Medical treatment of movement disorders continues to be effective but has substantial limitations. For decades, the surgical treatment of movement disorders centered around the creation of lesions within the brain. Developments in technology made neuromodulation, in the form of deep…
Clinical Vignette A 25-year-old swimming champion presented with sudden onset of gait disturbance and tremor. She presented to the clinic with her boyfriend and mother. On examination, she walked slowly and gingerly with her arms held out and fell repeatedly…
Clinical Vignette A 52-year-old Caucasian woman presented to a psychiatrist with her first manic episode. Patient had never been treated with any antipsychotic medication in her life. During the current episode, she was treated with aripiprazole 30 mg During a follow-up…
Clinical Vignette A 9-year-old boy presented to the neurology clinic with 1 year of excessive eye blinking. He was accompanied by his parents. His past medical history was unremarkable; he was born at term and reached all developmental milestones appropriately.…
Clinical Vignette A 73-year-old, right-handed man with history of coronary artery disease, myocardial infarction, peripheral vascular disease, and hypertension presented with cardiac arrest followed by resuscitation with subsequent development of anoxic brain injury. He was seen by a neurologist in…
Clinical Vignette Sylvia is a 59-year-old, right-handed teacher who developed jerky movements in her body within the past 3–4 years and was now “fidgety” all the time. Her family observed intellectual changes; she seemed withdrawn and forgetful, was occasionally inappropriate…
Clinical Vignette A 22-year-old previously healthy woman developed slurred speech, difficulty walking, and hand tremors over the course of 1 month after a severe psychologic trauma. She had mild neck pain and took cyclobenzaprine without benefit. She denied any history…
Clinical Vignette A 31-year-old woman had the spontaneous onset of a relatively mild horizontal (“no-no”) head tremor. She had no family history of neurologic disorders. This tremor was initially inconsequential but it gradually increased in severity. Turning her head to…
Atypical parkinsonian syndromes, previously called Parkinson-plus syndromes, are chronic, progressive neurodegenerative disorders characterized by rapidly evolving parkinsonism in association with other signs of neurologic dysfunction beyond the spectrum of idiopathic Parkinson disease (PD). These include early dementia, postural instability, supranuclear…
Clinical Vignette This 64-year-old auto mechanic noticed intermittent tremor in his right hand while working. His wife reported he was not swinging his right arm when walking, and she was also observing tremor in his right hand when they were…