# Progress and Prospects in Parkinson's Research/Symptoms/Motor

Motor symptoms of Parkinson's disease
The symptoms that usually lead a clinician to suspect Parkinson's are the ones that affect movement.
Bradykinesia :
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Bradykinesia
Slowness of movement.
The following references are relevant:-
Morris et al (2010) Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders
Schenkman et al (2011) Profile of Functional Limitations and Task Performance Among People With Early- and Middle-Stage Parkinson Disease
Heldman et al (2011) The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures
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See Also:-
Introduction to Parkinson's Science/Q Page 2
Symptomatic Relief for PD/Bradykinesia
References
↑ Morris, Meg E.; Mrtin, Clarissa L. and Schenkman, Margaret. (2010) Full Text Phys. Ther. 90 (2) 280 – 288. Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816030/
↑ Schenkman, Margaret S.; Ellis, Terry; Christiansen, Cory; Baron, Anna E.; Tickle-Degnen, Linda; Hall, Deborah A. and Wagenaar, Robert. (2011) Full Text Phys. Ther. 91 (9) 1339 – 1354 Profile of Functional Limitations and Task Performance Among People With Early- and Middle-Stage Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169785/
↑ Heldmann, dustin A.; Giuffrida, Joseph P.; Che, Robert; Payne, Megan, Mazzella, Filomena; Duker, Adrew P.; Shy, Alek; Kim, Sang Jin; Revilla, Fredy J. and EspY, Alberto J. (2011) Full Text Mov. Disord. 26 (10) 1859 – 1863 The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324112/ :
Rigidity :
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Hypokinesia
Reduced force, impetus or speed of movement
The following refences are relevant:-
Ackermann et al (1989) Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease.
Heldman et al (2011) The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures #
Espay et al (2011) Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease
Further Research
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Search the scientific literature for Rigidity
Literature search:
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References
↑ Ackermann, H.; Ziegler,W. andOertel, W.H. (1989) Full Text J. Neurol. Neurosurg. Psychiatry. 52 (6) 805 – 807. Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1032047/
↑ Heldman, Dustin A.; Giuffrida, Joseph P.; Robert; Megan; Filomena; Andrew P.; Alok; Sang Jin; Fredy J. and Espay, Alberto J. (2011) Full Text Mov. Disord. 26 (10) 1859 – 1863. The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324112/
↑ Espay, Alberto J,;Giuffrida, Joe P.; Chen, Robert; Payne, Megan; Mazzella, Filomena; Dunn, Emily; Vaughan, Jennifer E.; Duker, Andrew P.; Sahay, Alok; Kim, Sang Jin; Revilla, Fredy J. and Heldman, Dustin A. (2011) Full TextMov. Disord. 26 (14) 2504 – 2508. Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318914/
Reference :
Tremor :
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Tremor
Involuntary shaking, trembling or quivering movements of the muscles
The following references are relevant:-
Sanchez-Ramos et al (2011) Quantitative Analysis of Tremors in Welders
Mure et al (2011) Parkinson’s Disease Tremor-Related Metabolic Network: Characterization, Progression, and Treatment Effects
Helmich et al (2012) Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits?
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References
↑ Sanchez-Ramos; Reimer, Dacy; Zesiewiccz, Theresa; Sulliven, Kelly and Nausieda, Paul A.
(201) Full TextInt. J. Environ. Res. Public Health 8 (5) 1478 – 1490 Quantitative Analysis of Tremors in Welders
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108121/
↑ Mure, Hideo; Hirano, Shigeki; Tang, Chris C,; Isias, Ioannis U.;Antonini, Angelo; Ma, Yilong; Dhaan, Vijay and Eidelberg, David (1965) Full TextNeuroimage 54 (2) 1244 – 1253 Parkinson’s Disease Tremor-Related Metabolic Network: Characterization, Progression, and Treatment Effects
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997135/
↑ Helmich, Rick C.; Hallett, Mark; Deuschl, Gunther; Toni, Ivan and Bloem, Bastiaan R. (1965) Full TextBrain 135 (11) 3206 – 3226. Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501966/ :
Here is a list of other motor symptoms of Parkinson's. Some are less prominent than those above, at least initially and some may occur only rarely. Many are not unique to Parkinson's:
Akathesia :
Redirected to Restless Legs Syndrome:
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Restless Legs Syndrome
Uncontrollable, involuntary movement of the legs and feet
The following references are relevant:-
Gao et al (2010) Restless Legs Syndrome and Erectile Dysfunction
Gao et al (2010) Restless legs syndrome and Parkinson’s disease in men
Pourcher et al (2010)
Compulsive habits in restless legs syndrome patients under dopaminergic treatment
Peeraully and Tan (2012) Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidence
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802250/
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References
↑ Gao, Xiang; Schwarzchilds, Michael A.: O’Reilly, Eilis J.; Wang, Hao and Ascherio, Alberto (2010) Full TextSleep 33 (1) 75 – 79 Restless Legs Syndrome and Erectile Dysfunction http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802250/
↑ Gao, Xiang; Schwarzschild, Michael A.; O’Reilly, Eilis J.; Wang, Hao and Ascherio, Alberto (2010) Full Text Mov. Disord. 25 (15) 2654 – 2657 Restless legs syndrome and Parkinson’s disease in men http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114885/
↑ Pourcher, E.; Remillard, S. and Cohen, H. (2010) Full TextJ. Neurol. Sci. 290 (1-2) 52 -56 Compulsive habits in restless legs syndrome patients under dopaminergic treatment. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114885/
↑ Peeraully, Tasneem and Tan, Eng-King (2012) Full TextTransl. Neurodegener. 2012; 1: 6. Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidencehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514082/ :
Akinesia :
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Akinesia
Also see Freezing
Put further text about the symptom here
Further Research
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References :
Amimia :
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Amimia
Fixed and vacant expression (masking)
Very little research has been carried out on this common PD symptom but the following are relevant :-
Allen (1931) The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign
Hemmesch et al (2009)The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease.
Clark et al (2011) Visual Exploration of Emotional Facial Expressions in Parkinson's Disease
Tickle-Degnen et al (2011) Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease <
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References
↑ http://medical-dictionary.thefreedictionary.com/
↑ Allen, I.M.(1931) Full Text The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1038785/?page=1
↑ Hemmesch. Amanda R.; Tickle-Degnen, Linda and Zebrowitz, Leslie A. (2009) Full Text Psychol. Aging 24 (3) 542 – 549 The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761205/
↑ Clark, Uraina S.; Neargarder, Sandy and Cronin-Golomb, Alice (2011) Full Text Visual Exploration of Emotional Facial Expressions in Parkinson's Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876199/
↑ Tickle-Degnen, Linda and Zebrowitz, Leslie A. and Ma, Hui-ing (2011) Full Text Soc. Sci. Med. 73 (1) 95 – 102 Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142938/ :
Aphagia :
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Aphagia
Inability to swallow
Swallowing problems are frequently reported by PD patients but the symptom awaits detailed scientific research.
The following references are relevant:-
eHealthMe (1977)Could Parkinson's disease cause Aphagia? A study of 26 patients
eHealthMe (1977)
Could Azilect cause Aphagia?
Russell et al (2010) Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease
Further Research
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References
↑ eHealthMe (1977) Article
Could Parkinson's disease cause Aphagia? A study of 26 patients http://www.ehealthme.com/cs/parkinson's+disease/aphagia
↑ eHealthMe(1977) Article
Could Azilect cause Aphagia? http://www.ehealthme.com/ds/azilect/aphagia
↑ Russell, John A.; Ciucci, Michelle, R.; Connor, Nadine P. and Schallert, Timothy(2010) Full TextBrain Res. 1341 : 3 – 11. Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908992/ :
Aphonia :
Aphonia: Inability to make sounds.
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Aphonia
Inability to make sounds
The following references are relevant:-
Critchley (1981) Speech disorders of Parkinsonism: a review
Russell et al (2010) Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease
Hallett (2011) Psychogenic Parkinsonism
Search the scientific literature (Aphonia)
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References
↑ Critchley, E,M, (1981) Full TextJ. Neurol. Neurosurg. Psychiatry 44 (9) 751 – 758 Speech disorders of Parkinsonism: a review http://www.ncbi.nlm.nih.gov/pmc/articles/PMC491132/
↑ Russell, John A.; Ciucci, Michelle, R.; Connor, Nadine P. and Schallert, Timothy(2010) Full TextBrain Res. 1341 : 3 – 11. Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908992/
↑ Hallett, Mark (2011) Full TextJ. Neurol. Sci. 310 (1-2) 163 – 165 Psychogenic Parkinsonism http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139799/ :
Athetosis :
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Athetosis
Involuntary movements of the face, tongue and extremities.
A number of projects have concentrated on this symptom:-
Neilson (1974) Measurement of involuntary arm movement in athetotic patients
Hallett and Alvarez (1983) Attempted rapid elbow movements in patients with athetosis
Further Research
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Literature search:
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References
↑ Neilson, Peter D. (1974) Full Text J. Neurol. Neurosurg. Psychiatry. 37 (2) 171–177. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC494600/
↑ Halett, M. and Alvarez, N. (1983) Full Text J. Neurol. Neurosurg. Psychiatry. 46 (8) 745–750. Attempted rapid elbow movements in patients with athetosis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1027529/ :
Automatism :
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Automatism
Forced obedience to external stimuli or commands.
Some potentially relevant references are:-
Allain et al (1995) Explicit and procedural memory in Parkinson's disease.
Allain et al (1995) Procedural memory and Parkinson's disease.
Perez-Velazquez (2012) The biophysical bases of will-less behaviours
Further Research
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References
↑ .Allain,H,; Lieury, A.; Thomas V.; Reymann JM.; Gandon, J.M. and Belliard, S. (1995) Abstract Biomed. Pharmacother. 49 (4) 179 – 186 Explicit and procedural memory in Parkinson's disease.http://www.ncbi.nlm.nih.gov/pubmed/7669937
↑ Allain, H.; Lieury, A.; Quemener, V.; Thomas, V.; Reymann, J.M, and Gandon, J.M. (1995) Abstract Dementia 6 (3) 174 – 178 Proceadurl memory and Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/7620531
↑ Perez-Valaquez, Jose L. (2012) Abstract Front. Integr. Neirosci. 2012:6:98 The biophysical bases of will-less behaviours http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3478585/ :
Balance :
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Balance
Susceptibility to falls
Alternative terms
Postural instability---Falls
The following references are relevant:-
King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease?
Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease?
Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease
Further Research
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Literature search:
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References
↑ King, L.A.; Mancini, M,; Priest, K.; Salarian, A.; Rodrigues-de-Paula, F. and Horak, F. (2012) Full Text J. Neurol. Phys. Ther. 36 (1) 25 – 31 Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? http://www.ncbi.nlm.nih.gov/pubmed/22333919
↑ Duncan, Ryan P. And Earhart, Gammon M. (2012) Full Text Parkinsons Dis. 2012 923493 Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503435/A
↑ Boonsinsukh, Rumpa; Saegsirsuwan, Vitoon; Carlson-Kuta, Patricia and Horak, Fay.B. (2012) Full Text Phys. Ther. 92 (9) 1117 – 1129 A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432949/ :
Blepharospasm :
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Blepharospasm
Spasm of the eyelid
The following references are relevant:-
Elston (1992) A new variant of blepharospasm
Hallett et al (2008) ..Update on blepharospasm: Report from the BEBRF International Workshop
Armstrong (2011) Visual symptoms in Parkinson's Disease
Further Research
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Literature search:
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References
↑ Elston, J.S. (1992) Full Text J. Neurol. Neurosurg. Pstchiatry 55 (5) 369 – 371 A new variant of blepherospasm http://www.microsofttranslator.com/bv.aspx?from=&to=en&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC489077%2F
↑ .Hallett, Mark; Evinger, Craig. Jankovic, Josph and Stacy. Marc (2008) Full text Neurology 71 (16) 1275 – 1282 Update on blepharospasm: Report from the BEBRF International Workshop http://www.microsofttranslator.com/bv.aspx?from=&to=en&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2676990%2F
↑ Armstrong, R,A. (2011) Full Text Parkinsons Dis. 2011 908306 Visual symptoms in Parkinson’s Disease http://www.microsofttranslator.com/bv.aspx?from=&to=en&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3109513%2F :
Bruxism :
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Bruxism
Grinding of teeth
These references are relevant:-
Magee (1970) Bruxisma related to levadopa therapy
Durham et al (1993) Management of orofacial manifestations of Parkinson's disease with splint therapy: a case report.
Stivastaya et al (2002) Bruxism as presenting feature of Parkinson's disease.
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References
↑ Magee, K.R.
(1970) JAMA 214 (1) 147 Bruxisma related to levadopa therapy http://www.ncbi.nlm.nih.gov/pubmed/5469056
↑ Durham, T.M.; Hodges, E.D.; Henry, M.J.; Geasland, J. and Straub, P. (1993) Abstract Spec. Care Dentist 1 (4) 155 – 158 Management of orofacial manifestations of Parkinson's disease with splint therapy: a case report.http://www.ncbi.nlm.nih.gov/pubmed/8303510
↑ Srivastava.; T. Ahuja, M.; Srivastava.; M. and Trivedi, A.< (2002) AbstractBruxism as presenting feature of Parkinson's disease.http://www.ncbi.nlm.nih.gov/pubmed/11922248 :
Catalepsy :
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Catalepsy
Tireless, timeless , effortless maintenance of postures.
The following references are relevant:-
Azam et al (2010) Design, synthesis and anti-Parkinsonian evaluation of 3-alkyl/aryl-8-(furan-2-yl)thiazolo[5,4-e][1,2,4]triazolo[1,5-c]pyrimidine-2(3H)-thiones against neuroleptic-induced catalepsy and oxidative stress in mice.
Nayebi et al (2010) Buspirone improves 6-hydroxydopamine-induced catalepsy through stimulation of nigral 5-HT(1A) receptors in rats.
Mahmoudi et al (2011) Buspirone improves the anti-cataleptic effect of levodopa in 6-hydroxydopamine-lesioned rats.
Further Research
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References
↑ Azam, F.; El-gnidi BA.; Alkskas, I.A. and Ahmed, M.A.
(2010) AbstractJ. Enzyme Inhib. Med. Chem. 25 (6) 818 – 826. Design, synthesis and anti-Parkinsonian evaluation of 3-alkyl/aryl-8-(furan-2-yl)thiazolo[5,4-e][1,2,4]triazolo[1,5-c]pyrimidine-2(3H)-thiones against neuroleptic-induced catalepsy and oxidative stress in mice. http://www.ncbi.nlm.nih.gov/pubmed/20429782
↑ Nayebi, A.M.; Rad, S.R.; Saberian, M.; Azimzadeh, S. and Samini, M.(2010) Abstract Pharmacol. Rep. 62 92) 258 – 264 Buspirone improves 6-hydroxydopamine-induced catalepsy through stimulation of nigral 5-HT(1A) receptors in rats. http://www.ncbi.nlm.nih.gov/pubmed/20508280
↑ Mahmoudi, J.; Nayebi, A.M.; Samini, M.; Reyhani-Rad, S.; and Babapour, V. (2011) Abstract Pharmacol. Rep. 63 (4) 908 – 914. Buspirone improves the anti-cataleptic effect of levodopa in 6-hydroxydopamine-lesioned rats. http://www.ncbi.nlm.nih.gov/pubmed/22001978 :
Catatonia :
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Catatonia Holding of statuesque postures
The following references are relevant:-
Northoff et al (1997) Glutamatergic dysfunction in catatonia? Successful treatment of three acute akinetic catatonic patients with the NMDA antagonist amantadine.
Bhati et al(2007) Clinical Manifestations, Diagnosis, and Empirical Treatments for Catatonia
Carroll et al(2007) Katatonia - A New Conceptual Understanding of Catatonia and a New Rating Scale
Further Research
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References
↑ Northoff, G.; Eckert, J. and Fritze, J.
(1997) Full text J. Neurol. Neurosurg. Psychiatry. 62 (4) 404 – 406.
> Glutamatergic dysfunction in catatonia? Successful treatment of three acute akinetic catatonic patients with the NMDA antagonist amantadine. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1074105/
↑ Bhati, Mahendra T. Catherine J. and O'Reardon, John P. (2007) Full Text Psychiatry (Edgmont). 4 (3) 46–52. Clinical Manifestations, Diagnosis, and Empirical Treatments for Catatonia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922358/
↑ Carrol, Brendan T.; Kirkhart, Rob: Ahuia, Niraj; Soovere, Ilo; Lauterbach, Edward C.; Dhossche, Dirk and Talbert, Rebecca. (2007) Full Text Psychiatry (Edgmont). 4 (3) 46 – 52. Katatonia - A New Conceptual Understanding of Catatonia and a New Rating Scale. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729619/ :
Chorea :
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Chorea
Involuntary, desultory flickering movement.
The following references are relevant:-
Barbeau et al (1965) Fingerprint Patterns in Huntington's Chorea and Parkinson's Disease
Reuter et al (2000) Late onset levodopa responsive Huntington's disease with minimal chorea masquerading as Parkinson plus syndrome
Ciammola et al (2011) Atypical Parkinsonism Revealing a Late Onset, Rigid and Akinetic Form of Huntington's Disease
Further Research
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References
↑ Barbeau, Andre; Trudeau, Jean-Guy and Coiteux, Carl (1965) Full Text Can. Med. Assoc. J. ; 92 (10): 514 – 516. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1928158/
↑ Reuter, I.; Hu, M.; Andrews, T.; Brooks, D.; Clough, C. and Chaudhuri, K. (2000) Full Text J. Neurol. Neurosurg. Psychiatry. 68 (2) 238 – 241. Late onset levodopa responsive Huntington's disease with minimal chorea masquerading as Parkinson plus syndrome http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736772/
↑ Ciammola, A.; Sassone, J.; Poletti, B.; Menacacci, N.; Benti, R. and Silani,, V. (2011) Full Text Case Report Neurol. Med. 2011 696053. Atypical Parkinsonism Revealing a Late Onset, Rigid and Akinetic Form of Huntington's Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3420516/ :
Choreoathetosis :
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Choreoathetosis
Involuntary jerky snake-like movements usually of the arms.
The following references are relevant:-
Teräväinen and Calne (1980) Action tremor in Parkinson’s disease
Bhidayasiri and Truong,(2004) Chorea and related disorders
Perkovic et al (2010) Sildenafil induced choreoathetosis in men with Parkinson's disease.
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References
↑ H Teräväinen, H. and Calne, (1980) Full Text D.B. J. Neurol. Neurosurg. Psychiatry 43(3) 257 – 263 Action tremor in Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC490518 /
↑ Bhidayasiri, R, and Truong, D. (2004) Full Text
Postgrad. Med. J. 80 (947) 527 – 534. Chorea and related disorders http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1743104/
↑ Perkovic. O.; Vitezic, D.; Rudez, J.; Vitezic, M.; Kovacevic, M.; Mrsic-Pelcic, J.; Ljubicic, D. and Jurjevic ,A.(2010) AbstractInt. J. Clin. Pharmacol. Ther.. 48 (1) 76 – 78. Sildenafil induced choreoathetosis in men with Parkinson's disease.http://www.ncbi.nlm.nih.gov/pubmed/20040342 :
Clonus :
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Clonus
Vibrato-like reaction to forced muscle stretching.
The following references are relevant:-
Hofmann (1962) Observations on peripheral servo mechanisms in Parkinsonian rigidity
Burke et al (1972) Tonic vibration reflex in spasticity, Parkinson's disease, and normal subjects
Findley et al (1981)
Tremor, the cogwheel phenomenon and clonus in Parkinson's disease
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References
↑ Hofmann, William Ward .J. Neurol. Neurosurg. Psychiatry. 25 (3) 203 – 207. (1962) Full Text Observations on peripheral servo mechanisms in Parkinsonian rigidity http://www.ncbi.nlm.nih.gov/pmc/articles/PMC495444/
Burke, David; Andrews,Colin J. and James W.(1972)Full TextTonic vibration reflex in spasticity, Parkinson's disease, and normal subjectshttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC494108/
↑ Findley, L.J.; Grety, M.A. and Halmagy, G.M.(1981)Full TextTremor, the cogwheel phenomenon and clonus in Parkinson's disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC491035/ :
Cogwheel rigidity :
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Cogwheel rigidity
Stiffness in the muscles, with a jerky quality when arms and legs are repeatedly moved.
The following references are relevant:-
Lance et al(1963) Action tremor and the cogwheel phenomenon in Parkinson’s disease
Findley et al (1981) Tremor, the cogwheel phenomenon and clonus in Parkinson’s disease
Ghiglione et al(2005) Cogwheel Rigidity
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rigidity Pubmed (abstracts)
rigidity Pubmed_Central (Full_Text)
rigidity Google_Scholar
References
↑ Lance, James W.; Schwab, Paul S. and Peterson, Elizabeth R. (1963) Full Text Brain 86 (1) 85 – 110 Action tremor and the cogwheel phenomenon in Parkinson’s disease http://brain.oxfordjournals.org/content/86/1/95.extract
↑ Findley, L.J.; Gresty, M.A. and Halmagy, G.M.(1981) Full TextJ. Neurol. Neurosurg. Psychiatry. 1981 44 (6) 534 –5 46. Tremor, the cogwheel phenomenon and clonus in Parkinson's disease.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC491035/
↑ Ghiglione, Paolo, Mutani, Roberto and Chio, Adriano (2005) Full Text Jama 62 (5) http://archneur.jamanetwork.com/article.aspx?articleid=788358 :
Contractures :
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Contractures
Permanent contraction at joints.
