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Dystonia and psychiatric morbidity

Seshadri Sekhar Chatterjee, Soumitra DAS, Sukanya Gupta, Sanhita Bhattacharya
Psychogenic dystonia is one of the most common problems encountered in movement disorder patients and accounted mostly for misdiagnosis, management confusion and treatment resistance. Psychiatric morbidities often are the culprit, hence proper psychiatric history taking is of utmost importance. Here we report one case where dystonia was the main presenting complaint of an underlying depressive episode and discuss how managing the cause alleviated the symptoms.
April 25, 2018: Shanghai Archives of Psychiatry
M Manjunath, Ravi Yadav, Srinivas Dwarakanath, Ketan Jhunjhunwala, A Jafar, Pratibha Surathi, Abhishek Lenka, Albert Stezin, S Sampath, Pramod K Pal
INTRODUCTION: Dystonia is one of the most prevalent forms of movement disorders and is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonia causes significant morbidity with an adverse impact on the quality of life. When dystonia is medically refractory, causing severe pain and impairment in activities of daily living, deep brain stimulation (DBS) of the globus pallidus interna (GPi) is a potential option to reduce disability...
November 2017: Neurology India
Marjan Jahanshahi
Dystonia is a hyperkinetic movement disorder, characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Executive dysfunction is a feature of cognitive function in idiopathic and DYT1 dystonia. Psychiatric morbidity is increased in dystonia, and depression, anxiety, obsessive compulsive disorders are the most common disorders. Sleep problems and pain are also frequently experienced. Evidence suggest that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, but also that psychiatric co-morbidity can be secondary to pain experience and the psychosocial functioning and quality of life of the patients...
November 1, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
E R Timmers, A Kuiper, M Smit, A L Bartels, D J Kamphuis, N I Wolf, B T Poll-The, T Wassenberg, E A J Peeters, T J de Koning, M A J Tijssen
BACKGROUND: In patients with GTP-cyclohydrolase deficient dopa-responsive dystonia (DRD) the occurrence of associated non-motor symptoms (NMS) is to be expected. Earlier studies report conflicting results with regard to the nature and severity of NMS. The aim of our study was to investigate the prevalence of psychiatric disorders, sleep problems, fatigue and health-related quality of life (HR-QoL) in a Dutch DRD cohort. METHODS: Clinical characteristics, motor symptoms, type and severity of psychiatric co-morbidity, sleep problems, fatigue and HR-QoL were assessed in DRD patients with a confirmed GCH1 mutation and matched controls...
December 2017: Parkinsonism & related Disorders
Lyang Huh, Bong Ju Lee
Tardive dystonia (TDt) is a debilitating side effect of long-term antipsychotic treatment. Even though TDt is associated with increased psychiatric morbidity, mortality, and severely decreased quality of life, there are no treatment modalities for TDt. Clozapine has been used as a treatment option for TDt in patients with schizophrenia. Interestingly, several recent case reports have indicated that it can enhance or induce TDt. We report a case of clozapine-associated TDt that was treated with low-dose aripiprazole (0...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
Carsten Buhmann, Torge Huckhagel, Katja Engel, Alessandro Gulberti, Ute Hidding, Monika Poetter-Nerger, Ines Goerendt, Peter Ludewig, Hanna Braass, Chi-Un Choe, Kara Krajewski, Christian Oehlwein, Katrin Mittmann, Andreas K Engel, Christian Gerloff, Manfred Westphal, Johannes A Köppen, Christian K E Moll, Wolfgang Hamel
BACKGROUND AND OBJECTIVE: The extent to which deep brain stimulation (DBS) can improve quality of life may be perceived as a permanent trade-off between neurological improvements and complications of therapy, comorbidities, and disease progression. PATIENTS AND METHODS: We retrospectively investigated 123 consecutive and non-preselected patients. Indications for DBS surgery were Parkinson's disease (82), dystonia (18), tremor of different etiology (21), Huntington's disease (1) and Gilles de la Tourette syndrome (1)...
2017: PloS One
M Smit, A Kuiper, V Han, V C R Jiawan, G Douma, B van Harten, J M T H Oen, M E Pouwels, H J G Dieks, A L Bartels, M A Tijssen
INTRODUCTION: The aim of this study was to systematically investigate the prevalence of psychiatric disorders and factors influencing health-related quality of life (HR-QoL) in cervical dystonia (CD) patients, in the context of objective dystonia motor severity. METHODS: We studied 50 CD patients and 50 matched healthy controls. Psychiatric assessment included the MINI-PLUS interview and quantitative questionnaires. Dystonia motor severity (based on video evaluation), pain and disability were determined with the TWSTRS rating scale...
