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Krygier M, Talaśka-Liczbik W, Zawadzka M, Mazurkiewicz-Bełdzińska M. Hyperkinetic movement disorder in FBXO28-related developmental and epileptic encephalopathy. Seizure 2024; 119:1-2. [PMID: 38728953 DOI: 10.1016/j.seizure.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Affiliation(s)
- Magdalena Krygier
- Department of Developmental Neurology, Medical University of Gdansk, ul. Debinki 7, Gdansk 80-952, Poland.
| | - Weronika Talaśka-Liczbik
- Department of Developmental Neurology, Medical University of Gdansk, ul. Debinki 7, Gdansk 80-952, Poland
| | - Marta Zawadzka
- Department of Developmental Neurology, Medical University of Gdansk, ul. Debinki 7, Gdansk 80-952, Poland
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Friedman-Korn T, Weill C, Ben-Haim S, Arkadir D. Delayed levodopa-responsive parkinsonism following acute midbrain injury. J Neurol Sci 2024; 459:122983. [PMID: 38574438 DOI: 10.1016/j.jns.2024.122983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/26/2024] [Accepted: 03/31/2024] [Indexed: 04/06/2024]
Abstract
Acute midbrain injury may cause both hyperkinetic movement disorders and parkinsonism. The temporal interval between the insult and the emergence of hyperkinetic disorders can last years. A delayed appearance of parkinsonism, on the other hand, was rarely described. We present three cases of male patients (50-, 58- and 28-year-old) who developed levodopa-responsive parkinsonism 20, 8 and two years, respectively, after acute brain insult involving the midbrain. Insults included subcortical intracerebral hemorrhage dissecting into the midbrain, embolic basilar occlusion and trauma. A fluorodopa scan, performed in two cases, revealed reduced striatal uptake. All individuals improved on low doses of levodopa and developed motor fluctuations shortly after levodopa was introduced. We conclude that delayed, levodopa-responsive parkinsonism following midbrain injury should be recognized in the relevant clinical setup. Possible mechanisms include age-related loss of dopaminergic neurons superimposed on acute injury and secondary neurodegeneration.
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Affiliation(s)
- Tali Friedman-Korn
- Department of Neurology, Hadassah Medical Center and the Faculty of Medicine, The Hebrew University, Jerusalem, Israel.
| | - Caroline Weill
- Department of Neurology, Hadassah Medical Center and the Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Simona Ben-Haim
- Department of Nuclear Medicine, Hadassah Medical Center and the Faculty of Medicine, The Hebrew University, Jerusalem, Israel; University College London, London, UK
| | - David Arkadir
- Department of Neurology, Hadassah Medical Center and the Faculty of Medicine, The Hebrew University, Jerusalem, Israel
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Koul R, Maiwall R, Sarin SK, Bhatia V, Deshmukh A, Kumar C, Khajuria R, Rudra OS, Papneja S, Kantale P, Pamecha V. Unusual Facial Movements (Ictal Blinking, Oculogyric Crises, and Jaw Seizure) in Severe Liver Disease: A Case Series. J Clin Exp Hepatol 2023; 13:1149-1155. [PMID: 37975048 PMCID: PMC10643264 DOI: 10.1016/j.jceh.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/10/2023] [Indexed: 11/19/2023] Open
Abstract
Background Seizures are reported in about one-third of patients with severe liver disease in association with acute or chronic liver failure. The majority of the seizures are of focal type. Occasionally generalized tonic-clonic seizures are seen when there is ethanol withdrawal. Not much is known about ictal blinking (IB) in severe liver disease. IB is the rare form of seizures and was reported in severe liver disease recently from this institute. Oculogyric crisis (OGC) is rarely reported in relation to the severe liver disease. OGC was also noted first time in our intensive care unit. Methods At the Institute of Liver and Biliary Sciences (ILBS), data on patients with IB and OGC were analyzed from October 2018 to January 2023 (52 months). All the patients had video electroencephalograph (video-EEG) recording after proper permission/consent. The patients were followed up later for the course of the illness. Results A total of 16 (12M:4F) patients were seen. Majority 12 (75%) were IB and 3 OGC. EEG was abnormal in nine (75.0%) of IB patients. Brain imaging had nonspecific findings. The outcome was based on the severity and recovery of the underlying liver disease. Conclusions Unusual facial movements in the form of IB and OGC are reported, which are most of the time missed. This report highlights the importance of recognition of these events and proper in time management to improve the outcome.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Shiv K. Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Vikram Bhatia
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Akhil Deshmukh
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Chandan Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Rahul Khajuria
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Omkar S. Rudra
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Sangam Papneja
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Priyanka Kantale
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Vineyndra Pamecha
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
