Subthalamic deep brain stimulation versus best medical treatment: a 12-year follow-up.

Purpose: Electrical stimulation of the sub-thalamic nucleus (STN-DBS) is well established to alleviate motor fluctuations in advanced Parkinson's disease but little is known about its very long-term efficacy.

Methods: We followed over 12 years 15 parkinsonian patients having undergone STN-DBS and compared them to a matched group of 14 patients with best medical drug therapy. All had been considered as good candidates for surgery.

Dye-Sensitized Cu2 XSnS4 (X=Zn, Ni, Fe, Co, and Mn) Nanofibers for Efficient Photocatalytic Hydrogen Evolution.

The photocatalytic hydrogen evolution activities of low-cost and noble-metal-free Cu2 XSnS4 (X=Zn, Ni, Fe, Co, and Mn) nanofiber catalysts have been investigated using triethanolamine as an electron donor and eosin Y as a photosensitizer under visible-light irradiation. The rates of hydrogen evolution by Cu2 XSnS4 (X=Zn, Ni, Fe, Co, and Mn) nanofibers have been compared with each other and with that of the noble metal Pt. The hydrogen evolution rates for the nanofibers change in the order Cu2 NiSnS4 >Cu2 FeSnS4 >Cu2 CoSnS4 >Cu2 ZnSnS4 >Cu2 MnSnS4 (2028, 1870, 1926, 1420, and 389 μmol g(-1) h(-1) , respectively).

Mitochondrial encephalomyopathy with cytochrome c oxidase deficiency caused by a novel mutation in the MTCO1 gene.

Cytochrome c oxidase (COX) deficiency is one of the most common respiratory chain deficiencies. A woman was presented at the age of 18y with acute loss of consciousness, non-convulsive status epilepticus, slow neurological deterioration, transient cortical blindness, exercise intolerance, muscle weakness, hearing loss, cataract and cognitive decline. Muscle biopsy revealed ragged-red fibers, COX negative fibers and a significant decreased activity of complex IV in a homogenate.

Chorea associated with anti-phospholipid antibodies: case report.

A seventeen year-old boy developed left sided chorea in a few days, subsequently involving the four limbs. Although he presented a marfanoid phenotype, genetic analysis of the Fibrillin 1 was normal. The genes for familial chorea and Huntington's disease were also negative.

Epidemiology of major depression in Belgian parkinsonian patients.

Background: Epidemiological data concerning the prevalence of major depression in PD patients in Belgium is very scarce.

Methods: A total of 1086 patients with idiopathic Parkinsons disease were included in the analysis. The neurological evaluation of the patients was made by the Hoehn and Yahr Staging of Parkinsons disease, the Unified Parkinson Disease Rating Scale (UPDRS), and the Schwab and England Activities of Daily Living.

Table tennis dystonia.

Focal task-specific dystonia (FTSD) occurs exclusively during a specific activity that usually involves a highly skilled movement. Classical FTSD dystonias include writer's cramp and musician's dystonia. Few cases of sport-related dystonia have been reported.

Treatments for progressing Parkinson's disease: a clinical case scenario study.

Objective: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts.

Methods: The opinions of 9 experts in movement disorders on the appropriateness of 9 common pharmacological treatments for 33 hypothetical patient profiles were compared to those of 14 general neurologists. Before rating the case scenarios, all participants received a document integrating European and US guidelines for the treatment of patients with advanced PD.

The cost effectiveness of 123I-FP-CIT SPECT imaging in patients with an uncertain clinical diagnosis of parkinsonism.

Purpose: (123)I-N-omega-fluoropropyl-2-beta-carboxymethoxy-3beta-(4-iodophenyl)nortropane ((123)I-FP-CIT) Single-photon emission computed tomography (SPECT) has been suggested to be a useful diagnostic adjunct in patients with clinically uncertain parkinsonism. We developed a pharmaco-economic (PE) model, evaluating the cost effectiveness of adding (123)I-FP-CIT SPECT to the diagnostic workup. As the model was developed before application of the diagnostic technique in real practice, a predictive validity assessment was performed based on data from a large nationwide patient registry in these patients.

[Gilles de la Tourette syndrome: a self-administered assessment questionnaire].

Introduction: An association of patients with Gilles de la Tourette syndrome enabled us to gather a large body of information regarding the disease manifestations, and patient-perceived consequences.

Method: 350 questionnaires were sent to patients belonging to the AFSGT (French Association of Patients Suffering from Gilles de la Tourette Syndrome). 187 responses were received (53 percent).

Atypical propriospinal myoclonus with possible relationship to alpha interferon therapy.

