Cases reported "Parkinson Disease"

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1/19. Deceiving appearances. Communicating with facially inexpressive older adults.

    The term "facially inexpressive" is introduced to describe individuals who have lost the ability to produce facial expressions as a result of a neuromuscular disorder. Difficulties in communication may be compounded by presentation of this condition in individuals of mature appearance because the expectation of diminished functioning may increase. Practical techniques are offered to circumvent inaccurate and potentially detrimental assumptions both practitioners and laypeople tend to make when communicating with older adults whose conditions prevent the normal yield of social cues. A case study is presented and implications for the wider geriatric population are discussed.
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2/19. Treatment of pathological crying with citalopram.

    Pathological laughing and/or crying may occur as a concomitant symptom of various diseases of the central nervous system. No known anatomical basis for any of these disorders exists at present. However, references to a disturbance in central serotoninergic neurotransmission have become frequent in the literature, implicating this as an important etiological factor. In the present communication three cases of successful treatment of pathological crying using the SSRI citalopram are reported. Besides the response of pathological crying in cerebral ischemia to SSRIs, which has already been described in earlier publications, this is the first report on the successful administration of citalopram for treating pathological crying in Parkinson's disease. Onset of response was very rapid in all cases.
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3/19. Magnetic fields in the therapy of parkinsonism.

    In a recent editorial published in this Journal, I presented a new and revolutionary method for the treatment of Parkinson's disease (PD). I reported that extracranial treatment with picoTesla magnetic fields (MF) is a highly effective, safe, and revolutionary modality in the symptomatic management of PD. My conclusion was based on experience gained following the successful treatment of over 20 Parkinsonian patients, two of whom had levodopa-induced dyskinesias. None of the patients developed side effects during a several month period of follow-up. In the present communication, I present two reports. The first concerns four Parkinsonian patients in whom picoTesla MF produced a remarkable and sustained improvement in disability. Three of the patients had idiopathic PD and the fourth patient developed a Parkinsonian syndrome following an anoxic episode. In all patients, treatment with MF was applied as an adjunct to antiParkinsonian medication. The improvement noted in these patients attests to the efficacy of picoTesla MF as an additional, noninvasive modality in the therapy of the disease. The second report concerns two demented Parkinsonian patients in whom treatment with picoTesla MF rapidly reversed visuospatial impairment as demonstrated by the Clock Drawing Test. These findings demonstrate, for the first time, the efficacy of these MF in the amelioration of cognitive deficits in Parkinson's disease. Since Alzheimer's pathology frequently coexists with the dementia of Parkinsonism, these observations underscore the potential efficacy of picoTesla MF in the treatment of dementias of various etiologies.
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4/19. Magnetic fields mimic the behavioral effects of REM sleep deprivation in humans.

    The discovery of rapid eye movement (REM) sleep by Aserinsky and Kleitman in 1953 initiated the impetus for sleep research and specifically the investigations of the effects of REM sleep deprivation (RSD) on animal and human behavior. The behavioral effects of RSD include the enhancement of motivational and "drive"-related behaviors. In laboratory animals, RSD has been reported to increase appetite, sexual behavior, aggressiveness, and locomotor activity. Moreover, RSD reportedly improves mood in patients with endogenous depression and heightens appetite and sexual interest in normal subjects. Since "drive"-related behaviors are thought to involve activation of limbic dopaminergic reward sites, RSD may enhance motivational behaviors through an action on limbic dopaminergic functions. In the present communication, we present two patients (one with multiple sclerosis and the other with Parkinson's disease) in whom treatment with magnetic fields produced behavioral effects which paralleled those observed in REM-sleep-deprived animals and humans. We propose, therefore, that the behavioral and mental effects of treatment with magnetic fields may be mediated via RSD and, by inference, involve activation of limbic dopaminergic reward sites.
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5/19. Reversal of visuospatial deficit on the Clock Drawing Test in Parkinson's disease by treatment with weak electromagnetic fields.

