By Stephen G. Reich
Written in an easy-to-follow, fast reference structure, Movement problems: a hundred Instructive instances provides a sequence of a hundred case reviews of sufferers with stream problems. Radiology pictures, histopathology, and sufferer images are awarded in complete colour. The book’s uniform constitution of directory every one ailment by means of exam, dialogue, and instructing issues guarantees fast assimilation of the material.
A bonus web site hyperlink contains video-clips of every sufferer. The captions and key issues supplied permit the busy neurologist to fast reference details wanted in day by day practice.
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Extra info for Movement Disorders: 100 Instructive Cases
There was still a left facial droop, which we attributed to the residual effects of botulinum toxin. Our final diagnosis was left hemifacial spasm. 1 It is an uncommon movement disorder, with an annual incidence of almost 1 per 100 000. 3 Patients usually present in their fifth decade of life. In most patients, the initial complaint is of forceful, unilateral eye closure due to contraction of the orbicularis oculi muscle. This can interfere with vision and cause embarrassment. During a period of months to years, other muscles innervated by the ipsilateral facial nerve, including muscles in the cheek, perioral region, and chin, become involved in a synchronous manner.
The non-motor symptoms may fluctuate with the motor symptoms of parkinsonism, and the temporal association is an important clue. Patients often fail to recognize this temporal relationship. Both motor and non-motor symptoms may sometimes respond to dopamine replacement therapy in an all-or-none manner, as if there is a dose threshold. Off-phase symptoms may become persistent if PD drugs (especially levodopa) are reduced below threshold. A single supra-threshold dose of carbidopa/levodopa, followed by observation in the office or at the bedside, may help to confirm the origin of levodopa responsive non-motor symptoms.
After a streptococcal pharyngitis, he developed severe neck and shoulder pain and retrocollis and his gait worsened. Trials of levodopa, benzodiazepines, and botulinum toxin offered minimal to no benefit. There was a strong family history of a movement disorder on the paternal side and his paternal aunt had also undergone thalamotomy. 1). He was unable to lie, sit, stand, or walk without disabling movements. The movement subscore of the Burke Fahn Marsden Dystonia Rating Scale (BFMDRS)1 score was 44.