The effect of propranolol on parkinsonian tremor induced by peripheral trauma.
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Biomedical subjects
Publications and source records attributed to R Sandyk.
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The case of a 66-year-old man with a 4-month history of parkinsonism caused by a chronic subdural haematoma is presented. Disappearance of the extrapyramidal symptoms followed craniotomy and removal of the haematoma.
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A case of familial myoclonus epilepsy with progressive mental deterioration is presented. The genetic pattern, symptomatology, EEG recording and good response to anticonvulsant medication are discussed. This case does not conform to any known form of familial myoclonus epilepsy and is most probably an atypical form of paramyoclonus multiplex.
The electromyographic silent period produced by electrical stimulation of the median nerve was recorded in the abductor pollicis brevis muscle in a group of 7 patients with Huntington's chorea (5 adults and 2 children). The adults had short values of 60.0--75 ms, while the values in the children were within normal limits (90--140 ms). These results suggest: (i) that the short silent period in Huntington's chorea is due to reduced excitation (or increased inhibition) of spinal interneurons; and (ii) that Huntington's chorea in childhood differs from that in adults not only with regard to the clinical picture but with regard to silent period values elicited by stimulation of the median nerve.
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Voluntary responses to peripheral stimulation in 12 normal subjects and 12 parkinsonian patients in the same age group were examined electromyographically. The successive reaction (SR) times (interval between two quick repetitive voluntary movements) of the arm flexors and extensors, as well as the head flexors and extensors and the foot flexors and extensors, in the normal subjects were compared with those in the parkinsonian patients. The study was carried out in order to find out whether there are differences in the cortical responses to successive voluntary movements from different areas of the periphery, and to try to explain clinical phenomena such as the gait difficulties (marche á petit pas), the poor arm swing when walking and the early forward head inclination of the parkinsonian. The voluntary responses of the parkinsonian patients revealed significant prolonged SR times in all examined muscles, but especially following voluntary muscle activity of the foot flexors and extensors. These results suggest that the cortical inhibition after peripheral voluntary response is not uniform in all muscle groups and perhaps reflects selective inhibitory mechanisms via the motor cortex.
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The blink reflex (orbicularis oculi reflex) was studied electromyographically in 5 children ranging in age from 2 months to 15 years and in 5 age-matched children with advanced hydrocephalus. All the hydrocephalic children demonstrated: (a) prolonged reflex response latencies compared with mean values for the age-matched controls; (b) a decrease in the response latencies following a shunting procedure and habituation of the reflex postoperatively; and (c) failure of the reflex to habituate for the shunting procedure. Study of the blink reflex in hydrocephalic infants at risk of cerebral damage can be a useful way of detecting dysfunction and monitoring response to therapy.
The head retraction reflex consists of a brief, involuntary extension of the neck on tapping the upper lip. This reflex was found to be present in 17.2% of patients with Parkinson's disease, but in only 4.9% of normal controls and 8% of cases of senile dementia. In addition there was a correlation between the severity of the Parkinson's disease and the presence of the reflex. This suggests that the reflex is specifically related to the Parkinson's disease process rather than to aging or the presence of dementia.
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