    Visuospatial deficits are among the most frequently encountered abnormalities in neuropsychological testing of patients with Parkinson's disease, being present in up to 90% of cases. Clinically, impairment of visuospatial functions may not be noted by Parkinsonian patients but may contribute to various functional disabilities including frequent falls, difficulties operating a vehicle, ambulating, and dressing. I have reported recently that treatment with external electromagnetic fields (EMFs) in the picotesla (pT) range intensity is an effective nonpharmacological modality in the management of the motor and various cognitive deficits of Parkinsonism including visuoperceptive and visuospatial functions. The present communication concerns four fully medicated Parkinsonian patients who, in response to treatment with EMFs, exhibited reversal of visuospatial impairments as demonstrated on the Clock Drawing Test. Specifically, prior to treatment with EMFs these patients demonstrated a visuospatial deficit which was evident by the placement of the numbers on the clock distant from the periphery. Following a series of treatments with EMFs this visuospatial deficit was corrected. The report supports prior observations demonstrating that externally applied pT range intensity EMFs may bring about reversal of visuospatial deficits in Parkinsonian patients which usually are not improved by treatment with dopaminergic or anticholinergic drugs.
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6/19. Improvement of body image perception in Parkinson's disease by treatment with weak electromagnetic fields.

    Neuropsychological studies have demonstrated that Parkinson's disease (PD) is associated with various cognitive deficits ultimately leading in about 30% of patients to the development of dementia. These studies have demonstrated also a greater decrement of right hemispheric functions which are manifested by visuospatial deficits occurring in up to 90% of PD patients. The Human Figure Drawing Test has been employed in the assessment of generalized intellectual deterioration and specifically in the evaluation of visuperceptive, visuospatial and visuoconstructional abilities in brain injured patients. I have demonstrated recently, on the basis of various drawing tests, that external application of electromagnetic fields (EMFs) in the picotesla (pT) range intensity improved visuoperceptive and visuospatial functions in Parkinsonian patients. In the present communication I present 4 fully medicated nondemented Parkinsonian patients who were administered the Human Figure Drawing Test before and after a series of treatments with EMFs. The Human Figure Drawing Test was selected for the study specifically since it was shown to be sensitive to the effects of surgery to the basal ganglia in Parkinsonian patients. Prior to application of EMFs these patients' drawings showed distortion, poor perspective, impoverished facial expression, and lack of attention to details suggested poor body image perception related to right posterior hemispheric dysfunction. In response to the administration of EMFs the group demonstrated a striking improvement in the drawings particularly the depiction of the face the perception of which is localized to the right parietal lobe. These findings demonstrate that treatment with pT EMFs improves body image perception in Parkinsonian patients, a deficit which may remain unaffected by treatment with standard dopaminergic pharmacotherapy.
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7/19. A drug naive parkinsonian patient successfully treated with weak electromagnetic fields.

    Brief cerebral application of picotesla (pT) electromagnetic fields (EMF) has been demonstrated an efficacious, revolutionary treatment modality for the therapy of Parkinson's disease (PD) with clinical benefits being evident in all motor aspects of the disease as well as in nonmotor symptoms such as mood, sleep, pain, sexual dysfunction, autonomic regulation and cognitive functions. Since treatment with pT EMF has involved PD patients who were treated with dopaminergic agents at the time they received EMF there may have been a synergistic interaction between dopaminergic drugs and EMF. The present communication concerns a 49-year-old male Parkinsonian patient with stage 3 disability on the Hoehn and Yahr scale (1967) who, in response to brief extracranial applications of pT EMF, demonstrated a marked improvement in motor, depressive symptomatology and cognitive functions and was classified as stage 1 several weeks later. This case is remarkable in that the patient did not receive treatment with dopaminergic drugs prior to or during the course of EMF therapy. It suggests that (a) pT range EMF may be efficacious as a monotherapy for PD and should be considered also as a treatment modality for de novo diagnosed patients, and (b) application of these EMF improves Parkinsonism by a mechanism which involves, among others, augmentation of dopaminergic and serotonergic neurotransmission.
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8/19. Weak electromagnetic fields reverse visuospatial hemi-inattention in Parkinson's disease.

