PHYSIOLOGICAL ANALYSIS OF INVOLUNTARY MOVEMENTS

肌阵挛和其他一些快速不自主运动 在临床上很难分类。多发性硬化症的临床和生理分析 持续的患者系列导致了新的分类和 病理生理学方面的见解。一系列部分性癫痫患者 继续研究；病理生理学是异质性的，但在 大多数电生理技术都可以识别大脑中的可兴奋区域 大脑皮层。一系列成人发作性抽动的患者已经被 已分析并制定了临床规则以作出此诊断。 腭裂患者的正电子发射断层扫描研究 肌阵挛显示下层橄榄是过度活跃的。宠物 对半身肌症患者的研究表明，运动能力低下 同侧纹状体是由于大脑中的 丘脑底核。 在姿势动作震颤的研究中，我们一直在分析振幅 作为四肢精确姿势的函数的震颤。对许多人来说 震颤，如小脑姿势震颤，震颤时更严重 手臂靠近身体，双手指向对方。为 其他震颤这不是真的，而且临床和生理上 这一点的意义正在被探索。 手部的特异性局灶性肌张力障碍，如作家抽筋和 已经对钢琴家的抽筋进行了分析，并对一些生理学问题 特征已经被定义。他们的能力似乎有所减弱 自主操控手指与体感诱发门控 自主运动的电位是异常的。痉挛本身就有 被刻画成不同的模式。眨眼的异常 反射已在肌张力障碍中被发现。我们已经核实了这一点 在我们自己的一些患者身上，现在正在将这一测试应用于 局灶性手部抽筋的患者。

Myoclonus and a number of other rapid involuntary movements have been difficult to classify clinically. Clinical and physiological analysis of a continuing series of patients has led to new classifications and pathophysiological insights. A series of patients with epilepsia partialis continue have been studied; the pathophysiology is heterogeneous, but in most electrophysiological techniques can identify an excitable region in cerebral cortex. A series of patients with adult onset tic have been analyzed and clinical rules have been formulated to make this diagnosis. Positron emission tomography (PET) studies of patients with palatal myoclonus have revealed that the inferior olives are hyperactive. PET studies of patients with hemiballimus have revealed that hypoactivity of the ipsilateral striatum occurs as a result of the lesion in the subthalamic nucleus. In studies of postural action tremors, we have been analyzing the amplitude of the tremor as a function of the precise posture of the limbs. For many tremors, such as cerebellar postural tremor, the tremor is worse when the arms are near the body and the hands are pointing towards each other. For other tremors this is not true, and the clinical and physiological significance of this is being explored. Task specific focal dystonias of the hands such as writer's cramp and pianist's cramp have been analyzed and a number of physiological characteristics have been defined. There appears to be diminished ability to control the fingers independently and gating of somatosensory evoked potentials with voluntary movement is abnormal. The spasms themselves have been characterized into different patterns. Abnormalities of the blink reflex have been identified in dystonic disorders. We have verified this in a number of our own patients and are now applying this test to the patients with focal hand cramps.