Spastic ataxia

Of the specific cannabinoids studied at Edgewood, pharmacologic data are available on DMHP. It was effective in producing sedation in animals at oral doses lower than 0.5 mg/kg. Several doses and routes of administration were studied, up to 1 mg/kg given intravenously. In rats, sedation occurred without initial stimulation in dogs and monkeys, hyperactivity was followed by depression and then, at higher doses, by coma. Motor effects were dramatic, in that animals developed spastic ataxia and showed extremely active deep tendon... 

Visceromegaly, CNS involvement Visceromegaly, CNS involvement Nodular swelling around joints, hypotonia, visceromegaly, CNS involvement, angiokeratoma Spasticity, ataxia, weakness, hypotonia, CNS involvement... 

Charcot-Marie-Tooth disj Amyotrophic latet Lsglerosis Silver spastic paraplegia syiiUioTne1 Spastic ataxia/paraplegi Fanconi anemia-... 

Neurological Tremor, myoclonus, chorea, spasticity, ataxia, convulsions, neuropathy, exaggerated tendon reflexes, headache, vertigo, incoordination, cerebellar signs, delirium, seizures, coma, psychiatric symptoms (see Table 8—4)... 

Functional recovery occurs with time in less severe cases, with most distal involvement and sparing of spinal cord axons. Otherwise, pyramidal and other signs of central neurological involvement may become more evident, and spastic ataxia may be a permanent outcome of severe OPIDP (Morgan and Petrovich, 1978 Susser and Stein, 1957). The very few cases of OPIDP reported in young individuals indicate that they recover completely, even from severe lower and upper limb involvement (Senanayake, 1981 Goldcnstcin ef c/., 1988). 

Lafora s disease manifest an accumulation of polyglucosan, in the CNS and PNS as well as in other tissues [1]. Lafora s disease is transmitted as an autosomal recessive trait and is characterized by epilepsy, myoclonus and dementia. Other neurological manifestations include ataxia, dysarthria, spasticity and rigidity. Onset is in adolescence, and death occurs in most patients before 25 years of age. 

Ramaekers VT, Hausler M, Opladen T, Heimann G, Blau N (2002) Psychomotor retardation, spastic paraplegia, cerebellar ataxia and dyskinesia associated with low 5-methyltetrahydro-folate in cerebrospinal fluid a novel neurometabolic condition responding to folinic acid substitution. Neuropediatrics 33 301-308... 

At present, there is no approved medical use for cannabis in patients with neurological disorders. However, it is illegally used for spasticity and ataxia in patients with multiple sclerosis and spinal cord injury, and for the treatment of trigeminal nerve pain and, to a lesser extent, attention deficit hyperactivity disorder. Individuals with spinal cord injury have reported a reduction in spasticity after cannabis use. 

K5. Kjellin, K. G., Stibler, H., Protein patterns of cerebrospinal fluid in hereditary ataxias and hereditary spastic paraplegia. J. Neurol. Sci. 25(1), 65-74 (1975). 

In nine cases of phencyclidine hydrochloride poisoning, early signs of overdose included drowsiness, nystagmus, miotic pupils, raised blood pressure, increased deep tendon reflexes, ataxia, anxiety, and agitation. In more severe cases, seizures, spasticity, and opisthotonos were seen, in addition to deep coma and respiratory depression (28). 

While preclinical data from CsA in neurodegenerative disorders was promising, larger studies in Parkinson s disease did not show any benefit along with side complications. Major neurological complications secondary to cyclosporine are well documented and are known to include confusion, cortical blindness, seizure, spasticity, paresis, ataxia and coma. Most previous reports attribute these to white matter CNS lesions or white/grey matter border lesions. Moreover, several publications appeared recently refuted neuroprotective properties of CsA and similar compounds (immu-nophilin ligands). 

Spasticity is a central feature of multiple sclerosis (MS) and spinal cord injury (SCI). It consists of a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex as one component of the upper motor syndrome (Young 1994). Existing drug therapy is far from satisfactory in terms of efficacy and unwanted effects (Panegyres 1992). Tremor, ataxia and lower urinary tract symptoms are frequently troublesome in MS. Both neuropathic and nociceptive pain (dealt with in Sect. 2.3) are also common in MS and SCI, and dozens of very painful muscle spasms can occur each day. Small wonder that there is also a high incidence of anxiety and depression in these conditions. 

Meinck HM, Schonle PW, Conrad B (1989) Effect of cannabinoids on spasticity and ataxia in multiple scleroris. J Neurol 236 120-122... 

Neurological Headache, coma, loss of reflexes, Cheyne-Stokes respiration, seizures, electroencephalogram abnormalities Organophosphate-induced delayed polyneuropathy manifested by flaccidity or paralysis of extremities, paresthesias, footdrop, gait ataxia, spasticity develops 1-2 weeks after exposure Intermediate syndrome 1-4 days after exposure manifested by weakness of proximal limb and respirator muscles, loss of knee reflexes, cranial nerve palsy, death... 

Organophosphate-induced delayed polyneuropathy manifested by flaccidity or paralysis of extremities, paresthesias, footdrop, gait ataxia, spasticity develops 1-2 weeks after expo-... 

Movement disorders refer to those clinical syndromes involving (a) a deficit in non- or extrapyramidal function and (b) at least one non-epileptic abnormal movement. Typical symptoms include akinesia or bradykinesia, ataxia, catalepsy, chorea, spasm, tremor and dystonia (slow involuntary muscle contractions producing abnormal posture or position), either focal or generalized. Many movement disorders are poorly controlled with current therapies, especially those with dystonia, spasticity and iatrogenic dyskinesia, and better drug therapies are clearly indicated. 

The disease is characterized by episodes of nenrologic symptoms occnrring over a period of days to weeks, followed by complete or incomplete remissions of various durations. Early signs and symptoms of MS commonly inclnde fatigue, gait and limb ataxia, spasticity, dizziness, donble vision, acnte optic nenritis, and nnmbness and weakness in one or more limbs. 

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