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The Role of Fecal Microbiota Transplantation in Neurological Diseases
Published in David Perlmutter, The Microbiome and the Brain, 2019
Thomas Borody, John Bienenstock
One case of Tourette’s being reversed by FMT has been reported in the literature.121 A 9-year-old male presented with classic symptoms of Tourette’s, including involuntary eye turning, headshaking, shrugging, and vocal tics, which he had experienced for two-and-a-half years. After receiving treatment with tiapride 100 mg three times daily and probiotics consisting of Bacillus subtilis, Clostridium butyricum, and an Enterococcus, the patient experienced an initial improvement in symptoms for two months before reporting a gradual recurrence of symptoms. The patient was subsequently offered FMT as a treatment for tic symptoms and was administered 100 ml dose FMT via gastroscopy into the small intestine and 300 ml via colonoscopy using stool from a healthy 14-year-old male donor. Following FMT, the patient experienced a dramatic improvement in symptoms, including a reduction in tic severity score from 31 to 5, motor severity score from 16 to 5, and vocal severity score from 15 to 0.
Migraine
Published in M.D. Francesco Amenta, Peripheral Dopamine Pathophysiology, 2019
Marcello Fanciullacci, Massimo Alessandri, Bruno M. Fusco
Domperidone (10 mg i.v.) is capable of preventing, totally or partially, all of these disturbances except headache.15 Otherwise, haloperidol (0.5 mg i.v.) and tiapride (100 mg i.v.), which are DA antagonists able to cross the BBB, also prevent headache.15,16 This suggests that in the mechanism of migraine, the dopaminergic system also may be involved inside the BBB, especially in originating pain. Of additional interest is the observation that a slow intravenous injection of approximately 1 mg of DA can also provoke, in migraineurs, an attack.17
Tic Disorders and Tourette Syndrome
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Valerie Brandt, Samuele Cortese
The pharmacological treatment is one of the components of the multimodal treatment of tics. To date, the most comprehensive evidence synthesis on the pharmacological treatment is provided by the network meta-analysis (NMA, an advanced meta-analytic approach allowing the comparison of two or more treatments even when they have not been compared head-to-head in individual trials) conducted by Yang et al. (2019). The authors included 60 RCTs, for a total of 4,077 participants (aged 2–65 years) with a clinical diagnosis of tic disorders as per the Diagnostic and Statistical Manual of Mental Disorders-3 (DSM-3), DSM-4, or DSM-4-Text Revision, the International Classification of Diseases-10 (ICD-10) or the Chinese Classification and Diagnostic Criteria of Mental Disorders (CCMD). Haloperidol (standardised mean difference, SMD = –3.20, 95% CI [ –6.52, –0.14]), olanzapine (SMD = –6.11, –11.86, 0.55), ziprasidone (SMD = –5.57, –11.15, –0.048), risperidone (SMD = –3.47, –6.87, –0.37), aripiprazole (SMD = –4.74, –8.67, –1.06) and quetiapine (SMD = –12.32, –19.09, –5.63) were significantly more efficacious than placebo in improving tic severity. Quetiapine was significantly more efficacious than haloperidol, pimozide, risperidone, tiapride, aripiprazole and penfluridol. Aripiprazole was significantly more efficacious than tiapride. Unfortunately, this NMA did not report comparative tolerability of drugs and did not conduct subgroups analyses in children/adolescents only. Therefore, the reader should interpret with caution the overall findings of this meta-analysis and refer to guidelines based on evidence and expert consensus as well.
Progressive supranuclear palsy presenting with hyperkinetic movement disorder and hemiplegic dystonia: a case report
Published in International Journal of Neuroscience, 2020
Wei Zhang, Wei Mao, Erhe Xu, Jagadish K. Chhetri, Piu Chan
She performed poorly in the executive function, visuospatial, attention, and memory cognitive domains of the Montreal Cognitive Assessment (MoCA) with a total score of 17. MRI showed atrophy of midbrain and right temporal lobe (Figure 1A,B). [18F]FDG PET result showed moderate reduction of 18F-FDG uptake with obvious laterality (right > left) in the right basal ganglia and severe reduction in the right frontal lobe, parietal lobe, temporal lobe, and thalamus (Figure 1C,D). [18F]AV-133 PET showed reduced radioactivity distribution in the bilateral caudate nucleus, right putamen, and left anterior putamen (Figure 1E,F). [18F]THK5317 PET showed increased uptake in the bilateral basal ganglia and brain stem (Figure 1G,H). Transactive response DNA binding protein (TARDBP), microtubule-associated protein tau (MAPT), and frontotemporal dementia-related genes did not show pathogenic mutations. Treatment with Tiapride significantly improved chorea-like movements, however, other motor symptoms were not alleviated. At her latest follow-up in June 2019 the patient was unable to ambulate even with assistance .
Asymmetric lenticulostriate arteries in patients with moyamoya disease presenting with movement disorder: three new cases
Published in Neurological Research, 2020
Jiali Xu, Sijie Li, Gary B. Rajah, Wenbo Zhao, Changhong Ren, Yuchuan Ding, Qian Zhang, Xunming Ji
Case 1 was treated with aspirin and tiapride for about 2 weeks, but she stopped taking medicine as the symptoms were not relieved at all. Case 2 and case 3 took aspirin only. None of them accepted revascularization therapy. At one-year follow-up, case 1 and case 2 reexamined VWI demonstrating that the previously seen asymmetry between bilateral LSAs diminished (Figure 2, A2 and B2). The numbered ratio of case 1 was 5:4, and the total length of contralateral and ipsilateral LSAs were 148.50 mm and 126.93 mm (Figure 3, A); in case 2, the numbered ratio was 5:4, and the total length of contralateral and ipsilateral LSAs were 150.59 mm and 134.13 mm, respectively (Figure 3, B). What’s more, their symptoms resolved spontaneously.
Tourette syndrome and other chronic tic disorders: an update on clinical management
Published in Expert Review of Neurotherapeutics, 2018
Davide Martino, Tamara M Pringsheim
There has been a single, small (less than 30 participants) study of ziprasidone [59] in children with tics, reporting a significant benefit compared to placebo. There is one large study in children of tiapride compared to placebo and the 5 Ling granule (traditional Chinese medicine) which reported a significant improvement with tiapride relative to placebo on the YGTSS [60]. Tiapride is not available in the United States or Canada.