Movement disorders associated with

In Parkinson s disease the dopamine-releasing cells are damaged or die, thus reducing the release of dopamine. Loss of the dopamine neurotransmitter contributes to the movement disorders associated with Parkinson s disease. Typically, the loss of dopamine-producing cells in a very specific location in the brain does not become evident until old age, and for a long time Parkinson s disease was thought of as... 

Leo, R. (1996). Movement disorders associated with the serotonin selective reuptake inhibitors. Journal of Clinical Psychiatry, 57, 449—454. 

Tardive tremor is a hyperkinetic movement disorder associated with chronic neuroleptic drug treatment. It was first described in 1991 as a symmetrical tremor, of low frequency, present at rest and during voluntary movements but most prominent during maintenance of posture, and often accompanied by tardive dyskinesia. Tetrabenazine is the current treatment. Sequential responsiveness to both tetrabenazine and clozapine has been reported (97). 

Bohr IJ, Ray MA, McIntosh JM, Chalon S, GuiUoteau D, McKeith IG, Perry RH, Clement F, Perry EK, Court JA, Piggott MA (2005) Cholinergic nicotinic receptor involvement in movement disorders associated with Lewy body diseases. An autoradiography study using [(125)l]alpha-conotoxinMII in the striatum and thalamus. Exp Neurol 191 292-300... 

Gitiaux C, et al. Spectrum of movement disorders associated with glutaric aciduria type 1 a study of 16 patients. Mov Disord. 2008 23(16) 2392-7. 

Term used to describe a patient s restlessness and inability to sit still. Shortly after the introduction of neuroleptics, akathisia was recognized as one of the most common and distressing side effects. Propranolol is often useful in treating such symptoms. Movement disorder characterized by reduction or loss of ability to initiate voluntary muscle movements. Often associated with side effects of neuroleptics mask-like facial expression, absent arm swing, low voice. 

Lesch-Nyhan syndrome is characterized by virtual absence of HPRT, excessive production of uric acid, and abnormalities of the central nervous system. These abnormalities include mental retardation, spasticity (increased muscle tension resulting in continuous increase of resistance to stretching), choreoathetosis (characterized by irregular, jerky, or explosive involuntary movements, and writhing or squirming, which may involve any extremity or the trunk), and a compulsive form of self-mutilation. The disorder associated with partial deficiency of HPRT also leads to hyperuricemia but lacks the devastating neurological and behavioral features characteristic of the Lesch-Nyhan syndrome. Both disorders are X-linked. 

Antidepressants tend to provide a more sustained and continuous improvement of the symptoms of attention-deficit/hyperactivity disorder than do the stimulants and do not induce tics or other abnormal movements sometimes associated with stimulants. Indeed, desipramine and nortriptyhne may effectively treat tic disorders, either in association with the use of stimulants or in patients with both attention deficit disorder and Tourette s syndrome. Antidepressants also are leading choices in the treatment of severe anxiety disorders, including panic disorder with agoraphobia, generalized anxiety disorder, social phobia, and obsessive-compulsive disorder, as weU as for the common comorbidity of anxiety in depressive illness. Antidepressants, especially SSRIs, also are employed in the management of posttraumatic stress disorder, which is marked by anxiety, startle, painful recollection of the traumatic events, and disturbed sleep. Initially, anxious patients often tolerate nonsedating antidepressants poorly (Table 17-1), requiring slowly increased doses. Their beneficial actions typically are delayed for several weeks in anxiety disorders, just as they are in major depression. 

Some first-generation agents, such as haloperidol, are rather specific for one subtype of dopamine receptor, D2. This suggests that some degree of both efficacy and side effects are associated with dopamine antagonism at this receptor. However, the situation is complex, as usual. There are five classes of dopamine receptors known Di through D5. To complicate matters further, several of these classes have subclasses. In total, there are at least 15 dopamine receptors. Which of these is important for relief of the symptoms of schizophrenia Which is responsible for movement disorders The answers to these questions are incomplete. We do have a few hints. 

Q80 Tardive dyskinesia is a chronic movement disorder characterised by uncontrolled facial movements. Tardive dyskinesia is associated with the use of trifluoperazine. 

Very rare disorders include juvenile metachromatic leukodystrophy, adrenoleucodystrophy, Wilson s disease These conditions are associated with movement disorders, particularly gait disturbance. It is important to attempt to distinguish between primary and secondary (antipsychotic related) movement disorders These conditions are characterized by a progressive loss of cognitive skills (in contrast to the more relative decline seen in schizophrenia and other developmental disorders, where a loss of previously learned skill is unusual)... 

Stroke is a leading cause of death and disability and is the most common neurological disorder of the elderly. A stroke is defined as the acute onset of a neurologic deficit (e.g., paralysis of motor movement in the arm and leg on the same side of the body— hemiplegia) associated with an abrupt alteration in blood supply to a discrete region of... 

IBS is an idiopathic chronic, relapsing disorder characterized by abdominal discomfort (pain, bloating, distention, or cramps) in association with alterations in bowel habits (diarrhea, constipation, or both). With episodes of abdominal pain or discomfort, patients note a change in the frequency or consistency of their bowel movements. 

The first generation antipsychotics, now known as typical drugs, were all D2 receptor blockers and, as such, very likely to produce Parkinsonian side effects. Because antipsychotic potency was associated with D2 receptor affinity, it was assumed that dopamine overactivity was the essential defect in schizophrenia and that a direct dopamine blockade was the definitive route to treatment. But these drugs affected both the target dopamine pathways of the mesolimbic projection and the uninvolved nigrostriatal projection. Unfortunately, that meant that movement disorders were the price that had to be paid for antipsychosis. 

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