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At least 1,027 records · Page 57Linked to original sources
PubMed2003

[Reversible choreoathetosis associated with lithium intoxication].

Several reports have been published in the literature of choreoathetosis associated with lithium intoxication, but little is known about choreoathetosis without concurrent antipsychotic treatment. We report a 65-year-old woman with lithium intoxication whose choreoathetosis completely recovered without sequela following decrease of her serum lithium level. She had been treated elsewhere for bipolar II disorder and also for hypertension, chronic hepatitis type C and diabetes mellitus. As she became hypomanic, lithium carbonate at 600 mg/day was commenced, which was increased to 1200 mg/day due to unfavorable therapeutic response. She began to manifest disorientation and abnormal involuntary movement and was therefore referred to our Department of Psychiatry. Her clinical symptoms at admission included consciousness disturbance with marked bilateral symmetrical slow-wave activity in her EEG and choreoathetosis was observed in her face and upper and lower extremities. Cerebellar symptoms were minimal with only mild ataxic gait and finger-to-nose test did not show dysmetria or intention tremor. Her serum lithium level was 3.52 mEq/L, which was clearly in the toxic range. She demonstrated no metabolic abnormalities including hyperglycemia, and was diagnosed with lithium intoxication and treated with water loading and mannitol for forced diuresis. On the 14th day after admission her consciousness disturbance and choreoathetosis resolved, but EEG abnormalities still persisted. On the 23rd day after admission, she was discharged with clinical remission and normal EEG background activity. Although she developed mild renal dysfunction, hemodialysis was not indicated. Hypersensitivity of dopamine receptor in the nigrostriatal pathways may contribute to choreoathetosis in association with the patient's vulnerability. Choreoathetosis can be a sign of lithium intoxication and prompt treatment is required following careful differential diagnosis.

Aged↗
PubMed1992

[A case of cervical myelopathy due to atlanto-axial subluxation with athetoid cerebral palsy].

We reported cervical myelopathy due to atlanto-axial subluxation of athetoid quadriplegia of cerebral palsy. This lesion was present from upper cervix to lower medulla oblongata, and appeared on MRI. The changes of sSEP was useful to evaluate his spinal function. We think that pediatricians need to understand this pathophysiology, particularly for multihandicapped children.

Adolescent↗
PubMed2004

[Late-onset of idiopathic paroxysmal kinesigenic choreoathetosis: a case report].

A case of late-onset idiopathic paroxysmal kinesigenic choreoathetosis (PKC) is described herein. A 50-year-old right-handed Japanese man with no family history of neurological disease or consanguinity was referred to our neurological unit because of paroxysmal involuntary movement of his right extremities. Physical examination findings were normal. Neurological examination during the interictal period revealed no abnormality. The attacks were triggered by abrupt initiation of voluntary movement and occurred about 30 times a day, lasting 30 to 60 seconds with no disturbance of consciousness. No metabolic abnormalities were found, and brain magnetic resonance imaging showed no abnormality including lacunar infarction. Interictal single photon emission computed tomography (SPECT) showed hypoperfusion of left basal ganglia. Interictal electroencephalography was normal without epileptic discharges. Because the patient did not have any condition that could cause secondary PKC, he was diagnosed as having idiopathic PKC. Treatment with carbamazepine 200 mg once a day resulted in control of the attacks, and 500 mg a day resulted complete resolution. To the best of our knowledge, this case may represent the oldest age reported for idiopathic PKC onset. Although the etiology of PKC remains unknown, late-onset idiopathic PKC is rare. Our SPECT finding leads us to suppose that dysfunction of the basal ganglia is likely involved in the pathogenesis of PKC.

Athetosis↗
PubMed1992

Chorea and ballism.

Chorea and ballism are hyperkinetic movement disorders which can be caused by a variety of conditions including metabolic abnormalities, neurodegenerative and immunologic disorders, as well as structural lesions. In addition, paroxysmal dyskinesias may be associated with chorea. Chorea is increasingly recognized as a symptom of a variety of different conditions. The pathophysiologic mechanisms underlying choreic disorders, however, need further elucidation.

Athetosis↗
PubMedDate not supplied

[Brachial presentation of spinal pseudochoreoathetosis. The result of proprioceptive information being processed in parallel].

INTRODUCTION: The term pseudochoreoathetosis is used to refer to the choreoathetoid movements that are produced by alterations in the proprioceptive sensitivity due to damage it has suffered at some point along its course. Proprioceptive sensitivity is considered to go up as far as the cortex along the posterior cords of the spinal cord, which means that if they are injured in the cervical region there should be a sensory deficit in both the upper (UL) and lower limbs (LL). CASE REPORTS: We describe five cases of transverse myelitis with localised cervical injury that selectively and mainly affected the posterior cords of the spinal cord. In the five patients there was selective involvement of the proprioceptive sensitivity in the UL respecting the LL and pseudochoreoathetoid movements of the limb that has been deafferented for proprioceptive sensitivity. The dissociation between the UL and the LL occurs because the spinocerebellar and spinocervical tracts take the proprioceptive information from the LL in parallel to the posterior cords, which receive the proprioceptive sensitivity from the UL. CONCLUSIONS: At present, the most widely accepted physiopathological mechanism explaining pseudochoreoathetosis consists in a failure in the integration of the sensory-motor afferences in the striatum, which causes faulty sensory-motor integration at this level and gives rise to pseudochoreoathetosis.

