Epidemiology of major depression in Belgian parkinsonian patients

in Acta Neurologica Belgica (2010), 110

Treatments for progressing Parkinson's disease: a clinical case scenario study.

in Acta Neurologica Belgica (2009), 109(3), 189-99

OBJECTIVE: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts. METHODS ... [more ▼]

OBJECTIVE: A 'case scenario' study on clinical decisions in progressing Parkinson's disease (PD) was developed to complement scientific evidence with the collective judgment of a panel of experts. METHODS: The opinions of 9 experts in movement disorders on the appropriateness of 9 common pharmacological treatments for 33 hypothetical patient profiles were compared to those of 14 general neurologists. Before rating the case scenarios, all participants received a document integrating European and US guidelines for the treatment of patients with advanced PD. Case scenarios showing disagreement or with inconsistencies in appropriateness ratings were discussed at a feedback meeting. A tool for interactive discussion on the clinical case scenarios included was developed based on the outcome of the study. RESULTS: Current guidelines are often insufficient to adequately guide the management of patients with progressing PD. The case scenario study did not reveal major differences in opinions between experts in movement disorders and general neurologists about the appropriateness of certain drug choices for specific case scenarios. However in about 1 out of 5 treatment decisions where experts stated appropriateness or inappropriateness, the general neurologists panel had no or dispersed opinions. CONCLUSIONS: This study reveals more uncertainty about treatment of advanced PD in general neurologists compared with experts in movement disorders and underlines the need for additional support for guiding treatment decisions in clinical practice. [less ▲]

Painful legs and moving toes: a syndrome with different physiopathologic mechanisms.

in Neurology (1984), 34(8), 1108-12

Six patients with the syndrome of "painful legs and moving toes" were studied. Although clinical differences were nonspecific, the EMG disclosed two subgroups: one with a simple, erratic pattern of ... [more ▼]

Six patients with the syndrome of "painful legs and moving toes" were studied. Although clinical differences were nonspecific, the EMG disclosed two subgroups: one with a simple, erratic pattern of spontaneous activities in foot and leg muscles, and the other with a complex alternating pattern in antagonistic muscles. In the first group, the physiopathologic mechanism is thought to act in the periphery: in the lumbar roots when local anesthesia of the posterior tibial nerve suppresses spontaneous discharges, or in the nerve trunk when it is ineffective. In the second group, the symptomatology may be generated centrally, implying a more general disturbance of sensorimotor control. [less ▲]

Painful legs and moving toes: démembrement clinique et physiopathologique du syndrome

in Acta Neurologica Belgica (1983), 83