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Extrapyramidal syndrome

James B Leonard, Kashif M Munir, Hong K Kim
Metoclopramide (MCP) is a commonly used anti-emetic in the emergency department (ED). Its use is generally well tolerated; although infrequent adverse reactions such as extrapyramidal reactions or tardive dyskinesia are reported. However, many ED providers are not familiar with the potentially life-threatening hypertensive emergency that can be precipitated by MCP administration in patients with pheochromocytoma. A previously healthy 36-year-old woman presented to the ED with headache and nausea. She developed acute hypertensive emergency (acute agitation, worsening headache, chest pain and wide complex tachycardia) when her blood pressure (BP) increased to 223/102mmHg (initial BP, 134/86mmHg) after receiving intravenous MCP...
March 5, 2018: American Journal of Emergency Medicine
Taro Kishi, Yuki Matsui, Yuki Matsuda, Asuka Katsuki, Hikaru Hori, Hiroko Yanagimoto, Kenji Sanada, Kiichiro Morita, Reiji Yoshimura, Yoshihisa Shoji, Katsuhiko Hagi, Nakao Iwata
INTRODUCTION: We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing blonanserin with other antipsychotics (amisulpride, aripiprazole, haloperidol, paliperidone, and risperidone). METHODS: Weighted mean difference (WMD), risk ratio, and number needed to harm (NNH) with 95% confidence intervals (95% CIs) were calculated using random-effects model. RESULTS: Ten RCTs (n = 1521) were included in this study...
March 7, 2018: Pharmacopsychiatry
Yanling Zhou, Guannan Li, Dan Li, Hongmei Cui, Yuping Ning
BACKGROUND: The long-term effects of dose reduction of atypical antipsychotics on cognitive function and symptomatology in stable patients with schizophrenia remain unclear. We sought to determine the change in cognitive function and symptomatology after reducing risperidone or olanzapine dosage in stable schizophrenic patients. METHODS: Seventy-five stabilized schizophrenic patients prescribed risperidone (≥4 mg/day) or olanzapine (≥10 mg/day) were randomly divided into a dose-reduction group ( n=37) and a maintenance group ( n=38)...
February 1, 2018: Journal of Psychopharmacology
Jia-Yin Yeh, Kun-Yu Tu, Ping-Tao Tseng, Yu Lee, Pao-Yen Lin
Belly dancer syndrome, also called belly dance syndrome or belly dancer dyskinesia, is a kind of abdominal dyskinesia with painful sensation. Its etiology is still unclear and there are few studies reporting its association with antipsychotics. Quetiapine is an atypical antipsychotic that causes lower risk of extrapyramidal symptoms than typical antipsychotics. Here, we presented the first case of belly dancer syndrome in a 71-year-old woman with major depressive disorder after short-term use of quetiapine.
February 22, 2018: Clinical Neuropharmacology
Quintí Foguet-Boreu, Montse Coll-Negre, Montse Serra-Millàs, Miquel Cavalleria-Verdaguer
Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT...
January 8, 2018: Clinics and Practice
André Pessoa, Vanessa van der Linden, Marshalyn Yeargin-Allsopp, Maria Durce Costa Gomes Carvalho, Erlane Marques Ribeiro, Kim Van Naarden Braun, Maureen S Durkin, Daniel M Pastula, Jazmyn T Moore, Cynthia A Moore
Initial reports of congenital Zika virus (ZIKV) infection focused on microcephaly at birth with severe brain anomalies; the phenotype has broadened to include microcephaly that develops after birth and neurodevelopmental sequelae. In this narrative review, we summarize medical literature describing motor abnormalities and epilepsy in infants with evidence of congenital ZIKV infection and provide information on the impact of these conditions. Specific scenarios are used to illustrate the complex clinical course in infants with abnormalities that are consistent with congenital Zika syndrome...
February 2018: Pediatrics
Milad Hosseinialhashemi, Babak Daneshfard, Atefe Hashemi
Hallervorden-Spatz syndrome is a rare neurodegenerative disorder with hereditary properties. It usually occurs in young adolescents with extrapyramidal symptoms besides disturbed mental function. In this study, we present a 23-year-old neuropsychiatric patient who primarily misdiagnosed to have conversion disorder. She had 5-year history of progressive dysarthria and generalized abnormal movements. After detecting the pathognomonic sign of "eye of the tiger" diagnosis was confirmed. The patient was discharged...
