Acessibilidade / Reportar erro

Incidência e características dos movimentos involuntários que espontaneamente surgem em indivíduos idosos

Incidence and characteristics of spontaneous involuntary movements in the elderly: study of 44 cases

Resumos

Dos pacientes internados num asilo para pessoas idosas 36,36% que não tinham tido qualquer contato anterior com neurolépticos, apresentavam movimentos involuntários menos intensos, mas muito semelhantes ao da discinesia tardia. A incidência desses movimentos tendia a aumentar com a idade e muitas vezes eram concomitantes a sinais de parkinsonismo. Alguns achados da literatura indicariam que esses movimentos e as hipercinesias da discinesia tardia poderiam ser produzidos por mecanismos comuns. No particular, entraria em jogo um desequilíbrio entre sistemas colinérgicos e dopaminérgicos.


Involuntary repetitive movements in which several muscle groups are involved are described in connection with several mental and physical syndroms. In this study those occurring in the elderly, when age seems solely to be influencing, are focalized. We found that 36.36% of the residents in an old people home had those symptoms. They were mostly buccolinguomastigatory, less intense but similar to those found in tardive dyskinetic patients. There was a tendency of increasing their incidence with age and sometimes they appeared together with other extrapyramidal manifestations such as parkinsonism. The possibility and importance of a lack of balance between dopaminergic and cholinergic systems to explain those symptoms are discussed.


Incidência e características dos movimentos involuntários que espontaneamente surgem em indivíduos idosos

Incidence and characteristics of spontaneous involuntary movements in the elderly: study of 44 cases

I. G. KarniolI; D. S. P. MouraII

IProfessor Livre Docente do Departamento de Psicologia Médica e Psiquiatria da FCM-UNICAMP

IIProfessor Colaborador do Departamento de Psicologia Médica e Psiquiatria da FCM-UNICAMP

RESUMO

Dos pacientes internados num asilo para pessoas idosas 36,36% que não tinham tido qualquer contato anterior com neurolépticos, apresentavam movimentos involuntários menos intensos, mas muito semelhantes ao da discinesia tardia. A incidência desses movimentos tendia a aumentar com a idade e muitas vezes eram concomitantes a sinais de parkinsonismo. Alguns achados da literatura indicariam que esses movimentos e as hipercinesias da discinesia tardia poderiam ser produzidos por mecanismos comuns. No particular, entraria em jogo um desequilíbrio entre sistemas colinérgicos e dopaminérgicos.

SUMMARY

Involuntary repetitive movements in which several muscle groups are involved are described in connection with several mental and physical syndroms. In this study those occurring in the elderly, when age seems solely to be influencing, are focalized. We found that 36.36% of the residents in an old people home had those symptoms. They were mostly buccolinguomastigatory, less intense but similar to those found in tardive dyskinetic patients. There was a tendency of increasing their incidence with age and sometimes they appeared together with other extrapyramidal manifestations such as parkinsonism. The possibility and importance of a lack of balance between dopaminergic and cholinergic systems to explain those symptoms are discussed.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Este trabalho faz parte da tese de Livre-Docência que I. 6. Karniol apresentou à FCM-UNICAMP, em dezembro de 1979.

Departamento de Psicologia Médica e Psiquiatria - Faculdade de Ciências Médicas da UNICAMP - Rua José Teodoro de Lima 44 - 13100 Campinas SP - Brasil.

