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Microencephaly in macrocephaly: Rare report of two siblings with glutaric aciduria type 1 小头症中的小头症:罕见的两个兄弟姐妹1型戊二酸尿症报告
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_4_20
Ayush Agarwal, D. Garg, S. Agarwal
Glutaric aciduria type 1 is an autosomal recessive disorder caused by mutations in GCDH gene on chromosome 19 leading to the deficiency of glutaryl-CoA dehydrogenase which causes an abnormal metabolism of lysine, hydroxylysine and tryptophan with resultant accumulation of glutaric acid and 3-hydroxy glutaric acid. Usual presentations include macrocephaly with recurrent dystonic episodes, along with developmental regression. The diagnosis is based on characteristic magnetic resonance imaging finding of widening of sylvian fissures and urinary tandem mass spectroscopic analysis of excess glutarylcarnitine and hydroxyglutaric acid. Management includes lysine-free diet and carnitine supplementation.
1型谷氨酸尿症是一种常染色体隐性遗传疾病,由19号染色体GCDH基因突变引起,导致戊二酰辅酶A脱氢酶缺乏,导致赖氨酸、羟基赖氨酸和色氨酸代谢异常,从而导致戊二酸和3-羟基戊二酸积累。常见的表现包括小头畸形伴反复的肌张力障碍发作,以及发育退化。诊断是基于特征性磁共振成像发现的侧裂加宽和尿中过量戊二酰肉碱和羟基戊二酸的串联质谱分析。管理包括无赖氨酸饮食和补充肉碱。
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引用次数: 0
Impact of sleep quality on cognitive functions in Parkinson’s disease 帕金森病患者睡眠质量对认知功能的影响
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_58_20
Saurav Aggrawal, B. Paul, Gagandeep Singh, R. Bansal
BACKGROUND: Sleep disorders lead to cognitive deficits in healthy people and are thought to have significant impact on cognition in Parkinson’s disease (PD). OBJECTIVE: To study the sleep pattern and its relationship to cognitive functioning in non-demented PD cohort. MATERIALS AND METHODS: Sleep was evaluated by Pittsburg Sleep Quality Index (PSQI) in a cohort of PD patients. Comprehensive assessment of cognitive domains including attention, executive functions, short/long-term verbal memory, visual memory, and visuospatial functioning was done by battery of neuro-physiological tests on patients in “ON” state. Based on the component PSQI sleep score, patients were grouped as having "good quality sleep" (PSQI score ≤ 5) or "poor quality sleep" (PSQI score > 5). The demographic profile, disease characteristics, treatment, and cognitive tests were then compared between the two groups. RESULTS: Of 130 patients with diagnosis of PD, 85 patients were included. 63 (74.1%) had good sleep quality while 22 (25.9%) had poor sleep quality. Mean age and disease characteristic were comparable between two groups except that females had statistically significant (P = 0.001) poor sleep quality as compared to men. Poor sleep quality had significant effect on cognitive functions including generativity, inhibition, set-shifting, perseveration, and attention but there was no impact of sleep on verbal memory, visual memory, and visuospatial abilities. CONCLUSION: PD patients with poor sleep quality on PSQI questionnaire should be carefully screened for presence of any cognitive impairment especially executive impairment, as these two may be inter-related. Intervention to improve sleep would have far reaching benefits to improve the quality of life of PD patients.
背景:睡眠障碍会导致健康人的认知缺陷,并被认为对帕金森病(PD)的认知有重大影响。目的:研究非痴呆PD患者的睡眠模式及其与认知功能的关系。材料和方法:采用匹兹堡睡眠质量指数(PSQI)对帕金森病患者的睡眠进行评估。通过对处于“on”状态的患者进行一系列神经生理测试,对包括注意力、执行功能、短期/长期言语记忆、视觉记忆和视觉空间功能在内的认知领域进行了全面评估。根据PSQI睡眠评分的组成部分,将患者分为“睡眠质量好”(PSQI评分≤5)或“睡眠质量差”(PSQI评分>5)。然后比较两组的人口统计学特征、疾病特征、治疗和认知测试。结果:在130例诊断为帕金森病的患者中,85例被纳入。63人(74.1%)睡眠质量良好,22人(25.9%)睡眠质量差。两组之间的平均年龄和疾病特征具有可比性,除了女性与男性相比睡眠质量差具有统计学意义(P=0.001)。睡眠质量差对认知功能有显著影响,包括生成性、抑制性、定势转换、持续性和注意力,但睡眠对言语记忆、视觉记忆和视觉空间能力没有影响。结论:PSQI问卷中睡眠质量差的PD患者应仔细筛查是否存在任何认知障碍,尤其是执行障碍,因为这两者可能相互关联。改善睡眠的干预措施将对改善帕金森病患者的生活质量产生深远的益处。
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引用次数: 0
Oculopalatal tremor: Illustrative cases with a review of literature 眼腭震颤:附文献回顾的说明性病例
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_31_20
M. Umaiorubahan, S. Meenakshisundaram
Oculopalatal tremor (OPT) is a unique clinical sign characterized by involuntary movements of the soft palate in synchrony with ocular nystagmus, usually the pendular type. It is highly suggestive of and is a delayed complication of a brainstem lesion, often a stroke. The mechanism and clinical implications of OPT are still not fully elucidated and present a treatable complication of brainstem disease. We searched PubMed and Google Scholar for articles with keywords “Oculopalatal tremor.” Most relevant articles were reviewed, based on the number of citations and information was collated by both the authors. We present two cases of OPT which illustrate the clinical spectrum of OPT.
