🚀 go-pugleaf

On Thu, 14 Nov 1996 10:31:04 -0600, tomh@flash.net wrote:

>Elderly gentleman seeking relief for unusual medical condition.  A circular
>or swirling motion in the tongue and feet.  This began in 1988 after his hip
>joint replacement.  He was treated with Klonopin.  After one year the motion
>stopped suddenly.  Oct 1995 the motion returned in the tongue and feet.  He
>has been treated with Klonopin, muscle relaxers, anti-depressants, Botox shots -
>two shots directly to tongue did not work.  
>
>69 year old man has several problems:
>
>Aneurysm - causing loss of blood flow to the feet (toes black)  9-1-95
>Kidney failure - dialysis 3x week  2-1-96
>Insulin dependent diabetic (many years)
>5 way bypass  1986
>hip joint replacement 2x  1988 - 1990
>Clogged arteries and aneurysm
>Strokes that affected eyes and hand (seems to have repaired)
>Had Bell Palsy (repaired itself)
>High blood pressure
>He can't be operated on due to plaque in arteries
>
>We have taken him to several Neurologists and Specialists for tongue and feet.
>Nothing has stopped or slowed the circular motion.  He can't chew or swallow
>whole food because of the motion.  He is desperate for relief!  Any help
>or experience with this dystonia would be very much appreciated.
>
>D&S  tomh@flash.net
>
>
>-----------------------------------------------------------------------
>This article was posted to Usenet via the Posting Service at Deja News:
>http://www.dejanews.com/           [Search, Post, and Read Usenet News]
Has he had a trial of reserpine?  H2

This seems to be a complex problem.  The person has clearly suffered from
multiple brain lesions from which he has made substantial recoveries but he
has developed a form of dystonia involving his feet and tongue.  He has
already tried most of the standard therapies, including botox injections to
the tongue.  He has many risk factors would argue against surgical therapy. 
Therapeutic options are thus limited.  
1.  It seems to me that clues may be available in the disappearance of his
symptoms for one year.  If one could perhaps look through his medical
records and caretakers to see what happened during that one year, i.e.
medication, that could be associated with the disappearance and
reappearance of the symptoms.  It seems also that the motion returned in
October after he suffered from an ischemic episode of his toes.  Was he
treated in any way for that episode and how was it resolved?
2.  Perhaps one should consider a trial of an anti-epileptic drug such as
Tegretol.  This is a long shot but one may be able to shift the
excitability balance of motor centers where these motions are stemming.  
3.  The movements appear to be peculiarly localized.  The involvement of
the tongue and feet are unusual.  Most dystonia involve neck and trunk
muscles.  This gentleman has an apparent dystonia involving the tongue
which is mediated by cranial nerves and another that involves a distal limb
mediated through the spinal cord.  There are very few places in the brain
where neurons influencing tongue and feet are in close proximity to each
other.  The only place I can think of is his brainstem.  It is possible
that this is resulting from some kind of irritation or ischemia of the
brainstem.  Does he have any other brainstem signs (I know that he had
Bell's palsy but this is peripheral)?  How are his eye movements; does he
have nystagmus associated with the tongue movements.  Does it extend into
his larynx and jaw?   Does he get dizzy?  Is he on any other medications
right now, particularly drugs that affect the dopaminergic system?  Has he
had an MRI of his brainstem?  If his problem can be localized to a brain
site and perhaps attributable to a blocked artery to that site, one might
consider less invasive interventional neuroradiological procedures to
improve flow that that site.  That is about all that I can think of.

Wise.

Wise Young, Ph.D., M.D.
Department of Neurosurgery, NYU Medical Center
550 First Avenue, New York, NY 10016
tel: 212-263-6316, fax: 212-689-0334, email: wisey@pipeline.com

In article <847985417.22956@dejanews.com>, tomh@flash.net wrote:

> Elderly gentleman seeking relief for unusual medical condition.  A circular
> or swirling motion in the tongue and feet.  This began in 1988 after his hip
> joint replacement.  He was treated with Klonopin.  After one year the motion
> stopped suddenly.  Oct 1995 the motion returned in the tongue and feet.  He
> has been treated with Klonopin, muscle relaxers, anti-depressants, Botox
shots -
> two shots directly to tongue did not work.  
> 
> 69 year old man has several problems:
> 
> Aneurysm - causing loss of blood flow to the feet (toes black)  9-1-95
> Kidney failure - dialysis 3x week  2-1-96
> Insulin dependent diabetic (many years)
> 5 way bypass  1986
> hip joint replacement 2x  1988 - 1990
> Clogged arteries and aneurysm
> Strokes that affected eyes and hand (seems to have repaired)
> Had Bell Palsy (repaired itself)
> High blood pressure
> He can't be operated on due to plaque in arteries
> 
> We have taken him to several Neurologists and Specialists for tongue and feet.
> Nothing has stopped or slowed the circular motion.  He can't chew or swallow
> whole food because of the motion.  He is desperate for relief!  Any help
> or experience with this dystonia would be very much appreciated.
> 
> D&S  tomh@flash.net
> 
> 
> -----------------------------------------------------------------------
> This article was posted to Usenet via the Posting Service at Deja News:
> http://www.dejanews.com/           [Search, Post, and Read Usenet News]

Wise.

Are the swirling/circular motions repetitive?  Has the gentleman been 
tested for Tourette's Syndrome?

Howard Homler wrote:
> 
> On Thu, 14 Nov 1996 10:31:04 -0600, tomh@flash.net wrote:
> 
> >Elderly gentleman seeking relief for unusual medical condition.  A circular
> >or swirling motion in the tongue and feet.  This began in 1988 after his hip
> >joint replacement.  He was treated with Klonopin.  After one year the motion
> >stopped suddenly.  Oct 1995 the motion returned in the tongue and feet.  He
> >has been treated with Klonopin, muscle relaxers, anti-depressants, Botox shots -
> >two shots directly to tongue did not work.[snip]

In <3292B65A.33BA@hooked.net> Amy Sargent <asargent@hooked.net> writes:

>
>Are the swirling/circular motions repetitive?  Has the gentleman been 
>tested for Tourette's Syndrome?
>
>Howard Homler wrote:
>> 
>> On Thu, 14 Nov 1996 10:31:04 -0600, tomh@flash.net wrote:
>> 
>> >Elderly gentleman seeking relief for unusual medical condition.  A
circular
>> >or swirling motion in the tongue and feet.  This began in 1988
after his hip
>> >joint replacement.  He was treated with Klonopin.  After one year
the motion
>> >stopped suddenly.  Oct 1995 the motion returned in the tongue and
feet.  He
>> >has been treated with Klonopin, muscle relaxers, anti-depressants,
Botox shots -
>> >two shots directly to tongue did not work.[snip]

Tardive dyskinesia???

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney

I've had Torsion Dystonia since childhood.I'm now in my  late 40's. I've only 
met one other person with this disability so it's interesting to discover 
this newsgroup.  I had several neurosurgeries in my teens, which effectively 
controlled the worst symptoms. I use a wheelchair when I need to walk any 
distance, since the more I walk the worse the spasms become in my  left leg 
and foot,. I'm also speech impaired, which I always thought was a result of 
one of the surgeries, untill I read some of the information in the newsgroup. 
I'm very active in disability rights issues and worked in a large Independent 
Living Center untill last year when I had to go on disability due to an 
exacerbation of the symptoms of Myasthenia Gravis, which I also 
have(unrelated to dystonia). However, I am managing to enjoy my "retirement" 
and keep plenty busy.
                          Lynne McKinney