Adherence to treatment in Parkinson's disease: A multicenter exploratory study with patients from six Latin American countries.

Background: Adherence to treatment in Parkinson's disease (PD) is compromised due to the need for multiple therapies, comorbidities related to aging, and the complexity of therapeutic schemes. In the present study, we aimed to explore adherence to treatment in groups of PD patients from six Latin-American (LA) countries and identify its associated demographic and clinical parameters.

Methods: A multicenter, cross-sectional, exploratory study was conducted from September 2016 to March 2017.

Lewy bodies in the olfactory system and the hypothalamus.

Lewy bodies are intraneuronal eosinophilic cytoplasmic inclusions, and their presence in the specific areas of the central nervous system defines the so-called Lewy body disorders such as Parkinson's disease and dementia with Lewy bodies. The protein alpha-synuclein is the major component of Lewy bodies and there is evidence suggesting that it is capable of spreading from cell to cell within the central nervous system thereby propagating the pathological process. The olfactory system, particularly the olfactory bulb, is almost always affected in Parkinson's disease and dementia with Lewy bodies.

Weight Loss in Parkinson's Disease: The Relationship with Motor Symptoms and Disease Progression.

Objectives: To determine the prevalence of weight loss (WL) in PD patients, its relationship to the severity of motor manifestations and appetite changes.

Methods: 144 PD patients and 120 controls were evaluated in a single session. All subjects were asked about changes in body weight and appetite.

Holmes tremor: Clinical description, lesion localization, and treatment in a series of 29 cases.

Objective: To describe the clinical features, etiology, findings from neuroimaging, and treatment results in a series of 29 patients with Holmes tremor (HT).

Methods: A retrospective study was performed based on review of medical records and videos of patients with HT diagnosis.

Results: A total of 16 women and 13 men were included.

Writing tremor secondary to ischemic stroke: a report on a case with a remarkable response to topiramate.

Unlabelled: Writing tremor (WT) is a task-specific tremor that occurs only or mostly while writing with the dominant hand. Secondary cases are extremely uncommon. We report on a patient who, after developing a WT after an ischemic stroke, had a remarkable response to topiramate (TPM).

Piribedil and pathological gambling in six parkinsonian patients.

Unlabelled: Impulse control disorders (ICD) in Parkinson's disease (PD) have attracted increasing interest. They are characterized by the inability to control the impulse to perform an act that can be detrimental to them or to others. Although dopamine agonists (DA), as a group, have been associated with impulse control disorders (ICD), piribedil has rarely been reported to cause them.

Gastrointestinal manifestations in Parkinson's disease: prevalence and occurrence before motor symptoms.

To assess the prevalence of gastrointestinal symptoms (GIS) in Parkinson's disease (PD) compared to control subjects and their timing of appearance in relationship to the onset of motor symptoms. There is a rostrocaudal gradient of alpha-synuclein (α-SYN) neuropathology in the enteric nervous system at early stages of PD with higher burden in the upper than the lower gut. However, only constipation has been recognized as a premotor gastrointestinal manifestation of PD.

Dry mouth: an overlooked autonomic symptom of Parkinson's disease.

There is involvement of salivary glands by α-synuclein pathology in PD. However, the prevalence of dry mouth has not been systematically assessed in these patients. We studied 97 PD patients and 86 controls using a structured questionnaire.

Use of complementary and alternative therapies in outpatients with Parkinson's disease in Argentina.

We interviewed 300 patients (54.7% male; mean age was 65.8 ± 9.

Micro lesion effect of the globus pallidus internus and outcome with deep brain stimulation in patients with Parkinson disease and dystonia.

To determine whether the immediate response to electrode implantation (micro lesion effect, MLE) in the internal segment of the globus pallidus (GPi) predicts symptom improvement with deep brain stimulation (DBS) at 6 months in patients with Parkinson's disease (PD) or generalized dystonia. Electrode implantation in the subthalamic nucleus (STN) prior to electrical stimulation has been reported to predict a beneficial effect of DBS in patients with PD, but whether this is also the case for the GPi in either PD or dystonia patients has not been established. We studied 20 patients (11 with PD and 9 with dystonia) who underwent electrode implantation in the GPi.