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Yogi TN, Bhusal A, Limbu S, B.C. P, labh S, Kafle R. Olanzapine-induced oculogyric crisis in a patient with mania without psychotic symptoms: a case report. Ann Med Surg (Lond) 2023; 85:5255-5258. [PMID: 37811096 PMCID: PMC10553192 DOI: 10.1097/ms9.0000000000001262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/23/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction and importance Oculogyric crisis (OGC), marked by upward eye deviation, is rare and linked to diverse causes, including drugs and neurological conditions. This study details a 16-year-old male's OGC onset after olanzapine treatment for an initial mania episode, highlighting the need to recognize this potential side effect. Case presentation A 16-year-old male with nonpsychotic mania was treated with olanzapine and sodium valproate. On day 30, he developed OCG due to olanzapine, managed with medication. After discharge, similar ocular symptoms emerged. Gradual olanzapine tapering alongside anticholinergic administration led to symptom relief. The Young Mania Rating Scale score decreased; psychoeducation was provided to the patient and family. Discussion This study presents an exceptional case of olanzapine-induced OGC, a rare dystonic eye movement reaction. The patient's presentation matched OGC criteria, confirmed by a high Adverse Drug Reaction Probability Scale score. Unusually, symptoms appeared 30 days postolanzapine initiation. A thorough assessment ruled out alternative causes. Mechanisms, possibly related to dopamine-choline balance and receptor sensitivity, remain uncertain. Despite atypical antipsychotics' lower risk, olanzapine's moderate D2 receptor binding led to this unusual response. Management involved dose reduction and anticholinergic therapy. Conclusion This case report highlights the rare occurrence of olanzapine-induced OCG in a patient with nonpsychotic mania. Effective management requires proper history taking, examination, regular follow-up, monitoring, and appropriate medication use. The case demonstrates the need for caution when increasing olanzapine dose in manic patients with untreated mental illness and a history of neurological symptoms.
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Affiliation(s)
- Tek N. Yogi
- Department of Psychiatry, MD, BP Koirala Institute of Health Sciences (BPKIHS), Nepal
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Kim T, Ha SH, Yoo D, Park KS, Ahn TB. A Novel Variant of GCH1 in Dopa-Responsive Dystonia With Oculogyric Crises and Intrafamilial Phenotypic Heterogeneity. J Mov Disord 2023; 16:339-342. [PMID: 37482672 PMCID: PMC10548081 DOI: 10.14802/jmd.23085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 07/25/2023] Open
Affiliation(s)
- Taewoo Kim
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Su Hyeon Ha
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Dallah Yoo
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Kyung Sun Park
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
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Oculogyric crisis induced by risperidone in a child with GRIN1 variant. BRAIN DISORDERS 2023. [DOI: 10.1016/j.dscb.2023.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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Oculogyric Crisis after Initiation of Aripiprazole: A Case Report of an Active Duty Service Member. Case Rep Psychiatry 2023; 2023:9440028. [PMID: 36660180 PMCID: PMC9845035 DOI: 10.1155/2023/9440028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Oculogyric crisis is an acute dystonic reaction characterized by sustained, bilateral, and upward deviation of the eyes. It is a relatively uncommon extrapyramidal side effect of antipsychotic medications. Aripiprazole is an atypical antipsychotic that is FDA-approved for the treatment of schizophrenia, bipolar disorder, Tourette's disorder, and treatment resistant major depressive disorder. Compared to other antipsychotics, it is thought to have a lower propensity for causing dystonic side effects. Clinical Case. This case report is of a 19-year-old male who was psychiatrically hospitalized for first episode psychosis and initiated on low-dose oral aripiprazole. Three days after initiation of the medication, the patient was found to be markedly anxious and pacing around his room. Exam was notable for intermittent upward eye rolling, sustained upward conjugate gaze, and limited downward gaze. No other facial dyskinetic movements were observed. Treatment. The patient's oral aripiprazole was held, and he was administered 50 mg of oral diphenhydramine with improvement in symptoms within one hour. Ocular symptoms, dizziness, frontal headache, and pacing were resolved the following morning. He declined reinitiation of an antipsychotic medication. Conclusion Aripiprazole-induced acute dystonia, specifically OGC, is a rare potential adverse effect of aripiprazole. Risk factors include male gender, young age, use of typical antipsychotics, and initiation or uptitration of an antipsychotic. Even though atypical antipsychotics including aripiprazole are associated with lower risk for extrapyramidal symptoms, the possibility of oculogyric dystonia merits close monitoring especially in young, male, and drug naive patients. Anticholinergic agents such as diphenhydramine can treat symptoms of acute dystonia.