January 2018: Acta Medica Iranica
Alireza Ghajar, Mohammad-Reza Khoaie-Ardakani, Zahara Shahmoradi, Amir-Reza Alavi, Mohsen Afarideh, Mohammad-Reza Shalbafan, Maryam Ghazizadeh-Hashemi, Shahin Akhondzadeh
Since l-carnosine has shown effectiveness in improvement of cognition in patients with schizophrenia, this 8-week, randomized, double-blind, placebo-controlled pilot study was conducted. Sixty-three patients with chronic schizophrenia, who were clinically stable on a stable dose of risperidone, entered the study. The patients were randomly assigned to l-carnosine (2 gr/day in two divided doses) or placebo for eight weeks. The patients were assessed using the positive and negative syndrome scale (PANSS), extrapyramidal symptom rating scale (ESRS), and Hamilton depression rating scale (HDRS) during the study course...
February 3, 2018: Psychiatry Research
Nuno Mendonça, Marcondes C França, António Freire Gonçalves, Cristina Januário
Machado-Joseph disease (MJD) also known as Spinocerebellar ataxia type 3, is a hereditary neurodegenerative disease associated with severe clinical manifestations and premature death. Although rare, it is the most common autosomal dominant spinocerebellar ataxia worldwide and has a distinct geographic distribution, reaching peak prevalence in certain regions of Brazil, Portugal and China. Due to its clinical heterogeneity, it was initially described as several different entities and as had many designations over the last decades...
2018: Advances in Experimental Medicine and Biology
Vito A G Ricigliano, Barbara Fossati, Lorenzo Saraceno, Michele Cavalli, Elena Bazzigaluppi, Giovanni Meola
Thymoma is a tumor originating from thymic gland, frequently manifesting with paraneoplastic neurological disorders. Its association with paraneoplastic dysautonomia is relatively uncommon. Here, we describe the challenging case of a 71 year-old female who developed subacute autonomic failure with digestive pseudo-obstruction, dysphagia, urinary tract dysfunction and orthostatic hypotension complicating an underlying extrapyramidal syndrome that had started 3 months before hospital admission. Autonomic symptoms had 2-month course and acutely worsened just before and during hospitalization...
2018: Frontiers in Neuroscience
Marc Krause, Yikang Zhu, Maximilian Huhn, Johannes Schneider-Thoma, Irene Bighelli, Adriani Nikolakopoulou, Stefan Leucht
BACKGROUND: Negative symptoms are the core of schizophrenia, but whether antipsychotics are efficacious for their treatment is unclear. Moreover, there is debate whether patients in relevant trials should have predominant negative symptoms or whether prominent negative symptoms are also acceptable. METHODS: We systematically reviewed randomised, blinded antipsychotic drug trials in patients with schizophrenia and either predominant or prominent negative symptoms (last search Dec 12, 2017)...
January 24, 2018: European Archives of Psychiatry and Clinical Neuroscience
Hidenobu Suzuki, Hiroyuki Hibino, Yuichi Inoue, Hideo Matsumoto, Katsunaka Mikami
Background: Schizophrenia is a chronic disease that requires long-term management with antipsychotics. Antipsychotic drugs are given by tapering their dose, extending the dosing interval, and so on, as part of a treatment strategy to minimize the adverse effects while at the same time maintaining efficacy. Methods: We report the case of one patient with schizophrenia in whom the clinical symptoms were alleviated after treatment with 6 mg paliperidone. However, the patient developed extrapyramidal syndrome, for which 3 and 6 mg paliperidone were administered alternately every other day...
2017: SAGE Open Medical Case Reports
E Savard, A Declemy, V Coindreau, F Babany, C Chesnel, A Charlanes, F Le Breton, G Amarenco
INTRODUCTION: Lower urinary tract symptoms are common in Parkinson diseases, especially chronic urinary retention. In case of significant and symptomatic postvoid residual, a specific treatment is necessary in order to empty the bladder and nowadays the gold standard of such neurogenic bladder is based on self-intermittent-catheterizations, if possible at all. We carried out a retrospective study about feasibility and outcomes of self-intermittent-catheterizations in this population. METHODS: Retrospective study with qualitative and quantitative, clinical and instrumental (urodynamic) assessment, of lower urinary tract symptoms as urinary retention in extrapyramidal syndromes...
