Taakspecifieke focale dystonie bij musici

Author(s):  
T. DOOMS

Task-specific focal dystonia in musicians Task-specific focal dystonia is a neurological movement disorder characterized by involuntary contractions during a specific activity. In musicians, the abnormal movement can occur while playing an instrument or while singing. The muscle contractions are usually painless, but the function of the affected region is disturbed. The clinical picture occurs more in men than in women and is most frequent in pianists or guitarists. The abnormality is usually localized in the fingers, the hands or the entire arm. Drummers can have problems in the lower limbs. Brass and woodwind players can lose control of the lips, tongue or facial muscles. This is called “embouchure dystonia”. Singers suffer from the larynx. The diagnosis is a clinical diagnosis. It is important to observe the musician making music. Outside the musical activity, all tests are normal. Technical examinations can be useful to rule out other diagnoses. The therapy is difficult and often unsatisfactory. In many cases, the disease predicts the end of the musical career.

2003 ◽  
Vol 17 (4) ◽  
pp. 195-202 ◽  
Author(s):  
Vanessa K. Lim ◽  
John L. Bradshaw ◽  
Michael E.R. Nicholls ◽  
Ian J. Kirk ◽  
Jeff P. Hamm ◽  
...  

AbstractSimple tapping and complex movements (Luria finger apposition task) were performed unimanually and bimanually by two groups of professional guitarists while EEG was recorded from electrodes over the sensorimotor cortex. One group had a task-specific movement disorder (focal dystonia or musicians' cramp), while the other group did not (controls). There were no significant group interactions in the task-related power (TRPow) within the alpha range of 8-10Hz (mu1). In contrast, there was a significant group interaction within the alpha range of 10-12Hz (mu2); these latter frequencies are associated with task-specific sensorimotor integration. The significant group interaction included task (simple and complex) by hand (left, right, and both) by electrodes (10 electrodes over the sensorimotor areas). In the rest conditions, the alpha power (10-12Hz) was comparable between the groups; during movement, however, compared to the controls, patients demonstrated the greatest TRPow (10-12Hz) over all conditions. This was particularly evident when patients used their affected hand and suggests that patients with musicians' cramp have impaired task-specific sensorimotor integration.


2016 ◽  
Vol 26 (2) ◽  
Author(s):  
Deepesh Kumar ◽  
Sunny Verma ◽  
Sutapa Bhattacharya ◽  
Uttama Lahiri

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.


PEDIATRICS ◽  
1951 ◽  
Vol 7 (4) ◽  
pp. 537-549
Author(s):  
ELLEN P. MACKENZIE

Thirteen cases of pneumatosis intestinalis are reported, 12 of them in infants between 12 days and 12 months of age, one in a boy of 6 years. Review of these cases and of 32 reported cases falling within the pediatric age range discloses that the disease occurs most frequently in patients whose general condition is poor, that it is very often associated with congenital or acquired disease of the intestine, and that respiratory disease, usually infectious, frequently co-exists. The presence of pneumatosis in pediatric patients has so far been discovered only at autopsy, but clinical diagnosis, with the aid of the typical roentgenologic findings, is feasible and may be accomplished when the disease is more widely known. The clinical picture and roentgenographic findings in adults are reviewed. The most acceptable theories concerning the pathogenesis are discussed, with their possible relation to infantile diarrhea.


Author(s):  
Allan Hugh Cole

Through personal narrative, this chapter details the author’s experience of first becoming aware that something was not right with his body. This experience leads to visiting his primary care doctor who tells him that she is concerned about the possibility of his having Parkinson’s disease and then refers the author to a neurologist who is a movement disorder specialist. He is examined by this neurologist, who says, “What worries me is that I think you are in the early stages of Parkinson’s disease,” but who wants the author to have a brain scan that will confirm the clinical diagnosis given his young age and subtle symptoms. The author leaves his office, drives home, and informs his wife that this doctor thinks he have Parkinson’s disease. Here begins his new life as a person with Parkinson’s (PwP).


