(Pdf) beneficial effects of diphenhydramine in dystonia p gasol stats

##########

The objective of this paper was to evaluate the efficacy of diphenhydramine hydrochloride (DPH) in dystonic patients. In 1995 ortega y gasset, Truong et al reported encouraging results in five patients with idiopathic torsion dystonia (ITD) treated with DPH, an H1 antagonist with sedative and anticholinergic properties. Five patients with generalized ITD, one with secondary generalized dystonia and one with idiopathic segmental dystonia were included in the prospective study. Initially the response to intravenous administration of DPH versus placebo in two sessions a week apart was evaluated. Two weeks later all patients started oral DPH in increasing doses (range 100-300 mg, mean 164 mg). The degree of dystonia was determined by a modified University of Columbia Scale evaluating the baseline score, after placebo and DPH I.V. administration then at one and six months after starting oral treatment. The results were analyzed by Friedman’s test for repeated measurements. On comparing scores for baseline severity, I.V. placebo and I.V. DPH presented a highly significant correlation (12.09; p = 0.00) as well as comparing baseline score with oral DPH at one and 6 months, treatment (12.78; p = 0.00). Functional score results were 9.5 p = 0.01 and 8.4 p = 0.02 at one and 6 months respectively. The most common side effects were somnolence and dizziness. It can be concluded that DPH proved effective in our patients with mild to moderate adverse effects not requiring drug withdrawal in any case. However, I.V. challenge was unable to predict the long-term response to oral medication perhaps due to the limited number of cases.

Extrapyramidal symptoms are an uncommon but well-recognized side effect after the administration of general anesthesia in patients without a significant neurologic history. Several case reports implicate propofol as the likely causative agent producing these symptoms, which include ballismus, dystonia, choreoathetosis, and opisthotonus. Currently, there is no clear consensus on first-line treatment of these symptoms. In each of the published cases, anticholinergic medications and benzodiazepines were central to initial management, although the speed and extent of symptom resolution were variable. Here we present a case mp electricity bill payment online bhopal of a 17-year-old boy with ulcerative colitis who presented with ballismus, torticollis, tongue thrusting, and oculogyric movements after colonoscopy under general anesthesia with propofol. The patient responded promptly to treatment with diphenhydramine. This is the first reported case in which diphenhydramine was successfully used as the primary treatment of severe extrapyramidal symptoms in a pediatric patient after propofol administration.

Movement disorders are a heterogeneous group of both common and rare neurological conditions characterized by abnormalities of motor functions and movement patterns. This work overviews recent successes and ongoing studies of repositioning relating to this disease group, which power per kwh underscores the challenge of integrating the voluminous and heterogeneous findings required for making suitable drug repositioning decisions. In silico drug repositioning methods hold the promise of automated fusion of heterogeneous information sources, but the controllable, flexible and transparent incorporation of the expertise of medicinal chemists throughout the repositioning process remains an open challenge. In support of a more systematic approach toward repositioning, we summarize the application of a computational repurposing method based on statistically rooted knowledge fusion. To foster the spread of this technique, we provide a step-by-step guide to the complete workflow, together with a case study in Parkinson’s disease.

Essential Blepharospasm (EBS) alone or associated with oromandibular dystonia (OMD), a condition known as Meige syndrome, is one of the most frequent forms of adult onset focal/segmental dystonia respectively. Over the last 10 years 123 patients with EBS and EBS + OMD were evaluated showing a female/male preponderance (3/1) with a mean age at onset of 52.69 years. Although some patients presented with unilateral EBS, all progressed to bilateral involvement. The most frequent misdiagnosis was a psychogenic or ophthalmologic disease. Imaging studies including computed tomography and resonance imaging showed abnormalities in 12 cases, 6 of which were located within the basal ganglia. In our series 4 patients had a positive family history for cranial dystonia. The most effective treatment was botulinum electricity journal toxin locally administered. Our findings are comparable to other published series. We believe that a deeper clinical epidemiological insight into this often disabling condition, will allow a better and earlier diagnosis and lead to a simple, safe and effective therapeutic tool.