December 19, 2017: Progrès en Urologie
Divyani Garg, Varun Reddy, Rajesh Kumar Singh, Deepa Dash, Rohit Bhatia, Manjari Tripathi
Subacute sclerosing panencephalitis (SSPE) is a slowly progressive degenerative disorder caused by measles virus. It is characterised by typical clinical and electrophysiological features in the form of slow myoclonic jerks, with progressive cognitive impairment, visual symptoms, and periodic complexes on EEG, with raised titres of anti-measles antibodies in CSF and serum. Atypical presentations of SSPE have been reported including brainstem involvement, ADEM-like presentation, acute encephalitis, and cerebellar ataxia...
February 2018: Journal of Neurovirology
A E Taraskina, R F Nasyrova, A M Zabotina, D N Sosin, К А Sosina, E E Ershov, M N Grunina, E M Krupitsky
BACKGROUND: Biomarkers are now widely used in many fields of medicine, and the identification of biomarkers that predict antipsychotic efficacy and adverse reactions is a growing area of psychiatric research. Monoamine molecules of the peripheral bloodstream are possible prospective biomarkers based on a growing body of evidence indicating that they may reflect specific changes in neurotransmitters in the brain. The aim of this study was to detect peripheral biogenic amine indicators of patients with acute psychosis and to test the correlations between the biological measures studied and the psychopathological status of the patients...
December 8, 2017: BMC Psychiatry
D S Danilov
AIM: To assess the efficacy and tolerability of pericyazine in the treatment of patients with mental disorders manifesting with psychopathic-like symptoms and correction of pathocharacterological disorders in patients with personality disorders during the short-term admission to the hospital or the long-term outpatient treatment. MATERIAL AND METHODS: Sixty-three patients with schizotypal personality disorder and organic personality disorder with psychopathic-like symptoms and pathocharacterological changes within the diagnosis of dissocial personality disorder and borderline personality disorder were examined...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Jessica Graham, Michael Barberio, George Sam Wang
Cannabinoid hyperemesis syndrome (CHS) is an underrecognized diagnosis among adolescents. In the adult literature, it is characterized as nausea, vomiting, and abdominal pain in patients with chronic marijuana use. CHS is often refractory to the standard treatment of nausea and vomiting. Unconventional antiemetics, such as haloperidol, have been successful in alleviating symptoms; however, even 1 dose of haloperidol can lead to grave adverse effects, such as dystonia, extrapyramidal reactions, and neuroleptic malignant syndrome...
December 2017: Pediatrics
Lourdes A Carabias, Jordi Llaudó, Ignacio Ayani, Javier Martínez, Robert E Litman, Ibón Gutierro
This study characterized the pharmacokinetics, safety, and tolerability of Risperidone ISM, a new long-acting intramuscular formulation, for monthly administration without oral supplementation. Patients with schizophrenia received multiple intramuscular injections of 75 mg in the gluteal or deltoid muscle at 28-day intervals. Of the 70 randomized patients, 67 received at least one dose of study medication. The mean Cmax of the active moiety was achieved 24-48 h (tmax) after each administration, regardless of injection site...
November 3, 2017: International Clinical Psychopharmacology
Shashank Arunachal Udupi, Channaveerachari Naveen Kumar, Kudumallige K Suresh, Udupi Arunachala, Jagadisha Thirthalli
Aims of this study were to compare the prevalence of areca use among schizophrenia patients and general population of a south Indian rural community and to study the correlates of areca use among patients. A cohort of 300 schizophrenia patients, who are being followed up as a part of a community intervention program, formed the study group. The control group (n=382) was selected randomly from the general population of this region. Both were interviewed regarding the sociodemographic details, use of areca nut, alcohol and tobacco...
October 24, 2017: Asian Journal of Psychiatry
Paul Goldsmith, John Affinito, Maggie McCue, Max Tsai, Stefan Roepcke, Jinhui Xie, Lev Gertsik, Thomas A Macek
BACKGROUND: Phosphodiesterase 10A (PDE10A) is selectively expressed in medium spiny neurons of the striatum. TAK-063 is a selective inhibitor of PDE10A in clinical development for the treatment of schizophrenia. OBJECTIVES: Safety, tolerability, and pharmacokinetics (PK) of TAK-063 were evaluated following multiple rising oral doses, and PK/adverse event (AE) models were developed to characterize the relationship between TAK-063 exposure and incidence of specific AEs...
December 2017: Drugs in R&D
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