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CURRENT SCIENCE REVIEWS by Joe Bruman August 1996 (page 1 0f 2) Pullman S et al; Arch Neur 1996;53:617-624: In 8-year, open-label study of botulinum toxin on 187 patients (some PD) with varied symptoms of dystonia, spasticity, and tremor, treatment was found safe and useful; better for dystonia and spasticity than for tremor. Albanese A et al; J Neur N'surg Psych 1996;61:693: Botulinum toxin has been used for some time for blepharospasm (inability to open eyelids). In a selected group of patients responding poorly, authors found improvement by changing the injection site from the customary orbital portion of the eyelid muscles to the pretarsal portion (closer to margin of eyelid). Pridmore S, Pollard C; J Neur N'surg Psych 1996;61:693-694: Fourteen PD patients poorly responsive to drug therapy were given ECT (Electro-Convulsive Therapy) and followed for up to 30 months. About a third showed brief mild improvement, a third had sustained mild improvement, and the rest had sustained, marked improvement in akinesia, rigidity, and tremor. Older and more severely afflicted patients seemed to do best, and tremor was the most improved of the symptoms. Litvan I et al; J Neur N'surg Psych 1996;61:615-620: Authors studied 24 patients who died with PSP (Progressive Supranuclear Palsy). PSP was most often misdiagnosed as PD. Most common immediate cause of death was pneumonia. Among the most frequent early symptoms were postural instability, falls, and symmetric bradykinesia unresponsive to levodopa. Median survival after first visit was 5.6yr, and shorter term was associated with dysphagia and incontinence. Taylor J et al; J Neur N'surg Psych 1996;61:621-627: In UK law, epilepsy is the only condition calling for restriction of driver's license. Currently, candidates may apply if they have had no seizure in a year. Treatment by antiepileptic drugs was formerly regarded as indication of epilepsy, but that rule was overturned by the court in 1964. Authors surveyed 16958 drivers having history of epilepsy, in effort to establish criteria for accident risk prediction. Colosimo C et al; J Neur N'surg Psych 1996;61:634-637: To study the mechanism of levodopa-induced motor fluctuations (on-off effect), authors did a controlled comparison in 42 PD patients of levodopa versus apomorphine. Maruyama W et al; Ann Neur 1996;40:119-122: Concentration of (R)-N-methylsalsolinol, a dopamine-derived neurotoxin that induces parkinsonism in rats, was significantly greater in cerebrospinal fluid of untreated PD patients. Parkinson Study Group; Ann Neur 1996;40:99-107: Lazabemide (Ro 19-6327) is a short-acting MAO-B inhibitor like selegiline (Deprenyl) but does not metabolize to amphetamine. Previously found to be safe and well tolerated, it was tested in 321 patients followed for up to a year, to assess delay in need for levodopa. Benefits were like those found in selegiline, in the earlier DATATOP study. CURRENT SCIENCE REVIEWS by Joe Bruman August 1996 (p. 2 of 2) de Boer A et al; J Neur N'surg Psych 1996;61:71-74: Development by authors of a successful questionnaire to assess the quality of life in PD patients. Ben-Shlomo Y; J Neur N'surg Psych 1996;61:4-16: Comprehensive review of PD etiology (still obscure); 165 refs. NOTE: For an introduction to this monthly posting and its associated CSR Index, please refer to my post of 2 July 1996. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403