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ERTEKİN H, GÜMÜŞ BA. A case of metoclopramide-induced oculogyric crisis in a schizophrenic patient under anticholinergic therapy. FAMILY PRACTICE AND PALLIATIVE CARE 2022. [DOI: 10.22391/fppc.1031963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: Oculogyric crisis (OGC) is a dystonic reaction characterized as conjugate and typically upward deviation of the eyes lasting from seconds to hours which is seen as an uncommon neurologic manifestation. Metoclopramide is a prokinetic agent that is frequently prescribed in the treatment of nausea, vomiting prophylaxis, and vomiting. One of the side effects after metoclopramide treatment is acute dystonic reactions.Case Presentation: We report a case of metoclopramide-induced OGC despite the anticholinergic treatment in patient diagnosed with schizophrenia.Conclusions: Metoclopramide-induced OGC and other acute dystonic reactions may be more frequent than expected. Therefore, clinicians should monitor patients closely during treatment with metoclopramide and necessary precautions should be taken for these reactions.Keywords: Metoclopramide, oculogyric crisis, side effect, schizophrenia
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Affiliation(s)
- Hülya ERTEKİN
- Department of Psychiatry, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale
| | - Begüm Aygen GÜMÜŞ
- Department of Psychiatry, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale
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Dahl KL, Gjerdalen OS, Heramb C, Gardsjord ES. A woman in her 20s with delusions, hallucinations and dystonic eye movements. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2022; 142:21-0787. [DOI: 10.4045/tidsskr.21.0787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Lin J, Li C, Shang H. Teaching Video NeuroImage: Oculogyric Crises in a 12-Year-Old Girl With Rapid-Onset Dystonia Parkinsonism. Neurology 2022; 98:990-991. [PMID: 35483898 DOI: 10.1212/wnl.0000000000200584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/08/2022] [Indexed: 02/05/2023] Open
Affiliation(s)
- Junyu Lin
- From the Department of Neurology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Chunyu Li
- From the Department of Neurology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Huifang Shang
- From the Department of Neurology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Baizabal-Carvallo JF, Jankovic J. The clinical phenomenology and correlations of oculogyric tics. Acta Neurol Belg 2022; 122:925-930. [PMID: 35397742 DOI: 10.1007/s13760-022-01944-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oculogyric tics are identified in a substantial proportion of patients with Tourette syndrome (TS) and related tic-disorders. Nevertheless, studies assessing its frequency and clinical correlations are lacking. MATERIALS AND METHODS We reviewed video-recordings and clinical history of 201 patients with TS and chronic motor/phonic tic disorder, diagnosed according to DSM-5. RESULTS Oculogyric tics presented in 22.4% of our patients. Transient upward gaze was the most common phenomenology in patients with simple oculogyric tics; whereas eye-closure followed by upward and lateral deviations was the most commonly observed phenomenon in patients with combined oculogyric tics. Oculogyric tics have a median duration of 799 ms (range 299-34,500 ms). Patients with oculogyric tics were younger (P = 0.023) and had a higher frequency of cranial tics (P = 0.037) compared to those without oculogyric tics. No differences in tic severity, frequency of attention-deficit/hyperactivity disorder, obsessive-compulsive disorder or use of dopamine receptor antagonists were observed in patients with and without oculogyric tics. CONCLUSIONS Oculogyric tics are a common phenomenology in chronic tic disorders. They are more common in younger patients with TS and are markers of other cranial tics, but not of TS severity or comorbid neuropsychiatric syndromes.