We report on a man who received interferon-alpha 2a therapy for kidney cancer and who subsequently developed propriospinal myoclonus. The myoclonus was noted at rest and during movement. The jerks were reinforced by cutaneous stimuli and tendon taps and spread to the spinal cord via polysynaptic propriospinal pathways.

[Myoclonus].

Myoclonus (myos: muscles and klonos: agitation. jerk) reflect some dysfunction of the central nervous system. Their multiform clinical presentations correlate to various physiopathological mechanisms and neuropharmacological substrates, still imprecisely known.

Development of circulatory and metabolic shock following transient portal triad occlusion.

Liver ischemia is purposefully induced by portal triad occlusion (PTO) in several clinical situations including liver surgery for trauma, tumor, and transplantation. Despite significant morbidity from PTO, the hemodynamic and metabolic effects of PTO have not been evaluated relative to duration of ischemia. We investigated this using a total hepatic ischemia model.

A new model for inducing total hepatic ischemia while preventing circulatory collapse secondary to splanchnic vascular congestion.

Animal models used to study liver ischemia are limited by the lethal effect of splanchnic venous engorgement from portal triad occlusion (PTO). We compared a passive porto-systemic shunt (PSS) to a pump-driven PSS. The passive and pumped PSS groups (n = 6) received 60 min of PTO followed by 2 h of reperfusion.

Bitoric rigid contact lens with prism fitting in rare cases of moderate corneal and residual astigmatism.

We reviewed all records of bitoric rigid gas permeable (RGP) contact lenses with prism ballast fittings performed at Tulane University Hospital and affiliated clinics from 1985 to 1993. We found eight eyes of six patients fit were fit with this lens, which is indicated for the patient with a moderately astigmatic cornea in addition to residual refractive astigmatism. In this design, a small amount of prism is added to a standard bitoric design to achieve rotational stability.

Pars plana vitrectomy for complications of retinal arterial macroaneurysms--a case series.

Retinal arterial macroaneurysms are distinct vascular lesions with a typically benign course. Laser treatment to these vascular lesions is controversial, and has been limited to cases of persistent macular edema. Devastating vision loss can occur, however, through vitreous or subretinal hemorrhage.

Sustained-release levodopa in parkinsonian patients with nocturnal disabilities.

It is now well recognized that poor quality of sleep, with fragmentation as the main characteristic, is a common problem in patients with Parkinson's disease. The effect of a sustained-release levodopa compound (Prolopa HBS) was assessed in a long-term (12 months) study of 15 patients presenting with distressing night time symptoms prolopa HBS was administered only ante noctem, without changing the usual daytime treatment. It appeared that alleviation of nighttime akinesia, reflected by the ability to turn around in bed, was perceived as the most worthwhile improvement.

Neuro-ophthalmological findings in closed head trauma.

Visual abnormalities following closed head trauma are common and can affect any part of the visual pathway. We reviewed 181 consecutive patients referred with visual complaints following closed head trauma. A motor vehicle accident was the most common etiology of trauma in 57% of cases, direct trauma to the head in 15%, and injuries sustained from a fall in 13%.

Exteroceptive reflex myoclonus: clinical and electrophysiological study.

Clinical and electrophysiological data are reported on two patients presenting with unusual reflex myoclonus triggered specifically by exteroceptive stimulation.

[From movements to tics: neurophysiologic aspects].

The definition and classification of tics is still based on clinical data. Furthermore, in Gilles de la Tourette syndrome, organogenetic and psychogenetic determinants are still opposed and the true automatic involuntary nature of tics is still debated. Neurophysiological assessments can provide objective data, useful in analysing the physiopathology of tics.

[Clinical study of pergolide in Parkinson's disease].

Pergolide is thought to stimulate both D1 and D2 dopaminergic receptors. Its effects on Parkinson's disease were evaluated in an open trial, using clinical assessment scales and objective tests. Nine patients had previously been treated with L-dopa, but the drug had either gradually lost its effectiveness or produced invalidating side-effects.

Painful legs and moving toes: a syndrome with different physiopathologic mechanisms.

Six patients with the syndrome of "painful legs and moving toes" were studied. Although clinical differences were nonspecific, the EMG disclosed two subgroups: one with a simple, erratic pattern of spontaneous activities in foot and leg muscles, and the other with a complex alternating pattern in antagonistic muscles. In the first group, the physiopathologic mechanism is thought to act in the periphery: in the lumbar roots when local anesthesia of the posterior tibial nerve suppresses spontaneous discharges, or in the nerve trunk when it is ineffective.