眼腭震颤(OPT)是一种独特的临床症状,其特征是软腭不自主运动与眼球震颤同步,通常为钟摆型。它是脑干病变的一种迟发性并发症,通常是中风。OPT的机制和临床意义尚未完全阐明,是脑干疾病的一种可治疗的并发症。我们在PubMed和b谷歌Scholar上搜索了关键词为“眼腭震颤”的文章。根据引用次数对大多数相关文章进行了审查,并由两位作者对信息进行了整理。我们提出两个病例,说明临床频谱的OPT。
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引用次数: 0
Ophthalmological findings in movement disorders 运动障碍的眼科发现
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_35_20
S. Mehta, A. Takkar, S. Ray, V. Lal
Ocular manifestations form an important clinical component of several movement disorders. Both hypokinetic and hyperkinetic movement disorders can involve the eye. Ophthalmological manifestations can arise due to dysfunction at the level of retina, optic nerves, oculomotor system, or subcortical or visual cortex. Ophthalmological findings help in differentiating various movement disorders and give a clue about their severity. These follow or may precede the diagnosis of movement disorders. Basal ganglia and its various nuclei especially substantia nigra pars reticulata play an important role in the genesis of eye movements through its connections with the superior colliculus. Eye movement abnormalities using quantitative recording techniques are now being considered as noninvasive biomarkers not only for the diagnosis but also to track the progression of disease as well as to study the effects of therapies in various movement disorders. Moreover, there is ample evidence of presence of retinal degeneration in various neurodegenerative diseases evaluated using optical coherence tomography. Various patterns of retinal thinning have been described in different movement disorders and have been found to have a correlation with the stage and severity of the disorder. In this review, we discuss ophthalmological findings of common hypokinetic and hyperkinetic movement disorders.
眼部表现是多种运动障碍的重要临床组成部分。低动力和高动力运动障碍都可能涉及眼睛。眼科表现可能是由于视网膜、视神经、动眼神经系统或皮层下或视觉皮层的功能障碍引起的。眼科研究结果有助于区分各种运动障碍,并为其严重程度提供线索。这些症状发生在运动障碍的诊断之后或之前。基底神经节及其各种细胞核,特别是黑质网状部,通过与上丘的连接,在眼球运动的发生中发挥着重要作用。使用定量记录技术的眼球运动异常现在被认为是非侵入性生物标志物,不仅用于诊断,还用于跟踪疾病进展以及研究各种运动障碍的治疗效果。此外,有充分的证据表明,在使用光学相干断层扫描评估的各种神经退行性疾病中存在视网膜变性。已经在不同的运动障碍中描述了各种类型的视网膜变薄,并发现其与疾病的分期和严重程度有关。在这篇综述中,我们讨论常见的低动力和高动力运动障碍的眼科检查结果。
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引用次数: 0
Neural substrates of psychiatric symptoms in patients with Huntington’s Disease 亨廷顿氏病患者精神症状的神经基础
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_39_20
N. Kamble, J. Saini, L. George, Nikhil Ratna, Amitabh Bhattacharya, R. Yadav, S. Jain, P. Pal
INTRODUCTION: Numerous studies in Huntington’s disease (HD) have shown striatum as the major site of neuronal loss, but recently the presence of neurodegeneration in other regions of the brain is gaining attention. In our study, we used voxel-based morphometry and diffusion tensor imaging to identify other areas in the brain that are involved in the disease. METHODS: The present study is a prospective study conducted in the Departments of