1
|
Arabia G, De Martino A, Moro E. Sex and gender differences in movement disorders: Parkinson's disease, essential tremor, dystonia and chorea. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 164:101-128. [PMID: 36038202 DOI: 10.1016/bs.irn.2022.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sex and gender-based differences in epidemiology, clinical features and therapeutical responses are emerging in several movement disorders, even though they are still not widely recognized. In this chapter, we summarize the most relevant evidence concerning these differences in Parkinson's disease, essential tremor, dystonia and chorea. Indeed, both sex-related biological (hormonal levels fluctuations) and gender-related variables (socio-cultural and environmental factors) may differently impact symptoms manifestation and severity, phenotype and disease progression of movement disorders on men and women. Moreover, sex differences in treatment responses should be taken into account in any therapeutical planning. Physicians need to be aware of these major differences between men and women that will eventually have a major impact on better tailoring prevention, treatment, or even delaying progression of the most common movement disorders.
Collapse
Affiliation(s)
- Gennarina Arabia
- Magna Graecia University, Movement Disorders Center, Neurology Unit, Catanzaro, Italy.
| | - Antonio De Martino
- Magna Graecia University, Movement Disorders Center, Neurology Unit, Catanzaro, Italy
| | - Elena Moro
- Grenoble Alpes University, CHU of Grenoble, Division of Neurology, Grenoble Institute of Neurosciences, Grenoble, France
| |
Collapse
|
2
|
Abstract
Movement disorders in women during pregnancy are uncommon. Therefore, high quality studies are limited, and guidelines are lacking for the treatment of movement disorders in pregnancy, thus posing a significant therapeutic challenge for the treating physicians. In this chapter, we discuss movement disorders that arise during pregnancy and the preexisting movement disorders during pregnancy. Common conditions encountered in pregnancy include but are not limited to restless legs syndrome, chorea gravidarum, Parkinson disease, essential tremor, and Huntington disease as well as more rare movement disorders (Wilson's disease, dystonia, etc.). This chapter summarizes the published literature on movement disorders and pharmacologic and surgical considerations for neurologists and physicians in other specialties caring for patients who are pregnant or considering pregnancy.
Collapse
Affiliation(s)
- Fang Ba
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Janis M Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
3
|
Li W, Tang M. Application of botulinum toxin in pregnancy and its impact on female reproductive health. Expert Opin Drug Saf 2019; 19:83-91. [PMID: 31868020 DOI: 10.1080/14740338.2020.1707803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction: Botulinum toxin (BoNT) is a protein secreted by the anaerobic Gram-negative bacterium Clostridium botulinum. Among the seven known subtypes, type A is the most commonly used in women to treat diseases. It primarily blocks presynaptic release of acetylcholine at the neuromuscular junction, resulting in temporary muscle paralysis; thus, it is suitable for treating dystonia and other systemic diseases. BoNT is used widely for treating diseases that persist throughout, and may worsen during, pregnancy, such as cervical dystonia and achalasia. Thus, it is important to investigate whether BoNT injection during pregnancy causes side effects in pregnant women, fetuses, or newborns.Areas covered: This review highlights the efficiency and safety of BoNT injection in pregnancy. and assessed current literature with respect to the use of BoNT for disease treatment during pregnancy.Expert opinion: BoNT injection does not increase the risk of complications in pregnant women and fetuses. However, the use of BoNT to treat disease during pregnancy requires fully informed consent from patients. In addition, further research is needed to determine how to reduce the side effects of BoNT injection during pregnancy (e.g., by improving drug composition, or adjusting the amount of BoNT or the injection interval).
Collapse
Affiliation(s)
- Wu Li
- Gynecology Department, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, P.R. China
| | - Min Tang
- Neurology Department, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R. China
| |
Collapse
|
4
|
Palacios E, Navas ÁV. Movimientos anormales y embarazo. REPERTORIO DE MEDICINA Y CIRUGÍA 2016. [DOI: 10.1016/j.reper.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
5
|
Affiliation(s)
- Bradley J Robottom
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | | |
Collapse
|
6
|
Michelotti A, Silva R, Paduano S, Cimino R, Farella M. Oromandibular dystonia and hormonal factors: twelve years follow-up of a case report. J Oral Rehabil 2009; 36:916-21. [PMID: 19840357 DOI: 10.1111/j.1365-2842.2009.02007.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Oromandibular dystonia (OMD) is a focal neurological movement disorder characterized by involuntary sustained and often painful muscle contraction, usually producing repetitive movements or abnormal positions of the mouth, jaw and/or tongue. We report on a 30-year-old woman affected with OMD with a 12-year follow-up. Focal dystonia involved an involuntary activity of the lateral pterygoid muscles causing forceful jaw displacement in the maximal protrusive position. These episodes initially occurred during jaw function and increased up to an open-lock with bilateral pre-auricular pain. Dystonic spasms were absent during sleep and were reduced temporarily by sensory tricks. Treatment with botulinum toxin type A (BTX) was performed during three different sessions over a 1-year period. Electromyographic-guided BTX injections into the lateral pterygoid muscles were given with cannula electrodes. Botox reduced the involuntary activity of the muscles. Recurrence and exacerbation of dystonic symptoms occurred during the two pregnancies and completely disappeared immediately after both deliveries with prolonged symptom-free periods. During the last 8 years, the patient had a slight relapse of symptoms during flu attacks, periods of stress and during menses. The temporal pattern of these symptoms indicates a possible relationship between OMD and hormonal factors.