Adolescent↗
PubMed1992

The Lesch-Nyhan syndrome--an under-recognised condition in South Africa? A case report.

The Lesch-Nyhan syndrome is a rare inborn error of purine metabolism caused by a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT), which results in mental retardation with characteristic self-mutilation, spasticity, extrapyramidal signs and hyperuricaemia. The clinical and biochemical findings in an 18-month-old boy, who presented with renal calculi and was shown to have less than 1% of normal HGPRT activity, are reported. The obvious neurological abnormalities had previously been thought to be due to hypoxic-ischaemic encephalopathy. The expected incidence of this disease is much higher than the known number of cases diagnosed.

Athetosis↗
PubMedDate not supplied

Clinical manifestation and carbamazepine treatment of patients with paroxysmal kinesigenic choreoathetosis.

Paroxysmal kinesigenic choreoathetosis (PKC) is characterized by episodes of brief dystonia or choreoathetosis which is induced by sudden movement. We report the clinical manifestations and efficacy of treatment with carbamazepine in familial PKC. Seven patients from two families were diagnosed with PKC. The most common precipitating factors in our patients were sudden movement, anxiety and stress. The mean age of the first attack was around early puberty, and the symptoms became remarkable during early adulthood. Interictal single-photon emission computed tomography of the brain revealed abnormal perfusion of regional cerebral flow in either the basal ganglia or thalami in most of the patients. Four of seven patients were prescribed low dose of carbamazepine (1.5-2.0 mg/kg/day); the follow-up period ranged from 14 to 30 months. The patients who received carbamazepine treatment became attack-free without decline in school performance. The results suggest that the prognosis of PKC is a relatively benign entity due to spontaneous resolution since adulthood, and a low dose of carbamazepine is sufficient to manage PKC. Abnormal cerebral perfusion flow over the basal ganglia or thalami in these patients leads us to believe that PKC is a form of extrapyramidal disorder.

Adolescent↗
PubMed2006

Psychosis and Wilson's disease: a case report.

In this article we present a case of a 26-year-old woman with clinical picture of acute psychosis, as the first and main manifestation of Wilson's disease, who developed abnormal involuntary choreoathetoid limb movements, few days after initiation of neuroleptic therapy. At the first movement neurological symptoms were misinterpreted as side effect of haloperidol, but consulted neurologist suggested additional diagnostic procedure which confirmed Wilson's disease. Psychiatric symptomatology and abnormal involuntary movements were the clinical manifestation of this disease, which improved with neuroleptic and chelating treatment. Interdisciplinary approach with good collaboration of psychiatrists and neurologists is crucial for Wilson's disease, because early diagnosis and treatment without delay is critical to the prognosis. This case serves as a reminder that involuntary movements can be side effect of antipsychotics but also the clinical manifestation of some illnesses, for example Wilson's, Huntington's and Fuhr's diseases.

Acute Disease↗
PubMed1991

[The comparison of motor developmental processes between spastic diplegic children and athetotic children who have been treated since infancy].

We studied the correlation between motor developmental processes and prognosis of locomotion at the age of 4 years, among 15 spastic diplegic children (S) and 21 athetotic children (A), who started treatment under 1 year of age. The children of each type were divided into two groups according to the ability of locomotion at the age of 4 years; S- I: 6 walkers, S- II: 9 crawler, A- I: 11 walkers and A- II: 10 crawler. We compared the average corrected ages when the subjects attained the abilities to roll over, creep, sit with hands, crawl, sit up, cruise with support, stand up, and walk alone, and made a statistical analysis by t test among 4 groups. Also we compared the cumulative frequency percentages for the ages about the locomotion mentioned above. The S- I group attained all of the abilities of locomotion significantly earlier than the S- II group. The A- I group could crawl and sit up significantly earlier than the S- II group. The A- I group could crawl and sit up significantly earlier than the A- II group. The S- I group began to creep and sit with hands significantly earlier than the A- I group. We found no significant differences between the S- II group and the A- II group in motor developmental processes. These studies revealed that it would be possible to expect the prognosis of ambulation at the age of 4 years according to the early motor developmental processes among the spastic diplegic children.(ABSTRACT TRUNCATED AT 250 WORDS)

Athetosis↗
PubMed1977

[Striatal syndrome and hypokalemia].

The authors present the case of a patient with a striated syndrome resembling Wilson's disease but without the disorder of cooper metabolism. The clinical picture was completely masked by a hypokalemia at 1 mEq/l following urinary loss of this cation, due to ascending interstitial nephritis. Correction of the potassium deficiency produced rapid reappearance of the initial neurological syndrome.

Athetosis↗