Restless legs syndrome as side effect of second generation antidepressants.

Although of clinical interest, the question is still not fully answered whether antidepressants (AD) can cause or exacerbate restless legs syndrome (RLS). The literature provides contradictory information. This study addresses this problem for the class of second generation AD.

Effects of intravenous opioids on eye movements in humans: possible mechanisms.

Oculomotor symptoms such as downbeat nystagmus can be due to side effects of drugs. We investigated the clinical effects as well as the eye movement symptoms after intravenous administration of opiates (pethidine and fentanyl). Eye movements were recorded with the magnetic search coil technique.

[Valproic acid in prophylaxis of bipolar disorder. A case of valproate-induced encephalopathy].

A 28-year-old patient with a 5-year history of bipolar disorder developed signs of encephalopathy 2 weeks after the addition of valproic acid to his treatment regimen of doxepine, risperidone, and biperidene. The clinical signs were drowsiness, ataxic gait, asterixis, and a generalized epileptic seizure. Discontinuation of valproic acid gradually resulted in complete remission of these symptoms.

Intermittent claudication due to ischaemia of the lumbosacral plexus.

The distinct clinical syndrome of exercise induced ischaemia of the lumbosacral plexus is not a widely known cause for intermittent claudication. Eight patients with the mentioned syndrome were investigated clinically, neurophysiologically, and with imaging techniques. The clinical examination showed a typical exercise induced sequence of symptoms: pain, paraesthesia, and sensory and motor deficits.

Trigeminal neuralgia triggered by auditory stimuli in multiple sclerosis.

Objectives: To describe a patient with a demyelinating brainstem lesion who developed right-sided trigeminal neuralgia triggered by auditory stimuli and to discuss the pathophysiological mechanisms underlying this unusual phenomenon.

Design: Case report.

Setting: Referral center.

[Radiogenic amyotrophy. Cauda equina lesion as a late radiation sequela].

Purpose: Course and pathophysiology of a typical syndrome after irradiation of the cauda equina were studied.

Patients And Materials: 7 patients with irradiation damage of the cauda equina were examined clinically and neurophysiologically.

Results: After a mean delay of 5 years and 6 months all patients developed an ascending lower motor neuron weakness of the legs without pain, in part accompanied with mild sensory and sphincter symptoms.

Properties of horizontal saccades accompanied by blinks.

Using the magnetic search coil technique to record eye and lid movements, we investigated the effect of voluntary blinks on horizontal saccades in five normal human subjects. The main goal of the study was to determine whether changes in the dynamics of saccades with blinks could be accounted for by a superposition of the eye movements induced by blinks as subjects fixated a stationary target and saccadic movements made without a blink. First, subjects made voluntary blinks as they fixed on stationary targets located straight ahead or 20 degrees to the right or left.

Transforming sensory perceptions into motor commands: evidence from programming of eye movements.

The visual stimulus for a saccadic eye movement is encoded in place-coded maps in cerebral cortex and the dorsal superior colliculus. In contrast, the motor command for the saccade is encoded by the temporal discharge properties of ocular motoneurons and premotor burst neurons in the brain-stem reticular formation. Thus, there is need for a spatial-temporal transformation of neural signals, and recent findings suggest that the superior colliculus might contribute to this process.

Evidence for independent feedback control of horizontal and vertical saccades from Niemann-Pick type C disease.

We measured the eye movements of three sisters with Niemann-Pick type C disease who had a selective defect of vertical saccades, which were slow and hypometric. Horizontal saccades, and horizontal and vertical pursuit and vestibular eye movements were similar to control subjects. The initial movement of oblique saccades was mainly horizontal and most of the vertical component occurred after the horizontal component ended; this resulted in strongly curved trajectories.

A double-blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus.

We conducted a double-blind crossover trial comparing gabapentin (up to 900 mg/day) to baclofen (up to 30 mg/day) as therapy for acquired nystagmus in 21 patients. We measured visual acuity and the nystagmus before, and at the end of, 2 weeks on each medication. For a group of 15 patients with acquired pendular nystagmus (APN), visual acuity improved significantly with gabapentin, but not with baclofen.

Torsional eye movements in patients with skew deviation and spasmodic torticollis: responses to static and dynamic head roll.

We measured torsional eye movements induced by sinusoidal rotation or static tilt, of the head in roll while viewing a far or near target in 4 patients with skew deviation due to brainstem lesions, 4 patients with spasmodic torticollis (ST), 2 patients with unilateral eighth nerve section (VIIIS), and 10 normal subjects. Torsional nystagmus was present in all 4 patients with skew deviation. In subjects and patients, responses to both sinusoidal and static roll were larger while viewing the far target, consistent with factors dictated by geometry.

Quantitative measurements of eye movements in a patient with Tullio phenomenon.

The Tullio phenomenon consists of vestibular symptoms on exposure to high-intensity acoustic stimuli, reflecting pathological stimulation of semicircular canals or otoliths. We report a patient with posttraumatic Tullio phenomenon to illustrate how precise measurement of eye movements during auditory stimulation, using the magnetic search coil technique, may characterize movements that are not clinically apparent or easily measured by other means. Such measurements in patients with surgically verified lesions may further elucidate the mechanisms responsible for this phenomenon.

Dysfunction of pontine omnipause neurons causes impaired fixation: macrosaccadic oscillations with a unilateral pontine lesion.

Macrosaccadic oscillations of eyes (MSO) are regarded as a form of saccadic dysmetria secondary to cerebellar dysfunction. They are usually conjugate, horizontal, and symmetric in both directions of gaze. Using magnetic search coils, we studied a patient with MSO that developed five years following head injury and involved synchronously horizontal, vertical, and torsional planes.

A pilot study of gabapentin as treatment for acquired nystagmus.

The effects of the anticonvulsant gabapentin were measured on vision and eve movements in three patients with acquired pendular nystagmus. In two patients, the nystagmus was associated with multiple sclerosis and, in the other, it followed brainstem stroke. A single oral 600 mg dose of gabapentin produced improvement of vision due to changes in ocular oscillations in all three patients.

Dynamic properties of horizontal and vertical eye movements in parkinsonian syndromes.

We studied dynamic properties of horizontal, vertical, and oblique eye movements in 23 patients with the following parkinsonian syndromes: idiopathic parkinsonism (PD), multiple system atrophy (MSA), pure akinesia (PA), progressive supranuclear palsy (PSP), and cortical-basal ganglionic degeneration (CBGD). Compared with age-matched controls, only PSP patients showed slowing of saccades. Patients in all groups showed saccadic hypometria that was most marked vertically.

Normal and pathological saccadic dysmetria.

Initial saccades to visual targets are generally not precise in either normal subjects or patients with saccadic dysmetria. Quantitative criteria have to be applied to clearly distinguish between normal and pathological saccadic dysmetria, which is often found in patients with cerebellar lesions. To establish these criteria, the accuracy of visually guided horizontal saccades (10 degrees and 20 degrees target steps) was studied in a group of 24 patients with lesions affecting the cerebellum or its connections, and compared with data from 17 normal subjects.