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1.
Zusammenfassung 1. Es wurden Liquores und Seren von 23 Patienten mit Chorea Huntington analysiert. Im Liquor war die Aktivität der GPT erhöht, die Konzentration der BTS vermindert. Die Konzentrationen der Aminosäuren Asp, Glu, Gly, Thr wichen vom normalen Durchschnitt ab. Im Serum waren die Summen der mit Ninhydrin färbbaren Substanzen und die Konzentration der BTS leicht erhöht, die Aktivitäten der Transaminasen waren normal.2. Während der Behandlung von Chorea Huntington-Patienten mit -Methyldopa (3 Patienten) sank im Liquor u. a. die Konzentration von Phe; Im Serum war der Asp- und Glu-Spiegel vermindert, ANH2 und GHN2 erhöht. Die Aktivität der GPT war in Liquor und Serum vermindert. Der Behandlungserfolg war als befriedigend zu bezeichnen.3. Eine Applikation von 1×35 bis 75 mg l-DOPA i.v. (5 Patienten) zeigte, daß die Änderungen des Aminosäurespektrums in Liquor und Serum nicht parallel gingen. Der Effekt war nach 72 Std abgeklungen.
The effect of the administration of amino acids, especially of l-DOPA and -methyldopa, on the composition of cerebrospinal fluid in extrapyramidal syndromesIII. Alterations of cerebrospinal fluid in patients with huntington's chorea after -methyldopa or l-DOPA
Summary 1. Cerebrospinal fluid (CSF) and blood-serum are analysed in 23 patients suffering from Huntington's chorea. The activity of GPT is increased, the concentration of pyruvate is decreased in CSF. The concentrations of the aminoacids Asp, Glu, Gly and Thr are different to normals. In blood-serum the concentrations of ninhydrin reaktive compounds and of pyruvate is slightly increased, the activities of GPT and GOT are in normal range.2. In three patients the concentration of Phe decreased in CSF during therapy with -CH3-DOPA. In blood-serum the concentrations of Asp and Glu decreased, ANH2 and GNH2 increased. The activity of GPT was reduced in CSF as well as in blood-serum. From the clinical point of view the therapy was satisfactory.3. An intravenous injection of 1 × 35 to 75 mg l-DOPA (5 patients) showed, that the pattern of aminoacids in CSF and in blood-serum did not change in the same way. The effect of this application lasted not longer than 72 hrs.

Verzeichnis der Abkürzungen AS Summe aller mit Ninhydrin färbbaren Substanzen - Arg Arginin - Ala Alanin - Asp Asparaginsäure - ANH2 Asparagin - Cys Cystein + Cystin - l-DOPA L-Dihydroxyphenylalanin - Glu Glutaminsäure - GNH2 Glutamin - His Histidin - ILeu Isoleucin - Leu Leucin - Lys Lysin - Met Methionin - Phe Phenylalanin - Ser Serin - Thr Threonin - Tyr Tyrosin - Val Valin - BTS Brenztraubensäure - KGS -Ketoglutarsäure - OES Oxalessigsäure - GOT Glutamat-Oxalacetat-Transaminase - GPT Glutamat-Pyruvat-Transaminase - RNS Ribonucleinsäure - ZNS Zentralnervensystem  相似文献
2.

1. 1. Two hundred and thirty eight patients (144 males, 94 females) on long-acting neuroleptics; mainly fluphenazine decanoate, were surveyed and evaluated for abnormal involuntary movements and associated risk factors.

2. 2. A highly significant correlation was found between the three scales used in the evaluation.

3. 3. The prevalence rate for the transient, acute extrapyramidal syndrome was 37.38%, while that of tardive dyskinesia was 57%. Half of the tardive dyskinesia cases were of minimal severity. Most of these were located in orofacial region.

4. 4. Tardive dyskinesia was more frequent in younger patients but more severe in older age groups. Other associated risk factors were tremors and rigidity, and use of antiparkinsonien drugs.

5. 5. Tardive dyskinesia is a common abnormal involuntary movement in patients on long-acting neuroleptic. Early recognition of TD in this population could help in planning for its prevention by the use of minimum effective dose of medication.

Author Keywords: abnormal involuntary movements; fluphenazine decanoate; long acting neuroleptics; tardive dyskinesia; transient acute extrapyramidal syndrome  相似文献