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Affiliation(s)
- José Fidel Baizabal-Carvallo
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
- Department of Sciences and Engineering, University of Guanajuato, Ave León 428, Jardines del Moral, CP 37320, León, Guanajuato, Mexico.
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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Olszewska DA, Shetty R, Geetha TS, Ramprasad VL, Lang AE, Prashanth L. Oculogyric crisis phenotype of levodopa‐induced ocular dyskinesia. Mov Disord Clin Pract 2022; 9:390-393. [PMID: 36989007 PMCID: PMC8974885 DOI: 10.1002/mdc3.13416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/04/2021] [Accepted: 01/22/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Diana A. Olszewska
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital Toronto Ontario Canada
| | | | | | | | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital Toronto Ontario Canada
| | - L.K. Prashanth
- Center for Parkinson’s Disease and Movement Disorders Clinic, Vikram Hospital (Unit of Manipal Hospitals) Bangalore India
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Aripiprazole-Induced Oculogyric Crisis: A Pediatric Case Series and A Brief Narrative Review. CHILDREN 2021; 9:children9010022. [PMID: 35053647 PMCID: PMC8774535 DOI: 10.3390/children9010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/19/2021] [Accepted: 12/28/2021] [Indexed: 11/17/2022]
Abstract
Oculogyric crisis (OGC) represent an unusual type of dystonic movement disorder, usually reported as an adverse event of antipsychotic drugs, with acute or tardive onset, likely due to a functional disruption of dopaminergic neurotransmission. It is seldom reported in children with aripiprazole, an atypical antipsychotic commonly used in youths. In this manuscript, we report on a case series of three pediatric patients and provide a brief narrative review of the literature, in order to increase the awareness of clinicians and to foster future research in this area.
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Méneret A, Garcin B, Frismand S, Lannuzel A, Mariani LL, Roze E. Treatable Hyperkinetic Movement Disorders Not to Be Missed. Front Neurol 2021; 12:659805. [PMID: 34925200 PMCID: PMC8671871 DOI: 10.3389/fneur.2021.659805] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/27/2021] [Indexed: 12/13/2022] Open
Abstract
Hyperkinetic movement disorders are characterized by the presence of abnormal involuntary movements, comprising most notably dystonia, chorea, myoclonus, and tremor. Possible causes are numerous, including autoimmune disorders, infections of the central nervous system, metabolic disturbances, genetic diseases, drug-related causes and functional disorders, making the diagnostic process difficult for clinicians. Some diagnoses may be delayed without serious consequences, but diagnosis delays may prove detrimental in treatable disorders, ranging from functional disabilities, as in dopa-responsive dystonia, to death, as in Whipple's disease. In this review, we focus on treatable disorders that may present with prominent hyperkinetic movement disorders.