    Drawing tasks, both free and copied, have achieved a central position in neuropsychological testing of patients with unilateral cerebral dysfunction by virtue of their sensitivity to different kinds of organic brain disorders and their ability to provide information on lateralized brain damage. In the drawings of patients with right hemispheric damage, visuospatial neglect is revealed by the omission of details on the side of the drawing contralateral to the hemispheric lesion. patients with unilateral cerebral damage, particularly those with left hemispheric damage, also demonstrate a tendency to place their drawings on the side of the page ipsilateral to the cerebral lesion, a phenomenon which has been termed visuospatial hemi-inattention. It has been reported previously that brief external application of alternating pulsed electromagnetic fields (EMFs) in the picotesla (pT) range intensity improved visuoperceptive and visuospatial functions and reversed neglect in Parkinsonian patients. The present communication concerns four fully medicated elderly nondemented Parkinsonian patients (mean age: 74.7 /- 4.6 yrs; mean duration of illness: 7.7 /- 5.2 yrs) in whom application of these EMFs produced reversal of visuospatial hemi-inattention related to left hemispheric dysfunction. These findings support prior observations demonstrating that pT EMFs may bring about reversal of certain cognitive deficits in Parkinsonian patients.
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9/19. Improvement in short-term visual memory by weak electromagnetic fields in Parkinson's disease.

    Neuropsychological studies have demonstrated that Parkinson's disease (PD) is associated with various cognitive deficits ultimately leading in about 30% of patients to the development of dementia. These studies have demonstrated also a greater decrement of right hemispheric functions with visuospatial deficits occurring in up to 90% of PD patients. The Rey-Osterrieth Complex Figure (ROCF) Test has been employed in the assessment of right hemispheric functions and particularly for the evaluation of visuoconstructive abilities and short-term visual memory. I have demonstrated recently that external application of electromagnetic fields (EMFs) in the picotesla (pT) range intensity is an effective nonpharmacological modality in the management of the motor and cognitive deficits of Parkinsonism. In the present communication I present 3 fully medicated nondemented PD patients (mean age: 68 /- 8.1 yrs; mean duration of illness: 9.0 /- 4.0 yrs; mean disability on the Hoehn and Yahr scale: 3) who were tested on the ROCF Test before and after a series of treatments with EMFs. In response to the administration of EMFs the group demonstrated a mean of 23.1 /- 13.6% improved performance on copy of the ROCF and a 39.3 /- 13.4% improvement of short-term recall of the ROCF. These findings demonstrate that treatment with pT EMFs improves deficits in visuospatial functions and visual memory in Parkinsonism which usually remain unaffected during standard treatment with dopaminergic pharmacotherapy.
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10/19. Parkinsonian micrographia reversed by treatment with weak electromagnetic fields.

    Micrographia is one of the characteristic clinical signs of Parkinson's disease (PD) which is linked to striatal dopaminergic deficiency. It has been reported recently that external application of weak electromagnetic fields (EMFs) in the picotesla (pT) range and of low frequency produced dramatic improvements in motor symptoms in Parkinsonian patients indicating that a specific range of electromagnetic energy increases, among others, striatal dopaminergic neurotransmission. In the present communication, I present two fully mediated Parkinsonian patients who, prior to the application of EMFs, drew lilliputian sized figures reflecting the micrographia of the disease. In both patients a series of treatments with pT EMFs produced, in addition to improvement in motor symptoms, a dramatic increase in the size of their drawings with reversal of their micrographia. Since both patients were maintained on dopaminergic medications prior to and during treatment with EMFs it is suggested that Parkinsonian micrographia is related also to abnormalities of nondopaminergic systems which are affected by weak EMFs. This report corroborates previous observations demonstrating the powerful antiParkinsonian effect of pT range EMFs and highlights the unique efficacy of this treatment modality in Parkinsonism.
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