Neuroacanthocytosis and carbamazepine responsive paroxysmal dyskinesias.

Neuroacanthocytosis (NA) comprises a genetically heterogeneous group of disorders characterized by dysfunction of the erythrocyte membrane, presenting with acanthocytes and several neurological manifestations. We report the case of a 42-year-old woman with NA who in addition had episodes consistent with paroxysmal dyskinesias. She was diagnosed with NA featuring mild chorea, weakness of the right lower extremity and myoclonic jerks.

Pallidal surgery for the treatment of primary generalized dystonia: long-term follow-up.

Objective: To describe the results and long-term follow-up after functional surgery of the internal segment of the globus pallidus (GPi) in 10 patients with primary generalized dystonia.

Patients And Methods: Nine of the 10 patients were positive for the DYT1 gene mutation. Bilateral deep brain stimulation (DBS) of the GPi was performed in three cases, bilateral pallidotomy in two, and combined surgery (unilateral GPi lesion with contralateral stimulation) in the remaining five.

Posterior spinal cord stimulation in a case of painful legs and moving toes.

A 59-year-old woman with a 5-year history of right lower limb pain is reported. Symptoms developed initially when walking and progressively became bilateral, appeared at rest and involuntary movements of the toes became evident. A diagnosis of painful legs and moving toes was made.

Holmes tremor secondary to brainstem hemorrhage responsive to levodopa: report of 2 cases.

We report 2 patients who presented a brainstem hemorrhage and who, after 1 and 6 months, respectively, developed a 4-Hz postural and resting tremor consistent with Holmes tremor, which severely interfered with the activities of daily living. In both cases, levodopa dramatically improved the tremor. Pharmacological treatment of this condition is usually disappointing, and surgical procedures are commonly required for severe cases.

Bilateral STN-DBS fails to improve non-motor fluctuations in a PD patient.

We report the case of a 60-year-old woman with Parkinson's disease and severe motor fluctuations. During OFF periods she presented both motor and non-motor symptoms, which ameliorated rapidly after each levodopa dose. After undergoing bilateral STN DBS, motor complications improved markedly while non-motor symptoms remained unchanged.

Vascular hemichorea/hemiballism and topiramate.

Although vascular hemichorea/hemiballism (HC/HB) has been reported to be self-limited, in some cases, it can be irreversible and severely disabling. The standard treatment includes typical and atypical neuroleptics and GABA-mimetic drugs. Topiramate is a new antiepileptic drug possessing a complex mechanism of action, including the enhancement of GABA-mediated inhibition.

Low doses of topiramate are effective in essential tremor: a report of three cases.

We here report on 3 patients with essential tremor, otherwise unresponsive to pharmacological treatment, who greatly benefited from low doses of topiramate (50 mg/d). No side effects were observed and improvement was sustained during a mean of 7 months (range 3-12 months) follow up. Our results suggest that topiramate titration should be performed gradually, so as not to neglect cases responsive to low doses.

Parkinsonism as a manifestation of multiple sclerosis.

We describe a 48-year-old patient, with a diagnosis of relapsing-remitting multiple sclerosis, who presented to our service with a parkinsonian syndrome that markedly improved after corticosteroid treatment. To the best of our knowledge, only 12 cases of parkinsonism have been reported from 1970 to the present, of which only 8 seemed secondary to MS, i.e.

Quetiapine and essential tremor.

The safety and tolerability of quetiapine (up to 75 mg/day) as monotherapy on essential tremor were investigated in an open-label study in 10 patients. Five men and 5 women, with a mean age of 66.3 years, affected by essential tremor participated in the trial.

Beneficial effects of botulinum toxin type a for patients with painful tic convulsif.

Botulinum toxin is a well-known therapy for patients with diverse movement disorders. Its application has been extended to other disorders. Here, we document the case of a 70-year-old man with hemifacial spasm associated to trigeminal neuralgia secondary to an ectatic basilar artery.