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  • 1
    ISSN: 1432-0533
    Keywords: Post-encephalitic parkinsonian syndrome (PEPS) ; Idiopathic Parkinson's disease (PD) ; Substantia nigra ; Age ; I-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 12 cases of post-encephalitic parkinsonian syndrome (PEPS) starting at a mean age of 25.1 years, the mean disease duration of 35.8 years was twice as long as in 12 young patients with Lewy body-Parkinson's disease (LB-PD), whose disease started at a mean age of 39.9 years (mean duration 16.5 years). In PEPS the rate of progression of disease was extremely slow. The groups were of a similar age at death, but the post-encephalitic cases had 70% fewer cells in the substantia nigra than in idiopathic Parkinson's disease (PD) and 92% fewer than in controls. Nigra cell destruction was not found in PEPS, but active cell breakdown and abundant extraneuronal melanin were present in PD. A second group of 12 LB-PD cases with mean onset at 58.9 years survived for a mean of 10.1 years, but the number of remaining substantia nigra cells was the same as in the young onset cases of PD. This clinical and pathological evidence does not support the notion that progression of disease in PD can be attributed to the superadded effects of normal ageing on top of a primary acute noxious insult sustained in earlier life.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1459
    Keywords: Cervical dystonia ; Hand spasms ; Laryngeal dystonia ; Botulinum toxin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary One hundred and twenty-six patients with different forms of focal dystonia (89 with cervical dystonia, 12 with hand cramps and 25 with laryngeal dystonia) were treated with localised injections of botulinum toxin. Mean doses per muscle were 200 mouse units (m.u.) for treating cervical dystonia, 40–120 m.u. for forearm muscles in writers' cramp and 3.7 m. u. for the thyroarytenoid muscle in laryngeal dystonia. Responder rates have been above 80% in all patient groups and beneficial effects could be reproduced over follow-up periods of up to 4 years. The commonest side-effects were dysphagia after treatment of spasmodic torticollis, weakness of neighbouring muscles after injections for hand cramps and breathiness and hypophonia following laryngeal injections. All these were transient and generally well tolerated. It is concluded that botulinum toxin injections are a safe and effective treatment in all three types of focal dystonia.
    Type of Medium: Electronic Resource
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