Collapse
Affiliation(s)
- A Michelotti
- Department of Oral, Dental and Maxillo-Facial Sciences, Section of Orthodontics and Clinical Gnathology University of Naples Federico II, I-80131, Naples, Italy.
| | | | | | | | | |
Collapse
|
7
|
Malaty IA, Lansang MC, Okun MS. NEUROENDOCRINOLOGIC CONSIDERATIONS IN PARKINSON DISEASE AND OTHER MOVEMENT DISORDERS. Continuum (Minneap Minn) 2009. [DOI: 10.1212/01.con.0000300028.61027.6f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
8
|
Sinha A, Hartsilver E. Anaesthesia for caesarean section in a patient with dopa-responsive dystonia or Segawa’s syndrome. Int J Obstet Anesth 2009; 18:67-72. [DOI: 10.1016/j.ijoa.2008.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 06/21/2008] [Accepted: 07/01/2008] [Indexed: 11/15/2022]
|
9
|
Affiliation(s)
- Susan M Rubin
- Women's Neurology Center, Glenbrook Hospital, Glenview, Illinois, USA
| |
Collapse
|
10
|
Fasano A, Elia AE, Guidubaldi A, Tonali PA, Bentivoglio AR. Dystonia gravidarum: A new case with a long follow-up. Mov Disord 2007; 22:564-6. [PMID: 17260334 DOI: 10.1002/mds.21310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We report a case of cervical dystonia occurring in a 33-year-old without personal history of movement disorder but with family history of essential tremor, primigravid, primiparous woman at 1 weeks' amenorrhea, resolved completely after delivery in the course of 3 months. Dystonia never recurred in the following 5 years. Several neurological disorders are known to occur or worsen during pregnancy. As far as we know, this is the second reported case of dystonia occurring during pregnancy, thus confirming that dystonia gravidarum represents a new entity and should be considered in women of reproductive age affected by dystonia, especially when presenting with rapid-onset cervical dystonia.
Collapse
Affiliation(s)
- Alfonso Fasano
- Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | | | | | | | | |
Collapse
|
11
|
Sener EB, Kocamanoglu S, Ustun E, Tur A. Anesthetic management for cesarean delivery in a woman with Gilles de la Tourette’s syndrome. Int J Obstet Anesth 2006; 15:163-5. [PMID: 16434179 DOI: 10.1016/j.ijoa.2005.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2005] [Revised: 07/01/2005] [Accepted: 07/01/2005] [Indexed: 11/22/2022]
Abstract
Gilles de la Tourette's syndrome is a chronic neuropsychiatric disorder with an early childhood onset featuring mainly motor and vocal tics. We present the anesthetic management for cesarean delivery of a 21-year-old pregnant woman with Tourette's syndrome. She had shrugging of the shoulders and sudden, jerky, repetitive, irregular movements of the hands. General anesthesia was given for cesarean delivery. A live male infant weighing 3130 g was delivered. Her perioperative course was uneventful. No complication was observed. The patient and baby were discharged on the 4th postoperative day. It was decided to prescribe haloperidol 5 mg per day after lactation. Anesthesiologists should remember that there are special considerations when managing anesthesia in patients with Tourette's syndrome. The motor tics may lead to technical difficulty in performing regional anesthesia and surgery. Therefore general anesthesia may be appropriate in order to prevent agitation or involuntary movements. If patient movement and agitation can be controlled by sedation, regional block may be attempted. Drugs such as metoclopramide, ondansetron, midazolam and opioids may be used safely for anesthesia in Tourette's syndrome.
Collapse
Affiliation(s)
- E B Sener
- Department of Anesthesiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
| | | | | | | |
Collapse
|
12
|
Abstract
We describe cervical dystonia occurring in a 31-year-old, previously well, primigravid, primiparous Chinese woman at 4 weeks' amenorrhea, which was ameliorated with low-dose clonazepam and disappeared completely by the end of the second trimester without recurring despite her being tapered off benzodiazepine therapy. Investigations were unremarkable for structural and biochemical causes of dystonia. Chorea, paraballismus, and restless legs syndrome are known to occur during pregnancy, attributable to high estrogen levels. Dystonia, on the other hand, has not been described to occur de novo in pregnancy. This association should be considered in women of reproductive age who present with cervical dystonia.
Collapse
|