RESUMEN
OBJECTIVE: To evaluate changes in perceptual and several acoustic parameters of voice in patients with Parkinson's disease (PD) and to find out any relation with these parameters and motor components of Unified Parkinson's Disease Rating Scale (UPDRS) in this patient group. MATERIALS AND METHODS: Twenty patients with PD (12 male and 8 female) were given objective and subjective voice tests and results were compared with those of 20 age- and sex-matched controls. Patient's perceptual voice analysis was assessed using GRBAS scale including Grade of Dysphonia, Roughness, Breathiness, Asthenia and Strain items. Measurements for objective voice analysis, acoustic assessment tests including frequency perturbation [jitter (jitt)%], intensity perturbation [shimmer (shim)%], noise to harmonic ratio (NHR), fundamental frequency (F0), variability of fundamental frequency (vF0), diadochokinetic rate (DDK) and maximum phonation time (MPT) were used. An assessment of disability caused by voice disorders was scored according to the Voice Handicap Index (VHI) by the patient. All subjects also underwent videolaryngostroboscopic (VLS) examination. Motor components of UPDRS and acoustic parameters of voice were investigated for any correlations. RESULTS: Compared with controls, roughness (P = 0.15), breathiness (P = 0.004) and asthenia (P = 0.031) values of males and breathiness (P = 0.043) and asthenia (P = 0.023) values of females were higher in patients with PD. Mean VHI scores of patients with PD were higher for both male and female patients (P = 0.0001 for male, P = 0.002 for female). The mean values for MPT (P = 0.02) and DDK (P = 0.025) were shorter in patients with PD. Jitt%, shim% and mean F0 values were similar among the two groups. But mean vF0 values were significantly higher in male patients with PD (P = 0.05). On VLS examination, non-closure glottic pattern was found to be more frequent in the PD group. CONCLUSION: Although it is well known that pathophysiological changes in PD affect the voice, the present study found only few significant correlations between motor component of UPDRS and voice parameters.
Asunto(s)
Trastornos del Movimiento/complicaciones , Enfermedad de Parkinson/complicaciones , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/etiología , Anciano , Evaluación de la Discapacidad , Femenino , Ronquera/diagnóstico , Ronquera/etiología , Ronquera/fisiopatología , Humanos , Laringe/fisiopatología , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/fisiopatología , Músculo Esquelético/inervación , Músculo Esquelético/fisiopatología , Enfermedad de Parkinson/fisiopatología , Fonación , Caracteres Sexuales , Trastornos de la Voz/fisiopatologíaRESUMEN
Chorea is a rare complication of polycythaemia vera. Polycythaemic chorea occurs predominantly in females and usually in generalised form. We present a 66-year-old woman with acute onset hemichorea-ballism with no vascular pathology in the basal ganglia region. A clear relationship was observed between the onset of chorea and worsening of haematological parameters in the patient. After repeated phlebotomies the patient's clinical status was improved. Polycythaemic chorea must be considered, especially in the elderly, as early diagnosis leads to effective treatment and prevention of complications.
Asunto(s)
Corea/etiología , Policitemia Vera/complicaciones , Enfermedad Aguda , Anciano , Antidiscinéticos/administración & dosificación , Corea/tratamiento farmacológico , Antagonistas de Dopamina/administración & dosificación , Femenino , Haloperidol/administración & dosificación , Humanos , Flebotomía , Policitemia Vera/terapia , Sulpirida/administración & dosificaciónRESUMEN
A 21-year-old man with the diagnosis of paranoid schizophrenia was admitted to our clinic with cervical dystonia developing at the end of the first year of olanzapine therapy. The present case suggests that tardive dystonia in this patient is most likely associated with olanzapine administration as this is the main antipsychotic he received. Regarding the few case reports of olanzapine-associated tardive syndromes, patients taking olanzapine should be carefully screened for the appearance of tardive movements.
Asunto(s)
Antipsicóticos/efectos adversos , Discinesia Inducida por Medicamentos/etiología , Pirenzepina/análogos & derivados , Pirenzepina/efectos adversos , Esquizofrenia Paranoide/tratamiento farmacológico , Adulto , Benzodiazepinas , Humanos , Masculino , OlanzapinaRESUMEN
Progressive supranuclear palsy is one of the parkinsonial syndromes causing atypical parkinsonism. In recent reports, other than subcortical involvement, also cortical structures have been shown to be involved in progressive supranuclear palsy patients. One of the clinical presentations of this involvement is spontaneous arm levitation which is a component of alien limb syndrome. Here we report a clinically diagnosed progressive supranuclear palsy patient with spontaneous arm levitation. Clinically spontaneous levitation of one arm without denial of ownership suggests the presence of spontaneous arm levitation. Spontaneous arm levitation can occur in the setting of progressive supranuclear palsy and it possibly demonstrates the cortical involvement in this disorder.
Asunto(s)
Brazo/fisiopatología , Discinesias/etiología , Discinesias/fisiopatología , Parálisis Supranuclear Progresiva/complicaciones , Parálisis Supranuclear Progresiva/fisiopatología , Anciano , Dopaminérgicos/farmacología , Discinesias/patología , Humanos , Levodopa/administración & dosificación , Levodopa/efectos adversos , Masculino , Parálisis Supranuclear Progresiva/patología , Insuficiencia del TratamientoRESUMEN
Propranolol and primidone are widely used, effective agents in essential tremor although they are not tolerated by all patients. In the present study, the effectiveness of alprazolam, a triazole analog of benzodiazapine class, and acetazolamide, a carbonic anhydrase inhibitor, were investigated as symptomatic treatments for essential tremor. We studied 22 patients with essential tremor in a double-blind, cross-over, placebo-controlled design. The patients received in random order alprazolam, acetazolamide, primidone and placebo for four weeks, each separated by a two-week washout period. The study demonstrated that alprazolam was superior to placebo and equipotent to primidone, whereas there was no statistically significant difference between acetazolamide and placebo. The mean effective daily dose of alprazolam was 0.75 mg and there was not any troublesome side effect reported by the patients on alprazolam. Alprazolam can be used as an alternative agent in elderly essential tremor patients who can not tolerate primidone or propranolol.