  • 1. ALTROCHI, P. H. - Spontaneous oral-facial dyskinesia. Arch. Neurol. (Chicago) 26:506, 1972.
  • 2. BALDESSARINI, R. J. & TARSY, D. - Tardive dyskinesia. In Liptom, M. A.; DiMascio, A. & Killan, K. F. - Psychopharmacology, a Generation of Progresso. Raven Press, New York, 1978.
  • 3. BARBEAU, A. - Parkinson's disease: etiological considerations. In Yahr, M. D. - The Basal Ganglia. Raven Press, New York, 1976.
  • 4. BARBEAU, A. - The last ten years of progress in the clinical pharmacology of extrapyramidal symptoms. In Liptom, M. A.; DiMascio, A. & Killan, K. F. - Psychopharmacology, a Generation of Progress. Raven Press, New York, 1978.
  • 5. BIRKMAYER, W.; DANIELCZYK, W.; NEUMAYER, E. & RIEDERER, P. - Dopaminergic supersensitivity in parkisonism. In Calne, D. B.; Chase, T. N. & Barbeau. A. - Advances in Neurology, vol. 9. Raven Press, New York, 1975.
  • 6. BORDELEAU: J. M.; ALBERT, J. M.; KILLER, J. & TETREAULT, L. - Médication antiparkinsonienne et bilan extra-pyramidal: etude du trihexyphenidyl. Canad. psychiat. Assoc. J., 12:585, 1967.
  • 7. CALNE, D. B. - Clinical pharmacology of dopaminergic effects in parkinsonism. In Bradford, H. F. & Marsden, C. D. - Biochemistry and Neurology. Academic Press, London, 1976.
  • 8. CHADWICK, D.; REYNOLDS, E. H. & MARSDEN, C. D. - Anticonvulsant-induced dyskinesias: a comparison with dyskinesias induced by neuroleptics. J. Neurol. Neurosurg. Psychiat. (London) 39:1210, 1976.
  • 9. CHASE, T. N. - Rational approaches to the pharmacotheraphy of chorea. In Yahr, M. D. - The Basal Ganglia. Raven Press, New York, 1976.
  • 10. CHOWINARD, G.; ANNABLE, L. & ROSS-CHOWINARD, A. - Ethopropazine and benzatropine in neuroleptic-induced Parkinsonism. J. Clin. Psychiat., 40:147, 1979.
  • 11. CHRISTENSEN. E.: MOLLAR, J. E. & FAURBYE, A. - Neuropathological investigation of 28 brains from patients with dyskinesia. Acta psychiat. scand., 46:14, 1970.
  • 12. CLOW, A.; JENNER, P.; THEODOROU, A. & MARSDEN, C. D. - Striatal dopamine receptors become supersensitive while rats are given trifluoperazine for six months. Nature 278:59, 1979.
  • 13. COTZIAS, G. C.; PAPAVASILION, P. S. & GINOS, J. Z. - Therapeutic approaches in Parkinson's disease: possible roles of growth hormone and somatostatin. In Yahr, M. D. - The Basal Ganglia. Raven Press, New York, 1976.
  • 14. CRANE, E. G. - Persistent dyskinesias. Brit. J. Psychiat., 122:395, 1973.
  • 15. CRANE, E. G. - Tardive dyskinesia and related neurologic disorders. In Iversen, L. L.: Iversen, S. D. & Snyder, S. H. - Handbook of Psychopharmacology, vol. 10. Plennum Press, New York-London, 1978.
  • 16. DELWAIDE, P. J. & DESSEILLES, M. - Spontaneous buccolingual dyskinesia in the elderly. Acta neurol. scand., 56:256, 1977.
  • 17. DENNY-BROWN, O. & YANAGISAWA, N. - The role of the basal ganglia in the initiation of movement. In Yahr, M. D. - The Basal Ganglia. Raven Press, New York, 1976.
  • 18. DOMINO, E. F.; DREW, A. T. & GIARDINA, W. J. - Biochemical and neurotransmitter changes in the aging brain. In Lipton M. A.; DiMascio, A. & Killan, K. F. - Psychopharmacology: a Generation of Progress. Raven Press, New-York, 1978.
  • 19. Drugs for Parkinson's Disease. Lancet I: 754, 1978.
  • 20. DUVOISIN, R. C. - Parkinsonism: animal analogues of the human disorder. In Yahr, M. D, - The Basal Ganglia. Raven Press, New York, 1976.
