Essential Tremor Treatment with Multi-Modal Nutritional Therapy: A Case Study of a Teenage Patient | Chapter 3 |Achievements and Challenges of Medicine and Medical Science Vol. 5

 

Despite many years of ET research, its pathophysiology remains unknown. Essential tremor (ET) is common and frequently affects quality of life. The case outlines a safe and novel approach to ET treatment that can either be trialed in treatment-refractory cases or used in tandem with traditional therapy. Although traditional pharmacotherapy is sometimes effective, patient factors, lack of efficacy, and poor adherence sometimes limit its efficacy. Furthermore, the pathophysiology of ET is not fully understood, but it is increasingly regarded as a highly heterogeneous disorder of cerebellar pathways underpinned by low gamma-aminobutyric acid (GABA) tone. This knowledge and review of recent data prompted the development of a multi-modal nutritional therapy approach to target three putative ET pathways: (i) diet (specifically adopting a Mediterranean diet); (ii) GABA tone (through oral supplementation); and (iii) L-tryptophan/vitamin B pathways (Triptobel oral supplement). The approach is illustrated here with the case of a 13-year-old boy with ET causing severe functional impairment. A full history revealed no exposure to toxins and there was no family history of ET or other movement disorders. He was prescribed a sugar-free, Mediterranean-style diet rich in whole grains as a carbohydrate source and rich in vegetables, fruit, olive oil, and fish. After two months of therapy, his tremor decreased significantly and he regained normal function. In conclusion, ET is a common disorder that affects quality of life and is often treatment-refractory. The case identifies and highlights several areas worthy of further investigation, particularly with respect to establishing the role of oral GABA and vitamin B/tryptophan supplementation in ET. Given the safety and positive health benefits of this novel nutritional therapy approach, it can be trialed in patients with ET either with or without concurrent traditional pharmacotherapy.

 

Author(s)details:-

 

Maja Roje Novak
Private Neurological Practise, Pavla Hatza 27, 1 Zagreb, Croatia.

 

Please See the book here :- https://doi.org/10.9734/bpi/acmms/v5/2684

Modification of Biochemical Derangements and VEGF Secretion May Prevent Diabetic Retinopathy (DR): An Advance Study | Chapter 6 | Highlights on Medicine and Medical Research Vol. 6

 Unused, massive intracellular glucose in insulin-independent tissues, such as the retina, has many consequences: I increased formation of advanced glycation end products, (ii) polyol pathway activation, (iii) anaerobic glycolysis, (iv) glutamate toxicity, (v) lipid peroxidation and oxidative stress, and (vi) convergence to up regulation of antigenic peptides. The aim of this pilot study is to evaluate the effects of one type of intervention on the development of DR: B-vitamin supplementation (B1, B2, B3, B5, and B6), vitamin C, and vitamin E supplementation on amelioration of biochemical derangements related to DR development. In this unblended randomised trial, 400 diagnosed type 2 diabetic patients were randomly assigned to receive oral antidiabetic medication along with B-vitamins, vitamin C, and vitamin E or only antidiabetic medication to offer the study and monitored population from December 2004 to December 2017. Preliminary tasks were completed as follows: To begin, thorough fundoscopic examinations at baseline were sufficient to rule out the existence of retinopathy. Second, were baseline biochemical parameters such as NAD+, NADH, advanced glycation end products (AGEs), malondialdehyde (MDA), VEGF, and VEGFR2 measured in the blood? Finally, yearly fundoscopic exams were recorded in order to identify DR symptoms. The following conclusions were reached as a result of these efforts: 32 of the 187 (17.11%) patients who obtained B-vitamins, vitamin C, and vitamin E supplementation experienced very mild microangiopathy. 92 patients out of 200 (46%) with diabetic retinopathy experienced mild to moderate nonproliferative diabetic retinopathy (NPDR). Thirteen patients from the research group were counted as missing from the study's observation. The results lead to the following conclusion: To avoid biochemical derangements that lead to increased expression of VEGF, precursors of oxidised cofactors and antioxidants should be supplemented to the glycolysis and citric acid cycle.

Author (s) Details

Lakshmi Kanta Mondal
Regional Institute of Ophthalmology, Kolkata, India.

Subhasish Pramanik
Institute of Post-Graduate Medical Education & Research, Kolkata, India.

Sriparna De
Department of Polymer Science and Technology, University of Calcutta, Kolkata, India.

Suman K. Paine
Regional Medical Research Centre ICMR, Dibrugarh, India.

Gautam Bhaduri
MGM Medical College, Kissangang, Bihar, India.

View Book :- https://stm.bookpi.org/HMMR-V6/article/view/628