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Galit Kleiner-Fisman, Edwin Khoo, Nikohl Moncrieffe, Triina Forbell, Pearl Gryfe, David Fisman
OBJECTIVE: Evaluate safety and efficacy of Incobotulinumtoxin A in elderly patients with dementia and paratonia. SETTING: University-affiliated hospital, spasticity management Clinic. PARTICIPANTS: Ten subjects were enrolled. INCLUSION CRITERIA: 1) severe cognitive impairment 2) diagnosis of Alzheimer's disease, vascular dementia, or frontotemporal dementia, and 3) score >3 on the paratonic assessment instrument, with posture in an arm(s) interfering with provision of care...
2014: PloS One
Robert Fekete
Catatonia, originally described by Karl Kahlbaum in 1874, may be regarded as a set of clinical features found in a subtype of schizophrenia, but the syndrome may also stem from organic causes including vascular parkinsonism, brain masses, globus pallidus lesions, metabolic derangements, and pharmacologic agents, especially first generation antipsychotics. Catatonia may include paratonia, waxy flexibility (cerea flexibilitas), stupor, mutism, echolalia, and catalepsy (abnormal posturing). A case of catatonia as a result of acute renal failure in a patient with dementia with Lewy bodies is described...
January 2013: Case Reports in Neurology
Imre Szirmai
UNLABELLED: The "arteriosclerotic parkinsonism", which is called vascular parkinsonism (VP), was first described by Critchley'. The broad based slow gait, reduced stride lenght, start hesitation, freezing and paratonia was mentioned as "lower body parkinsonism" (LBP) which can be associated by slow speech, dysexecutive syndrome, and hand tremor of predominantly postural character. In VP the DAT-scan proved normal dopamine content of the striatum in contrast with Parkinson's disease (PD)...
November 30, 2011: Ideggyógyászati Szemle
Johannes Hans S M Hobbelen, Frans E S Tan, Frans R J Verhey, Raymond T C M Koopmans, Rob A de Bie
BACKGROUND: Paratonia causes severe movement dysfunction in late stage dementia. Passive Movement Therapy (PMT) is often used to decrease high muscle tone, but the efficacy has never been shown. The objective of this study is to investigate the effect of PMT on muscle tone after two and four weeks of treatment. METHODS: This study comprised a multicenter single-blinded RCT. Nursing home residents with dementia (according to the DSM-IV-TR criteria) and moderate to severe paratonia were randomly assigned to either a PMT or control group...
May 2012: International Psychogeriatrics
Johannes S M Hobbelen, Frans E S Tan, Frans R J Verhey, Raymond T C M Koopmans, Rob A de Bie
BACKGROUND: Paratonia is a progressive motor problem that is observed in individuals with dementia and is not a well-known phenomenon. This study explores the development and risk factors of paratonia in moderate stage dementia patients. METHODS: A multi-center, longitudinal, one-year follow-up cohort study was performed. Patients with an established diagnosis of dementia, with a score of 6 or lower on the Global Deterioration Scale (GDS) were included. The participants were assessed using the Paratonia Assessment Instrument (PAI), the Timed Up and GO test, the Qualidem, the Global Deterioration Scale (Reisberg et al...
September 2011: International Psychogeriatrics
Kenji Kamogawa, Shinya Okuda, Hitomi Tomita, Kensho Okamoto, Bungo Okuda
We report a 75-year-old, right-handed man, presenting with supplementary motor area (SMA) seizure. The patient had suffered from frequent attacks of transient inability to speak and move without loss of awareness. On admission, he presented with vertical gaze paresis, axial rigidity, paratonia of extremities and gait disturbance. The attacks were preceded by discomfort on the head, followed by inability to move the whole body and arrest of vocalization with tonic posture and exaggerated breathing. Consciousness and cognitive function were preserved throughout the attacks...
July 2010: Rinshō Shinkeigaku, Clinical Neurology
Hal S Wortzel, Kimberly L Frey, C Alan Anderson, David B Arciniegas
The presence of paratonia and primitive reflexes ("frontal release signs"), such as glabellar, snout, suck, grasp, and palmomental responses, after traumatic brain injury predicts performance on bedside cognitive assessments, level of functional independence, and duration of acute inpatient rehabilitation.
2009: Journal of Neuropsychiatry and Clinical Neurosciences
Johannes S M Hobbelen, Raymond T C M Koopmans, Frans R J Verhey, Kitty M Habraken, Rob A de Bie
BACKGROUND: Paratonia is one of the associated movement disorders characteristic of dementia. The aim of this study was to develop an assessment tool (the Paratonia Assessment Instrument, PAI), based on the new consensus definition of paratonia. An additional aim was to investigate the reliability and validity of the PAI. METHODS: A three-phase cross-sectional survey was conducted. In the first two phases, the PAI was developed and validated. In the third phase, the inter-observer reliability and feasibility of the instrument was tested...
August 2008: International Psychogeriatrics
Johannes S M Hobbelen, Frans R J Verhey, Jacobus H J Bor, Rob A de Bie, Raymond T C M Koopmans
BACKGROUND: Paratonia, a form of hypertonia, is associated with loss of mobility and with the development of contractures especially in the late stages of the dementia. Passive movement therapy (PMT) currently is the main physiotherapeutic intervention. General doubt about the beneficial effects of this widely used therapy necessitates a randomised clinical trial (RCT) to study the efficacy of PMT on the severity of paratonia and on the improvement of daily care. METHODS/DESIGN: A RCT with a 4-week follow-up period...
