Desórdenes neurológicos

Variations of the brachial plexus regarding the composition of nerve fibres and absence or communications are common and being reported by several authors. The objective of the study was to observe and document the variation on the subject of branches of the median nerve. This report will assist clinicians and surgeons by considering anatomical variation associated with the median nerve in interpreting atypical clinical presentations. This report illustrates the two variations in details and explains the consequences they lead to. It also provides first hand anatomic data and great referential value for the future clinical work.

Background: Jaw-opening dystonia is very rarely reported, and involuntary jaw-opening dystonia as an initial manifestation of psychogenic (functional) movement disorder has not yet been reported. This study aimed to report unusual cases of psychogenic (functional) jaw-opening dystonia and to compare the clinical patterns between organic and psychogenic (functional) jaw-opening dystonia. Method: We enrolled three psychogenic (functional) movement disorder patients presenting involuntary severe jaw-opening dystonia as an initial manifestation. Moreover, we review previously reported cases and analyze the clinical pattern of organic psychogenic (functional) jaw-opening dystonia in comparison with our cases. Results: Among 10 cases, including our cases, the most common pattern of organic jaw-opening dystonic symptoms was the sustained pattern. By contrast, all three patients with psychogenic (functional) jaw-opening dystonia presented with a paroxysmal pattern. The major neuro-radiologically associated localizations of organic jaw-opening dystonia were the cerebellum and basal ganglia. Sensory feedback or “sensory tricks” were only observed in organic jaw-opening dystonia. Conclusion: The results of this clinically investigative study may provide support for the differential diagnosis of jaw-opening dystonia between organic and psychogenic (functional) etiologies. Additionally, if paroxysmal jawopening dystonia combined with inconsistent, incongruous hyperkinetic movement symptoms is present, diagnosis of a psychogenic (functional) movement disorder should be considered.

The aim of this study was to identify the brain’s structural differences between males and females and how they relate to clinical manifestations of PD. Voxel-based morphometry (VBM) was used to detect the differences between both sexes in PD and in healthy controls (HC). Also, a Pearson correlation coefficient was used to correlate depression values to grey matter (GM) for PD and HC subjects and for males and females within each group. The VBM analysis results have shown large loss of cortical and subcortical regions in males compared to females in the PD and HC group. Moreover, multiple positive and negative correlations were found between depression and GM, and considered significant at P<0.05. In addition, in PD group, depression scores were correlated positively to the right amygdala in females and positively in males. These results can provide insights for clinicians and researchers who are investigating PD structural differences in males and females and how they might influence PD clinical appearance, changes in motor and non-motor areas might explain the clinical manifestations.

Henceforward, autism is considered as a neurodevelopmental disorder characterized by a deficit of language and communication both associated with a restricted repertoire of activities, motor actions and interests. The aim of the current work was to investigate into a comparative study between standard and autistic children the production of successive linked motor actions. We predicted that the autistic children as the standard ones succeeded to perform the basic motor actions like walking, catching, jumping or running. For example, all the children succeeded to throw the scarf (75%), even if the autistic children sometimes interrupted the execution of this task by stereotyped and repetitive movements (23%). A pragmatic control handled their performances. However, we also advanced a deficit of more cognitive levels in performing those motor actions in planning plan because they required a semantic control. For example, to place the circle in the marks drawn in the ground, the autistic children performed this task in (8 s ± 13.2 s) contrary to the standard ones (0.5 s ± 1 s).