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Affiliation(s)
- Aurélie Méneret
- Département de Neurologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Béatrice Garcin
- Service de Neurologie, Hôpital Avicenne, APHP, Bobigny, France
| | - Solène Frismand
- Département de Neurologie, Hôpital universitaire de Nancy, Nancy, France
| | - Annie Lannuzel
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
- Département de Neurologie, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France
- Faculté de Médecine, Université Des Antilles, Pointe-à-Pitre, France
- Centre D'investigation Clinique Antilles Guyane, Pointe-à-Pitre, France
| | - Louise-Laure Mariani
- Département de Neurologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Emmanuel Roze
- Département de Neurologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
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Levodopa-Induced Ocular Dyskinesia in an Early-Onset Parkinson Disease Patient With GBA Mutation. Clin Neuropharmacol 2021; 44:201-204. [PMID: 34654015 PMCID: PMC8594500 DOI: 10.1097/wnf.0000000000000484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Supplemental digital content is available in the text. Objectives The aim of this study was to report a case of levodopa-induced ocular dyskinesia in an early-onset Parkinson disease patient and to investigate the pathogenic gene. Methods We report the case of a 49-year-old male patient with a 13-year history of Parkinson disease. Involuntary eye movements were noticed after treatment with amantadine for limb dyskinesias. Levodopa-induced ocular dyskinesias involving repetitive, transient, and stereotyped rightward deviations of gaze appeared after intake of an antiparkinsonian drug. Limb dyskinesias also occurred simultaneously. We used a next-generation sequencing targeted gene panel and found a heterozygous missense mutation (p.R535H) in GBA. Direct Sanger sequencing verified the missense mutation. Conclusions We report the case of an uncommon early-onset PD patient carrying a GBA mutation presenting ocular dyskinesia. Genetic screening may provide a better mechanistic insight into dyskinesias.
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Abstract
OBJECTIVES Oculogyric crisis is a dystonic movement disorder characterized by continuous contraction of the ocular muscles and spasmodic movements of the pupils in a fixed position, usually upward. METHODS In this case report, an early-stage acute oculogyric crisis due to low-dose olanzapine in a 15-year-old adolescent boy is presented. RESULTS To the best of our knowledge, this is the first report showing that acute oculogyric crisis can develop with low-dose olanzapine administration. CONCLUSIONS Even though second-generation antipsychotics are safer than conventional antipsychotics in terms of extrapyramidal adverse effects, this possibility should always be taken into consideration through this case report.
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Desai K, Agrawal S, Walzade P, Ravat SH, Agarwal PA. Atypical, Early-Onset Dystonia-Parkinsonism with Oculogyric Crises and Anterior Horn Cell Disorder Due to a Novel DJ-1 Mutation. Mov Disord Clin Pract 2021; 8:S16-S18. [PMID: 34514038 DOI: 10.1002/mdc3.13282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/01/2021] [Accepted: 02/26/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Karan Desai
- Department of Neurology Seth GS Medical College and KEM Hospital Mumbai India
| | - Shruti Agrawal
- Department of Neurology Seth GS Medical College and KEM Hospital Mumbai India
| | - Priyanka Walzade
- Department of Neurology Seth GS Medical College and KEM Hospital Mumbai India
| | - Sangeeta H Ravat
- Department of Neurology Seth GS Medical College and KEM Hospital Mumbai India
| | - Pankaj A Agarwal
- Department of Neurology Seth GS Medical College and KEM Hospital Mumbai India.,Movement Disorders Clinic, Department of Neurology Global Hospitals Mumbai India
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Reich SG, Desai K, Agrawal S, Walzade P, Ravat S, Agarwal PA, Espay AJ. Commentary: Atypical, Early-Onset Dystonia-Parkinsonism with Oculogyric Crises and Anterior Horn Cell Disorder due to a Novel DJ-1 Mutation. Mov Disord Clin Pract 2021; 8:S19-S20. [PMID: 34514039 PMCID: PMC8414507 DOI: 10.1002/mdc3.13296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/30/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Stephen G. Reich
- The University of Maryland School of MedicineBaltimoreMarylandUSA
| | - Karan Desai
- Department of NeurologySeth GS Medical College and KEM HospitalMumbaiIndia
| | - Shruti Agrawal
- Department of NeurologySeth GS Medical College and KEM HospitalMumbaiIndia
| | - Priyanka Walzade
- Department of NeurologySeth GS Medical College and KEM HospitalMumbaiIndia
| | - Sangeeta Ravat
- Department of NeurologySeth GS Medical College and KEM HospitalMumbaiIndia
- Department of NeurologyGlobal HospitalsMumbaiIndia
| | - Pankaj A. Agarwal