2007: BMC Geriatrics
Ipsit Vahia, Carl I Cohen, Alla Prehogan, Zaitoon Memon
OBJECTIVE: Paratonia is an external stimulus dependent increase in muscle tone that is absent at rest. It is thought to occur commonly in Alzheimer disease (AD) but is understudied. This study examines paratonia in a multiracial sample. METHODS: The sample consisted of 80 patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for AD. They received a battery of neuropsychiatric assessments. The authors examined the relationship between paratonia and multiple variables...
April 2007: American Journal of Geriatric Psychiatry
Johannes S M Hobbelen, Raymond T C M Koopmans, Frans R J Verhey, Roland P S Van Peppen, Rob A de Bie
BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia. METHODS: The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia...
2006: Journal of Geriatric Physical Therapy
Alfredo Damasceno, Adriane M Delicio, Daniel F C Mazo, João F D Zullo, Patricia Scherer, Ronny T Y Ng, Benito P Damasceno
BACKGROUND: Data on the prevalence of primitive reflexes (PR) in adulthood, their pathological significance and relationship to age and cognition are controversial. OBJECTIVE: To study the relationship between PR and cognition in 30 patients with probable Alzheimer's disease (AD) and 154 control subjects. METHOD: Diagnosis of probable AD was based on DSM-IV, NINCDS-ADRDA, and CAMDEX criteria. Primitive reflexes were quantified from zero (absent) to 1 (mild) or 2 (markedly present)...
September 2005: Arquivos de Neuro-psiquiatria
Hayley P Bennett, Alastair J Corbett, Susan Gaden, David A Grayson, Jillian J Kril, G Anthony Broe
OBJECTIVES: To identify predictors of activity of daily living (ADL) and instrumental activity of daily living (IADL) decline in a population with subcortical vascular dementia (SVD) and to evaluate potential mechanism of decline. DESIGN: Longitudinal. SETTING: Hospital-based. PARTICIPANTS: Computed tomographic (CT) scanning identified 77 participants as having subcortical infarction. MEASUREMENTS: Participants were neurologically, neuropsychologically, behaviorally, and functionally assessed four times over 5...
December 2002: Journal of the American Geriatrics Society
R Rao
As the contribution of carotid stenosis to cognitive impairment still remains unclear, neuropsychological function and soft neurological signs were examined in patients aged 65 and over. Twenty-five patients with symptomatic carotid stenosis (CS) of 75% or more were compared with 25 patients with first anterior circulation stroke, 25 with peripheral vascular disease and 25 healthy controls. All patients were assessed using CAMCOG (Cambridge Cognitive Examination), tests examining frontal lobe function (Behavioural Dyscontrol Scale [BDYS], Trail-Making Tests A and B, Controlled Word Association Test) and a scale for primitive reflexes (Frontal Release Signs Scale)...
November 15, 2002: Journal of the Neurological Sciences
R Kurlan, I H Richard, M Papka, F Marshall
Rigidity, slowness, gait impairment, and other disorders of movement accompany Alzheimer's disease (AD) at various stages of the illness. The presence of these so-called extrapyramidal features have been reported to predict disease prognosis and pathologic localization. Unfortunately, failure to accurately characterize the movement disorder, particularly to distinguish parkinsonism from cortically based motor disturbances (that is, paratonia, apraxia), makes the results of many published studies difficult to interpret...
January 2000: Movement Disorders: Official Journal of the Movement Disorder Society
W Madei, T Altscher, R Nistor, K Hoerauf
HISTORY AND CLINICAL FINDINGS: A 14-year-old boy had in war-torn Bosnia sustained a transcranial gunshot wound from a 7.65 mm bullet. After primary medical care with craniotomy and the removal of bony fragments and cerebral debris followed by a duraplasty, he was transported to the French-German Field Hospital. On arrival he was breathing spontaneously and in stable cardiovascular state but with impaired responsiveness and somnolent. His pupils were moderately dilated with slight anisocoria (right > left)...
September 25, 1998: Deutsche Medizinische Wochenschrift
D Q Beversdorf, K M Heilman
OBJECTIVE: To learn if paratonia predicts frontal cognitive impairments. BACKGROUND: Paratonia, an alteration of tone to passive movement, can be divided into oppositional paratonia ("gegenhalten," "paratonic rigidity") and facilitory paratonia. Although paratonia has been thought to be induced by frontal lobe dysfunction, previous studies suggest that paratonia does not correlate with cognitive impairment. However, only oppositional paratonia has been studied in this manner, and in these studies only the presence or absence of paratonia was assessed instead of a quantitative scale...
October 1998: Neurology
A Chatterjee
No abstract text is available yet for this article.
October 1998: Neurology
L E Souren, E H Franssen, B Reisberg
As a result of the neuropathologic process of Alzheimer's disease (AD), significant changes occur in neuromotor function (e.g., paratonia and compulsive grasping). These changes become manifest in the moderately severe stage of AD, when patients begin to require ongoing assistance with activities of daily life (ADL), and they are prominent in the severe stage of AD, when patients are continuously dependent on a caregiver. Patients in these stages often display behavioral disturbances during care activities...
July 1997: Journal of Geriatric Psychiatry and Neurology
K Abe
Clinical and molecular analyses of neurodegenerative diseases such as Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), and spinocerebellar ataxia type 1 (SCA1) were performed. In the present study, a Japanese family of AD with an Ala285Val substitution in exon 8 of the presenilin-1 (PS-1) gene was found. This family was characterized by relatively late onset (mean age at 50 years) in familial AD with PS-1 gene mutation and by absence of myoclonus, seizure or paratonia. Magnetic resonance image (MRI) study showed marked linear signal abnormalities in white matter of parietoocctipital lobes, suggesting a presence of cortical amyloid angiopathy of the patient with PS-1 gene mutation...
April 1997: Tohoku Journal of Experimental Medicine
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