2020 ◽  
pp. 91-104
Author(s):  
Hiroshi Shibasaki ◽  
Mark Hallett ◽  
Kailash P. Bhatia ◽  
Stephen G. Reich ◽  
Bettina Balint

Chorea comprises irregular, apparently random movements of varying speeds involving hands, feet, mouth, and tongue. Particularly at the outset of the disorder, the movement may appear purposeful and can be easily imitated. Chorea is seen in association with various medical diseases such as cerebrovascular diseases (hemichorea), autoimmune diseases like Sydenham chorea, thyrotoxicosis, pregnancy, drug intoxication, and hereditary disorders like Huntington disease, neuroacanthocytosis, and dentato-rubro-pallido-luysian atrophy (DRPLA). Treatment with D2-blockers is effective in some cases. Ballism entailsgross violent movements of extremities that look like throwing or kicking. It is commonly caused by a vascular lesion of the subthalamic nucleus or striatum and thus involves contralateral upper and lower limbs (hemiballism). Vigorous muscle contractions irregularly involve the shoulder and pelvic girdles and the proximal limbs. In the chronic stage, each movement becomes less violent and resembles chorea, although it still involves primarily the proximal muscles. Ballism usually responds to medication with diazepam or D2-blockers like haloperidol.


2019 ◽  
Vol 21 ◽  
Author(s):  
Hao Deng ◽  
Shan Wu ◽  
Joseph Jankovic

Abstract Essential tremor (ET) is a neurological movement disorder characterised by bilateral limb kinetic/postural tremor, with or without tremor in other body parts including head, voice and lower limbs. Since no causative genes for ET have been identified, it is likely that the disorder occurs as a result of complex genetic factors interacting with various cellular and environmental factors that can result in abnormal function of circuitry involving the cerebello–thalamo–cortical pathway. Genetic analyses have uncovered at least 14 loci and 11 genes that are related to ET, as well as various risk or protective genetic factors. Limitations in ET genetic analyses include inconsistent disease definition, small sample size, varied ethnic backgrounds and many other factors that may contribute to paucity of relevant genetic data in ET. Genetic analyses, coupled with functional and animal studies, have led to better insights into possible pathogenic mechanisms underlying ET. These genetic studies may guide the future development of genetic testing and counselling, and specific, pathogenesis-targeted, therapeutic strategies.


Author(s):  
Md. Tanvir Kabir ◽  
◽  
Hasina Yasmin ◽  
Umme Salma Khanam ◽  
Mohd. Raeed Jamiruddin ◽  
...  

2020 ◽  
pp. 25-30
Author(s):  
P.I. Tkachenko ◽  
I.I. Starchenko ◽  
S.O. Bilokon ◽  
Y.V. Popelo ◽  
N.P. Bilokon ◽  
...  

It is generally accepted that dermoid and epidermoid cysts are the result of malformation of the ectoderm. The asymptomatic course, absence of pathognomonic symptoms and similarity of clinical manifestations at separate stages of growth, despite nosological form and place of occurrence, give this pathology of particular relevance in the practice of pediatric maxillofacial surgery. However, if there are no significant issues regarding the etiology and pathogenesis of dermoids and epidermoids, there is a problem of constant monitoring of their prevalence and structure for the formation of administrative organizational measures for the planning of specialized care for this category of patients. Special attention should also be given to the development of new, minimally invasive surgical interventions, given the increasing aesthetic demands and requirements of patients. The aim of the study is to study in a comparative aspect their own experience on the clinical and morphological features and principles of treatment of dermoid and epidermoid cysts of the maxillofacial area and neck in children with the results of scientific studies, covered in literature. A thorough analysis of fundamental scientific works and publications in periodicals devoted to the scientific development of various directions in relation to these issues is carried out. The clinical section of the work concerns 15 children with dermoids and 8 children with epidermoids who have been treated for 8 years in the surgical ward of the children's clinical hospital in Poltava. General clinical, additional, and specific examination methods were used to establish clinical diagnosis, including diagnostic puncture, ultrasound, and MRI examination, which was performed in complex and questionable cases. If it is necessary, the patients are consulted by doctors of related specialties. The microscopic structure of the postoperative material was studied on preparations made by conventional methods. An objective study found that the clinical picture of the dermoid and epidermoid cysts is similar, differing only in slight subjective sensations on palpation. Comparison of clinical diagnosis and results of postoperative morphological verification of removed soft tissue bones showed that in 23.9% of patients the clinical diagnosis did not coincide with pathohistological. The difference in dermoids was the largest (75.0%), which confirms the need for expanded use of additional examination methods both at the pre-hospital stage and under inpatient conditions immediately before surgery. In general, the obtained morphological picture of the postoperative material coincided with the literature data on the classical structure of the dermoid and epidermoid cysts of the soft tissues of the maxillofacial area. Thus, the dermoid and epidermoid cysts of the maxillofacial area in children, having a dysontogenic origin, are most often diagnosed at younger and older school age. Despite their classic clinical picture, a considerable number of discrepancies between clinical and pathohistological diagnoses are traced , requiring a careful examination at both the hospital and hospital stages using modern, informative supplementary and special methods of investigation in complex and doubtful cases of cases and complex cases. These materials may be the basis for further in-depth scientific studies on immunohistochemical structural features dermoids and epidermoids to determine immunocompetence layers cystic membranes and determine their probable role in causing acute inflammation depending on the type of formation.