The following references are relevant:-
Ebin (1951) Surgical Treatment of Parkinsonism: Indications and Results
Kyriakides and Hewer (1988) Hand contractures in Parkinson's disease.
Shah et al (2005) Flexion contracture after total knee arthroplasty in a patient with Parkinson's disease: successful treatment with botulinum toxin type A.
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References
↑ Ebin, Judah (1951) Full Text Bull. N. Y. Acad. Med. 27 (11) 653 – 678. Surgical Treatment of Parkinsonism: Indications and Results http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1930137/
↑ Kyriakides, T. and Hewer, R. L. (1988) Full Text J. Neurol. Neurosurg. Psychiatry. 51 (9) 1221 – 1223. Hand contractures in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1033032/
↑ Shah, S.N.; Hornyak, J. and Urquhart, A. G. (2005) Full TextJ. Arthroplasty 20 (8) 1078 - 1080. Flexion contracture after total knee arthroplasty in a patient with Parkinson's disease: successful treatment with botulinum toxin type A. http://www.ncbi.nlm.nih.gov/pubmed/16376267 :
Disequilibrium :
Redirected to Balance.
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Balance
Susceptibility to falls
Alternative terms
Postural instability---Falls
The following references are relevant:-
King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease?
Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease?
Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease
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References
↑ King, L.A.; Mancini, M,; Priest, K.; Salarian, A.; Rodrigues-de-Paula, F. and Horak, F. (2012) Full Text J. Neurol. Phys. Ther. 36 (1) 25 – 31 Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? http://www.ncbi.nlm.nih.gov/pubmed/22333919
↑ Duncan, Ryan P. And Earhart, Gammon M. (2012) Full Text Parkinsons Dis. 2012 923493 Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503435/A
↑ Boonsinsukh, Rumpa; Saegsirsuwan, Vitoon; Carlson-Kuta, Patricia and Horak, Fay.B. (2012) Full Text Phys. Ther. 92 (9) 1117 – 1129 A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432949/ :
Drop Foot :
Redirected to Foot_Drop
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Foot Drop or (Drop Foot)
Locomotion defect whereby the heel of a foot is raised from the ground while walking
The following references are relevant:-
Belfiore and Campanella (1994) A clinical sign of Parkinson's disease: the absence of lateral foot drop
Rogers et al (2011) Perturbations of ground support alter posture and locomotion coupling during step initiation in Parkinson's disease
The following references are relevant:-
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References
↑ Belfiore, G. and Campanella, G. (1994) AbstractActa Neurol. (Napoli). 16 (5-6) 291 – 92 A clinical sign of Parkinson's disease: the absence of lateral foot drop http://www.ncbi.nlm.nih.gov/pubmed/7709801
↑ Rogers, M.W.; Hilliard, M.J.; Martinez, K.; Zhang, Y.;Simuni, T. and Mille, M.L. (2011) AbstractExp. Brain Res. 208 (4) 557 – 567 Perturbations of ground support alter posture and locomotion coupling during step initiation in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/21153725a :
Dyskinesia :
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Dyskinesia
Abnormality of muscle tone or movement.
The following references are relevant:-
Chung et al(2010) Objective Measurement of Dyskinesia in Parkinson Disease using a Force Plate
Timbasco et al (2012) Clinical Aspects and Management of Levodopa-Induced Dyskinesia
Espay et al (2012) “On” state freezing of gait in Parkinson disease -A paradoxical levodopa-induced complication
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References
↑ Chung, Katherine A.; Lobb, Brenna M.; Nut, John G.; McNames, James and Horak, Fay (2010) Full Text
Mov. Disord. 25 (5) 602 – 608 Objective Measurement of Dyskinesia in Parkinson Disease using a Force Plate http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148105/
↑ Tambaco,Nicola; Smoni, Simone; Marsili, Erica; Sacchini, Elisa; Murasecco, Donatlla; Cardaioli, Gabriela, Ross, Aroldo an Clabresi, Paolo (2012) Full Text Parkinsons Dis. 2012: 745947. Clinical Aspects and Management of Levodopa-Induced Dyskinesia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372050/
↑ Espy, A.J.; Fasano, A.; van Nuenen, B.F.L.; Payne, M.M.; Snijders, A.H. and Bloem, B.R. (date) Full Text Neurology. 78 (7) 454 – 457. “On” state freezing of gait in Parkinson disease - A paradoxical levodopa-induced complication http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466608/ :
Dystonia :
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Dystonia
Sustained muscle contractions causing twisting and repetitive movements or abnormal postures.
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References :
Exotropia :
Redirected to Strabismus
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Strabismus
Divergent squint of the eyes
(See also Exotropia = Outward divergence and Esotropia = Inward Divergence. Also Tic)
The following references are relevant:-
Rascol et al (1991) Square wave jerks in parkinsonian syndromes
Scoditti, et al (1993) Peroneal muscular atrophy with parkinsonism, ptosis, and congenital strabismus.
Almer et al (2011) Ocular Motor and Sensory Function in Parkinson Disease
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References
↑ Rascol, O.; Sabatini, U.; Siminetta-Moreau, M.; Montatruc J.L.; Rascol, A. and Clanet, M. (1991) Full Text J. Neurol. Neurosurg. Psychiatry 54 (7) 599 – 602. Square wave jerks in parkinsonian syndromes.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014429/
↑ Scoditti, U.; Gemighnanai, F.; Colonna, F.; Ludovico, L. and Bettoni,(1993) Full Text L. Acta Neurol. Scand. 88 (4) 251 -253 Peroneal muscular atrophy with parkinsonism, ptosis, and congenital strabismus http://www.ncbi.nlm.nih.gov/pubmed/8256567
↑ Almer, Zina; Klein, Katheine S.; Marsh, Laura; Gerstenhaber, Melissa and Repka, Michael X. (2011) Full Text Ophthalmology. 119 (1) 178 – 182. Ocular Motor and Sensory Function in Parkinson Diseasehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3251710/ :
Facial Masking :
Redirected to Amimia
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Amimia
Fixed and vacant expression (masking)
Very little research has been carried out on this common PD symptom but the following are relevant :-
Allen (1931) The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign
Hemmesch et al (2009)The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease.
Clark et al (2011) Visual Exploration of Emotional Facial Expressions in Parkinson's Disease
Tickle-Degnen et al (2011) Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease <
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References
↑ http://medical-dictionary.thefreedictionary.com/
↑ Allen, I.M.(1931) Full Text The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1038785/?page=1
↑ Hemmesch. Amanda R.; Tickle-Degnen, Linda and Zebrowitz, Leslie A. (2009) Full Text Psychol. Aging 24 (3) 542 – 549 The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761205/
↑ Clark, Uraina S.; Neargarder, Sandy and Cronin-Golomb, Alice (2011) Full Text Visual Exploration of Emotional Facial Expressions in Parkinson's Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876199/
↑ Tickle-Degnen, Linda and Zebrowitz, Leslie A. and Ma, Hui-ing (2011) Full Text Soc. Sci. Med. 73 (1) 95 – 102 Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142938/ :
Falls :
Redirected to Balance
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Balance
Susceptibility to falls
Alternative terms
Postural instability---Falls
The following references are relevant:-
King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease?
Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease?
Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease
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References
↑ King, L.A.; Mancini, M,; Priest, K.; Salarian, A.; Rodrigues-de-Paula, F. and Horak, F. (2012) Full Text J. Neurol. Phys. Ther. 36 (1) 25 – 31 Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? http://www.ncbi.nlm.nih.gov/pubmed/22333919
↑ Duncan, Ryan P. And Earhart, Gammon M. (2012) Full Text Parkinsons Dis. 2012 923493 Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503435/A
↑ Boonsinsukh, Rumpa; Saegsirsuwan, Vitoon; Carlson-Kuta, Patricia and Horak, Fay.B. (2012) Full Text Phys. Ther. 92 (9) 1117 – 1129 A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432949/ :
Festination :
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Festination
Forced hurrying of walking, talking or thought.