Neurology, Psychiatry, and Neuroimaging and Interventional Radiology (NIIR), NIMHANS, Bengaluru. The study included 20 genetically confirmed HD patients and 20 healthy controls. Magnetic resonance imaging was performed on a 3-Tesla Philips Achieva scanner with a 32-channel head coil with the acquisition of whole-brain T1-weighted and DTI. RESULTS: The patients (41.25 ± 10.04 years) and controls (38.27 ± 11.29 years) were age-matched (P = 0.38), and the mean age at the onset of the symptoms of the disease was 37.53 ± 10.11 years, and the expanded CAG repeat allele was 45.95 ± 7.27 (range 40–73) repeats. All patients had psychiatric symptoms at presentation such as anger outbursts, irritability, abusive behavior, apathy, low mood, crying spells, delusions, lack of initiation, and obsessive–compulsive disorder. Compared with controls, HD patients had significant atrophy of bilateral caudate nuclei, right globus pallidus, left culmen, right precuneus, hypothalamus, and right superior temporal gyrus. Fractional anisotropy was increased in bilateral cerebral white matter and thalamus with the reduction in mean diffusivity. CONCLUSIONS: In addition to atrophy of caudate, atrophy was also observed in globus pallidus, thalamus, hypothalamus and right superior temporal gyrus. This may explain the neuropsychiatric and cognitive symptoms observed in these patients.
大量关于亨廷顿氏病(HD)的研究表明纹状体是神经元丢失的主要部位,但最近大脑其他区域的神经退行性变的存在正在引起人们的关注。在我们的研究中,我们使用基于体素的形态测量和扩散张量成像来识别大脑中与该疾病有关的其他区域。方法:本研究是在班加罗尔NIMHANS神经病学、精神病学、神经影像学和介入放射学(NIIR)部门进行的一项前瞻性研究。该研究包括20名基因确诊的HD患者和20名健康对照者。在3特斯拉Philips Achieva扫描仪上使用32通道头线圈进行磁共振成像,获取全脑t1加权和DTI。结果:患者(41.25±10.04岁)与对照组(38.27±11.29岁)年龄匹配(P = 0.38),出现症状的平均年龄为37.53±10.11岁,扩增CAG重复等位基因为45.95±7.27(范围40 ~ 73)个重复。所有患者在就诊时均有精神症状,如愤怒爆发、易怒、虐待行为、冷漠、情绪低落、哭泣、妄想、缺乏启蒙和强迫症。与对照组相比,HD患者的双侧尾状核、右侧苍白球、左侧孔口、右侧楔前叶、下丘脑和右侧颞上回明显萎缩。双侧脑白质和丘脑部分各向异性增加,平均弥漫性降低。结论:除尾状核萎缩外,苍白球、丘脑、下丘脑和右侧颞上回也出现萎缩。这也许可以解释在这些患者中观察到的神经精神和认知症状。
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引用次数: 0
Mineralization of the fascicula nigrale 黑束矿化
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_33_20
S. Prasad, J. Saini, P. Pal
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引用次数: 0
Huntington’s disease: The Indian perspective 亨廷顿舞蹈症:印度人的观点
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_47_20
Srinivasa Raju, P. Kukkle
Understanding of Huntington’s disease (HD) has been evolving since its early descriptions from nineteenth century. Significant breakthroughs into HD pathophysiology and therapeutic targets have been seen in last 50 years. Most of the publications in relation to HD are from European and American continents, indicating geographical higher prevalence. HD in India has been reported since early 1950s in the form of case reports and series, with exception of varying references in ancient Indian literature as “Tandavaroga.” In this review, we have amalgamated the various Indian publications on HD till date.