The central effects of a newly developed, long-acting H1 antihistamine, loratadine (10 and 40 mg), were compared with those of a standard H1 antihistamine, diphenhydramine (50 mg three times a day) with measures of performance and daytime sleepiness (multiple sleep latency test). Sixteen healthy adults (six women and 10 men), 19 to 35 years of age, received each of the drugs and placebo for 2 days, separated by 5 days at home. Each day, the drug or placebo thermal electricity how it works was administered at 8 A.M. and 12 and 4 P.M. Diphenhydramine was administered in three equal doses (50 mg), and loratadine was administered in a single dose followed by two placebo doses. Mean latency to sleep on tests done at 9 and 11 A.M. and 1, 3, and 5 P.M. was reduced significantly with diphenhydramine compared to placebo, whereas neither loratadine dose reduced sleep latency. Performance measured at 9:30 P.M. and 1:30 P.M. with a battery of tests, including reaction time, vigilance, digit symbol substitution, and symbol copying tasks demonstrated a significant reduction in symbols copied and digits substituted after diphenhydramine compared to both loratadine doses. These results demonstrate that loratadine (10 and 40 mg doses) did not have clinically significant central nervous system activity, whereas diphenhydramine increases sleepiness and disrupts performance efficiency.

Although diphenhydramine hydrochloride is known to eliminate or reduce the symptoms of dystonia in human patients with acute dystonic reactions and idiopathic torsion dystonia, its mechanism of action is still unclear. In the present study, we show that the antihistamine properties of diphenhydramine may contribute to its beneficial effects. Acute dystonic reactions were produced in rats with unilateral microinjection of haloperidol into the red nucleus as previously described. Similar to the pattern in humans, this effect could be attenuated by coadministration of diphenhydramine. Unilateral microinjection of histamine itself into the rat red gas 101 nucleus produced dystonic postures (torticollis) in a dose-dependent manner, demonstrating that a histamine dysfunction could contribute to the pathophysiology of dystonia. The torticollis produced by histamine could be significantly attenuated with coadministration of the H1 antagonists diphenhydramine or pyrilamine or the H2 antagonist cimetidine. These effects are thought to be mediated through the red nucleus because significantly more torticollis was observed when histamine was injected into the red nucleus rather than surrounding mid-brain areas, the substantia nigra, or the lateral ventricle. The present data, taken together with studies in humans, suggest the involvement of histamine in some types of dystonia. Furthermore, the red nucleus and related motor pathways may have a more important role in dystonia than previously thought.

Clinical files of 234 patients, 68 with a diagnosis of blepharospasm (BS) and 166 with hemifacial spasm (HS), all of whom received botulinum toxin from 1987 to 1995 at the Neurology Department, University Hospital, Buenos Aires city were reviewed. Fifty-five HS cases were men and 111 women, whose mean age was 57.5 years, while 17 of BS and/or BS/oromandibular dystonia cases were men and 52 were … [Show full abstract] women, whose mean age was 63 years. Age at onset was 56.3 years for HS and 56.8 years for BS. Etiologies for HS were postparalytic in 13 cases, brainstem tumors in 2, a vascular pontine lesion in one and Paget’s disease in one. The remainder were considered idiopathic although at brain MRI and CT many presented ectasias in the vertebrobasilar territory. Mean Botox dose for HS cases was 21.8 I.U. (range 12.5-50 I.U.), while for BS patients it was 33.1 I.U. (range 25-75 I.U.). Total infiltration number was 1910 with a mean of 9.8 for HS and 5.5 for BS. Mean duration of benefit after each dose was 3 months for both groups electricity 101. All patients markedly (77%) or moderately (27%) improved although 12.5% developed transient ptosis as a side effect. BS patients progressively required a 21% dose increase as an average throughout treatment while HS cases required 20% increase. Our results validate the usefulness of botulinum toxin for the management of HS and BS which should be considered as the treatment of choice. Read more