The following references are relevant:-
Devos et al (2007) Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson's disease
Hausdorff (2009) Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling
Hove et al (2012) Interactive Rhythmic Auditory Stimulation Reinstates Natural 1/f Timing in Gait of Parkinson's Patients
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References
↑ Devos, D.; Krystkowiak, P.; Clement, F.; Dujardin, K.; Cpttencin, O.; Wauquier, N.; Ajebbar, K.; Thielmans, B.; Kroumova, M.; Duhamel, A.; Deste, A.; Border, R. and Defebvre, L. (2007) Full Text J. Neurol. Neurosurg. Psychiatry. 78 (5) 470 – J Neurol Neurosurg Psychiatry. 78 (5) 470–475. Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson's disease. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2117830/
↑ Hausdorff, Jeffrey M. (2009) Full Text Chaos 19 (2) 026113 Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719464/
↑ Hove, Michael J.; Suzuki, Kazuko; Uchitomi, Hirotaka; Orimo, Satoshi and Miyake. Yoshihiro (2012) Full Text PLoS One 9 (3) e32600 Interactive Rhythmic Auditory Stimulation Reinstates Natural 1/f Timing in Gait of Parkinson's Patients http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292577/ :
Flexion :
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Flexion
Bent or curved posture
The following references are relevant:-
Hong and Earhart (2010) Effects of Medication on Turning Deficits in Individuals with Parkinson's Disease
Mak et al (2011) Limb Collapse, Rather Than Instability, Causes Failure in Sit-to-Stand Performance Among Patients With Parkinson Disease
Xia et al (2011) Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease
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References
↑ Hong, Minna and Earhart, Gammon M. (2010) Full Text J. Neurol. Phys. Ther. 34 (1) 11 – 16 Effects of Medication on Turning Deficits in Individuals with Parkinson's Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886796/
↑ Mak, Margaret K.Y.: Yang, Feng and Pai, Yi-Chung (2011) Full Text Phys. Ther. 91 (3) 381 – 391 Limb Collapse, Rather Than Instability, Causes Failure in Sit-to-Stand Performance Among Patients With Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048819/
↑ Xia, Ruiping; Powell, Douglas; Rymer, W. Zev.; Hanson, Nicholas;Fang, Xiang and Threlkeld, A. Joseph (2011) Full Text Exp. Brain Res. 209 (4) 609 – 618 Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142787/ :
Foot Drop :
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Foot Drop or (Drop Foot)
Locomotion defect whereby the heel of a foot is raised from the ground while walking
The following references are relevant:-
Belfiore and Campanella (1994) A clinical sign of Parkinson's disease: the absence of lateral foot drop
Rogers et al (2011) Perturbations of ground support alter posture and locomotion coupling during step initiation in Parkinson's disease
The following references are relevant:-
Further Research
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Literature search:
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References
↑ Belfiore, G. and Campanella, G. (1994) AbstractActa Neurol. (Napoli). 16 (5-6) 291 – 92 A clinical sign of Parkinson's disease: the absence of lateral foot drop http://www.ncbi.nlm.nih.gov/pubmed/7709801
↑ Rogers, M.W.; Hilliard, M.J.; Martinez, K.; Zhang, Y.;Simuni, T. and Mille, M.L. (2011) AbstractExp. Brain Res. 208 (4) 557 – 567 Perturbations of ground support alter posture and locomotion coupling during step initiation in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/21153725a :
Freezing of Gait :
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Freezing of gait
Inability to initiate locomotion
The following references are relevant:-
Morris et al (2010)
Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders
Maidan et al (2010)
Heart rate changes during freezing of gait in patients with Parkinson's disease
Espay et al(2012) “On” state freezing of gait in Parkinson disease - A paradoxical levodopa-induced complication
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References
↑ Morris, Meg. E.; Martin, Clarissa L. and Schenkman, Margaret L.(2010) Full Text
Phys. Ther. 90 (2) 280 – 288 Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816030/
↑ Maidan, I; Plotnik, M.; Mirelman, M. Wess, A.; Giladi, N.; and Haudorff, J.M. (2010) Full Text Mov. Disord. 25 (14) 2346 -2354 Heart rate changes during freezing of gait http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964413/
↑ Espay, A.J.; Fasano, A.; van Nuenen, B.F.J.; Payne, M.M; Snijders, A.H. and Bloem, B.R. (2012) Full Text. Neurology 78 (7) 454 – 457 ”On” state freezing of gait in Parkinson disease - A paradoxical levodopa-induced complication http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466608/ :
Hyperkinesia :
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Hyperkinesia
Increased force, speed, violence, speed of movement.
The following references are relevant:-
Ackermann et al (1989) Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease.
Inzelberg et al (1995) Kinematic properties of upper limb trajectories in idiopathic torsion dystonia
Thomsen et al (2011) Psychomotor stimulation by dopamine D1-like but not D2-like agonists in most mouse strains
Further Research
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References
↑ Ackermann, A; Ziegler, W. and Oertel, W. H. (1989) Full Text J. Neurol. Neurosurg. Psychiatry. 56 (6) 805 – 807. Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1032047/
↑ Inzelberg, R.; Flash, T.; Schechtmann, E and Korczyn, A.D. (1995) Full Text J. Neurol. Neurosurg. Psychiatry. 58 (3) 312 – 319. Kinematic properties of upper limb trajectories in idiopathic torsion dystonia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1073367/
↑ Thomsen, Morgane; Ralph, Rebecca J. and Caine, S. Barak (2011) Full Text Exp. Clin. Psychopharmacol. 19 (5) 342 – 360.Psychomotor stimulation by dopamine D1-like but not D2-like agonists in most mouse strains http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3319345/ :
Hypertonia :
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Hypertonia
Excessive muscle tone
The followng references are relevant:-
Wright et al (2007) Axial hypertonicity in Parkinson’s disease: Direct measurements of trunk and hip torque
Goldenberg(2008) Medical Management of Parkinson’s Disease
Xia et al (2011) Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease
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References
↑ Wright, W,G,; Gurfinkel, V.S.; Nutt, J.; Horak, F.B. and Cordo, P.J. (2007) Full Text Exp. Neurol. 208 (1) 38 – 46. Axial hypertonicity in Parkinson’s disease: Direct measurements of trunk and hip torque http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2144734/
↑ Goldenberg, Marvin M. (2008) Full Text P.T. 33 (10) 590 – 594, 599 – 606 Medical Management of Parkinson’s Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730785/
↑ Xia, Ruiping,; Powell, Douglas.; Rymer, W. Zev; Hanson, Nicholas;Fang, Xiang; and Threlkeld, A. Joseph (2011) Full TextExp. Brain Res. 209 (4): 609 – 618. Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142787/ :
Hypokinesia :
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Hypokinesia
Reduced force, impetus or speed of movement
The following refences are relevant:-
Ackermann et al (1989) Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease.
Heldman et al (2011) The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures #
Espay et al (2011) Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease
Further Research
Search the scientific literature for Hypokinesia
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Search the scientific literature for Rigidity
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References
↑ Ackermann, H.; Ziegler,W. andOertel, W.H. (1989) Full Text J. Neurol. Neurosurg. Psychiatry. 52 (6) 805 – 807. Palilalia as a symptom of levodopa induced hyperkinesia in Parkinson's disease.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1032047/
↑ Heldman, Dustin A.; Giuffrida, Joseph P.; Robert; Megan; Filomena; Andrew P.; Alok; Sang Jin; Fredy J. and Espay, Alberto J. (2011) Full Text Mov. Disord. 26 (10) 1859 – 1863. The Modified Bradykinesia Rating Scale for Parkinson’s Disease: Reliability and Comparison with Kinematic Measures http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324112/
↑ Espay, Alberto J,;Giuffrida, Joe P.; Chen, Robert; Payne, Megan; Mazzella, Filomena; Dunn, Emily; Vaughan, Jennifer E.; Duker, Andrew P.; Sahay, Alok; Kim, Sang Jin; Revilla, Fredy J. and Heldman, Dustin A. (2011) Full TextMov. Disord. 26 (14) 2504 – 2508. Differential Response of Speed, Amplitude, and Rhythm to Dopaminergic Medications in Parkinson’s Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318914/
Reference :
Kinesia paradoxa :
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Paradoxical kinesia
Sometimes referred to as 'Kinesia paradoxa'
Unexpected reversal of motor symptoms Many PD patients find that the daily onset of movement disorders is inconsistent and unpredictable and varies according to the type of activity they undertake, their emotional state and social circumstances. For example it may seem easier to walk across uneven ground rather than on a flat, hard surface, or it may seem easier to climb stairs or a slope than progress on the level. This gives a pointer to alternative neural pathways which could be exploited to ameliorate PD symptoms.
Faith 'Cures'
The earliest reference to this phenomenon is to be found in Chapter 2 of the Gospel of St. Mark, where Jesus is at Capernaum and is faced with a bedridden man who is "sick of the palsy".
10 But ye may know that the Son of man hath power on earth to forgive sins,(he saith to the sick of the palsy.)11. I say unto thee, Arise, and take up thy bed, and go thy way t12. And immediately he arose, took up the bed, and went forth before them all; insomuch that they were all amazed, and glorified God, saying, We never saw it on this fashion.
This account begs the questions as to whether the palsy as described equates with PD and whether the observable benefits were permanent or temporary.
In modern times the most documented "miracle" cure is that of Sister Marie Simon-Pierre, who attested that she had been cured of Parkinson's Disease after praying to the late Pope John Paul II.[who himself manifested advanced symptoms of PD]
ROME, APRIL 30, 2011 .- Here is a [part of]translation of the testimony of Sister Marie Simon-Pierre of the Congregation of the Little Sisters of Catholic Motherhood, regarding her miraculous cure from Parkinson's that she attributes to the intercession of Pope John Paul II. The testimony, written in 2006, formed part of John Paul II's case for beatification. Reports of medical and legal experts on the French nun's healing were submitted to the dicastery for scientific examination last October. The phenomenon was recognized by the Vatican as a miracle attributed to the intercession of John Paul II
In June 2001, I was diagnosed with Parkinson's disease. The disease had affected the whole left side of my body, creating great difficulties for me as I am left-handed. After three years, the initial phase of the disease, slow but progressive, was followed by an aggravation of the symptoms: accentuation of the trembling, rigidity, pain, insomnia. From April 2, 2005, I began to worsen week by week, I grew worse day by day, I was unable to write (I repeat that I am left-handed), and if I attempted it, what I wrote was unintelligible. I could drive only for short trips because my left leg would stiffen sometimes, and my rigidity would have impeded my driving. Moreover, to do my work in a hospital, it took more time than usual. I was exhausted.......
......On May 13 [2005}, feast of Our Lady of Fatima, Benedict XVI announced the special dispensation to initiate the cause of beatification of John Paul II. Beginning the following day, the sisters of all the French and African communities began to pray for my cure through the intercession of John Paul II. They prayed incessantly until the news arrived of my cure. At that time I was on vacation. On May 26, my time of rest being at an end, I re-turned totally exhausted by the disease. "If you believe, you will see the glory of God": this phrase of St. John's Gospel accompanied me from May 14 onward. On June 1, I was finished; I struggled to stand and to walk.
On June 2 in the afternoon. With effort, I wrote: "John Paul II." We remained in silence before the il-legible letters, then the day continued as usual. At the end of the evening prayer, at 9 o'clock at night, I went to my office before going to my room. I felt the need to pick up the pen and to write, just as if someone within me was saying: "Pick up the pen and write." It was between 9:30 and 9:40 at night. To my great surprise I saw that the writing was clearly legible. Not understanding anything, I went to bed. Two months exactly had gone by since John Paul II's departure to the House of the Father. I woke up at 4:30 a.m., surprised that I was able to sleep and I leapt out of bed: my body was no longer insensitive, rigid, and interiorly I was not the same.......
......Ten months have passed now since I interrupted all types of treatment. I am working normally again, I have no difficulty in writing and I also drive long distances. It feels as if I have been reborn: a new life, because nothing is as it was before.....
It is not possible to evaluate these events without a sight of the report of the panel of medical experts set up by the Vatican to evaluate claims of cures.
More Observations
(1921)
Souques observed the phenomenon and coined the term 'Paradoxical kinesia' to describe it.
(1976)
Marshall et al Activation-induced restoration of sensorimotor functions in rats with dopamine-depleting brain lesions succeeded in reproducing Kinesia Paradoxica by exposing Parkinsonian rats to potentially life-threatening situations.
They began to move and respond appropriately to environmental stimuli when placed in a sink of water, in a shallow ice bath, or among a colony of cats or rats. A reversal of the sensorimotor dysfunctions was still apparent shortly after the animals were removed from each activating situation. However, the therapeutic effects dissipated rapidly, and by 4 hr after an exposure the rats responded as poorly as they had prior to activation.
