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Journal ArticleDOI

Parkinson’s disease with camptocormia

TL;DR: 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.

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Citations
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Journal ArticleDOI
TL;DR: Agarwal et al. as discussed by the authors describe que the enfermedad de Parkinson (EP) idiopatica is un trastorno degenerativo del sistema nervioso central.

5 citations

Book ChapterDOI
01 Jan 2014
TL;DR: This chapter will review and assess the clinical utility of the various botulinum products in neuromuscular disorders and the cosmetic use of the neurotoxin.
Abstract: The original clinical application of botulinum neurotoxin was in the treatment of strabismus by local chemical denervation of the neuromuscular junction and relaxation of the muscle with a duration of several months. This initial application has been followed by use of the neurotoxin to treat a wide range of disorders of muscle hyper-contraction. Botulinum neurotoxin is now a major clinical product for the treatment of spasticity and muscle hyperactivity. Muscle relaxation also underpins the cosmetic use of the neurotoxin. This chapter will review and assess the clinical utility of the various botulinum products in neuromuscular disorders.

5 citations

Journal ArticleDOI
TL;DR: The patient with PD presenting severe trunk sagittal and frontal deformity had cauda equina syndrome due to progressive vertebral collapse of the lumbar spine, and anterior reconstruction surgery was performed at first in order to achieve improved lordotic alignment of the L1 spine.
Abstract: Parkinson's disease (PD) frequently develops postural abnormalities including extreme neck flexion and trunk flexion. Patients with PD sometimes have osteopenia and vertebral deformity due to the destruction of fragile bone can be also associated with the spinal deformity. Surgical treatment for these patients is very difficult. We encountered a patient with PD presenting severe trunk sagittal and frontal deformity. The patient had cauda equina syndrome due to progressive vertebral collapse of the lumbar spine. We performed anterior reconstruction surgery at first in order to achieve improved lordotic alignment of the lumbar spine. Then, we performed 2 posterior surgeries, resulting in total long fusion from T4 to S1. The clinical findings of this patient were presented, and the treatment options were discussed.

5 citations

Journal ArticleDOI
TL;DR: Dans ce cas, la tomodensitometrie est l’examen cle : elle montre une infiltration graisseuse diffuse, heterogene, debutant ou predominant a la distalite des masses musculaires paravertebrales dont le volume est conserve.
Abstract: Resume Camptocormie, cormoptose, bent-spine syndrome sont des termes decrivant des sujets qui se penchent involontairement vers l’avant. L’examen clinique doit differencier les cyphoses acquises, fixees, d’origine osseuse des cyphoses reductibles secondaires a une maladie neuromusculaire. La maladie de Parkinson, de par la dystonie, le canal lombaire etroit ou retreci au cours duquel le patient calme sa douleur a la marche par la position courbee vers l’avant, sont les etiologies les plus frequentes de camptocormie. Ces maladies ecartees, il faut evoquer une affection musculaire : (a) soit une myopathie diffuse d’origine inflammatoire (polymyosite), endocrinienne (myxœdeme, osteomalacie) ou congenitale (myotonie de Steinert, myopathie des ceintures, myopathie fascio-scapulo-humerale) predominant sur les muscle spinaux ; (b) soit une myopathie paravertebrale de revelation tardive, appartenant probablement au groupe des myopathies des ceintures. Dans ce cas, la tomodensitometrie est l’examen cle : elle montre une infiltration graisseuse diffuse, heterogene, debutant ou predominant a la distalite des masses musculaires paravertebrales dont le volume est conserve.

4 citations

Journal ArticleDOI
TL;DR: As postural disorders become irreversible after the development of secondary changes, such as muscle atrophy and bone fracture, physicians should recognize postural Disorders at early stages.
Abstract: SUMMARY Postural disorders are frequently observed in Parkinson’s disease patients and significantly affect patients’ quality of life. They may develop because of increased muscle tonus, which results in shortened muscle fibers and induces contracted postures and subsequent changes in muscles, connective tissue, bones and peripheral nerves. Enhanced muscle tonus may induce forward and/or lateral flexion of the spine. Abnormal postures usually occur in the middle or later stages of the disease, and are often reversible in the supine position. Forward flexion, lateral flexion and, less frequently, antecollis are the common axial postural disorders in Parkinson’s disease patients. While antiparkinsonian drugs may improve these symptoms, they may also induce or worsen them. As postural disorders become irreversible after the development of secondary changes, such as muscle atrophy and bone fracture, physicians should recognize postural disorders at early stages.

4 citations

References
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Journal ArticleDOI
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.

76,181 citations

01 Jan 2002
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Abstract: EXAMINATION of the mental state is essential in evaluating psychiatric patients.1 Many investigators have added quantitative assessment of cognitive performance to the standard examination, and have documented reliability and validity of the several “clinical tests of the sensorium”.2*3 The available batteries are lengthy. For example, WITHERS and HINTON’S test includes 33 questions and requires about 30 min to administer and score. The standard WAIS requires even more time. However, elderly patients, particularly those with delirium or dementia syndromes, cooperate well only for short periods.4 Therefore, we devised a simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely. It is “mini” because it concentrates only on the cognitive aspects of mental functions, and excludes questions concerning mood, abnormal mental experiences and the form of thinking. But within the cognitive realm it is thorough. We have documented the validity and reliability of the MMS when given to 206 patients with dementia syndromes, affective disorder, affective disorder with cognitive impairment “pseudodementia”5T6), mania, schizophrenia, personality disorders, and in 63 normal subjects.

70,887 citations

Journal ArticleDOI
TL;DR: It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
Abstract: A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.

35,518 citations

Journal Article
TL;DR: The Mini-International Neuropsychiatric Interview is designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings.
Abstract: The Mini-International Neuropsychiatric Interview (M.I.N.I.) is a short structured diagnostic interview, developed jointly by psychiatrists and clinicians in the United States and Europe, for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 minutes, it was designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings. The authors describe the development of the M.I.N.I. and its family of interviews: the M.I.N.I.-Screen, the M.I.N.I.-Plus, and the M.I.N.I.-Kid. They report on validation of the M.I.N.I. in relation to the Structured Clinical Interview for DSM-III-R, Patient Version, the Composite International Diagnostic Interview, and expert professional opinion, and they comment on potential applications for this interview.

19,347 citations

Journal ArticleDOI
TL;DR: Controversy over the effectiveness of therapeutic measures for parkinsonism is due partially to this wide variability and to the paucity of clinical information about the natural history of the syndrome.
Abstract: PARKINSONISM, described in its entirety over one hundred and fifty years ago,’ rarely presents itself as a diagnostic problem. In consequence, little scrutiny has been directed to the marked variability of this frequently encountered neurological syndrome and to the progression of the disease in large groups of patients. As with most chronic neurological disorders, marked diversity can be expected to exist in age and mode of onset, relative prominence of the cardinal signs and symptoms, rate of progression, and resultant degree of functional impairment. Controversy over the effectiveness of therapeutic measures for parkinsonism is due partially to this wide variability and to the paucity of clinical information about the natural history of the syndrome. It is also re-

11,606 citations