flunarizine and Syndrome

Secondary parkinsonism induced by exposure to dopamine (DA) receptor antagonists as first and second generation antipsychotics, DA storage depleters, calcium channel blockers, benzamides substituted and other classes of drugs is traditionally believed to be completely reversible in most of patients following withdrawal of the offending drug even though after a variable time delay. The lack of recovery or initial full recovery with subsequent development of progressive parkinsonism has been regarded to result from an underlying subclinical degenerative process like PD unmasked by the inducing drug. These well-recognized clinical outcomes of drug-induced parkinsonism (DIP) have disregarded the existence of another outcome, characterized by permanent non-progressive parkinsonism. This syndrome may fullfil the criteria of tardive parkinsonism, a controversial entity currently referred to as a persistent condition without indication of its long-term course and clinical features. On reviewing the published literature on DIP, we have identified two prospective long-term follow-up of elderly patients in which parkinsonism induced by the calcium channel antagonists cinnarizine and flunarizine became permanent and non-progressive following drug discontinuation in a non-negligible proportion of patients, consistent with the clinical concept of a true tardive syndrome, according to currently accepted criteria. The authors hypothesize that the development of tardive parkinsonism might be due to a neurotoxic effect of the pharmacodynamic proprieties of the calcium channel blockers and their metabolites, exerted on post-synaptic striatal neurons and/or a neurotoxic damage on presynaptic DA neurons in patients without an underlying subclinical degenerative parkinsonism, so accounting for the stable and non-progressive course over time.

Topics: Aged; Antipsychotic Agents; Calcium Channel Blockers; Cinnarizine; Dopamine Antagonists; Flunarizine; Humans; Parkinson Disease, Secondary; Parkinsonian Disorders; Prospective Studies; Syndrome

The action of the antagonists of the calcium was evaluated in the Urethral Syndrome of the woman (incontinence, urgency, disury).. In 60 female's patients that went for urethral syndrome. I used the Cinarizina in 20 patients, and the Flunarizina in 20 patients. And in 20 patients were used placebo.. In the patients that used Flunarizina and Cinarizina were observed a reduction of the urine incontinence, of the urgency, and the disury, the micturition was lingering and easy, the number of the micturitions decreased by the morning, compared with the patients that used placebo.. The antagonists of the calcium can be useful in those patients with urethral syndrome especially the biggest women.

Topics: Adult; Aged; Aged, 80 and over; Calcium Channel Blockers; Cinnarizine; Female; Flunarizine; Humans; Middle Aged; Postoperative Complications; Syndrome; Urethral Diseases; Urinary Incontinence; Vasodilator Agents

The effect of flunarizine (10 mg/day) was studied in open and double-blind clinical trials. Patients presenting the symptom of dizziness were diagnosed as having the hyperventilation syndrome. They showed vestibular hyperreactivity in the velocity step test. This test was performed before and after 4-6 weeks of treatment. The results of treatment were compared with a control or placebo group. In an open trial, 12 of 14 patients reported alleviation of dizziness during treatment and showed a significant decrease in right-left asymmetry of their velocity step responses. In a double-blind trial, no significant difference in effects or side effects was found between the drug and placebo groups.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Dizziness; Double-Blind Method; Electronystagmography; Female; Flunarizine; Humans; Hyperventilation; Male; Middle Aged; Reflex, Vestibulo-Ocular; Syndrome; Vestibular Function Tests

Twenty-seven boys with Duchenne muscular dystrophy (DMD) entered a double-blind controlled trial of treatment with the calcium antagonist flunarizine. They were matched for age and disability. At monthly intervals, muscle power, functional ability, locomotor score, contractures, and forced vital capacity were measured by a team not involved in clinical care. Over a period of 1 year, flunarizine in a dose of up to 0.25 mg/kg/day had no effect on the clinical course of the disease.