(1989)
Keefe et al Dopamine ReleaseStudies in an Animal Model found that by inducing PK they could switch Parkinson symptoms on and off in rats.
Rats were given brain lesions to inhibit their dopamine production capacity by 98% and they became Parkinsonian. They were placed in deep water and managed to swim effectively. They also escaped from shallow ice baths.
These behaviors were not abolished by pretreating the animals with the dopamine antagonists haloperidol and SCH-23390. In contrast, haloperidol completely blocked the brain-damaged animals' behavioral responses to amphetamine. These results suggest that the paradoxical kinesia of dopamine-depleted rats is not a consequence of dopamine release from residual dopaminergic fibers.
(2007)
Schlesinger et al interviewed 50 PD patients, who had been exposed to life-threatening situations in war. Two had experiened PK.
(2009)
Robottom et al <noted that symptoms varied when PD patients were placed under emotional or physical stress.
The Abruzzi earthquake
(2009)
At 03.32 Central European Summer Time on the night of 6th April 2009 the city of L'Aquila, which is the capital of the Abruzzo region in Italy, was devastated by a sudden earthquake with a strength of 5.8 on the Richter Scale. There was considerable damage to property, 308 people lost their lives and some 1,500 were injured.However there is a long history of earth tremors in the region and the majority of citizens evacuated their properties forthwith and survived.
It so happened that 70km. away was a Movement Disorder clinic, operated by the University G.D. Annunzio Chieti-Pescari, which had neen monitoring the symptoms of 14 patients in the city with parkinsonism and dementia. The movemnt disorders of all of them were at Hoehn and Yahr stages 3 to 5.
Measurements taken 3 months after the earthquake showed an unaccountable significant improvement in their UPDRS motor rating. There was also considerable anecdotal evidence of their performmance at the moment when the earthquake struck:-
"He ran like hell out of the two storey building pushing his two children (17 and 15 years old) and his wife" relates to a 59 year old retired chemical engineer in his tenth year since being diagnosed with PD.
"During the earthquake hit he ran from his house." describes a 58 year old retired truck driver five years after PD diagnosis.
"During the night time earthquake, she rose from her bed and hurried out of her apartment at the third floor. When she was examined, 15 days after the earthquake, she walked to the office assisted by her daughter (in the previous visit she had been carried on a wheelchair)." Describes a 90 year old woman with both PD and dementia.
"During the night time earthquake hit he ran away from his second floor apartment." relates to a 77 year od retired public employee.
"During the earthquake, he jumped out of bed and ran through three flights of stairs, carrying and pushing his 72 year old wife (she reported he practically lifted her up through the collapsing apartment and floors)." Part of an acount of a 77 year old retired engineer who had experienced PD symptoms for three year.
After 5 months the patients had regressed to their pre-earthquake state. A full account was published by Bonanni et al(2010) Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms
Oliver Sacks
PK can occur without the need for divine intervention or geological catastrophes.
“Awakenings”, by Oliver Sacks, is one of the most lucid and closely observed accounts of PD symptoms. It is based on the case notes of a series of encounters that he had with patients as a result of the PD pandemic called Encephalitis Lethargica. In the 1920’s. This form of the disease is characterised by its rapid onset and progression and its pronounced symptoms. For example bradykinesia progresses to the point where the patient becomes catatonic.
Sacks noted a number of occurrences of Pardoxical kinesia:-Thus one may see such patients rigid, motionless, seemingly lifeless as statues, abruptly called into normal life and action by some sudden exigency which catches their attention (in one famous case, a drowning man was saved by a Parkinsonian patient who leapt from his wheelchair into the breakers.)
In the 1950s there was a PD patient at the Highlands Hospital, London, who:-would often sit frozen and motionless unless he were thrown a ball.
This would instantly call him to life and he would leap to his feet, swerving, running, dribbling he ball……If thrown a match box he would catch it on the tip of one foot, kick it up, catch it, kick it up again, and in this fashion, juggling the matchbox on one foot, hop the entire length of the ward.
At the same hospital were two PD patients who shared a room for 20 years. Both were motionless and mute, but one evening:-
Dr. Stern heard a terrific noise coming from this room of perpetual silence. Rushing to it with a couple of nurses, he found its inmates in the midst if a violent fight, throwing each other around and houting obscenities. The moment they were separated they became motionless and mute again and have remained so ever since.
Another patient at Mount Carmel Hospital would sit completely motionless unless she was suddenly thrown three (or more) oranges.
Instantly she starts juggling them – she can juggle up to seven, in a manner incredible to see – and can continue doing so for half an hour on end, But if she drops one, or is interrupted for a moment, she suddenly becomes motionless again.
Another Mount Carmel patient seemed totally incapable of movement until one day when:-
he suddenly took up my ophthalmoscope, a most intricate one, unscrewed it, put it together again, and gave a stunning imitation of me examining an eye. The entire performance, which was flawless and brilliant, occupied no more than a few seconds.
Hypotheses for PK
(1989)
Morris et al evaluated the factors influencing gait in PD patients.
Through bypassing the defective basal ganglia and instead using the frontal cortex to regulate movement size or timing by consciously thinking about the desired movement, people with PD arguably compensate for the neurotransmitter imbalance in the basal ganglia. Other strategies include visualizing walking with long steps, mentally rehearsing the desired movement pattern before the action is performed, breaking down long or complex motor sequences into parts and focusing on the performance of each individual segment (segmentation), avoiding dual task performance, reading instructions on a cue card, and verbally reciting phrases such as “think big” or “long steps.”This model is based on the theory that the ability to move normally is not lost in PD. Instead, there is an activation problem that can be overcome through targeted physical therapy together with optimal pharmacotherapy.
(1991)
Glickstein and Stein
The stimuli that often elicit paradoxical movements are similar to those that relay visual information to the cerebellum. We suggest that many instances of paradoxical movement may be explained by the fact that the pathways relaying those visual stimuli can bypass the damaged basal ganglia and allow an intact cerebellar circuit to be used for visuomotor control.
(2009)
Schlesimger et al (Ibid) advanced three possible hypotheses to explain PK.
Basal Ganglia Reserves
This assumes that reserves of dopamine are held in the basal ganglia and are released in emergencies.
Compensatory cerebellar circuitry
This assumes that dormant alternative cerebellar circuitry can be activated by reward-seeking behaviour.
Noradrenic augmentation
This assumes that a primitive, latent system of movement can be stimulated into use by the secretion of the neurotransmitter noradrenaline acting upon the sympathetic nervous system.
This is also known as the "fight-or-flight response"
Visual Cueing
Visual cueing is a form of PK which can be activated, and controlled by an indvidual as an alternative form of locomotion.
Morris et alevaluated cadence control for slow to medium walking speeds in PD patients and showed that an increase in step frequency was a compensation for reduced stride length. They concluded:-
The findings indicated that cadence control remains unaffected throughout its entire range in Parkinson's disease and that gait hypokinesia is directly attributable to an inability to internally generate sufficiently large steps.
Further Reading
Search the scientific literature (Paradoxical_kinesia)
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Search the scientific literature (kinesia paradoxa)
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Related Pages
References
↑ Souques, A.A. (1921) Rev. Neurol. 37: 557-560.
↑ Marshall, J.F.; Levitan, D. and Striker, E.M. (1976) AbstractJ. Comp. Physiol. Psychol. (6) 536 - 546.Activation-induced restoration of sensorimotor functions in rats with dopamine-depleting brain lesions.
http://www.ncbi.nlm.nih.gov/pubmed/8470
↑ Keefe, Kristen A.; Salamone, John D.; Zigmond, Michael J. and Stricker, Edward M (1989) Abstract Arh. Neurol. 46 (10) 1070 – 1075 Dopamine ReleaseStudies in an Animal Model http://archneur.jamanetwork.com/article.aspx?articleid=589428
↑ Schlesinger, I.; Erikh, I. and Yarmitsky, D. (2009) AbstractMov. Disord. 22 2394 – 2397 Paradoxical kinesia at war http://onlinelibrary.wiley.com/doi/10.1002/mds.21739/full
↑ Robottom, B.J.; Weiner, W.J.; Asmus, F.; Huber, H. Gasser, T. and Schols L. (2009) Abstract Neurology 73 (4) 328-329 Kick and rush paradoxical kinesia in Parkinson disease.
http://pubget.com/paper/19636057/
↑ Bonanni, L.; Thomas, A.; Anzillotti, F.; Monaco, D. Ciccocioppo, F.; Veronese, S.;Bifolchetti, S.; D'Amico, M.C.; Di Iono A. and Onofrrj, M.(2010) AbstractNeurol. Sci. (6) 751 - 756.Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms.http://www.ncbi.nlm.nih.gov/pubmed/20859648
↑ Morris, Meg E.; Martin, Clarissa L. and Schenkman, Margaret L. (1989) Full Text J. Mot. Behav. 21 (1) :72 - 91 Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816030/
↑ Glickstein, M. and Stein, J. (1991) Abstract Trends Neurosci. 14 (11) 480-482 Paradoxical movement in Parkinson's Disease.http://www.ncbi.nlm.nih.gov/pubmed/1726761
↑ Morris, M.E.; Iansek, R.; Matyas, T.A. and Summers, J.J. (1994) Abstract J. Neurol. Neurosurg. Psychiatry 57 (12): 1532 – 1534 Ability to modulate walking cadence remains intact in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/7798986 :
Masking :
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Amimia
Fixed and vacant expression (masking)
Very little research has been carried out on this common PD symptom but the following are relevant :-
Allen (1931) The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign
Hemmesch et al (2009)The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease.
Clark et al (2011) Visual Exploration of Emotional Facial Expressions in Parkinson's Disease
Tickle-Degnen et al (2011) Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease <
Further Research
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References
↑ http://medical-dictionary.thefreedictionary.com/
↑ Allen, I.M.(1931) Full Text The Dissociation of voluntary and emotional movements of the face with special reference to emotional paresis as a physical sign http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1038785/?page=1
↑ Hemmesch. Amanda R.; Tickle-Degnen, Linda and Zebrowitz, Leslie A. (2009) Full Text Psychol. Aging 24 (3) 542 – 549 The Influence of Facial Masking and Sex on Older Adults’ Impressions of Individuals with Parkinson’s Disease.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761205/
↑ Clark, Uraina S.; Neargarder, Sandy and Cronin-Golomb, Alice (2011) Full Text Visual Exploration of Emotional Facial Expressions in Parkinson's Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876199/
↑ Tickle-Degnen, Linda and Zebrowitz, Leslie A. and Ma, Hui-ing (2011) Full Text Soc. Sci. Med. 73 (1) 95 – 102 Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142938/ :
Micrographia :
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Micrographia
Microscopic handwriting
The following references are relevant:-
Oliveira et al (1997) Micrographia in Parkinson's disease: the effect of providing external cues
Dounskaia et al (2009) Biased Wrist and Finger Coordination in Parkinsonian Patients during Performance of Graphical Tasks
Shukla et al (2012) Micrographia and related deficits in Parkinson's disease: a cross-sectional study
Further Research
Search the scientific literature
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Micrographia .
