Good correspondence between assumed and observed changes in patient management was found, indicating that (123)I-FP-CIT SPECT is influential in diagnosis and management of patients with uncertain clinical diagnosis of parkinsonism. This can be achieved at a marginal added cost to the health insurance and leads to a significant gain in ATY.

Six patients with the syndrome of "painful legs and moving toes" were studied. Although clinical differences were nonspecific, the EMG disclosed two subgroups: one with a simple, erratic pattern of spontaneous activities in foot and leg muscles, and the other with a complex alternating pattern in antagonistic muscles. In the first group, the physiopathologic mechanism is thought to act in the periphery: in the lumbar roots when local anesthesia of the posterior tibial nerve suppresses spontaneous discharges, or in the nerve trunk when it is ineffective. In the second group, the symptomatology may be generated centrally, implying a more general disturbance of sensorimotor control.

The histories of seven consecutive cases of Gilles de la Tourette's syndrome are presented to exemplify the range of clinical manifestations in this disease and to collate preliminary results with the new benzodiazepine, clonazepam, as a possible adjuvant therapy of this disorder. Controlled trials with clonazepam alone and in association with haloperidol are now justified. Five of our 7 patients had a positive RESUME: Nous presentons les histoires de cas de sept patients consecutifs atteints du syndrome de Gilles de la Tourette, afin d'illttstrer la variete des manifestations cliniques et afin de presenter quelques resultats preliminaires de I'emploi du nouveait benzodiazepine, le clonazepam, comma therapie de soutien dans cette maladie. Ces resultats preliminaires justifient des essais controles avec le clonazepam seal et en association avec I'haloperidol.Cinq de nos 7 patients presentment tine family history of tics, and 2 a confirmed family history of gout. Because clonazepam improves myoclonia and tics and because its mechanism of action possibly involves serotonin, we thought it worthwhile to study simultaneously the relative roles of serotonin and dopamine metabolism in the production of tics, and their relationship to possible defects in purine metabolism in Gilles de la Tourette's syndrome.histoirefamiliale positive pour tics, alors qu'tine incidence familiale de goute etait presente chez 2 de nos cas. Pane que le clonazepam est efficace contre les myoclonies ainsi que les tics et puree que son mecanisme d'action implique possiblement la serotonine, nous suggerons qu'il serait utile d'etudier simultanement les roles relalifs de la serotonine et de la dopamine dans la genese des tics, et leurs relations avec un defaut possible du metabolisme des purines dans le syndrome de Gilles de la Tourette.

Focal task-specific dystonia (FTSD) occurs exclusively during a specific activity that usually involves a highly skilled movement. Classical FTSD dystonias include writer's cramp and musician's dystonia. Few cases of sport-related dystonia have been reported. We describe the first four cases of FTSD related to table tennis (TT), two involving professional international competitors. We also systematically analyzed the literature for reports of sport-related dystonia including detailed clinical descriptions. We collected a total of 13 cases of sport-related dystonia, including our four TT players. Before onset, all the patients had trained for many years, for a large number of hours per week. Practice time had frequently increased significantly in the year preceding onset. As TT is characterized by highly skilled hand/forearm movements acquired through repetitive exercises, it may carry a higher risk of FTSD than other sports. Intensive training may result in maladaptive responses and overwhelm homeostatic mechanisms that regulate cortical plasticity in vulnerable individuals. Our findings support the importance of environmental risk factors in sport-related FTSD, as also suggested in classical FTSD, and have important implications for clinical practice.

We report on a man who received interferon-alpha 2a therapy for kidney cancer and who subsequently developed propriospinal myoclonus. The myoclonus was noted at rest and during movement. The jerks were reinforced by cutaneous stimuli and tendon taps and spread to the spinal cord via polysynaptic propriospinal pathways. Cerebrospinal fluid analysis, spinal cord magnetic resonance imaging, electroencephalogram with back-averaging, and somatosensory-evoked potentials were normal. No antineuronal antibodies were found. Although the mechanism of interferon neurotoxicity remains unclear, the possible responsibility of interferon was considered, as no focal lesion or paraneoplastic pathology were disclosed.