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Experts in the field, Drs. Singer, Mink, Gilbert, and Jankovic, fill the gap in the market by offering the only comprehensive text devoted solely to the diagnoses and treatment of all pediatric movement disorders. Discussions of common and rare disorders such as movements that occur in sleep and psychogenic movement disorders and the latest advances and developments in medications keep you apprised of today’s best practices. Each chapter is accessible, illustrated, stylistically uniform, and carefully referenced, making it easy to access the information you need. This brand-new reference is the ideal resource for the seasoned specialist as well as the non-expert clinician. Best of all, Expert Consult functionality gives you convenient access to the full text online – fully searchable, a downloadable image library, and enhanced visual guidance with narrated, diagnostic videos at expertconsult.com.

• Includes online access to the complete contents of the book, fully searchable, including all of the book’s illustrations, 58 narrated videos of actual patients and their disorders, and abstracts to Medline at expertconsult.com

• Discusses neurobiology, classification, diagnostic evaluation, and treatment, making this a one-stop-shop for all you need to know to diagnose and treat any child with any movement disorder.

• Offers expert guidance and detailed coverage on today’s hot topics, including movements that occur in sleep, drug-induced movement disorders in children, and psychogenic movement disorders to help you better treat whatever you encounter.

• Addresses developmental, paroxysmal, hyperkinetic and hypokinetic, and other movement disorders, offering complete, comprehensive coverage.

• Presents chapters based on clinical symptomology and disease with specific therapy guidance at the end of each chapter.

• Uses illustrations and a logical organization throughout, making reference a snap.


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Date de parution

10 mai 2010

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1

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9781455711307

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English

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2 Mo

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Movement Disorders in Childhood

Harvey S. Singer, MD
Professor of Neurology and Pediatrics, Haller Professor of Pediatric Neurological Diseases
Director of Pediatric Neurology, The Johns Hopkins Hospital, Baltimore, Maryland

Jonathan W. Mink, MD, PhD
Professor of Neurology, Neurobiology and Anatomy, and Pediatrics
Chief, Child Neurology, University of Rochester Medical Center, Rochester, New york

Donald L. Gilbert, MD
Director, Movement Disorder Clinic and Tourette’s Syndrome Clinic
Associate Professor of Pediatric Neurology, Cincinnati Children’s Hospital, Cincinnati, Ohio

Joseph Jankovic, MD
Professor of Neurology, Director, Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas
Saunders
Front matter
Movement Disorders in Childhood

Movement Disorders in Childhood
Harvey S. Singer, MD, Professor of Neurology and Pediatrics, Haller Professor of Pediatric Neurological Diseases, Director of Pediatric Neurology, The Johns Hopkins Hospital, Baltimore, Maryland
Jonathan W. Mink, MD, PhD , Professor of Neurology, Neurobiology and Anatomy, and Pediatrics Chief, Child Neurology, University of Rochester Medical Center, Rochester, New york
Donald L. Gilbert, MD , Director, Movement Disorder Clinic and Tourette’s Syndrome Clinic, Associate Professor of Pediatric Neurology, Cincinnati Children’s Hospital, Cincinnati, Ohio
Joseph Jankovic, MD , Professor of Neurology, Director, Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas
Copyright

MOVEMENT DISORDERS IN CHILDHOOD
ISBN: 978-0-7506-9852-8
Copyright © 2010 by Saunders, an imprint of Elsevier Inc.
All rights reserved . No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com . You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions .


Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on his or her own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher
Previous editions copyrighted 2010
Library of Congress Cataloging-in-Publication Data
Movement disorders in childhood / Harvey S. Singer … [et al.].—1st ed.
Includes bibliographical references.
ISBN 978-0-7506-9852-8
1. Movement disorders in children. I. Singer, Harvey S.
[DNLM: 1. Movement Disorders. 2. Child. WS 340 M9354 2010]
RJ496.M68M685 2010
618.92′683—dc22
2009034376
Acquisitions Editor : Adrianne Brigido
Development Editor : Taylor Ball
Publishing Services Manager : Anitha Raj
Project Manager : Mahalakshmi Nithyanand
Design Direction : Louis Forgione
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication
We dedicate this book to our patients, mentors, students, fellows, and other trainees for their inspiration and to our wives and families for their enduring support.
Preface