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
Micrographia Pubmed (abstracts)
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References
↑ Oliveira, R.; Gurd,J.; Nixon, P.; Marshall, J. and Passingham, (1997) Full Text R. J. Neurol. Neurosurg. Psychiatry. 63 (4) 429 – 433.Micrographia in Parkinson's disease: the effect of providing external cueshttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2169751/
↑ Dounskaia, Natalie; Van Gemmert, Arend W,A. ; Leis, Berta C. and Stelmach, George A. (2009) Full Text Neuropsychologia 47 (12) 2504 – 2514. Biased Wrist and Finger Coordination in Parkinsonian Patients during Performance of Graphical Tasks http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712583/
↑ Shukla, Aparna Wagle; Ounpraseuth, Songthip; Gray, Vickie; Schwankhaus, John; and Metzer, walter Steven (2012) Full Text BMJ Open. 2 (3): e000628. Micrographia and related deficits in Parkinson's disease: a cross-sectional study http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383984/ :
Motor fluctuations :
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Motor fluctuations
'On-off' periods, wearing off, dose failures, and freezing associated with long-term levodopa use
The following references are relevant:-
Bordelon et al (2011) Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease/
Bohnen et al (2011)
Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease
Mera et al (2012) Feasibility of home-based automated Parkinson’s disease motor assessment
Further Research
Search the scientific literature
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Motor_fluctuations.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
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References
↑ Bordelon, Yvett;M.; Hayes, Ron D,; Vassar, Stefanie D.; Diaz, Natalie; Bronstein, Jeff and Vickrey, Barbra, G. (2011) Full Text Parkinsons Dis. 2001 967839 Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236449
↑ Bohnen, Nicolaas I.; Muller, Martijn L.T.M.; Zarzhevsky, Natalia; Koeppe, Robert A.; Bogan, Christopher W.; Kilbourn, Michael R.; Frey, Kirk A. and Albin, Roger L.(2011) Full Text Brain 134 (8) 2358 – 2365 Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155702/
↑ Mera, Thomas O.; Heldman, Dustin (2012) Full Text J. Neurosci. Methods 203 (1) 152 – 156. Feasibility of home-based automated Parkinson’s disease motor assessment http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221741/ :
Myoclonus :
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Myoclonus
Sudden violent jerks.
The following references are relevant:-
Mera et al (2011) Feasibility of home-based automated Parkinson’s disease motor assessment
Lanska (2010) Chapter 33: the history of movement disorders
Kojovic et al (2011) Myoclonic disorders: a practical approach for diagnosis and treatment
Further Research
Search the scientific literature
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Myoclonus.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
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References
↑ Mera, Thomas O.; heldman, Dustin A; Epay, Albert J. ; Payne, Megan and Giuffrida, Joseph P. (2011) Full TextJ. Neurosci. Methods 203 (1) 152 – 156. Feasibility of home-based automated Parkinson’s disease motor assessment http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221741/
↑ Lanska, D.J. (2010) Full Text Handb. Clin. Neurol. 95:501-46. Chapter 33: the history of movement disorders http://www.ncbi.nlm.nih.gov/pubmed/19892136
↑ Kojovic, Maja; Cordivari, Carla and Bhatia, Kailash (2011) Full Text Ther. Adv. Neurol. Disord. 4 (1) 47 – 62. Myoclonic disorders: a practical approach for diagnosis and treatment http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036960/ :
Oculogyric crises :
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Oculogyric crises
Attacks of forced deviation of gaze;
The following references are relevant:-
Clough et al (1983) Oculogyric crises and parkinsonism. A case of recent onset
Furumoto et al (1989) Oculogyric crisis as an initial symptom of juvenile parkinsonism-like disease
Wilkaniec et al (2013)
Toxicity of extracellular secreted alpha-synuclein: Its role in nitrosative stress and neurodegeneration.
Further Research
Search the scientific literature
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Oculogyric.
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References
↑ Clough, C.G.; Plaitakis, A. and Yahr, M.D. (1983) Full Text Arch. Neurol. 40 (1) 36 - 37. Oculogyric crises and parkinsonism. A case of recent onset.http://www.ncbi.nlm.nih.gov/pubmed/6848086
↑ Furumoto,H; Kitano, K; Wang, d.s.; Matumoto, S. and Moroo (1989) Full Text Rinsho Shinkeigaku 29 (10) 1287 – 1298 Oculogyric crisis as an initial symptom of juvenile parkinsonism-like disease http://www.ncbi.nlm.nih.gov/pubmed/2605835
↑ Wilkaniec, A; Stosznajder,J.B. and Adamczyk, A. (2013) Full Text Neurochem. Int. 14. pii: S0197-0186(13)00043-0. Toxicity of extracellular secreted alpha-synuclein: Its role in nitrosative stress and neurodegeneration http://www.ncbi.nlm.nih.gov/pubmed/23416621 :
'On-off' :
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Motor fluctuations
'On-off' periods, wearing off, dose failures, and freezing associated with long-term levodopa use
The following references are relevant:-
Bordelon et al (2011) Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease/
Bohnen et al (2011)
Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease
Mera et al (2012) Feasibility of home-based automated Parkinson’s disease motor assessment
Further Research
Search the scientific literature
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Motor_fluctuations.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
Pubmed (abstracts)
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References
↑ Bordelon, Yvett;M.; Hayes, Ron D,; Vassar, Stefanie D.; Diaz, Natalie; Bronstein, Jeff and Vickrey, Barbra, G. (2011) Full Text Parkinsons Dis. 2001 967839 Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236449
↑ Bohnen, Nicolaas I.; Muller, Martijn L.T.M.; Zarzhevsky, Natalia; Koeppe, Robert A.; Bogan, Christopher W.; Kilbourn, Michael R.; Frey, Kirk A. and Albin, Roger L.(2011) Full Text Brain 134 (8) 2358 – 2365 Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155702/
↑ Mera, Thomas O.; Heldman, Dustin (2012) Full Text J. Neurosci. Methods 203 (1) 152 – 156. Feasibility of home-based automated Parkinson’s disease motor assessment http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221741/ :
Palipraxia :
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Palipraxia
Forced repetitive movement.
The following references are relevant:-
Ghika (----) Mood and behaviour in disorders of the basal ganglia.
Critchley (1970) Aphasioloy and other aspects of language
Naremore (1981) Language science : recent advances
Further Research
Search the scientific literature
Literature search:
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Palipraxia .
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References
↑ Ghika, Joseph (----) Full Text
Mood and behaviour in disorders of the basal ganglia.http://books.google.co.uk/books?hl=en&lr=&id=sBOUbCYrq9AC&oi=fnd&pg=PA122&dq=parkinson%27s+palipraxia&ots=D0AorK6t_P&sig=eKz0aiELSjKldHxsfU22EClD7HM#v=onepage&q=parkinson's%20palipraxia&f=false
↑ Critchley, Macdonald (1970) Full Text Aphasiology and other aspects of languagehttp://books.google.co.uk/books?id=Rq1rAAAAMAAJ&q=palipraxia&dq=palipraxia&hl=en&sa=X&ei=ZX9NUaLUBYeWPbm_gPAM&ved=0CEoQ6AEwBTgK
↑ Naremore Rita C, (1981) Full Text Language science : recent advanceshttp://books.google.co.uk/books?id=q9O2AAAAIAAJ&q=palipraxia&dq=palipraxia&hl=en&sa=X&ei=F4BNUf35CcPIPIe2gbgI&ved=0CE8Q6AEwBzgU :
Paradoxical kinesia :
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Paradoxical kinesia
Sometimes referred to as 'Kinesia paradoxa'
Unexpected reversal of motor symptoms Many PD patients find that the daily onset of movement disorders is inconsistent and unpredictable and varies according to the type of activity they undertake, their emotional state and social circumstances. For example it may seem easier to walk across uneven ground rather than on a flat, hard surface, or it may seem easier to climb stairs or a slope than progress on the level. This gives a pointer to alternative neural pathways which could be exploited to ameliorate PD symptoms.
Faith 'Cures'
The earliest reference to this phenomenon is to be found in Chapter 2 of the Gospel of St. Mark, where Jesus is at Capernaum and is faced with a bedridden man who is "sick of the palsy".
10 But ye may know that the Son of man hath power on earth to forgive sins,(he saith to the sick of the palsy.)11. I say unto thee, Arise, and take up thy bed, and go thy way t12. And immediately he arose, took up the bed, and went forth before them all; insomuch that they were all amazed, and glorified God, saying, We never saw it on this fashion.
This account begs the questions as to whether the palsy as described equates with PD and whether the observable benefits were permanent or temporary.
In modern times the most documented "miracle" cure is that of Sister Marie Simon-Pierre, who attested that she had been cured of Parkinson's Disease after praying to the late Pope John Paul II.[who himself manifested advanced symptoms of PD]
ROME, APRIL 30, 2011 .- Here is a [part of]translation of the testimony of Sister Marie Simon-Pierre of the Congregation of the Little Sisters of Catholic Motherhood, regarding her miraculous cure from Parkinson's that she attributes to the intercession of Pope John Paul II. The testimony, written in 2006, formed part of John Paul II's case for beatification. Reports of medical and legal experts on the French nun's healing were submitted to the dicastery for scientific examination last October. The phenomenon was recognized by the Vatican as a miracle attributed to the intercession of John Paul II
In June 2001, I was diagnosed with Parkinson's disease. The disease had affected the whole left side of my body, creating great difficulties for me as I am left-handed. After three years, the initial phase of the disease, slow but progressive, was followed by an aggravation of the symptoms: accentuation of the trembling, rigidity, pain, insomnia. From April 2, 2005, I began to worsen week by week, I grew worse day by day, I was unable to write (I repeat that I am left-handed), and if I attempted it, what I wrote was unintelligible. I could drive only for short trips because my left leg would stiffen sometimes, and my rigidity would have impeded my driving. Moreover, to do my work in a hospital, it took more time than usual. I was exhausted.......