2020 ◽  
Vol 12 (4) ◽  
pp. 368
Author(s):  
Mirain Phillips ◽  
Amanda Oakley

ABSTRACT INTRODUCTIONSubungual haemorrhage describes blood located between the nail matrix and nail plate caused by trauma. Lack of recalled trauma and long duration of nail pigmentation results in specialist referrals to rule out malignant pathology. AIMThis report aims to describe the macroscopic and dermoscopic characteristics of subungual haemorrhage and to highlight its clinical differentiation from melanocytic lesions. METHODSNinety-eight nails were assessed. Pigmentation in fifty-nine was due to subungual haemorrhage and was melanocytic in the remainder (identified by a longitudinal pigmented band). RESULTSPigmentation in subungual haemorrhage had a clear proximal margin (73%) and the dermoscopic pattern was homogenous (97%), globular (78%) or streaky (34%). Features included peripheral fading (68%) and periungual haemorrhage (5%). Malignancy could be excluded in these cases by careful clinical evaluation. DISCUSSIONA combination of macroscopic and dermoscopic characteristics help make a confident diagnosis of subungual haemorrhage. A two-stage process can aid clinical diagnosis by looking for known features of subungual haemorrhage and identifying absence of malignant features.


2018 ◽  
Vol 5 (2) ◽  
pp. 420
Author(s):  
Subhash N. Halbhavi ◽  
Mahantayya Ganjigatti ◽  
Shrikant B. Kuntoji ◽  
Mohammedgouse A. Karikazi

Background: A thyroid enlargement whether diffuses or in the form of nodules have to be investigated to rule out neoplasm. FNAC is the first line of investigation. USG and TFT are also used. The cases which are at high risk are considered for surgery. Aims and objectives of the study was the clinical presentation of thyroid swellings, incidence of various thyroid swelling, benign versus malignant lesion and to correlate the clinical diagnosis with that of pathological diagnosis.Methods: A case series study of 60 patients attending surgical OPD IPD with symptoms of thyroid in SNMRC and HSK hospital Bagalkot between 1-1-2015 to 30-6-2016. After detailed history thorough, clinical examination was carried out all the patients underwent routine investigations TFT FNAC USG neck. Few patients underwent surgery and all the thyroid specimens were sent for HPE and the clinical diagnosis is correlated with that of pathological diagnosis.Results: Of 60 cases female to male ratio was 9:1. The age group involved is between 31-40 years (31.67%). Duration of goiter is less than one year in 60% of cases. The chief complaint was swelling in front of the neck 100%. Duration of swelling ranged from 15 days to 15 years. Toxic features were present in 18.33% of cases, but after TFT the toxic cases were only 6.67%. Most of the patient showed colloid goiter (43.33%) on FNAC. Out of 60 cases only 22 cases did undergo surgery histopathological specimen were colloid versus nodular goiter in 81.88% out of 22 cases only.Conclusions: Thyroid swellings are common in females they occur in 3rd and 4th decade most commonly. FNAC is very useful in the diagnosis. The main indications of surgery are cosmetic problems, pressure effect symptoms are suspicion of malignancy.


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