- Department of NeurologySeth GS Medical College and KEM HospitalMumbaiIndia
- Department of NeurologyGlobal HospitalsMumbaiIndia
- Movement Disorders ClinicGlobal HospitalsMumbaiIndia
| | - Alberto J. Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of NeurologyUniversity of CincinnatiCincinnatiOhioUSA
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Amponsah EK, Sodnom-Ish B, Anyetei-Anum AS, Frimpong P, Kim SM. Adverse reaction to Coartem (artemether/lumefantrine) resulting in oculogyric crisis. Maxillofac Plast Reconstr Surg 2021; 43:13. [PMID: 34013443 PMCID: PMC8134644 DOI: 10.1186/s40902-021-00300-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Artemether/lumefantrine (AL), sold under the brand name Coartem, is the most common artemisinin-based combination therapy for the treatment of malaria. Drug-induced oculogyric crisis is a neurological disorder characterized by frequent upward deviations of the eye. In the literature, no cases of Coartem-induced oculogyric crisis have been reported in Ghana. CASE PRESENTATION A 19-year-old male patient, who presented fever measuring 37.9 °C, general body pains, and weakness was prescribed with antimalarial therapy artemether/lumefantrine, Coartem®, from a local pharmacy. Just after initiation of treatment, the patient complained of double vision, involuntary upward eye deviation, and inability to close both eyes. The patient was diagnosed with Coartem-induced oculogyric crisis and was treated with the cessation of the causing agent and intramuscular injection of promethazine hydrochloride. CONCLUSIONS When a patient exhibits a neurological disorder, such as oculogyric crisis, with normal conscious state and normal vital signs, special attention should be given to obtaining a history of recently administered medications. Clinicians should recognize adverse reactions to drugs based on a thorough patient history and examination. The goal of this report was to present Coartem-induced oculogyric crisis.
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Affiliation(s)
- Emmanuel Kofi Amponsah
- Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Brong Ahafo Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo, Ghana
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Aaron Sowah Anyetei-Anum
- Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Brong Ahafo Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo, Ghana
| | - Paul Frimpong
- Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Brong Ahafo Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo, Ghana
| | - Soung Min Kim
- Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Brong Ahafo Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo, Ghana. .,Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Badenoch J, Searle T, Watson I, Cavanna AE. Tics in patients with encephalitis. Neurol Sci 2021; 42:1311-1323. [PMID: 33486621 PMCID: PMC7955972 DOI: 10.1007/s10072-021-05065-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/15/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Movement disorders have been described in the context of different types of encephalitis. Among hyperkinetic manifestations, tics have sporadically been reported in cases of encephalitis resulting from a range of aetiologies. OBJECTIVE This review aimed to assess the prevalence and characteristics of tics in patients with encephalitis. METHODS We conducted a systematic literature review of original studies on the major scientific databases, according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS In addition to the established association between tics and encephalitis lethargica, our literature search identified reports of tics in patients with immune-mediated pathologies (including autoimmune encephalitides affecting the N-methyl-D-aspartate receptor, voltage-gated potassium channels, and glycine receptors) and infective processes (ranging from relatively common viral pathogens, such as herpes simplex, to prions, as in Creutzfeldt-Jakob disease). Tics were most commonly reported in the post-encephalitic period and involvement of the basal ganglia was frequently observed. DISCUSSION The association of new-onset tics and encephalitis, in the background of other neuropsychiatric abnormalities, has practical implications, potentially improving the detection of encephalitis based on clinical features. Future research should focus on the categorisation and treatment of hyperkinetic movement disorders associated with encephalitis.
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Affiliation(s)
- James Badenoch
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK
| | - Tamara Searle
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK
| | - Iona Watson
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK
| | - Andrea E Cavanna
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK.
- School of Life and Health Sciences, Aston University, Birmingham, UK.
- University College London and Institute of Neurology, London, UK.