......On May 13 [2005}, feast of Our Lady of Fatima, Benedict XVI announced the special dispensation to initiate the cause of beatification of John Paul II. Beginning the following day, the sisters of all the French and African communities began to pray for my cure through the intercession of John Paul II. They prayed incessantly until the news arrived of my cure. At that time I was on vacation. On May 26, my time of rest being at an end, I re-turned totally exhausted by the disease. "If you believe, you will see the glory of God": this phrase of St. John's Gospel accompanied me from May 14 onward. On June 1, I was finished; I struggled to stand and to walk.
On June 2 in the afternoon. With effort, I wrote: "John Paul II." We remained in silence before the il-legible letters, then the day continued as usual. At the end of the evening prayer, at 9 o'clock at night, I went to my office before going to my room. I felt the need to pick up the pen and to write, just as if someone within me was saying: "Pick up the pen and write." It was between 9:30 and 9:40 at night. To my great surprise I saw that the writing was clearly legible. Not understanding anything, I went to bed. Two months exactly had gone by since John Paul II's departure to the House of the Father. I woke up at 4:30 a.m., surprised that I was able to sleep and I leapt out of bed: my body was no longer insensitive, rigid, and interiorly I was not the same.......
......Ten months have passed now since I interrupted all types of treatment. I am working normally again, I have no difficulty in writing and I also drive long distances. It feels as if I have been reborn: a new life, because nothing is as it was before.....
It is not possible to evaluate these events without a sight of the report of the panel of medical experts set up by the Vatican to evaluate claims of cures.
More Observations
(1921)
Souques observed the phenomenon and coined the term 'Paradoxical kinesia' to describe it.
(1976)
Marshall et al Activation-induced restoration of sensorimotor functions in rats with dopamine-depleting brain lesions succeeded in reproducing Kinesia Paradoxica by exposing Parkinsonian rats to potentially life-threatening situations.
They began to move and respond appropriately to environmental stimuli when placed in a sink of water, in a shallow ice bath, or among a colony of cats or rats. A reversal of the sensorimotor dysfunctions was still apparent shortly after the animals were removed from each activating situation. However, the therapeutic effects dissipated rapidly, and by 4 hr after an exposure the rats responded as poorly as they had prior to activation.
(1989)
Keefe et al Dopamine ReleaseStudies in an Animal Model found that by inducing PK they could switch Parkinson symptoms on and off in rats.
Rats were given brain lesions to inhibit their dopamine production capacity by 98% and they became Parkinsonian. They were placed in deep water and managed to swim effectively. They also escaped from shallow ice baths.
These behaviors were not abolished by pretreating the animals with the dopamine antagonists haloperidol and SCH-23390. In contrast, haloperidol completely blocked the brain-damaged animals' behavioral responses to amphetamine. These results suggest that the paradoxical kinesia of dopamine-depleted rats is not a consequence of dopamine release from residual dopaminergic fibers.
(2007)
Schlesinger et al interviewed 50 PD patients, who had been exposed to life-threatening situations in war. Two had experiened PK.
(2009)
Robottom et al <noted that symptoms varied when PD patients were placed under emotional or physical stress.
The Abruzzi earthquake
(2009)
At 03.32 Central European Summer Time on the night of 6th April 2009 the city of L'Aquila, which is the capital of the Abruzzo region in Italy, was devastated by a sudden earthquake with a strength of 5.8 on the Richter Scale. There was considerable damage to property, 308 people lost their lives and some 1,500 were injured.However there is a long history of earth tremors in the region and the majority of citizens evacuated their properties forthwith and survived.
It so happened that 70km. away was a Movement Disorder clinic, operated by the University G.D. Annunzio Chieti-Pescari, which had neen monitoring the symptoms of 14 patients in the city with parkinsonism and dementia. The movemnt disorders of all of them were at Hoehn and Yahr stages 3 to 5.
Measurements taken 3 months after the earthquake showed an unaccountable significant improvement in their UPDRS motor rating. There was also considerable anecdotal evidence of their performmance at the moment when the earthquake struck:-
"He ran like hell out of the two storey building pushing his two children (17 and 15 years old) and his wife" relates to a 59 year old retired chemical engineer in his tenth year since being diagnosed with PD.
"During the earthquake hit he ran from his house." describes a 58 year old retired truck driver five years after PD diagnosis.
"During the night time earthquake, she rose from her bed and hurried out of her apartment at the third floor. When she was examined, 15 days after the earthquake, she walked to the office assisted by her daughter (in the previous visit she had been carried on a wheelchair)." Describes a 90 year old woman with both PD and dementia.
"During the night time earthquake hit he ran away from his second floor apartment." relates to a 77 year od retired public employee.
"During the earthquake, he jumped out of bed and ran through three flights of stairs, carrying and pushing his 72 year old wife (she reported he practically lifted her up through the collapsing apartment and floors)." Part of an acount of a 77 year old retired engineer who had experienced PD symptoms for three year.
After 5 months the patients had regressed to their pre-earthquake state. A full account was published by Bonanni et al(2010) Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms
Oliver Sacks
PK can occur without the need for divine intervention or geological catastrophes.
“Awakenings”, by Oliver Sacks, is one of the most lucid and closely observed accounts of PD symptoms. It is based on the case notes of a series of encounters that he had with patients as a result of the PD pandemic called Encephalitis Lethargica. In the 1920’s. This form of the disease is characterised by its rapid onset and progression and its pronounced symptoms. For example bradykinesia progresses to the point where the patient becomes catatonic.
Sacks noted a number of occurrences of Pardoxical kinesia:-Thus one may see such patients rigid, motionless, seemingly lifeless as statues, abruptly called into normal life and action by some sudden exigency which catches their attention (in one famous case, a drowning man was saved by a Parkinsonian patient who leapt from his wheelchair into the breakers.)
In the 1950s there was a PD patient at the Highlands Hospital, London, who:-would often sit frozen and motionless unless he were thrown a ball.
This would instantly call him to life and he would leap to his feet, swerving, running, dribbling he ball……If thrown a match box he would catch it on the tip of one foot, kick it up, catch it, kick it up again, and in this fashion, juggling the matchbox on one foot, hop the entire length of the ward.
At the same hospital were two PD patients who shared a room for 20 years. Both were motionless and mute, but one evening:-
Dr. Stern heard a terrific noise coming from this room of perpetual silence. Rushing to it with a couple of nurses, he found its inmates in the midst if a violent fight, throwing each other around and houting obscenities. The moment they were separated they became motionless and mute again and have remained so ever since.
Another patient at Mount Carmel Hospital would sit completely motionless unless she was suddenly thrown three (or more) oranges.
Instantly she starts juggling them – she can juggle up to seven, in a manner incredible to see – and can continue doing so for half an hour on end, But if she drops one, or is interrupted for a moment, she suddenly becomes motionless again.
Another Mount Carmel patient seemed totally incapable of movement until one day when:-
he suddenly took up my ophthalmoscope, a most intricate one, unscrewed it, put it together again, and gave a stunning imitation of me examining an eye. The entire performance, which was flawless and brilliant, occupied no more than a few seconds.
Hypotheses for PK
(1989)
Morris et al evaluated the factors influencing gait in PD patients.
Through bypassing the defective basal ganglia and instead using the frontal cortex to regulate movement size or timing by consciously thinking about the desired movement, people with PD arguably compensate for the neurotransmitter imbalance in the basal ganglia. Other strategies include visualizing walking with long steps, mentally rehearsing the desired movement pattern before the action is performed, breaking down long or complex motor sequences into parts and focusing on the performance of each individual segment (segmentation), avoiding dual task performance, reading instructions on a cue card, and verbally reciting phrases such as “think big” or “long steps.”This model is based on the theory that the ability to move normally is not lost in PD. Instead, there is an activation problem that can be overcome through targeted physical therapy together with optimal pharmacotherapy.
(1991)
Glickstein and Stein
The stimuli that often elicit paradoxical movements are similar to those that relay visual information to the cerebellum. We suggest that many instances of paradoxical movement may be explained by the fact that the pathways relaying those visual stimuli can bypass the damaged basal ganglia and allow an intact cerebellar circuit to be used for visuomotor control.
(2009)
Schlesimger et al (Ibid) advanced three possible hypotheses to explain PK.
Basal Ganglia Reserves
This assumes that reserves of dopamine are held in the basal ganglia and are released in emergencies.
Compensatory cerebellar circuitry
This assumes that dormant alternative cerebellar circuitry can be activated by reward-seeking behaviour.
Noradrenic augmentation
This assumes that a primitive, latent system of movement can be stimulated into use by the secretion of the neurotransmitter noradrenaline acting upon the sympathetic nervous system.
This is also known as the "fight-or-flight response"
Visual Cueing
Visual cueing is a form of PK which can be activated, and controlled by an indvidual as an alternative form of locomotion.
Morris et alevaluated cadence control for slow to medium walking speeds in PD patients and showed that an increase in step frequency was a compensation for reduced stride length. They concluded:-
The findings indicated that cadence control remains unaffected throughout its entire range in Parkinson's disease and that gait hypokinesia is directly attributable to an inability to internally generate sufficiently large steps.
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Related Pages
References
↑ Souques, A.A. (1921) Rev. Neurol. 37: 557-560.
