Talk:Klazomania

Room For Improvement

This article could be improved if it included what effects Klazomania can have on you life, pictures, or explained exactly what, if any, limitations there may be to the compulsive shouting. Dingmana (talk) 22:10, 18 September 2011 (UTC)

Hi Dingmana, Thank you for the suggestion. I think if you read the article now, with help from the edits of SandyGeorgia your suggestion has been implemented. (Adondaki (talk) 23:10, 8 November 2011 (UTC))

Copied from User talk:NeuroJoe/BI481 Spring 2011

I see your students have been working on this article in sandbox. My experience with student projects in the past has been that they do not engage on article talk, so I'm posting here instead, although I'll repeat this conversation at Talk:Klazomania and hope the students will follow it there.

The work on cursory glance looks reasonable (I haven't examined it in detail yet for close paraphrasing, copyvio, and correct use of secondary peer-reviewed sources per WP:MEDRS, but what stands out right away are the following:

1. Most significantly, the article lead has been eliminated: see WP:LEAD.
2. The article sections should conform with Wikipedia:MEDMOS#Diseases or disorders or syndromes; some of them are misnamed, some text could be better placed, History should not be first, and the order of sections could be improved to comply with WP:MEDMOS. A good deal of text needs to be moved around.
3. PMIDs are missing for verification that secondary sources are used and primary sources are not overused. I'll work on adding those, but it would be helpful if your students viewed this Dispatch on "Sources in biology and medicine".
4. Sourcing: the Merck Manual is not a good source for medical articles, and there are secondary peer reviewed sources that have been neglected. Please have your students review WP:MEDRS and the Dispatch above.
5. See WP:MEDMOS wrt audience-- words like "sufferers" for example are better replaced with neutral words like "individuals".
6. I'll fix the faulty footnote placement (students may want to review WP:FN, footnotes go after punctuation except dashes).
7. Much attention is needed to wikilinking.
8. The bottom of the article was wiped out along with the lead.

Finally, if your students would post a note to article talk when they are working in sandbox, their work can be guided by others and may be more productive and efficient. It's a very nice start, and I hope this list will help the article become even better, in line with Wikipedia medical standards.

Regards, SandyGeorgia (Talk) 01:32, 2 November 2011 (UTC)

Specifics

From this version posted from sandbox:

1. The subject generally appears angry during these attacks,

   Please provide the exact text from the source: I doubt that this is "generally" true, although it may sometimes be true.

   This was a misquote of sorts. Bates et al. remark that Benedek's colleagues (presumably E. Von Thurzó and T. Katona) noted the "angry, flushed face of the patient", so I switched it to flushed instead. Fowlerta (talk) 03:19, 2 November 2011 (UTC)

   Great-- here's my concern-- the people I know with klazomania do not ever appear angry during this tic, so my concern was that one patient was generalized to all-- I doubt that is correct. I also doubt that they are generally "flushed"-- if the source noted it in one patient, the problem is the use of the word "generally". By the way, in order to preserve the bullet formatting of this list, just have a look at this post and see how I formatted it (add one more period after the pound sign). SandyGeorgia (Talk) 03:23, 2 November 2011 (UTC)

2. The discussion (now under "Classification") of klazomania as a tic or compulsion needs clarification for the average reader, who likely isn't aware of the fuzzy border between tics and compulsions (in fact, even I had a hard time understanding what the writers were intending to say here).
3. Further, if klazomania is a tic, then this statement needs adjusting:

   Studies have shown that klazomania is similar to Tourette syndrome and obsessive-compulsive disorder, which involve tics and compulsions

   Is it a tic or isn't it? Is it thought to a tic or a compulsion? Regardless, is it "similar" to TS an OCD, or is it a "symptom" (just like other tics and compulsions) of TS and OCD? Studies have shown it to be similar "how"? No idea what this sentence is intending to say; please place the exact text from the source here on talk and I'll parse it.

