tailieunhanh - PARKINSON’S DISEASE AND RELATED DISORDERS - PART 3

Điều này liên quan đến việc tăng tần suất chớp mắt có thể lên đến đỉnh cao trong mắt trở nên gần như vĩnh viễn đóng lại (hình 54). Đôi khi một cảm ứng ánh sáng để mí mắt có thể làm giảm co thắt | Blepharospasm This involves an increased blinking frequency which may culminate in the eyes becoming almost permanently closed Figure 54 . Sometimes a light touch to the eyelid may relieve the spasm as may various diversionary physical actions on the part of the patient. Oromandibular dystonia This describes an abnormal movement of the jaw mouth and tongue associated with dysphagia and dysarthria. The symptoms are typically triggered by attempts to speak or eat. Trauma to the tongue and buccal mucosa is a common occurrence. Spasmodic dysphonia Dystonia of the laryngeal muscles produces an abnormal voice pattern. Adduction of the vocal cords is seen more often than is abduction and imparts a strained and harsh quality to the speech. Spasmodic torticollis Abnormal neck postures result from contraction of the sternocleidomastoid splenius capitis or both. There may be predominant rotation or lateral flexion or extension. The condition may resolve only to return later Figure 55 . A tremulous movement is often superimposed on a more sustained posture. Neck discomfort is common and some patients develop degenerative disease of the cervical spine. Writer s cramp This is one of a number of occupational cramps in which dystonic posturing frequently of a painful nature develops in patients who use their hands habitually in performing a skilled task. Other activities associated with this condition include typing playing the violin and cutting hair. The movements typically are generated only when a specific task is attempted. Other skilled activities of the hand are spared. Typically excessive force is used and the pen is held in an abnormal posture. The movement is often accompanied by inappropriate movement and posturing of the proximal arm muscles. Occasionally the problem remits. Eventually some patients learn to write with the other hand although at the risk of then developing the problem in that hand as well. Treatment Treatment of the focal dystonias has been largely .