↑ Marshall, J.F.; Levitan, D. and Striker, E.M. (1976) AbstractJ. Comp. Physiol. Psychol. (6) 536 - 546.Activation-induced restoration of sensorimotor functions in rats with dopamine-depleting brain lesions.
http://www.ncbi.nlm.nih.gov/pubmed/8470
↑ Keefe, Kristen A.; Salamone, John D.; Zigmond, Michael J. and Stricker, Edward M (1989) Abstract Arh. Neurol. 46 (10) 1070 – 1075 Dopamine ReleaseStudies in an Animal Model http://archneur.jamanetwork.com/article.aspx?articleid=589428
↑ Schlesinger, I.; Erikh, I. and Yarmitsky, D. (2009) AbstractMov. Disord. 22 2394 – 2397 Paradoxical kinesia at war http://onlinelibrary.wiley.com/doi/10.1002/mds.21739/full
↑ Robottom, B.J.; Weiner, W.J.; Asmus, F.; Huber, H. Gasser, T. and Schols L. (2009) Abstract Neurology 73 (4) 328-329 Kick and rush paradoxical kinesia in Parkinson disease.
http://pubget.com/paper/19636057/
↑ Bonanni, L.; Thomas, A.; Anzillotti, F.; Monaco, D. Ciccocioppo, F.; Veronese, S.;Bifolchetti, S.; D'Amico, M.C.; Di Iono A. and Onofrrj, M.(2010) AbstractNeurol. Sci. (6) 751 - 756.Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms.http://www.ncbi.nlm.nih.gov/pubmed/20859648
↑ Morris, Meg E.; Martin, Clarissa L. and Schenkman, Margaret L. (1989) Full Text J. Mot. Behav. 21 (1) :72 - 91 Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816030/
↑ Glickstein, M. and Stein, J. (1991) Abstract Trends Neurosci. 14 (11) 480-482 Paradoxical movement in Parkinson's Disease.http://www.ncbi.nlm.nih.gov/pubmed/1726761
↑ Morris, M.E.; Iansek, R.; Matyas, T.A. and Summers, J.J. (1994) Abstract J. Neurol. Neurosurg. Psychiatry 57 (12): 1532 – 1534 Ability to modulate walking cadence remains intact in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/7798986 :
Paratonia :
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Gegenhalten
Involuntary variable resistance during passive movement
The following references are relevant:-
Bahram et al (2009) Exercise therapy, quality of life, and activities of daily living in patients with Parkinson disease: a small scale quasi-randomised trial
Franzen et al (2009) Reduced Performance in Balance, Walking and Turning Tasks is Associated with Increased Neck Tone in Parkinson's Disease
Xia et al (2011) Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease
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References
↑ Yousefi, Bahram; Tadibi Valud; Khoei, Ali Fathollahzadeh and Montazen, Ali (2009) Full Text Trials 2009 10 67 Exercise therapy, quality of life, and activities of daily living in patients with Parkinson disease: a small scale quasi-randomised trial < http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736167/
↑ Franzen, Erika; Paquette, Caroline; Gurfunkel, Victor S.; Cordo, Paul J.; Nutt, John G. and Horak, Fay B. (2009) Full Text Exp. Neurol. 218 (2) 430 – 438 Reduced Performance in Balance, Walking and Turning Tasks is Associated with Increased Neck Tone in Parkinson's Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775914/
↑ Xia, Ruiping; Powell, Douglas ; Rymer, W. Zev ; Hanson, Nicholas; Fang, Xiang and Joseph A. 2011 Full Text Exp. Brain Res. 209 (4) 609 – 618 Differentiation between the contributions of shortening reaction and stretch-induced inhibition to rigidity in Parkinson’s disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142787/ :
Paresis :
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Paresis
Partial paralysis.
The following references are relevant:-
Chao et al (2007) Surgical Management of Parkinson's Disease: Update and Review
Halett(2011) Psychogenic Parkinsonism
Armstrong et al(2011) Visual Symptoms in Parkinson's Disease
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References
↑ Chao, Y; Gang, L.; Na,Z.L.; Ming, W.Y.; Zhong, W.S. and Mian, W.S. (2007) Full TextInterv. Neuroradiol. 13 (4) 359 – 368 Surgical Management of Parkinson's Disease: Update and Review http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329242/
↑ Hallett, Mark (2011) Full TextJ. Neurol. Sci. 310 (1-2): 163 – 165. Psychogenic Parkinsonism <big.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139799/
↑ Armstrong, R.A. (2011) Full TextParkinsons Dis. 2011 9083006. Visual Symptoms in Parkinson's Diseasehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109513/ :
Postural instability :
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Balance
Susceptibility to falls
Alternative terms
Postural instability---Falls
The following references are relevant:-
King et al (2012) Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease?
Duncan and Earhart (2012) Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease?
Boonsinsukh et al (2012) A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease
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References
↑ King, L.A.; Mancini, M,; Priest, K.; Salarian, A.; Rodrigues-de-Paula, F. and Horak, F. (2012) Full Text J. Neurol. Phys. Ther. 36 (1) 25 – 31 Do clinical scales of balance reflect turning abnormalities in people with Parkinson's disease? http://www.ncbi.nlm.nih.gov/pubmed/22333919
↑ Duncan, Ryan P. And Earhart, Gammon M. (2012) Full Text Parkinsons Dis. 2012 923493 Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503435/A
↑ Boonsinsukh, Rumpa; Saegsirsuwan, Vitoon; Carlson-Kuta, Patricia and Horak, Fay.B. (2012) Full Text Phys. Ther. 92 (9) 1117 – 1129 A Cane Improves Postural Recovery From an Unpracticed Slip During Walking in People With Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432949/ :
Propulsive gait :
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Propulsive gait
When walking, steps become faster and faster with progressively shorter steps that passes from a walking to a running pace
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References :
Resting Tremor :
Redirected to Tremor
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Tremor
Involuntary shaking, trembling or quivering movements of the muscles
The following references are relevant:-
Sanchez-Ramos et al (2011) Quantitative Analysis of Tremors in Welders
Mure et al (2011) Parkinson’s Disease Tremor-Related Metabolic Network: Characterization, Progression, and Treatment Effects
Helmich et al (2012) Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits?
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References
↑ Sanchez-Ramos; Reimer, Dacy; Zesiewiccz, Theresa; Sulliven, Kelly and Nausieda, Paul A.
(201) Full TextInt. J. Environ. Res. Public Health 8 (5) 1478 – 1490 Quantitative Analysis of Tremors in Welders
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108121/
↑ Mure, Hideo; Hirano, Shigeki; Tang, Chris C,; Isias, Ioannis U.;Antonini, Angelo; Ma, Yilong; Dhaan, Vijay and Eidelberg, David (1965) Full TextNeuroimage 54 (2) 1244 – 1253 Parkinson’s Disease Tremor-Related Metabolic Network: Characterization, Progression, and Treatment Effects
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997135/
↑ Helmich, Rick C.; Hallett, Mark; Deuschl, Gunther; Toni, Ivan and Bloem, Bastiaan R. (1965) Full TextBrain 135 (11) 3206 – 3226. Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501966/ :
Restless Legs Syndrome :
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Restless Legs Syndrome
Uncontrollable, involuntary movement of the legs and feet
The following references are relevant:-
Gao et al (2010) Restless Legs Syndrome and Erectile Dysfunction
Gao et al (2010) Restless legs syndrome and Parkinson’s disease in men
Pourcher et al (2010)
Compulsive habits in restless legs syndrome patients under dopaminergic treatment
Peeraully and Tan (2012) Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidence
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802250/
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References
↑ Gao, Xiang; Schwarzchilds, Michael A.: O’Reilly, Eilis J.; Wang, Hao and Ascherio, Alberto (2010) Full TextSleep 33 (1) 75 – 79 Restless Legs Syndrome and Erectile Dysfunction http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802250/
↑ Gao, Xiang; Schwarzschild, Michael A.; O’Reilly, Eilis J.; Wang, Hao and Ascherio, Alberto (2010) Full Text Mov. Disord. 25 (15) 2654 – 2657 Restless legs syndrome and Parkinson’s disease in men http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114885/
↑ Pourcher, E.; Remillard, S. and Cohen, H. (2010) Full TextJ. Neurol. Sci. 290 (1-2) 52 -56 Compulsive habits in restless legs syndrome patients under dopaminergic treatment. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114885/
↑ Peeraully, Tasneem and Tan, Eng-King (2012) Full TextTransl. Neurodegener. 2012; 1: 6. Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidencehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514082/ :
Tachykinesia :
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Tachykinesia
Rapid Movement
The following references are relevant:-
Ellis et al (2011) Which Measures of Physical Function and Motor Impairment Best Predict Quality of Life in Parkinson’s Disease?
Ellis et al (2011) Factors Associated With Exercise Behavior in People With Parkinson Disease
Espay et al(2012) “On” state freezing of gait in Parkinson disease - A paradoxical levodopa-induced complication
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References
↑ Ellia, T.; Cavannaugh, J.T.; Earhart, G.M.; Ford,M.p.; Forrman, K.B. and Dible, l.E., (1999) Full Text Parkinsonism Relat. Disord. 17 (9) 693 – 697. Which Measures of Physical Function and Motor Impairment Best Predict Quality of Life in Parkinson’s Disease? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200468/
↑ Ellis, Terry; Cavanaugh, James T.; Earhart, Gammon M.; Ford, Matthew P.; Foreman, Bo; Fedman, Lisa; Boudreau, Jennifer K. and Dibble, Leland E. (2011) Full Text Phys. Ther. 91 (12) 1838 – 1848 Factors Associated With Exercise Behavior in People With Parkinson Disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229047
↑ Espay, A.J.; Fasano, A.; van Nuenen, A.; Payne, M.M.; Snijders, A.H. and Bloem, B.R. (2012) Full Text Neurology 78 (7) 454 – 457. “On” state freezing of gait – A paradoxical levodopa-induced complication http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466608/ :
Tic :
Redirected to Blepharospasm
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Blepharospasm
Spasm of the eyelid
The following references are relevant:-
Elston (1992) A new variant of blepharospasm
Hallett et al (2008) ..Update on blepharospasm: Report from the BEBRF International Workshop
Armstrong (2011) Visual symptoms in Parkinson's Disease
Further Research
Search the scientific literature
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References
↑ Elston, J.S. (1992) Full Text J. Neurol. Neurosurg. Pstchiatry 55 (5) 369 – 371 A new variant of blepherospasm http://www.microsofttranslator.com/bv.aspx?from=&to=en&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC489077%2F
↑ .Hallett, Mark; Evinger, Craig. Jankovic, Josph and Stacy. Marc (2008) Full text Neurology 71 (16) 1275 – 1282 Update on blepharospasm: Report from the BEBRF International Workshop http://www.microsofttranslator.com/bv.aspx?from=&to=en&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2676990%2F
↑ Armstrong, R,A. (2011) Full Text Parkinsons Dis. 2011 908306 Visual symptoms in Parkinson’s Disease http://www.microsofttranslator.com/bv.aspx?from=&to=en&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3109513%2F :
Torticolls :
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Torticollis
Asymmetric spasm of the neck muscles
The following references are relevant:-
Bronstein and Rudge (1986) Vestibular involvement in spasmodic torticollis
Jahanshah (2000)
Factors that ameliorate or aggravate spasmodic torticollis
Thompson et al (2011) Convergent mechanisms in etiologically-diverse dystonias
Further Research
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Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Torticollis.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
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References
↑ Bronstein, A.M. and Rudge, P. (1986) Full TextJ. Neurol. Neurosurg. Psychiatry 49 (3) 290 – 295 Vestibular involvement in spasmodic torticollis. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1028728/
↑ Jahanshah, M. (2000) Full TextJ. Neurol. Neurosurg. Psychiatry 68 (2) 227 – 229 Factors that ameliorate or aggravate spasmodic torticollis
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736788/
↑ Thompson, Valerie B.; Jinnah, H.A. and Hess, Ellen J.
(2011) Full text Expert Opin. Ther. Targets 15 (12) 1387 – 1403 Convergent mechanisms in etiologically-diverse dystonias http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514401/ :
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