September 2016: Parkinsonism & related Disorders
Jeanett Østerby Bauer, Dina Stenborg, Tue Lodahl, Mik Mathias Mønsted
BACKGROUND: Agitation is frequent in the acute psychiatric setting. The observation and treatment of agitation is important to avoid harm to patients or staff, to reduce distress of the patient, and to reduce the risk of coercion, especially physical restraint. AIM: To evaluate the effect of intramuscular treatment with psychotropics on agitation in a non-selected acute psychiatric population. METHODS: The Positive and Negative Syndrome Scale Excitement Component (PANSS-EC) was implemented in the acute psychiatric ward at Psychiatric Center Copenhagen to improve assessment and treatment of agitation...
November 2016: Nordic Journal of Psychiatry
M Smit, A L Bartels, M van Faassen, A Kuiper, K E Niezen-Koning, I P Kema, R A Dierckx, T J de Koning, M A Tijssen
Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions. Emerging data describe high prevalences of non-motor symptoms, including psychiatric co-morbidity, as part of the phenotype of dystonia. Basal ganglia serotonin and serotonin-dopamine interactions gain attention, as imbalances are known to be involved in extrapyramidal movement and psychiatric disorders. We systematically reviewed the literature for human and animal studies relating to serotonin and its role in dystonia...
June 2016: Neuroscience and Biobehavioral Reviews
Sara Meoni, Mateusz Zurowski, Andres M Lozano, Mojgan Hodaie, Yu-Yan Poon, Melanie Fallis, Valerie Voon, Elena Moro
OBJECTIVE: To evaluate changes in the diagnosis of Axis I psychiatric disorders in patients with primary and secondary dystonia after deep brain stimulation (DBS) of the globus pallidus internus (GPi). METHODS: Structured Clinical Interviews for the DSM-IV, Axis I psychiatric disorders, were prospectively performed before and after surgery. Diagnoses were made based on DSM-IV criteria. Psychiatric disorders were grouped into 5 categories: mood, anxiety, addiction, obsessive-compulsive disorders, and psychosis...
August 4, 2015: Neurology
Sandra M A van der Salm, Johan N van der Meer, Aart J Nederveen, Dick J Veltman, Anne-Fleur van Rootselaar, Marina A J Tijssen
BACKGROUND: Myoclonus-dystonia (MD) is a movement disorder characterized by myoclonic jerks, dystonic postures and psychiatric co-morbidity. A mutation in the DYT11 gene underlies half of MD cases. We hypothesize that MD results from a dysfunctional basal ganglia network causing insufficient inhibitory motor control. To test this hypothesis functional MRI (fMRI) was performed using a validated "Go/No go" task, in order to localize blood-oxygen-level dependence (BOLD) effects corresponding to Response Inhibition (RI)...
September 2013: Experimental Neurology
Allison Brashear, Jared F Cook, Deborah F Hill, Alethea Amponsah, Beverly M Snively, Laney Light, Niki Boggs, Cynthia K Suerken, Mark Stacy, Laurie Ozelius, Kathleen J Sweadner, W Vaughn McCall
OBJECTIVE: Rapid-onset dystonia-parkinsonism (RDP) is caused by a variety of missense mutations in the ATP1A3 gene. Psychiatric comorbidity has been reported, although systematic examination of psychiatric disease in individuals with RDP is lacking. This study examines psychiatric morbidity for 23 patients with RDP in 10 families with family member control subjects and in 3 unrelated patients with RDP, totaling 56 individuals. METHODS: Twenty-nine ATP1A3 mutation-positive individuals were examined; 26 exhibited motor symptoms (motor manifesting carrier [MMC]) and 3 did not (nonmotor manifesting carriers [NMC])...
September 11, 2012: Neurology
Matthew F DiFrancesco, Casey H Halpern, Howard H Hurtig, Gordon H Baltuch, Gregory G Heuer
PURPOSE: Based on the success of deep brain stimulation (DBS) in the treatment of adult disorders, it is reasonable to assume that the application of DBS in the pediatric population is an emerging area worthy of study. The purpose of this paper is to outline the current movement disorder indications for DBS in the pediatric population, and to describe areas of investigation, including possible medically refractory psychiatric indications. METHODS: We performed a structured review of the English language literature from 1990 to 2011 related to studies of DBS in pediatrics using Medline and PubMed search results...
