Seventy-two children and adolescents with obsessive movements and tics of residual-organic etiology were treated by combined application of benzodiazepins (diazepam, phenazepam), lithium carbonate and haloperidol. The nature of obsessive syndromes and tics is considered in the light of the theory of generator mechanisms of neuropathological syndromes. The use of the studied combination due to its synergic action on the structures of the pathological system elicited a good therapeutic response while using lower doses of each drug (half to two-thirds of the conventional age-specific dosage). Reduction in drug doses in combined therapy decreases the risk of side effects and complications. The above treatment was followed by disappearance of essential and facultative symptoms in 21 patients, considerable improvement with a marked reduction of facultative symptoms in 22 cases, clear-cut improvement in combination with decreased facultative symptomatology in 14 patients, and insignificant improvement in 6 patients.
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Surg Neurol Int
December 2024
Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States.
Neurosurgical operations treat involuntary movement disorders (MvDs), spasticity, cranial neuralgias, cancer pain, and other selected disorders, and implantable neurostimulation or drug delivery devices relieve MvDs, epilepsy, cancer pain, and spasticity. In contrast, studies of surgery or device implantations to treat chronic noncancer pain or mental conditions have not shown consistent evidence of efficacy and safety in formal, randomized, controlled trials. The success of particular operations in a finite set of disorders remains at odds with disconfirming results in others.
View Article and Find Full Text PDFBrain Sci
December 2024
Movement Disorder Unit, Neurology Department, Hospital de Sant Pau, 08041 Barcelona, Spain.
Background/objectives: The treatment of tics and psychiatric comorbidities is crucial when they affect the patient's well-being and relationships. However, the optimal pharmacological treatment (PT) tailored to each patient's phenotype remains unclear. The primary objective of this study is to describe the clinical characteristics and treatment received for tics and psychiatric comorbidities in our cohort of children and adult patients with tic disorders.
View Article and Find Full Text PDFJ Neurosurg
January 2025
1Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
Objective: Deep brain stimulation (DBS) is an effective neurosurgical option for patients with treatment-resistant obsessive-compulsive disorder (OCD). Despite being more costly than neuroablative procedures of comparable efficacy, DBS has gained popularity over the years for its reversibility and adjustability. Although the cost-effectiveness of DBS has been investigated extensively in movement disorders, few economic analyses of DBS for psychiatric disorders exist.
View Article and Find Full Text PDFDev Med Child Neurol
December 2024
Innovative Therapies in Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain.
Aim: To investigate the natural progression of SGCE-associated myoclonus dystonia from symptom onset in childhood to early adulthood.
Method: Myoclonus and dystonia were monitored using rating scales in two cohorts of participants from Spain and the Netherlands. Individual annualized rates of change were calculated and longitudinal trends were assessed using Bayesian mixed models.
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