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Abstract
BACKGROUND Oculogyric crisis (OGC) is a form of acute dystonia characterized by sustained dystonic, conjugate, and upward deviation of the eyes. It was initially reported in patients with postencephalitic parkinsonism. But later, other factors such as medications, movement disorders, metabolic disorders, and focal brain lesions were also found to be associated with OGC. METHODS The literature regarding OGC was searched via PubMed, Google Scholar, and through citations in relevant articles till December 2019, with keywords including OGC, oculogyric eye movements, tonic eye movement, neuroleptics and OGC, antipsychotics and OGC, and all combinations of these. Only original articles (abstract or full text) that were published in the English language were reviewed. RESULTS Hypodopaminergic state is implicated in the pathogenesis of OGC. Common risk factors are younger age, male sex, severe illness, high neuroleptic dose, parenteral administration of neuroleptics, high potency of neuroleptic drugs, abrupt discontinuation of anticholinergic medication, and family history of dystonia. CONCLUSION OGC is an acute dystonic reaction leading to tonic upward deviation of eyes. It is associated with various neurometabolic, neurodegenerative, and movement disorders and medications such as antipsychotics, antiemetics, antidepressants, antiepileptics, and antimalarials. OGC can adversely impact the compliance and prognosis of the primary illness. Hence, it needs to be managed at earlier stages with appropriate medication, primarily anticholinergics.
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Affiliation(s)
- Pankaj Mahal
- Dept. of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Navratan Suthar
- Dept. of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Naresh Nebhinani
- Dept. of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Wilson A, Filatov A, Azhar M, Swerdloff M, Husain Wilson S. Ziprasidone-Induced Oculogyric Crisis in a 74-Year-Old Female. Cureus 2020; 12:e9100. [PMID: 32789046 PMCID: PMC7417033 DOI: 10.7759/cureus.9100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Oculogyric crisis is a rare ocular dystonia first appearing at the turn of the last century in postencephalitic patients. In the modern era, they were most frequently associated with first-generation D1 dopaminergic receptor blocking antipsychotic medication. We present an unusual case of acute oculogyric crisis in a 74-year-old woman with long-standing Parkinson disease following exposure to the second-generation neuroleptic ziprasidone, which has dopaminergic (D2) and serotoninergic (5-HT2A) receptor blocking effects and is used for severe delusions and psychosis. To the best of our knowledge, there are no other published reports.
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Liuzzo K, Stutzman D, Murphy J. Olanzapine-Induced Withdrawal Oculogyric Crisis in an Adolescent With a Neurodevelopmental Disorder. J Pediatr Pharmacol Ther 2020; 25:455-458. [DOI: 10.5863/1551-6776-25.5.455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This case report describes an adolescent female with a complex psychiatric history and Fragile X syndrome who developed an antipsychotic-withdrawal emergent oculogyric crisis (OGC) in approximately 12 hours following reduction in olanzapine dose from 20 mg total daily dose to 5 mg twice daily. The team concluded that the OGC was likely related to olanzapine withdrawal based on the following clinical factors: 1) prior treatment with olanzapine 20 mg for 4 to 5 days/week for several months, without such reaction; 2) proximity of the OGC to the olanzapine dose reduction (within 12 hours); and 3) lack of recurrence with olanzapine dose increase. Additionally, her neurodevelopmental disorder and age were identified as risk factors for an acute dystonic reaction. Published case reports describe withdrawal emergent dystonia, including OGC, following abrupt discontinuation of clozapine in adults. Given structural similarities of clozapine and olanzapine it can be postulated that this phenomenon is based in muscarinic receptor function—specifically, super-sensitized muscarinic receptors may react to excessive acetylcholine upon antipsychotic discontinuation, resulting in muscle motor end plate hyperactivity. Providers caring for pediatric patients with neurodevelopmental disorders should carefully consider risks for withdrawal emergent dystonia, obtain clear medication histories, and consider slow, conservative tapers when discontinuing antipsychotics.
