Phenomenology of abnormal ocular and eyelid movements may appear complex and difficult to describe at first but recognition of an overall pattern is helpful in characterization: Ocular flutter comprises bursts of saccades in one plane, typically horizontal, during forward fixation. There are no intervals between saccades. Opsoclonus is a continuous succession of multidirectional conjugate saccadic eye movements with no inter-saccadic interval, sometimes aptly called ‘saccadomania’. Patients can manifest ocular flutter when developing or recovering from opsoclonus, and both disorders probably …
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Structure: BTX is synthesized as a single-chain peptide with a molecular mass of 150 kilodaltons. This form has relatively little potency as a neuromuscular blocking agent, and activation requires a 2-step modification in the tertiary structure of the protein. This process converts the single-chain neurotoxin to a di-chain neurotoxin comprising a 100,000-dalton heavy chain (HC) linked by a disulfide bond to a 50,000-dalton light chain (LC). BTX acts at the neuromuscular junction where it exerts its effect by inhibiting the …
HFS: Involuntary, irregular, clonic or tonic contractions of muscles innervated by the facial nerve. Usually start from the eyelid and spreads to involve all ipsilateral muscles of the facial nerve including platysma. All muscles involved contract synchronously. PAradoxical synkinesis: In 1905, Babinski described paradoxical synkinesis in HFS ‘‘when orbicularis oculi contracts and the eye closes, the internal part of the frontalis contracts at the same time, the eyebrow rises during eye occlusion.’’ This ‘‘other Babinski’s sign’’ is typically present in …
Indications for supplementation in atypical presentations either movement disorder or others: Pyridoxine for mild ataxia. Pyridoxine for some cases autism. Folinic acid and PLP may interestingly help in pyridoxine dependent epilepsy cases. Pyridoxine will NOT help PNPO mutations (that’s PLP) but PLP would help in Pyridoxine dependency (ALDH7A1). Biotin B7 may help in spastic paraplegia and ataxia (myelopathy presentation in adolescence). Biotinidase deficiency should be ruled out in all dyskinesias as it may cause BG calcification. Can ne treated by …
A movement disorder neurologist has to see lots of strange unusual movement phenomena in their practice. Key is to isolate the individual movement fragments and assess their temporal and spatial relationships to make a sense of overall gestalt. Over years, lots of unusual movement phenomena have been reported which do not readily fit into the common types hypo-kinetic and hyper-kinetic movement phenomenologies. Some of these exotic patterns are mentioned below: The dancing larynx: This has been described as complex arrhythmical …
For Registration please visit: http://appna.org/2018-global-healthcare-summit/ A Practical Everyday Neurology, Hands-on Review for Bedside practice. A collaboration between: APPNA MERIT Committee Pakistan International NeuroScience Society (PINS) Pakistan Society of Neurology (PSN) Course Directors: International: Drs Danish Bhatti and Shahid Rafiq National:Drs Athar Javed and Sarwar Siddiqui Course Introduction: Up to 10% of patients seen by family practitioners present with neurologic symptoms. Only 16% are ever evaluated by neurologists in US and is likely even less, given significant lack of Neurologist …
Danish’s 9 Step of Life Simplification: 1. Do I Really NEED it! a. Does it add value to my life? (love, happiness, content, satisfaction, success) b. Will I survive without it. c. Will I miss its Loss. 2. Do I really WANT it! a. Will I regret not doing it. b. Will I sacrifice something for it. c. How Bad do I want it. 3. Can I really GET it! a. Is it ever achievable. b. Will I still do …
Teachers Need Real Feedback. Most teachers love to teach but how do we tell them where are they doing a good job and where they can improve. And how do you know when the learning has occurred. The current understanding in education is that 4 proper learning student it is important to understand what is learning and how is learning. The burden of learning is traditionally been on the student and the teachers considered it student fault if they are …
In this article, we will continue where we left off in the last newsletter in terms of research and neuroprotection in Parkinson’s Disease. This article may be read separately but is a continuation of the theme of neuroprotection research in Parkinson’s Disease. Gout, the unwalkable disease, was first identified by Egyptians nearly 2,600 years BC, but the most famous reference is to the description by Hippocrates in the Fifth Century B.C. whose aphorism for Gout still hold true. Over the …
Imagine you are on a road trip through the mountains with your family, (mom, spouse, kids). Imagine that you are driving through this serene national park with lakes and in middle of nature. Now imagine that your car breaks and you have no signals on your phone in the middle of nowhere. Hard to imagine, shouldn’t be. It actually happened to me on a trip in Colorado last summer. Your head gets dizzy with the endless barrage of questions. 1. …
