body Part ◽  
Adaptive Controller ◽  
Theoretical Development ◽  
Pneumatic Cylinder ◽  
Medical Treatments ◽  
Non Invasive ◽  
Oscillatory Movement ◽  
Tremor Suppression ◽  
Tremor Frequency ◽  
Intentional Motion

Tremor is a rhythmical and involuntary oscillatory movement of a body part. Mechanical loading via wearable exoskeletons is a non-invasive tremor suppression alternative to medical treatments. In this approach, the challenge is attenuating the tremor without affecting the patient’s intentional motion. An adaptive tremor suppression algorithm was designed to estimate and restrict motion within the tremor frequency band. An experimental setup was designed and developed to simulate the dynamics of a human arm joint with intentional and tremorous motion. The required orthotic suppressive force was applied via a pneumatic cylinder. The algorithm was implemented with a real-time controller and experimental results show tracking of the tremor frequency and a 97% reduction of tremor amplitude at the fundamental frequency.

scholarly journals Clinical features and para-clinical findings of cryptococcal meningitis in the North of Iran during 2011-19

2021 ◽  
Author(s):  
Farhang Babamahmoodi ◽  
Kobra Gerizade firozjaii ◽  
Masoumeh Bayani ◽  
Tahereh Shokohi ◽  
Jamshid Yazdani ◽  
...  
Keyword(s):  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Underlying Disease ◽  
Clinical Findings ◽  
Hiv Positive ◽  
The North ◽  
Medication Consumption ◽  
Significant Difference ◽  
North Of Iran ◽  
Hiv Negative

Background and Purpose:Cryptococcalmeningitis (CM) is a serious fungal infection that especially affectspatients with human immunodeficiency virus (HIV). In this regard,the present retrospective study aimed to analyze the clinical and laboratory features and therapeutic outcomes of patients with CM admitted to two teaching referral centersin the north of Iran during 2011-19. Materials and Methods:This study was performed onall the hospitalized patients diagnosed with CM in two therapeutic centers of infectious diseases in the north of Iran. The required data,such as demographic characteristics and clinical and paraclinical features of patients, were extracted and entered in the information forms. Finally, the collected data were analyzed inSPSSsoftware(version16). Results:For the purpose of the study, records of 12confirmed CM patients were evaluatedin this research. Based on the results,75% of the patients were male. Moreover,the average age of the subjects was 40.33± 8.93 years old and 66.6%ofthem(n=8) were HIV-positive. Other underlying diseases among HIV-positive patients included infection with hepatitis C virus (25%) and a history of tuberculosis (25%). In total, threeHIV-negative patients suffered from Hodgkin lymphoma (25%), sarcoidosis (25%),and asthma (25%) and one patient (25%) had no underlying disease. Headache (75%), weakness,and fatigue (75%) were the most common symptoms among the participants. The cluster of differentiation 4count in all HIV-positive patients was less than 100 cells/μl. There was no significant difference between symptoms in HIV-positive and HIV-negative patients. Besides, no significant difference was observed between the groups of HIV-positive and HIV-negative patients regarding the period between the onset of symptoms and diagnosis of CM,the length of hospital stay,and the duration of antifungal medication consumption. In total,three patients (25%) expired,and six patients recovered. The CM recurred in two HIV-negative and oneHIV-positive subjects;the two HIV-negative patients were treated,whilethe HIV-positive patient expired due to this recurrence. Conclusion:Clinical features and cerebrospinal fluid parameters were not different in HIV-positive and HIV-negative participants. Despite the fact thatCM is not common in Iran, due to the increasing number of immunosuppressive patients, the differential diagnosis of CM should be considered for patients with signs and symptoms of infection in the central nervous system.

scholarly journals SÍNDROME DE TAKOTSUBO Y ESTRÉS AGUDO.

2021 ◽  
Vol 32 (1) ◽  
pp. s17-s18
Author(s):  
Stalin Bismarck Castillo ◽  
Daniela Alejandra Pozo ◽  
Cecibel Estefanía Villacís ◽  
María José Portero
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Beta Blockers ◽  
Viral Myocarditis ◽  
Acute Chest Pain ◽  
Signs And Symptoms ◽  
Anatomical Variations ◽  
Underlying Disease ◽  
Angiotensin Ii Receptor ◽  
Catecholamine Levels

