Parkinson’s disease with camptocormia
Frédéric Bloch,J. L. Houeto,S. Tezenas du Montcel,Fabrice Bonneville,Fabien Etchepare,M.-L. Welter,Sophie Rivaud-Péchoux,Valérie Hahn-Barma,Thierry Maisonobe,C. Béhar,J. Y. Lazennec,Ewa Kurys,Isabelle Arnulf,Anne-Marie Bonnet,Yves Agid +14 more
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TLDR
Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm, and it is suggested that the salient features of parkinsonism observed in patients with camps are likely to represent a specific form of Parkinson’s disease.Abstract:
Background: Camptocormia is defined as an abnormal flexion of the trunk that appears when standing or walking and disappears in the supine position. The origin of the disorder is unknown, but it is usually attributed either to a primary or a secondary paravertebral muscle myopathy or a motor neurone disorder. Camptocormia is also observed in a minority of patients with parkinsonism. Objective: To characterise the clinical and electrophysiological features of camptocormia and parkinsonian symptoms in patients with Parkinson’s disease and camptocormia compared with patients with Parkinson’s disease without camptocormia. Methods: Patients with parkinsonism and camptocormia (excluding patients with multiple system atrophy) prospectively underwent a multidisciplinary clinical (neurological, neuropsychological, psychological, rheumatological) and neurophysiological (electromyogram, ocular movement recording) examination and were compared with age-matched patients with Parkinson’s disease without camptocormia. Results: The camptocormia developed after 8.5 (SD 5.3) years of parkinsonism, responded poorly to levodopa treatment (20%) and displayed features consistent with axial dystonia. Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm. Conclusion: We suggest that (1) the salient features of parkinsonism observed in patients with camptocormia are likely to represent a specific form of Parkinson’s disease and camptocormia is an axial dystonia and (2) both camptocormia and parkinsonism in these patients might result from additional, non-dopaminergic neuronal dysfunction in the basal ganglia.read more
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Can postural abnormality really respond to levodopa in Parkinson's disease?
Hiroshi Kataoka,Satoshi Ueno +1 more
TL;DR: Two phenotypes of levodopa-responsiveness exist in patients with abnormal posture, and this observation is associated with an 'off' state, especially in patients of Parkinson's disease who have anterior trunk flexion.
Journal ArticleDOI
Deep brain stimulation as a treatment for Parkinson's disease related camptocormia.
TL;DR: Although the results are from a small group of patients, DBS has achieved sustained improvement in camptocormia with low postoperative morbidity, and appears to be a promising treatment option.
Journal ArticleDOI
Impact of Movement Disorders on Management of Spinal Deformity in the Elderly
Yoon Ha,Jae Keun Oh,Jae Keun Oh,Justin S. Smith,Tamir Ailon,Tamir Ailon,Michael G. Fehlings,Christopher I. Shaffrey,Christopher I. Shaffrey,Christopher P. Ames +9 more
TL;DR: The success of spinal surgery in patients with Parkinson disease depends on an interdisciplinary approach, including both surgeons and movement disorder specialists, to select appropriate surgical patients and manage postoperative movement in order to decrease mechanical failures.
Journal ArticleDOI
Surgical management of camptocormia in Parkinson's disease: systematic review and meta-analysis.
Andrew K Chan,Alvin Y. Chan,Darryl Lau,Beata Durcanova,Catherine Miller,Paul S. Larson,Philip A. Starr,Praveen V. Mummaneni +7 more
TL;DR: SSurgical options include transient, external spinal stimulation; DBS targeting the subthalamic nuclei; and spinal deformity surgery, which were associated with a high complication rate.
Journal ArticleDOI
Dystonia redefined as central non-paretic loss of control of muscle action: a concept including inability to activate muscles required for a specific movement, or 'negative dystonia'.
TL;DR: The author proposes a revised definition of dystonia as a symptom characterized by the central non-paretic loss of voluntary control of muscle activities, which may result in either excessive or deficient contractions of muscles, frequently causing twisting and repetitive movements, limitation of movements, or abnormal postures.
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