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Movement disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
Paratonia is the appearance of increased tone that is caused by a failure to relax muscles during a neurological examination. It has been described in two forms:Oppositional (also called ‘gegenhalten') – the person being assessed inappropriately resists limb movement. It becomes pronounced with more rapid passive limb movementsFacilitatory (also called ‘mitgehen') – the person being assessed tries to actively aid the examiner's movements of their limbs
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Characteristic clinical features in AD include: Memory loss: insidious onset short-term memory decline is the primary feature of AD. Episodic memory is affected early, with loss of memory for everyday events. Patients may begin to repeat questions and comments frequently or misplace objects frequently. Previously stored long-term memories are preserved early on, as is immediate memory (e.g. digit span). Impaired learning (encoding) of new verbal and visual information is evident on neuropsychologic assessment.Visuospatial and language deficits: commonly coexist in AD. There may be focal cortical neurologic signs including aphasia, agraphia, dyscalculia, apraxia (ideomotor and dressing), agnosia for objects or faces, and neglect or sensory inattention. These generally appear after presentation of memory impairment, but in rare cases may mark the onset of disease.Psychiatric features: may include paranoia and other personality or behavioral changes. Some patients develop a delusion that people are stealing from them, which may or may not be the result of item misplacement. If hallucinations are present, they are typically persecutory or featuring deceased family members.Motor symptoms: including muscular rigidity (paratonia) as well as reduced gait speed and stride.Terminal stage signs: may include myoclonic jerking, seizures, urinary and bowel incontinence, and akinetic mutism.
Functional behaviour analysis guided interventions might improve transfer-related behaviour in dementia care dyads: a single case study
Published in European Journal of Physiotherapy, 2020
Charlotta Thunborg, Anne Söderlund, Petra von Heideken Wågert
The RTC-DAT was used to assess the resistiveness to care of the person with dementia in care dyad 2. This scale includes 13 items: paratonia, grab object, say no, adduct, grab person, pull away, clench, cry, scream, turn away, push away, hitch/kick, and threaten [7]. The RTC-DAT scores range from 0–156, where high scores indicate greater problems with resistiveness to care. Regarding reliability, 0.82–0.87 internal consistency estimates and good to excellent kappa values have been demonstrated [7]. Criterion-related validity with observed discomfort and construct validity have been shown by factor analysis to support the validity of the RTC-DAT.
Role of GPR40 in pathogenesis and treatment of Alzheimer's disease and type 2 diabetic dementia
Published in Journal of Drug Targeting, 2019
Jing-Jing Chen, Yu-Hang Gong, Ling He
Advanced glycation end products (AGEs) were associated with the presence of paratonia in the early-onset of dementia. And patients with diabetes showed a significantly higher risk of paratonia development [38]. Studies have revealed that AGEs contributed to the pathogenesis of neurodegenerative diseases and were thought to be the seed of Aβ aggregation. Besides, Lubitz et al. [39] found that high dietary AGEs were related to the poor spatial learning and deposition of Aβ in the AD model. Furthermore, studies have shown that AGEs aggravated IR [40] and both AD and diabetes had a close connection with the high concentration of AGEs.