Topics: Adolescent; Animals; Calcium Channel Blockers; Child; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Flunarizine; Humans; Male; Muscular Dystrophies; Rats; Syndrome

Topics: Aged; Amiodarone; Female; Flunarizine; Humans; Supranuclear Palsy, Progressive; Syndrome; Vasodilator Agents

Topics: Aged; Anticonvulsants; Flunarizine; Humans; Male; Middle Aged; Migraine without Aura; Noise; Sensation Disorders; Sleep Wake Disorders; Syndrome

Cyclical vomiting syndrome (CVS), and abdominal migraine (AM) are relatively unusual periodic syndromes, generally believed to be migraine equivalents, and are characterized by recurrent and severe paroxysmal episodes of vomiting and/or abdominal pain lasting hours to days, separated by weeks to months of no symptoms. Flunarizine is a calcium channel-blocking agent that has been used successfully as a prophylactic agent in the prevention of both childhood and adult-onset migraine syndromes. The purpose of this study was to evaluate the efficacy of flunarizine as a prophylactic/preventive agent in the treatment of CVS and AM. Eight children with CVS and 10 children with AM were included in the study. The mean dose of flunarizine was 5 mg/day in children with CVS, and 7.5 mg/day in children with AM. Follow-up ranged from 6 to 24 months (mean 13 months). There was a 57% reduction in frequency and 44% reduction in duration of attacks of CVS, and a 61% reduction in frequency and 51% reduction in duration of attacks of AM. Sixty-four percent of patients with CVS and AM had history of episodic recurrent headaches with 60% reduction in frequency of attacks on treatment. Flunarizine showed to be equally efficacious than previously tried therapies in the prophylaxis of a small cohort of patients with CVS and AM.

Topics: Calcium Channel Blockers; Child; Child, Preschool; Female; Flunarizine; Humans; Male; Migraine Disorders; Periodicity; Retrospective Studies; Syndrome; Treatment Outcome; Vomiting

Topics: Adult; Brain Stem Neoplasms; Calcium Channel Blockers; Child; Diagnosis, Differential; Epilepsy; Female; Flunarizine; Gastrointestinal Diseases; Humans; Menstruation; Metabolic Diseases; Migraine without Aura; Recurrence; Syndrome; Vomiting

Episodic spontaneous hypothermia is an infrequent disorder, with unknown pathogenic mechanisms. A systemic cause or underlying brain lesion has not been found for the disease. We report four new patients, 3-9 years old, with episodic hypothermia lower than 35 degrees C, marked facial pallor, and absent shivering. The episodes could last a few hours or four days, and recurred once a week or every 2-3 months. Two patients also demonstrated bradycardia, mild hypertension, and somnolence during the events; in one of them, profuse sweating was also a feature, and all four presented with either headache, a periodic childhood syndrome, or both (recurrent abdominal pain, cyclic vomiting, or vertigo). Three patients reported a family history of migraine. Neurologic examination, endocrine function, and imaging studies were normal. Migraine prophylactic therapy was of moderate efficacy. Spontaneous resolution was observed in one patient. The clinical characteristics of the syndrome allow for its inclusion as a childhood periodic syndrome related to migraine.

Topics: Abdominal Pain; Body Temperature; Bradycardia; Child; Child, Preschool; Consciousness Disorders; Cyproheptadine; Diagnosis, Differential; Female; Flunarizine; Genetic Predisposition to Disease; Humans; Hyperhidrosis; Hypertension; Hypothermia; Infant; Male; Migraine Disorders; Neurologic Examination; Periodicity; Reference Values; Remission, Spontaneous; Syndrome

Alternating hemiplegia of childhood is a rare disorder characterized by recurrent attacks of hemiplegia affecting either side of the body, oculomotor and autonomic disturbances, movement disorders, and progressive cognitive impairment. We report on one family with autosomal dominant alternating hemiplegia. The disorder was first recognized in a 9-year-old child, the third son of the family, who presented with learning disability, tonic-clonic seizures, dystonic attacks, and episodes of alternating hemiplegia starting at the age of 2 1/2 years. His mother and three brothers had similar symptoms. The maternal uncle, who has learning disability, had experienced multiple dystonic attacks. Tests performed on the family, including computerized tomography, magnetic resonance imaging, and magnetic resonance angiography of the brain as well as metabolic evaluation, were normal. Cytogenetic analysis was normal and mitochondrial DNA analysis revealed no deletions or mutations in the four affected family members and the grandmother. An autosomal dominant mode of inheritance is suggested by the fact that both sexes are affected in two generations.

