Oculofacial-skeletal myorhythmia in central nervous system Whipple's disease: additional case and review of the literature.
Identifieur interne : 004689 ( Ncbi/Curation ); précédent : 004688; suivant : 004690Oculofacial-skeletal myorhythmia in central nervous system Whipple's disease: additional case and review of the literature.
Auteurs : D A Simpson [États-Unis] ; R. Wishnow ; R B Gargulinski ; A M PawlakSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1995.
English descriptors
- KwdEn :
- MESH :
- chemical , pharmacology : Ceftriaxone, Sulfamethoxazole, Trimethoprim, Valproic Acid.
- drug therapy : Whipple Disease.
- pathology : Oculomotor Muscles.
- Adult, Follow-Up Studies, Humans, Male, Movement Disorders, Treatment Outcome.
Abstract
A case of oculofacial-skeletal myorhythmia associated with cerebral Whipple's disease is presented. This peculiar abnormal movement disorder consists of a convergent-divergent pendular nystagmus associated with a synchronous, rhythmic movement of the mouth, jaw, and extremities. The movements in previous cases have responded inconsistently to a variety of broad-spectrum antibiotic drugs, and antiepileptic, muscle relaxant, antispastic, and psychotropic drugs. The current patient's mental status improved after starting intravenous ceftriaxone but improvement of the abnormal movements occurred only after the addition of oral valproate. Current treatment consists of intravenous trimethoprim-sulfamethoxazole for 2 weeks followed by oral trimethoprim-sulfamethoxazole twice daily for 1 year. Presented here is an alternative treatment of intravenous ceftriazone followed by oral trimethoprim-sulfamethoxazole in combination with valproate for abnormal movements not responsive to antibiotic drugs alone.
DOI: 10.1002/mds.870100210
PubMed: 7538627
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pubmed:7538627Le document en format XML
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<author><name sortKey="Simpson, D A" sort="Simpson, D A" uniqKey="Simpson D" first="D A" last="Simpson">D A Simpson</name>
<affiliation wicri:level="1"><nlm:affiliation>Michigan Institute for Neurological Disorders, Farmington Hills 48334, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Michigan Institute for Neurological Disorders, Farmington Hills 48334</wicri:regionArea>
<wicri:noRegion>Farmington Hills 48334</wicri:noRegion>
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<author><name sortKey="Wishnow, R" sort="Wishnow, R" uniqKey="Wishnow R" first="R" last="Wishnow">R. Wishnow</name>
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<author><name sortKey="Gargulinski, R B" sort="Gargulinski, R B" uniqKey="Gargulinski R" first="R B" last="Gargulinski">R B Gargulinski</name>
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<author><name sortKey="Pawlak, A M" sort="Pawlak, A M" uniqKey="Pawlak A" first="A M" last="Pawlak">A M Pawlak</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Oculofacial-skeletal myorhythmia in central nervous system Whipple's disease: additional case and review of the literature.</title>
<author><name sortKey="Simpson, D A" sort="Simpson, D A" uniqKey="Simpson D" first="D A" last="Simpson">D A Simpson</name>
<affiliation wicri:level="1"><nlm:affiliation>Michigan Institute for Neurological Disorders, Farmington Hills 48334, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Pawlak, A M" sort="Pawlak, A M" uniqKey="Pawlak A" first="A M" last="Pawlak">A M Pawlak</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Male</term>
<term>Movement Disorders</term>
<term>Oculomotor Muscles (pathology)</term>
<term>Sulfamethoxazole (pharmacology)</term>
<term>Treatment Outcome</term>
<term>Trimethoprim (pharmacology)</term>
<term>Valproic Acid (pharmacology)</term>
<term>Whipple Disease (drug therapy)</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Whipple Disease</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Follow-Up Studies</term>
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<front><div type="abstract" xml:lang="en">A case of oculofacial-skeletal myorhythmia associated with cerebral Whipple's disease is presented. This peculiar abnormal movement disorder consists of a convergent-divergent pendular nystagmus associated with a synchronous, rhythmic movement of the mouth, jaw, and extremities. The movements in previous cases have responded inconsistently to a variety of broad-spectrum antibiotic drugs, and antiepileptic, muscle relaxant, antispastic, and psychotropic drugs. The current patient's mental status improved after starting intravenous ceftriaxone but improvement of the abnormal movements occurred only after the addition of oral valproate. Current treatment consists of intravenous trimethoprim-sulfamethoxazole for 2 weeks followed by oral trimethoprim-sulfamethoxazole twice daily for 1 year. Presented here is an alternative treatment of intravenous ceftriazone followed by oral trimethoprim-sulfamethoxazole in combination with valproate for abnormal movements not responsive to antibiotic drugs alone.</div>
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