• Title/Summary/Keyword: Chorea disorders

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Generalized Chorea-Ballismus Associated with Nonketotic Hyperglycemia in Diabetes Mellitus -A Case Report- (당뇨환자에서 비케톤성 고혈당에 동반하여 나타난 전신성 무도병 1예)

  • Shin, Hyun-Ran;Kim, Ji-Hoon;Park, Mee-Young
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.136-143
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    • 2002
  • Even though the nonketotic hyperglycemia is a metabolic disorder, it complicates hemichorea-hemiballism rarely. Moreover, generalized chorea-ballism associated with nonketotic hyperglycemia in diabetes mellitus is very rare, so it has not been reported in Korean literature. Although the precise pathophysiologic mechanisms of these disorders are still poorly understood, deficiency of gamma aminobutyric acid (GABA) in nonketotic hyperglycemia or reduced GABAnergic inhibition by striatal lesion may increase inhibitory output to subthalamic nucleus. These result loss of pallidal inhibition and produce contralateral hemichorea-hemiballism. The striatal lesions, such as transient ischemia with reactive astrocytosis or small amount of petechial hemorrhage, are related with changes of magnetic resonance image (MRI) findings presumably. We report a diabetic old woman who developed generalized chorea-ballismus as a very rare complication of nonketotic hyperglycemia. Her brain MRI showed high signal intensity in left lentiform nucleus and right pallidum on T1 weighted images and low signal intensity in bilateral putamen on T2 weighted images with highly enhanced corresponding lesions on T1 weighted enhancement images.

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Two Cases of Dystonia and Chorea in Basal Ganglia (기저핵병변(基底核病變)에 의(依)한 불수의운동(不隨意運動) 환자(患者) 2례(例)에 대(對)한 임상보고(臨床報告))

  • Kim, Gi-Yeol;Kim, Jong-Dae;Jeong, Ji-Cheon
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.215-228
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    • 1997
  • Extrapyramidal movement disorders are divided descriptively into hypokinesias(such as parkinsonism), characterized by poverty and slowness of movement : hyperkinesias(such as chorea, athetosis, dystonia, ballism, etc.), manifested by abnormal involuntary movement. Chorea refers to widespread arrythythmic movements of a forcible, rapid, jerky, restless type Choreic movements are noted for their irregularity and variability. They are generally continuous, may be simple or quite elaborate, and affect any part of the body. Dystonla refers to abnormally increased muscular tone that causes fixed abnormal postures. Some patients with dystonia also have shifting postures, resulting from irregular, forceful twisting movement that affect trunk and produce bizarre, grotesque movements and positions of the body. The most frequent and familiar type of focal dystonia is spasmodic torticollis. It consists of an involuntary turning of the head to one side - intermittent at first, then gradually worsening to the point of being more or loss continuous. The combination of blepharospasm and oromandibular dystonia is sometimes refered to as Meige's syndrome. We report two patients with dystonia and chorea in cerebral infarction at basal ganglia. We have experienced good improvement by the oriental medicine and acupuncture treatment.'rho acupuncture points of LI 4, ST 36, TE 3, GB 34, GB 41, LR 3, GB 39 were used. The therapies of herb-medicine were treated by Zibu-Ganshen(滋補肝腎), Huoxue-Xifeng-Tongluo(活血息風通絡).

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Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder

  • Nam, Seok-Hyun;Lim, Myung Ho;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.2
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    • pp.27-34
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    • 2022
  • Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

Minamata Disease and the Mercury Pollution of the Globe

  • Harada Masazumi
    • Journal of Environmental Health Sciences
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    • v.31 no.6
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    • pp.451-456
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    • 2005
  • Minamata disease made its first appearance in the world at Minamata City, Kumamoto Prefecture, in May 1956. In 1962 methyl mercury poisoning through the placenta was found for the first time in the world. This was called congenital Minamata disease. In all cases the clinical symptoms were consistent with those of cerebral palsy. The time and place of outbreak were the same as those for Minamata disease. Their mothers had eaten fish and shellfish during pregnancy. The principal symptoms of congenital Minamata disease are mentalretardation ($100\%$); primitive reflexes ($100\%$); disturbance of coordination ($100\%$); dysarthria ($100\%$); limb deformation (100%); growth disorders ($100\%$); nutritional disorders ($100\%$); chorea-athetose ($95\%$); and hypersalivation ($95\%$). However, today, when the world is polluted by mercury in various places and at various levels, the data we need is not represented by those severe cases, but rather by the chronic milder type. Even in Minamata, the issue of Minamata disease has not been resolved. And likewise, on a global scale the problem of Minamata disease is not yet over.

A CASE OF PANDAS WITH CHILDHOOD DISINTEGRATIVE DISORDER (소아기 붕괴성 장애의 양상을 보이는 PANDAS 1례)

  • Cho, Soo-Churl;Seong, Deock-Kyu
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.149-156
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    • 2001
  • After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.

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