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Clinical and Genetic Overview of Paroxysmal Movement Disorders and Episodic Ataxias. Int J Mol Sci 2020; 21:ijms21103603. [PMID: 32443735 PMCID: PMC7279391 DOI: 10.3390/ijms21103603] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022] Open
Abstract
Paroxysmal movement disorders (PMDs) are rare neurological diseases typically manifesting with intermittent attacks of abnormal involuntary movements. Two main categories of PMDs are recognized based on the phenomenology: Paroxysmal dyskinesias (PxDs) are characterized by transient episodes hyperkinetic movement disorders, while attacks of cerebellar dysfunction are the hallmark of episodic ataxias (EAs). From an etiological point of view, both primary (genetic) and secondary (acquired) causes of PMDs are known. Recognition and diagnosis of PMDs is based on personal and familial medical history, physical examination, detailed reconstruction of ictal phenomenology, neuroimaging, and genetic analysis. Neurophysiological or laboratory tests are reserved for selected cases. Genetic knowledge of PMDs has been largely incremented by the advent of next generation sequencing (NGS) methodologies. The wide number of genes involved in the pathogenesis of PMDs reflects a high complexity of molecular bases of neurotransmission in cerebellar and basal ganglia circuits. In consideration of the broad genetic and phenotypic heterogeneity, a NGS approach by targeted panel for movement disorders, clinical or whole exome sequencing should be preferred, whenever possible, to a single gene approach, in order to increase diagnostic rate. This review is focused on clinical and genetic features of PMDs with the aim to (1) help clinicians to recognize, diagnose and treat patients with PMDs as well as to (2) provide an overview of genes and molecular mechanisms underlying these intriguing neurogenetic disorders.
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Balint B, Stephen CD, Udani V, Sankhla CS, Barad NH, Lang AE, Bhatia KP. Paroxysmal Asymmetric Dystonic Arm Posturing-A Less Recognized but Characteristic Manifestation of ATP1A3-related disease. Mov Disord Clin Pract 2019; 6:312-315. [PMID: 31061839 DOI: 10.1002/mdc3.12747] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 02/03/2023] Open
Abstract
Background ATP1A3 mutations cause a wide clinical spectrum, and are one of the "commoner rare diseases". Methods Case series of four patients with ATP1A3 mutations. Results The patients displayed characteristic episodes of dystonic arm posturing, involving a dystonic, flexed arm held in front of the body or close to the body, but with the hand raised upwards. Other attacks manifested with arm extension, either beside the body or reaching upwards. Dystonic posturing occurred paroxysmally, with no neurological signs between attacks, or combined with other signs like chorea, ataxia, and hypotonia. Conclusions While previous diagnostic criteria have not included paroxysmal or episodic dystonia, recent expert consensus has proposed to include alternating or paroxysmal dystonia as major feature calling for ATP1A3 genetic testing. Attacks of marked arm flexion posturing, either paroxysmal or as episodic exacerbation of mild pre-existent dystonia, are a characteristic clue to ATP1A3-related disease.
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Affiliation(s)
- Bettina Balint
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Neurology University Hospital Heidelberg Heidelberg Germany
| | - Christopher D Stephen
- Movement Disorders Unit, Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
| | | | | | | | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital - UHN, Division of Neurology University of Toronto Toronto Ontario Canada
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
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Rohani M, Shahidi G, Vali F, Lang AE, Slow E, Gahl WA, Behnam B. Oculogyric crises in PLA2G6 associated neurodegeneration. Parkinsonism Relat Disord 2018; 52:111-112. [PMID: 29574084 DOI: 10.1016/j.parkreldis.2018.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/27/2018] [Accepted: 03/13/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Mohammad Rohani
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamali Shahidi
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Vali
- Department of Medical Genetics and Molecular Biology, Iran University of Medical Sciences, Tehran, Iran
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada
| | - Elizabeth Slow
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada
| | - William A Gahl
- Medical Genetics Branch, National Human Genome Research Institute (NHGRI), Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Babak Behnam
- Department of Medical Genetics and Molecular Biology, Iran University of Medical Sciences, Tehran, Iran; Medical Genetics Branch, National Human Genome Research Institute (NHGRI), Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
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Davis JL, Kurek JA, Morgan JC, Sethi KD. Teaching Video NeuroImages: Oculogyric crisis in treated Parkinson disease. Neurology 2018; 90:e263. [DOI: 10.1212/wnl.0000000000004816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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