A.C. Williams

Pesticide toxicity and motor neuron disease.

recurrent spontaneous accessory 1 At the age of 23 the patient de aching discomfort in the right si neck. This resolved after a few da several weeks he became aware of i shoulder elevation. Examinatio weakness and wasting confined t trapezius muscle. Nerve conduci of the accessory nerve, recorc trapezius, revealed latencies of the right and 2-9 ms on the Ic < 3-2 ms). Electromyography sl motor unit potentials and reduc ment in the right trapezius only. A five months the condition improN size and strength of the righ returned to normal. He remained well and continue

Movement disorder associated with abnormal copper metabolism and decreased blood antioxidants.

as important in extrapyramidal disorders.3 The normal defence against such oxidation is provided by a range of antioxidants of which glutathione is an important intracellular one.4 We describe a patient with a dystonic movement disorder who was found to have low serum copper, increased liver copper and decreased erythrocyte glutathione levels. We suggest that the combination of the copper and glutathione abnormalities may have resulted in dystonia when either on its own may have been insufficient to cause symptoms. A 15 year old Indian schoolboy presented with a 3 year history suggestive of intellectual deterioration which improved spontaneously while undergoing investigation and a 1 year history of persistent and progressive abnormal movements and posture. During this year he had lost 6kg in weight. He was not taking any drugs and in particular had never taken phenothiazines or other antidopaminergic medication. There were no abnormal vocalisations nor any obsessive compulsive behaviour. There