October 2012: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
S Wagner, A-S Brunet, M Bost, A Lachaux, E Broussolle, V Des Portes, L Lion-François
Wilson disease is an autosomal recessive disease that produces a copper accumulation in many organs, initially in the liver, progressing to liver cirrhosis, and in the brain, with different neurologic symptoms. Diagnosis is based on clinical, biochemical, and genetic tests. Different treatments based on chelating agents may help reduce the disease's spontaneous morbidity and mortality. We describe three patients who presented Wilson disease before 18 years of age, with initial neurologic symptoms between 1998 and 2010...
March 2012: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Marjan Jahanshahi, Virginie Czernecki, And Mateusz Zurowski
We review the impact of dystonia and its surgical treatment with deep brain stimulation (DBS) on cognitive function, psychiatric morbidity, and health-related quality of life. The current evidence suggests that globus pallidus internus (GPi) DBS does not cause cognitive decline in primary dystonia. However, we recommend general preoperative screening of cognition in patients with dystonia to evaluate baseline cognitive status and monitor for possible postoperative changes. Patients with mild to moderate depression appear to do well postoperatively; however, there are scant data about those with severe depression...
June 2011: Movement Disorders: Official Journal of the Movement Disorder Society
Renato P Munhoz, Jorge A Zavala, Nilson Becker, Hélio A G Teive
OBJECTIVE: To describe the profile and presentation of a Brazilian series of psychogenic movement disorders (PMD) patients and to perform a comparative analysis with the previous series published worldwide. METHODS: A total of 83 patients with a clinical diagnosis of PMD were included. All patients were assessed and followed at the Movement Disorders Outpatient clinic from 2000 to 2008. Demographic, clinical, paraclinical, and treatment outcome data were collected using a standardized protocol...
February 2011: Clinical Neurology and Neurosurgery
Roberto Marconi, Andrea Landi, Franco Valzania
Deep brain stimulation (DBS) is an effective surgical treatment for advanced Parkinson's disease (PD), with significant advantages in morbidity-mortality and quality of life when compared to lesion techniques such as thalamotomy and/or pallidotomy. The procedure is indicated in patients with severe resting tremor, unresponsive to conventional medical treatment or with motor complications. The most commonly reported complications in the intra- and post-surgical period are aborted procedure, misplaced leads, intracranial haemorrhage, seizures and hardware complications, whereas in the long-term period, cognitive and psychiatric complications can be observed...
December 2008: Neurological Sciences
Yuval O Herishanu, Ruti Parvari, Yaakov Pollack, Ilan Shelef, Batia Marom, Tiziana Martino, Milena Cannella, Ferdinando Squitieri
We report a cluster of patients from a Karaite Jew community with a movement disorder suggestive of Huntington disease (HD), in some cases associated with repeat lengths below the edge of 36 CAG repeats. The study describes the clinical and genetic features of four patients who were followed over several years. Patients belonged to an inbred family in whom progressive chorea, manifesting predominantly with dystonia and cerebellar features, developed during middle age. Although severe psychiatric symptoms ultimately developed in two of the four patients, cognitive function remained reasonably well preserved in all of them even after several disease years...
February 15, 2009: Journal of the Neurological Sciences
Cole A Giller, Hanli Liu, Dwight C German, Dheerendra Kashyap, Richard B Dewey
OBJECT: The authors previously developed an optical stereotactic probe employing near-infrared (NIR) spectroscopy to provide intraoperative localization by distinguishing gray matter from white matter. In the current study they extend and further validate this technology. METHODS: Near-infrared probes were inserted 203 times during 138 procedures for movement disorders. Detailed validation with postoperative imaging was obtained for 121 of these procedures and with microelectrode recording (MER) for 30 procedures...
February 2009: Journal of Neurosurgery
Alim Louis Benabid
For 20 years, deep brain stimulation (DBS) at high frequency has been developed as a substitute for the classical lesioning methods previously used in stereotactic and functional neurosurgery. This method has proven its efficacy, based on its reversibility and adaptability: two factors that are responsible for low morbidity. The method has been initially developed for and applied to movement disorders in several target areas; such as the thalamus, the pallidum and the subthalamic nucleus. It has now also been extended to other indications, such as epilepsy, dystonias and cluster headache and, more recently, to psychiatric disorders, such as obsessive-compulsive disorder, Gilles de la Tourette tics and depression...
November 2007: Expert Review of Medical Devices
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