Topics: Adult; Anticonvulsants; Child; Dystonia; Family Health; Female; Flunarizine; Genes, Dominant; Hemiplegia; Humans; Male; Neurologic Examination; Pedigree; Seizures; Syndrome

Three new cases compatible with hypnic headache syndrome (HHS) are presented. The patients were 70, 77, and 79 years of age (2F, 1M). They described a history of nocturnal headache ranging from 5 months to 7 years. One patient was afflicted with diffuse pain but the other two had unilateral pain. In one patient headache was clearly related with dreams, but in the other two this point could not be confirmed. Except for headache being unilateral in two cases, the remaining HHS criteria were present. It is noteworthy that pain responded to flunarizine in two patients.

Topics: Aged; Calcium Channel Blockers; Dominance, Cerebral; Dopamine Antagonists; Dreams; Female; Flunarizine; Headache; Humans; Male; Sleep Wake Disorders; Syndrome; Treatment Outcome

Alternating hemiplegia of childhood is a rare syndrome characterized by onset before 18 months of age of frequent attacks of alternating paralysis, transient ocular palsies, nystagmus, choreoathetosis, and autonomic dysfunction. We describe features of 10 patients followed for up to 27 years. The mechanism of alternating hemiplegia remains unknown but an association to migraine is suspected because of the strong family history of migraine and aura symptoms in some patients. We treated nine patients with flunarizine, a calcium channel blocker, for up to 5 years; they showed a reduction in duration of the hemiplegic attacks, but the episodes ceased completely in only one patient. With long-term follow-up, the persistent motor, movement, and cognitive deficits are more apparent. It is not certain if the flunarizine alters this course.

Topics: Adolescent; Adult; Autonomic Nervous System Diseases; Child; Child, Preschool; Electroencephalography; Female; Flunarizine; Hemiplegia; Humans; Magnetic Resonance Spectroscopy; Male; Muscles; Nystagmus, Pathologic; Organophosphorus Compounds; Recurrence; Retrospective Studies; Status Epilepticus; Syndrome

We report the familial occurrence and apparent autosomal dominant inheritance of alternating hemiplegia of childhood. The proband, a 9-year-old boy, presented with developmental retardation, rare tonic-clonic seizures, and frequent episodes of flaccid alternating hemiplegia that had been presumed to represent postictal paralysis. The hemiplegia spells, which started in his first year, did not respond to multiple antiepileptics. Between attacks, there was choreoathetosis and dystonic posturing. Father, brother, paternal uncle, and paternal grandmother had similar histories of alternating hemiplegia. Investigations included negative CT, metabolic, and coagulation studies. EEG and SPECT 99mTc exametazime scanning failed to reveal any significant slowing or any major changes in cortical perfusion during hemiplegia as compared with nonhemiplegic periods. The karyotype revealed a balanced reciprocal translocation, 46,XY,t(3;9)(p26;q34) in the patient, in all the affected living relatives, and in one apparently unaffected sibling. The asymptomatic mother had a normal karyotype. Analysis of DNA markers was consistent with the karyotype results. Both affected siblings were treated with and responded to flunarizine therapy, with a greater than 70% decrease in attack frequency. Documented flunarizine trough serum concentrations were 28.9 ng/ml in the proband and 6.6 ng/ml in his brother.

Topics: Adult; Child; Child, Preschool; Diagnosis, Differential; Electroencephalography; Epilepsy; Flunarizine; Genes, Dominant; Genetic Linkage; Hemiplegia; Humans; Karyotyping; Male; Pedigree; Polymorphism, Restriction Fragment Length; Syndrome; Tomography, Emission-Computed, Single-Photon