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Basic psychopharmacology
Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019
Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson
Dyskinesias (= abnormal involuntary movements); commonly: Dystonia (= abnormal posture): dynamic (e.g. oculogyric crisis) or static (e.g. torticollis).Tardive (delayed onset) dyskinesia: Especially orofacial movements.Others: Tremor, chorea, athetosis, hemiballismus, myoclonus, tics.
Healthcare and Accelerometry: Applications for Activity Monitoring, Recognition, and Functional Assessment
Published in Daniel Tze Huei Lai, Rezaul Begg, Marimuthu Palaniswami, Healthcare Sensor Networks, 2016
Andrea Mannini, Angelo Maria Sabatini
Dyskinesia assessment and monitoring are performed in a similar way. Manson et al. (2000) developed a triaxial accelerometer worn on the shoulder to monitor subject behaviour during dyskinesia-provocation tasks, obtaining high correlations between clinical scores and mean accelerations. Keijsers, Horstink, and Gielen (2003) propose an ANN-based automatic procedure to assess the severity of levodopa-induced dyskinesia using six triaxial accelerometers; reasonable agreements with the clinical scores are also reported. A machine learning approach is applied in Patel et al. (2009); they implement a SVM classifier to estimate the severity of tremor, bradykinesia and dyskinesia using eight uniaxial accelerometers.
Medical Conditions and Diseases
Published in Clete A. Kushida, Sleep Deprivation, 2004
Naomi L. Rogers, Jacqueline D. Kloss
Although l-dopa can increase dopamine levels in the brain, its effectiveness decreases across time, such that larger and more frequent doses are required for it to be effective. In addition, after only 2–5 years of l-dopa treatment, its duration of effect is reduced. Chronic administration of l-dopa has been reported to produce psychiatric symptoms, such as paranoia, mania, anxiety, depression, hallucinations as well as increased incidence of insomnia and nightmares (92). It is not clear whether these symptoms are associated with chronic l-dopa therapy or disease course, since the two are temporally related (94). Chronic l-dopa therapy may also produce a state where patients’ response to administration fluctuates, such that they experience an on/off phenomena of l-dopa’s effects. Additional symptoms of dyskinesias, e.g., involuntary twisting and writhing, are associated with this on/off phenomenon. Consequently, treatment with l-dopa is typically delayed until other treatments are no longer effective.
Effect of targeted movement interventions on pain and quality of life in children with dyskinetic cerebral palsy: a pilot single subject research design to test feasibility of parent-reported assessments
Published in Disability and Rehabilitation, 2023
Nadine Smith, Simon Garbellini, Natasha Bear, Ashleigh Thornton, Peta Watts, Noula Gibson
Dyskinesia describes abnormal postures or movements associated with impaired muscle tone regulation, movement control, and coordination [1]. Children with dyskinetic cerebral palsy (CP) make up to 7–15% of the total population of children with CP, however this may be underreported due to mixed presentations of movement disorder [2–4]. Dystonia and choreoathetosis are simultaneously present in children with dyskinetic movement disorders, however dystonia is more predominant in the majority of children [5]. Dystonia is defined as involuntary sustained or intermittent muscle contractions causing twisting or repetitive movements, abnormal postures or both [6,7]. It has been identified as one of the most common causes of pain in children and youth with CP [8] and found to be a major predictor of emotional and behavioural problems [9]. Gross motor function, activity and participation are negatively impacted by the presence of dystonia, suggesting that dystonia should be addressed as a priority in children with CP [1].
Atypical dyskinesias under treatment with antipsychotic drugs: Report from the AMSP multicenter drug safety project
Published in The World Journal of Biological Psychiatry, 2022
Jessica Baumgärtner, Renate Grohmann, Stefan Bleich, Catherine Glocker, Johanna Seifert, Sermin Toto, Eckart Rüther, Rolf R. Engel, Susanne Stübner
The pathophysiology of involuntary movement disorders is not fully understood. Dyskinesias in general seem to be caused by a pharmacologically induced imbalance in the basal ganglia which regulate the rapid coordination of unconscious automated fine motor movements (Hacke and Poeck 2006). The fact that these very abstruse movements, which one would expect to be disturbing, are sometimes not noticed by patients, or are not considered as debilitating, could indicate that dyskinesias are unconscious and very early, phylogenetically atavistic, movement patterns (personal communication with Prof. Dr. E. Rüther, December 2020). In order to better understand involuntary movement disorders and especially AtypDs it is important to precisely document exact clinical manifestation and corresponding time course.
Present and future of subthalamotomy in the management of Parkinson´s disease: a systematic review
Published in Expert Review of Neurotherapeutics, 2021
Jorge U. Máñez-Miró, Rafael Rodríguez-Rojas, Marta Del Álamo, R. Martínez-Fernández, José A. Obeso
Six pilot studies [12,44,63,65,71] were published between 2001 and 2003 reporting a series of between 8 and 26 patients (seeTable 2for details). Regarding motor efficacy, the median improvement of these studies for overall and contralateral motor scores was 28% and 56% respectively; with benefit reported for all contralateral signs: tremor (73%), rigidity (71%) and bradykinesia (37%). Moreover, of the 90 patients treated unilaterally, only 5 cases of severe and/or persistent (lasting longer than three months) dyskinesia were reported. One of these patients died allegedly because of severe HCB [45] and the other cases required an additional procedure for alleviating subthalamotomy induced-dyskinesia, such as ipsilateral pallidotomy [12], Vim/VOp thalamotomy [65] or DBS electrode implantation in the Zi/H2 area dorsal to the original lesion [71]. Only Parkin et al., did not report post-operative dyskinesia, though probably their lesions were smaller and achieved no significant motor benefit [44]. The rate of transient dyskinesia was nearly 10% when reported [12,63,71]. It is conceivable, though, that similar rates were seen in the other series, but the authors focused on describing in detail only the severe cases.