  • 21. EPSTEIN, L. J. - Anxiolytics, antidepressants and neuroleptics in the treatment of geriatric patients. In Lipton, M. A.; DiMascio, A. & Killan, K. F. - Psycho-pharmacology: a Generation of Progress, New York, 1978.
  • 22. FANN, W. E. & WHELESS, J. C. - Effects of psychotherapeutic drugs in geriatric patients. In Usdim, E. & Forrest, I. S. - Psychotherapeutic Drugs. Marcel Dekker Inc., New York, 1976.
  • 23. FRY, J. P. & SHERMAN, D. F. - The effect of tranquillizing drugs on the metabolism of transmitter substances in the central nervous system. In Bradford, Ή. F. & Marsden, C. D. - Biochemistry and Neurology. Academic Press, London, 1976.
  • 24. General discussion on dyskinesia - In Bradford, H. F. & Marsden, C. D. - Biochemistry and Neurology. Academic Press, London, 1976.
  • 25. GERLACH, J. - Relationship between tardive dyskinesia, L-dopa-induced hyperkinesia and parkinsonism. Psychopharm. 51:259, 1977.
  • 26. GERLACH, J. - The relationship between parkisonism and tardive dyskinesia. Am. J. Psychiat., 134:781. 1977.
  • 27. HOEL, P. G. - Estatística Elementar. Fundo de Cultura, Rio de Janeiro, 1968.
  • 28. HORNYKIEWICZ, O. - Brain monoamines and parkinsonism. In Bernard, B. K. - Aminergic hypotheses in behavior: reality or cliche? Research Monograph Series 3, NIDA. Maryland, 1975.
  • 29. HORNYKIEWICZ, O. - Neurohumoral interactions and basal ganglia function and dysfunction. In Yahr, M. D. - The Basal Ganglia. Raven Press, New York, 1976.
  • 30. KLAWANS, H. L. - The pharmacology of tardive dyskinesias. Am. J. Psychiat., 130:82, 1973.
  • 31. LOEB, C.; ROCCATAGLIATA, G.; MEDICA, G.; ALBBRUZZESE, G. & ALBANO, C. - Levodopa and Huntington's Chorea. J. Neurol. Neurosurg. Psychiat. (London) 39:958, 1976.
  • 32. MARSDEN, C. D. - Clinical aspects of the dyskinesias. In Bradford, H. F. & Marsden, C. D. - Biochemistry and Neurology. Academic Press, London, 1976.
  • 33. MARSDEN, C. D.; TARSY, D. & BALDESSARINI, R. J. - Spontaneous and drug-induced movements disorders in psychotic patients. In Benson, D. F. & Blumer, D. - Psychiatric aspects of neurologic disease. Grune and Stratton, New York, 1975.
  • 34. MEHTA, D.: MEHTA, S. & MATHEW, P. - Tardive dyskinesia in psychogeriatric patients: a five-year follow-up. J. amer. ger. Soc, 25:545, 1977.
  • 35. MOURA, D. S. P. & KARNIOL, I. G. - Algumas considerações sobre a incidência da discinesia tardia e suas características no nosso meio. Rev. Assoc. med. brasil, (no prelo).
  • 36. PARKES, J. D. - Clinical aspects of tardive dyskinesia. In Bradford, H. F. & Marsden, C. D. - Biochemistry and Neurology. Academic Press. London, 1976.
  • 37. RASKIND, M. & EISDORFER, C. - Psychopharmacology of the aged. In Simpson, L. L. - Drug Treatment of mental disorders. Raven Press, New York, 1976.
  • 38. SPEHLMANN, R. & STAHL, S. M. - Dopamine acetylcholine imbalance in Parkinson's disease. Lancet II: 724, 1976.
  • 39. TAMMINGA, C. A.: CRAYTON, J. W. & CHASE, T. - Improvement in tardive dyskinesia after muscinol therapy. Arch. gen. Psychiat., 36:595, 1979.
  • 40. TARSY, D. & BALDE SSARINI, R. J. - The pathophysiologic basis of tardive dyskinesia. Biol. Psychiat., 12:431, 1977.

Datas de Publicação

  • Publicação nesta coleção
    20 Ago 2012
  • Data do Fascículo
    Jun 1981
Academia Brasileira de Neurologia - ABNEURO R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices Torre Norte, 04101-000 São Paulo SP Brazil, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revista.arquivos@abneuro.org