Abstract
Dystonia, an intractable and cryptogenic disease, causes tortile involuntary movements of neck, trunk or extremities. Results of electrophysiological study indicate that dystonia is caused by disorders of basal ganglia.
Patient:
A 41-year-old male.
Chief complaints:
Involuntary movement of right upper extremity & hiccups.
Case report:
Involuntary movement of the right upper extremity and lassitude of the right lower extremity suddenly appeared in August, 1999. The involuntary movement happened 4 or 5 times a day in fits, and it was sometimes prolonged. The patient could write with his right hand by pressing on it with his left hand. He consulted a neurologist and an orthopedist, and was administered the following medicines: arotinolol hydrochloride, clonazepam, trihexyphenidyl hydrochloride and tizanidine hydrochloride. However, these medicines were not effective. On November 18, patient consulted our hospital. The first Bi-Digital O-Ring Test (BDORT) was performed, and 200 ng of herpes simplex virus type-1 (HSV-I) and 150 mg of mercury were detected in the left parietal lobe of his cerebrum. Amalgams containing mercury in 4 of the patient’s teeth were also detected by BDORT. The patient’s viral antibody values, as determined by EIA, were as follows: VZV IgM (-), VZV IgG (+) 58.5 (under reference values of 2), HSV IgM (-), HSV IgG (-), CMV IgM (-), CMV IgG (+) 30 (under reference values of 4). White blood cell count was 5300/μl, and differential white blood count was within normal range. Erythrocyte sedimentation rate was 16 mm/hour. The patient was started on EPA+DHA (EPA α; Yamanouchi Pharmacy, Tokyo, Japan) 3 capsules and cilantro 500 mg per dose. Also, the patient stopped drinking alcohol, in accordance with our advice. After one week, the patient was started on Omura’s “Selective Drug Uptake Enhancement Method” and therapeutic electrical stimulation of his head. After a month, the patient could run and the involuntary movement of his right hand had almost remitted. On March 16,2000, odontotherapy was concluded.
The involuntary movement of the patient’s right hand remained near remission. The second Bi-Digital O-Ring Test was performed on April 13, 2000, and 100 ng of cytomegalovirus (CMV), 50 mg of mercury, 50 mg of lead and 50 mg of aluminum were detected in the patient’s head. One dose of EPA + DHA (EPA α) I capsule and cilantro 150 mg was effective in relieving the patient’s symptoms. On July 27, 2000, the involuntary movement of the patient’s hand finally disappeared, but the lassitude of the right hand remained. On August 10, 2000, the patient drank some beer, and the involuntary movement of his right hand subsequently reappeared and continued for about 30 minutes. The patient was then started on EPA + DHA (Fish oil, Ootsuka Pharmacy, Japan) 3 capsules and cilantro 200 mg 4 times per day. On December 11, 2000, after the patient drank some beer, the involuntary movement of his right hand improved. Hiccups and hyperpnea appeared. Beginning on December 20, 2000, hiccups and involuntary movement of the rectus abdominis muscle occurred 3 times per day. The patient was then started on EPA + DHA (EPA α) 3 capsules and cilantro 100 mg 4 times per day. Hiccups and involuntary movement decreased, and all symptoms had disappeared by January 11, 2001. However, on February 9, pectoralgia appeared. The third Bi-Digital O-Ring Test was then performed. We detected 300 ng of Chlamydia trachomatis in the patient’s diaphragm and thymus. The patient was treated with the antibiotic levofloxacin for a month, but pectoralgia continued. Moreover, involuntary movement, swelling and numbness of the right hand, and hiccups appeared. On March 9, 2001, the fourth Bi-Digital O-Ring Test was performed. We found 60 ng of integrin α 5 β 1, 1 ng of acetylcholine, 300 mg of mercury and 20 μ g of Mycobacterium tuberculosis in the patient’s head, lungs and stomach. The patient was started on EPA + DHA (EPA α) 3 capsules, cilantro 300 mg and saiko-keishi-to 1.25 g 4 times per day. On April 6, 2001, the hiccups had disappeared and the frequency of involuntary movement of the right hand was once per week. No integrin α 5 β 1 was detected in the head or lungs. On April 27, 2001, no integrin α 5 β 1 was detected anywhere and the frequency of involuntary movement of the right hand was only once per month. The patient required 33 seconds to complete Gibson’s maze test, whereas he required 71 seconds the first time he tried it. Three months later, the patient exhibited no symptoms.
Discussion:
BDORT revealed infection of HSV-1 and CMV in the head and infection of Chlamydia trachomatis in the diaphragm and thymus. However, results of the fourth BDORT indicated that the symptoms were due to metastasis of gastric cancer to the head and to the hilum of the left lung, the latter of which pressed against the left phrenic nerve. The administration of cilantro and EPA + DHA started soon after the first consultation. The involuntary movement was slow to disappear, because cancer growth was gradually intensified by the patient’s consumption of alcohol. After treatment of cancer based on results of BDORT, the patient regained the ability to write because his dystonia disappeared. The possibility of cancer should be considered when diagnosing dystonic patients, because cancer can cause dystonia, as seen in the present case.
Conclusion:
In the present case, the patient suffered from dystonia caused by metastasis to the head.
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