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1.  Influence of sensory manipulation on postural control in Parkinson's disease. 
Postural control was assessed on a tilting platform system in 20 patients with idiopathic Parkinson's disease and 20 age-matched controls. The amount of information provided by vision and lower limb proprioception was varied during the experiment to investigate the influence of changes in sensory cues on postural control. The patient group with clinical evidence of impaired postural control (Hoehn and Yahr III) had significantly higher sway scores over all sensory conditions than either the Hoehn and Yahr II group or controls. The pattern of sway scores indicated that no obvious deficit in the quality, or processing, of sensory information was responsible for the postural instability observed in this group. The patients in both Hoehn and Yahr groups were also able to respond appropriately to potentially destabilising sensory conflict situations and significantly improved their sway scores when provided with visual feedback of body sway. The results indicate that in Parkinson's disease, the main site of dysfunction in postural control is likely to be at a central motor level.
PMCID: PMC1015374  PMID: 8270927
2.  Coordination of eye and head movements during smooth pursuit in patients with vestibular failure. 
During pursuit of smoothly moving targets with combined eye and head movements in normal subjects, accurate gaze control depends on successful interaction of the vestibular and head movement signals with the ocular pursuit mechanisms. To investigate compensation for loss of the vestibulo-ocular reflex during head-free pursuit in labyrinthine-deficient patients, pursuit performance was assessed and compared under head-fixed and head-free conditions in five patients with isolated bilateral loss of vestibular function. Target motion consisted of predictable and unpredictable pseudo-random waveforms containing the sum of three or four sinusoids. Comparison of slow-phase gaze velocity gains under head-free and head-fixed conditions revealed no significant differences during pursuit of any of the three pseudo-random waveforms. The finding of significant compensatory eye movement during active head movements in darkness in labyrinthine-deficient patients, which were comparable in character and gain to the vestibular eye movement elicited in normal subjects, probably explains the similarity of the head-fixed and head-free responses. In two additional patients with cerebellar degeneration and vestibular failure, no compensatory eye movement response was observed, implying that the cerebellum is necessary for the generation of such responses in labyrinthine-deficient patients.
PMCID: PMC1015324  PMID: 1479390
3.  Feasibility of percutaneous transluminal angioplasty for carotid artery stenosis. 
Percutaneous transluminal balloon angioplasty was attempted in seven patients with internal carotid artery stenosis, including one patient who had two procedures. All had recurrent, carotid territory, neurological symptoms considered haemodynamic in origin. Six had occlusion of the contralateral internal carotid artery. Cerebral blood flow studies confirmed diminished cerebrovascular reserve in six patients studied. In five patients (six procedures) angioplasty of the stenosed internal carotid artery was carried out successfully. With two patients technical difficulty in crossing the stenosis prevented angioplasty and in one patient with bilateral stenosis the procedure was not attempted on the second side because of the severity of the stenosis. In two patients transient aphasia developed during cannulation of the carotid artery and in another a transient monoparesis developed during the procedure. Both these haemodynamic complications recovered within ten minutes. No other complications occurred. Our experience suggests that balloon angioplasty is technically feasible in the management of stenotic carotid disease associated with haemodynamic stroke. It is a technically simple procedure requiring only a brief admission to hospital. However, its general application to patients with thromboembolic carotid-territory stroke will depend on the risk/benefit ratio compared to carotid endarterectomy or to conventional medical treatment.
PMCID: PMC1014136  PMID: 2139110
4.  Idiopathic dystonia and cervical spondylotic myelopathy. 
Cervical myelopathy developed in two patients with idiopathic torsion dystonia. There were marked spondylotic changes in both patients, probably attributable to the incessant dystonic movements of the neck. Previous cervical spine surgery may have exacerbated the myelopathy in one of the patients. Cervical myelopathy complicating idiopathic dystonia must be distinguished from other causes of neurological deterioration, since it may be improved by appropriate neurosurgical treatment.
PMCID: PMC1031604  PMID: 2614440

Results 1-4 (4)