3.
4.
We report the case of a young man with possible post-traumatic extrapyramidal syndrome. Some features of this case have a bearing on the controversy surrounding the existence of post-traumatic Parkinson disease.
Sommario Si descrive il caso di un giovane paziente affetto da possibile sindrome extrapiramidale post traumatica. Alcune caratteristiche di questo caso rivestono una certa importanza nell'ambito della discussione concernente la possibile esistenza di un Parkinson post traumatico.
  相似文献
5.
We report a 63-year-old woman with a progressive illness which began as a parkinsonian syndrome with bilateral rest tremor, limb rigidity and a gait disorder followed by cognitive decline, visuomotor apraxia and visual agnosia. She died 10 years after the onset of the illness and at autopsy the brain showed characteristic changes of progressive multifocal leukoencephalopathy (PML) with the presence of the JC virus confirmed by in situ hybridisation. Neuropathology also showed some unusual features in the form of atypical linear lesions at the cortico-white matter junction. Some of these lesions were active while others were inactive and similar to the rarely described burnt out lesions of PML. PML can in rare cases occur without an underlying immune disorder or malignancy (primary PML) and a parkinsonian syndrome can be produced by a predominantly white matter disorder.  相似文献
6.
抗精神病药物导致的迟发性锥体外系综合征(TES)由迟发性运动障碍(TD)发展而来。TES分TD、迟发性肌张力障碍(TDT)等多个亚型,以TD最多见。TES的治疗无特效方法,因此预防尤为重要。本研究对上海地区七个精神病医疗单位进行普查,诊断TES113例,并采用病例-对照研究设计,对23个相关因素进行Logistic回归分析,推测TES的危险因子。结果发现,年龄、性别、抗胆碱能药物、用药总时间和目前用药量等五个因素在0.05或0.01水平上对TES的存在有显著意义上的作用。氯氮平、急性锥体外系统综合征还不能肯定为危险因子。  相似文献
7.
Abstract:  Atypical antipsychotics are associated with fewer movement disorders and a lower risk of tardive dyskinesia than conventional antipsychotics, but are not without side-effects. Metabolic side-effects associated with some of the atypical antipsychotics are a concern for both clinicians and patients. Adverse events related to central nervous system effects, weight gain, and alterations in glucose, lipid, and prolactin levels in patients with depression, bipolar, and anxiety disorders have been reported. Balancing the significant benefits of treatment with these agents against the potential risks of metabolic disturbances and other adverse effects is crucial. Emerging data are making it possible to determine the risk–benefit analysis for specific atypical antipsychotics in individual patients and allow for targeted selection of treatment. A new concept of effectiveness is emerging that attempts to balance adverse effects of treatment with patient quality of life. Patients treated with atypical antipsychotics should have their weight, waist circumference, glucose, and lipids monitored on a regular basis. Monitoring of prolactin levels is not suggested; however, a baseline measurement before initiating treatment can be useful, with subsequent assessment only if a patient demonstrates symptoms. Prevention of weight gain is important. Diet and exercise should be considered for prevention and management, with the use of pharmacologic strategies approached with caution in patients with mood disorders. If a patient is at high risk of developing diabetes, certain pharmacologic agents have been shown to delay the onset of overt diabetes. Once diabetes or dyslipidemia are diagnosed, management should proceed in accordance with approved guidelines for these conditions.  相似文献
8.
1病例简介 患者,女,18岁,因“猜疑、耳闻人语4月,加重1周,总病程7年”第2次住院。患者2003年3月起病,表现为猜疑被害,曾在当地医院住院,诊断精神分裂症,予以氯氮平治疗,最高剂量为125mg/d,用药后第4周出现粒细胞下降(白细胞2.7×10^9/L,中性粒细胞1.24×10^9/L),而自动出院。  相似文献
9.
Parkinson's Disease (PD) and Extrapyramidal Syndrome (EPS) are movement disorders that result from degeneration of the dopaminergic input to the striatum and chronic inhibition of striatal dopamine D2 receptors by antipsychotics, respectively. Adenosine A2A receptors are selectively localized in the basal ganglia, primarily in the striatopallidal (“indirect”) pathway, where they appear to operate in concert with D2 receptors and have been suggested to drive striatopallidal output balance. In cases of dopaminergic hypofunction, A2A receptor activation contributes to the overdrive of the indirect pathway. A2A receptor antagonists, therefore, have the potential to restore this inhibitor imbalance. Consequently, A2A receptor antagonists have therapeutic potential in diseases of dopaminergic hypofunction such as PD and EPS. Targeting the A2A receptor may also be a way to avoid the issues associated with direct dopamine agonists. Recently, preladenant was identified as a potent and highly selective A2A receptor antagonist, and has produced a significant improvement in motor function in rodent models of PD. Here we investigate the effects of preladenant in two primate movement disorder models. In MPTP-treated cynomolgus monkeys, preladenant (1 or 3 mg/kg; PO) improved motor ability and did not evoke any dopaminergic-mediated dyskinetic or motor complications. In Cebus apella monkeys with a history of chronic haloperidol treatment, preladenant (0.3–3.0 mg/kg; PO) delayed the onset of EPS symptoms evoked by an acute haloperidol challenge. Collectively, these data support the use of preladenant for the treatment of PD and antipsychotic-induced movement disorders.  相似文献
10.
A number of studies have investigated the effectiveness of the dopamine transporter (SLC6A3) Gene as an antipsychotic target. However, the focus has mainly been on a 40-bp variable number of a tandem repeat (VNTR) in the 3′-region and results have been inconsistent. To fully evaluate SLC6A3 as a therapeutic antipshycotic target we investigated association of the gene with responses to chlorpromazine and clozapine and with chlorpromazine-induced extrapyramidal syndrome (EPS) in the Chinese schizophrenia population. Six polymorphisms across the whole region of this gene were analyzed, namely rs2652511 (T-844C) and rs2975226 (T-71A) in the 5′-regulatory region, rs2963238 (A1491C) in intron 1, a 30-bp VNTR in intron 8, rs27072 and the 40-bp VNTR in the 3′-region. We found that the polymorphic marker, rs2975226, showed significant association of allele and genotype frequencies with response to clozapine (allele-wise: adjusted p = 0.00404; genotype-wise: adjusted p = 0.024), and that patients with the T allele had a better response to the drug. The haplotype block constructed from the first three markers near the 5′-region showed significant association with response to clozapine (for haplotype T-T-A: p = 0.0085; for haplotype C-A-C: p = 0.0092). We did not identify any significant association of the six genetic variants or haplotypes with EPS after Bonferoni correction. Our findings suggest that the 5′-regulatory region of SLC6A3 plays an important role in response to clozapine and that its role in EPS needs to be replicated in a large-scale well designed study.  相似文献
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