自19世纪亨廷顿舞蹈症(HD)的早期描述以来,对它的理解一直在发展。在过去的50年里,HD的病理生理学和治疗靶点取得了重大突破。大多数与HD相关的出版物来自欧洲和美国大陆,表明其在地理上的流行率较高。自20世纪50年代初以来,印度的HD一直以病例报告和系列的形式报道,但古印度文献中不同的参考文献“Tandavaroga”除外。在这篇综述中,我们合并了迄今为止关于HD的各种印度出版物。
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引用次数: 0
Cognition, behavior, and pupillary reflex in neurosyphilis-associated movement disorder 神经梅毒相关运动障碍的认知、行为和瞳孔反射
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_61_20
Jamir Pitton Rissardo, A. Caprara
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引用次数: 0
A reversible lentiform nucleus T1 hyperintensity in hypoglycemic chorea 低血糖舞蹈病中可逆的透镜状核T1高强度
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.4103/AOMD.AOMD_40_20
D. Chouksey, Pankaj Rathi, N. Goyal, A. Sodani
Acute to subacute onset chorea is commonly due to stroke, metabolic, post-infectious, and autoimmune disorders. Chorea in diabetes (DM) patient is mostly due to hyperglycemia, and few cases were reported due to hypoglycemia. The mechanism at the cellular level is still evolving. The MRI changes in diabetic chorea patients are variably reported. It is important to discuss our patient with hypoglycemic hemichorea because of unique features like low BMI, recently diagnosed DM on sulphonylurea with a history of hypoglycemic episodes, and acute left hemichorea that was controlled with neuroleptics, and her MRI brain showed reversible lentiform nucleus T1 hyperintensity without diffusion restriction and blooming on SWI.
急性至亚急性发作的舞蹈病通常是由中风、代谢、感染后和自身免疫性疾病引起的。糖尿病(DM)患者的绒毛膜炎主要是由于高血糖引起的,很少有病例是由于低血糖引起的。细胞水平的机制仍在发展。糖尿病舞蹈病患者的MRI变化有不同的报道。重要的是要讨论我们的低血糖性脑脊髓炎患者,因为其独特的特征,如低BMI,最近诊断的磺脲类糖尿病有低血糖发作史,以及用神经抑制剂控制的急性左脑脊髓炎,她的MRI大脑显示可逆的豆状T1核高信号,没有扩散限制,在SWI上开花。
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引用次数: 0
Does quality of sleep differ in familial and sporadic Parkinson’s disease? 家族性和散发性帕金森病患者的睡眠质量不同吗?
Q3 Medicine Pub Date : 2020-09-01 DOI: 10.4103/aomd.aomd_7_20
R. Mahale, R. Yadav, P. Pal
Background: Sleep disturbances are commonly seen in Parkinson’s disease and are often under-recognized and under treated in clinical practice. Objectives: To determine the quality of sleep in patients with familial Parkinson’s disease (PD) and to note any difference from those with sporadic Parkinson’s disease. Methods: One hundred and fifty six patients with Parkinson’s disease (familial PD- 20, sporadic PD-136) were clinically examined and quality of sleep was determined using Pittsburgh sleep quality index (PSQI), Parkinson’s disease Sleep Scale (PDSS) and Epworth Sleep Scale (ESS). Other scales included Unified Parkinson’s Disease Rating Scale -part III (UPDRS-III), Hoehn & Yahr Stage, Mini Mental Status Examination, Hamilton anxiety rating scale and Hamilton depression rating scale. Results: Global PSQI score, percentage of patients with global PSQI score >5, total PDSS score, and percentages of patients with total PDSS scores < 82 was similar in both groups. The total ESS score was higher in sporadic PD as compared to familial PD (p=0.04) and the frequency of patients with total ESS score >10 was greater in sporadic PD (p=0.02). The frequency of insomnia, occurrence of nightmares, involuntary limb movements during sleep and sleep behaviour disrupting sleep continuity was similar in both groups. Conclusions: There was no difference in the sleep quality between familial PD and sporadic PD patients.
背景:睡眠障碍常见于帕金森病,但在临床实践中往往未被充分认识和治疗。目的:确定家族性帕金森病患者(PD)的睡眠质量,并注意与散发性帕金森病患者的差异。方法:对156例帕金森病患者(家族性PD- 20,散发性PD-136)进行临床检查,采用匹兹堡睡眠质量指数(PSQI)、帕金森病睡眠量表(PDSS)和Epworth睡眠量表(ESS)测定其睡眠质量。其他量表包括统一帕金森病评定量表-第三部分(UPDRS-III)、Hoehn & Yahr分期、迷你精神状态检查、汉密尔顿焦虑评定量表和汉密尔顿抑郁评定量表。结果:两组总体PSQI评分、总体PSQI评分为bb50分的患者百分比、总PDSS评分、总PDSS评分< 82分的患者百分比相似。散发性PD患者ESS总分高于家族性PD患者(p=0.04),散发性PD患者ESS总分bbb10的发生率高于家族性PD患者(p=0.02)。失眠的频率,噩梦的发生,睡眠中不自主的肢体运动和睡眠行为破坏睡眠连续性在两组中是相似的。结论:家族性帕金森病患者与散发性帕金森病患者的睡眠质量无显著差异。
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引用次数: 0
期刊
Annals of Movement Disorders
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