Introduction Takotsubo Syndrome (STk) is characterized by a transient systolic regional dysfunction on the left ventricle, usually diagnosed in 2% of the patients presenting with clinical suspicion of ST elevating myocardial infarction (STAMI). Main etiology is still unclear, correlating with pericardial artery spasm, microvascular alterations, viral myocarditis, heightened catecholamine levels with alteration of sympathetic system, and anatomical variations of the anterior descendent artery. Several emotional and physical triggers are linked to its development, but symptoms can arise in their absence. Most common signs and symptoms include: acute chest pain, dyspnea and syncope, initially indistinct to those of an acute myocardial infarction. Its presence varies according to the trigger: on those with a strong emotional trigger chest pain and palpitations, while on physical stress, underlying disease predominates (stroke, seizure). Case description A 58 year old female, without medical history of cardiovascular disease, was admitted to the hospital because of left sided chest pain, beginning 2 hours ago, most likely caused by emotional distress. On arrival, initial diagnosis was Acute Coronary Disorder (ACD). Coronarography, and anterior oblique right ventriculography confirming the diagnosis. Requiring mainly low-molecular-weight heparin anticoagulation during admission and novel anticoagulants for outpatient care, added to anxiety treatment. Follow-up started October 2019 and went on during 2020. Conclusion STk has similar characteristics to those of ACD on postmenopausal women. The present Clinical Case meets 3 of the 4 Mayo Criteria, and has 61 points on the InterTak score. Acute chest pain, dyspnea and syncope plus several additional studies can confirm STk. EKG showing ST elevation (90%), negative T wave on precordial leads (44%), Q wave present (15-27%). Elevation of the ST segment on V4 to V6 is higher than V1 to V3, with absence of Q anomaly. Heightened troponin levels, but lower than AMI; Heghtened BPN or proBPN could be present. Myocardial stunning could be liked to catecholamine levels 2 to 3 times higher than AMI with Killip III. The recovery does not require treatment, but could require diuretics, beta blockers, ACEs, angiotensin-II receptor blockers, statins and acetylsalicylic acid. Prognosis is favorable with mortality under the 2%.

scholarly journals Premenstrual Syndrome (PMS): An Enigma

2019 ◽  
Vol 3 (5) ◽  
Keyword(s):  
Premenstrual Syndrome ◽  
Diagnostic Tests ◽  
Luteal Phase ◽  
Clinical Evidence ◽  
Psychological Symptoms ◽  
Signs And Symptoms ◽  
Premenstrual Dysphoric Disorder ◽  
Treatment Modalities ◽  
Symptom Profile ◽  
Underlying Causes

Many women in their reproductive years experience cyclical physical, emotional & psychological symptoms in the week prior to menses or during luteal phase of menstrual cycle. PMS affects about 5-8 % of women and most of them meet the criteria for premenstrual dysphoric disorder (PMDD). The etiology remains unknown and is complex and multifactorial. The diagnosis of PMS is solely based on signs and symptoms and no specific diagnostic tests to confirm the diagnosis. Numerous treatment modalities are available but only few are supported by clinical evidence. The article describes the disorder, with brief account of the theories for the underlying causes of PMS. It discusses the array of non pharmacological and pharmacological strategies available with stress on individualized treatment according to symptom profile.

scholarly journals A comprehensive review on clinical and mechanistic pathophysiological aspects of COVID-19 Malady: How far have we come?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Baila Shakaib ◽  
Tanzeel Zohra ◽  
Aamer Ikram ◽  
Muhammad Bin Shakaib ◽  
Amna Ali ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Signs And Symptoms ◽  
Organ Damage ◽  
Underlying Disease ◽  
The Body ◽  
Host Cells ◽  
Irreversible Damage ◽  
Organ Systems ◽  
Wide Range

AbstractSince its outbreak in 2019, the coronavirus disease (COVID-19) has become a pandemic, affecting more than 52 million people and causing more than 1 million mortalities globally till date. Current research reveals a wide array of disease manifestations and behaviors encompassing multiple organ systems in body and immense systemic inflammation, which have been summarized in this review. Data from a number of scientific reviews, research articles, case series, observational studies, and case reports were retrieved by utilizing online search engines such as Cochrane, PubMed, and Scopus from December 2019 to November 2020. The data for prevalence of signs and symptoms, underlying disease mechanisms and comorbidities were analyzed using SPSS version 25. This review will discuss a wide range of COVID-19 clinical presentations recorded till date, and the current understanding of both the underlying general as well as system specific pathophysiologic, and pathogenetic pathways. These include direct viral penetration into host cells through ACE2 receptors, induction of inflammosomes and immune response through viral proteins, and the initiation of system-wide inflammation and cytokine production. Moreover, peripheral organ damage and underlying comorbid diseases which can lead to short term and long term, reversible and irreversible damage to the body have also been studied. We concluded that underlying comorbidities and their pathological effects on the body contributed immensely and determine the resultant disease severity and mortality of the patients. Presently there is no drug approved for treatment of COVID-19, however multiple vaccines are now in use and research for more is underway.

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