Harvey S. Singer, MD, Jonathan W. Mink, MD, PhD, Donald L. Gilbert, MD, MS, Joseph Jankovic, MD
Movement disorders are a relatively new area of specialization within child neurology. For many years, movement abnormalities affecting the pediatric population received little attention in adult-oriented textbooks, and chapters were frequently written by adult neurologists. Over the past several decades, child neurologists have assumed a greater role in the care of children with movement disorders and the investigation of their underlying etiologies and mechanisms.
The decision to produce a high-quality text devoted to movement disorders in children was based on a perceived need for an informative, useful resource that would benefit the care of affected individuals. In the process of attaining this ultimate goal, several working aims were established. First and foremost, each chapter would be written by a board-certified child neurologist with a strong clinical and scientific background in the field. Second, the number of authors would be limited, in order to maintain an active dialogue and comprehensive review of each chapter. Lastly, recognizing that written descriptions of abnormal movements are often limited and that visual aides are an essential teaching tool, the inclusion of videos was a requirement.
Chapters were written by Harvey Singer, Jonathan Mink, and Donald Gilbert and reviewed by all authors. Patient videos, designed to illustrate and enhance the described phenomenology, were provided by Joseph Jankovic, who also reviewed and edited all the chapters. The book is organized in sections. The first section, Chapters 1 to 4 , includes basal ganglia and cerebellar anatomy, physiology, and pharmacology; standard definitions; and diagnostic approaches. Subsequent chapters are disease oriented, based on age of presentation, predominant motor phenomenology (hypokinetic or hyperkinetic), or clinical etiology (static encephalopathy, metabolic disease, etc). Where possible, chapters share a common format consisting of an overview, definition, review of clinical characteristics, neuronatomic localization, and pathophysiology, followed by a discussion of individual diseases and disorders. Lastly, we have included appendices with information of general relevance to a clinician managing a child with a movement disorder. Appendix A covers common medications used in the treatment of movement disorders (doses, side effects, and drug interactions). Appendix B provides a guide for diagnosing heritable movement disorders, with tips on the use of the Online Mendelian Inheritance in Man (OMIM) and Genetests websites. Appendix C provides legends to the videos.
For all, this was a labor of pleasure and one of continued learning. We believe that this book provides a fundamental background of neuronal circuitry, an approach to patient evaluation, and a comprehensive review of disorders that should be acceptable to readers at all levels of experience. We fully recognize that advances in pediatric movement disorders continue to proceed at a rapid pace and that future updates may be required.
FALL, 2009
Acknowledgments
The authors would like to thank the staff at Elsevier for their assistance and flexibility. In particular, we acknowledge the efforts of Taylor Ball and Mahalakshmi Nithyanand.
Table of Contents
Instructions for online access
Front matter
Copyright
Dedication
Preface
Acknowledgments
Section 1: Overview
Chapter 1: Basal Ganglia Anatomy, Biochemistry, and Physiology
Chapter 2: Cerebellar Anatomy, Biochemistry, and Physiology
Chapter 3: Classification of Movement Disorders
Chapter 4: Diagnostic Evaluation of Children with Movement Disorders
Section 2: Developmental Movement Disorders
Chapter 5: Transient and Developmental Movement Disorders in Children
Section 3: Paroxysmal Movement Disorders
Chapter 6: Tics and Tourette Syndrome
Chapter 7: Motor Stereotypies
Chapter 8: Paroxysmal Dyskinesias
Section 4: Hyperkinetic and Hypokinetic Movement Disorders
Chapter 9: Chorea, Athetosis, and Ballism
Chapter 10: Dystonia
Chapter 11: Myoclonus
Chapter 12: Tremor
Chapter 13: Ataxia
Chapter 14: Parkinsonism
Section 5: Selected Secondary Movement Disorders
Chapter 15: Inherited Metabolic Disorders Associated with Extrapyramidal Symptoms
Chapter 16: Movements That Occur in Sleep
Chapter 17: Cerebral Palsy
Chapter 18: Drug-Induced Movement Disorders in Children
Chapter 19: Psychogenic Movement Disorders
Drug Appendix
Search Strategy for Genetic Movement Disorders
Video Atlas
Index
Section 1
Overview
1 Basal Ganglia Anatomy, Biochemistry, and Physiology

Introduction
The basal ganglia are large subcortical structures comprising several interconnected nuclei in the forebrain, diencephalon, and midbrain. Historically, the basal ganglia have been viewed as a component of the motor system. However, there is now substantial evidence that the basal ganglia interact with all of the frontal cortex and with the limbic system. Thus the basal ganglia likely have a role in cognitive and emotional function in addition to their role in motor control. Indeed, diseases of the basal ganglia of

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