4. There is a misplaced citation here which gives rise to WP:COPYVIO concern; did it come from another article? What is it supposed to be? Copying text from sources is a good way to get into trouble ala WP:PARAPHRASE. Please fix the (4) and avoid copying text from other articles, if that's where it came from:

   One hypothesis researchers have produced is that klazomania originates in the periaqueductal gray matter in the mesencephalon (4) ...

   This was an oversight on our part. We were marking where citations needed to go and I missed replacing this one with the proper citation. It should be fixed now. Fowlerta (talk) 03:10, 2 November 2011 (UTC)

5. What is "sham rage"?
6. The weakest section is text that is now all under "Pathophysiology" (once the text is cleaned up, it may result that the text doesn't belong there, in fact, in the article at all, too much detail, but hard to tell until it's linked and copyedited). It is in need of linking (see WP:MOSLINK, avoid WP:OVERLINKing).
7. Does " ... then send a weaker inhibitory gabaergic ... " intend to be "gabaminergic"?
8. What is this article? I can't locate it in PubMed, and there are far better (and freely available) Leckman articles describing tics. I can't find a PMID for this:

   Marsh R, Leckman JF, Bloch MH, Yazgan Y, Peterson BS. "Tics and Compulsions: Disturbances of Self-Regulatory Control in the Development of Habitual Behaviors". Neurodevelopmental Aspects of Clinical Disorders: 717–37.{{cite journal}}: CS1 maint: multiple names: authors list (link)

9. Ditto, I can't locate this article indexed at PubMed, so can't tell if it is a secondary review or a primary study:

   Bates GDL; Lampert I; Prendergast M; Van Woerkom AE (1996). "Klazomania: The screaming tic". Neurocase 2 (1): 31-34.

10. Sourcing problem: a 1987 case report is not an adequate source for this statement in 2011 (besides that I can't tell what the sentence is trying to say, even after cleaning it up-- clarify pls?):

    While klazomania is associated with other complex phonic tics, research focused on the disease has suggested that the rare brain inflammatory disease encephalitis lethargica—and only a few individuals diagnosed with encephalitis lethargica placed under research observation—have exhibited klazomaniac symptoms.

SandyGeorgia (Talk) 02:58, 2 November 2011 (UTC)

Hi SandyGeorgia,

Thanks for the feedback! That was very quick. One thing, I believe we are planning to add a LEAD later tonight and just hadn't gotten around to it, but hopefully we will have something better up later on. Otherwise, thank you so much for all of your feedback and we will definitely get on it.

Fowlerta (talk) 02:58, 2 November 2011 (UTC)

Excellent-- I didn't want to leave the article "naked", so I plopped back in the old lead. I'm tired for now, not nearly done, but will go to bed and leave you all time to work on what I've listed so far. Nice start, and a fine article will result if we can work through some of this. Best, SandyGeorgia (Talk) 03:00, 2 November 2011 (UTC)

PS, if I had known you all were still working, I would have waited-- it's a good idea to let others know on talk when you're working in sandbox :) I see the new lead is in-- it needs some copyediting and some wikilinking. For example, "is a neurological disorder attributed to compulsive shouting" can't be correct :) I'll check in tomorrow-- nice work so far. SandyGeorgia (Talk) 03:08, 2 November 2011 (UTC)

I'm going to bed as well, but will try to work on this tomorrow. By the way, thanks for the formatting tip for writing here, I was wondering about that. Talk to you later :) Fowlerta (talk) 03:33, 2 November 2011 (UTC)

Continuing

We see an abrupt jump in the text here: does the second paragraph refer to the same K.R. as above?

--- He subsequently served as a model to describe klazomania from beginning to end.

As seen in K.R., the onset was characterized by absentmindedness: the patient stared straight ahead and only responded in monosyllables in the minutes leading up to the incident. ---

Also, I'm finding a lot of text that needs to be removed because the sources don't deal with klazomania at all and the text applies to TS and tics in general. I'm finding it hard to sort this without access to the Wohlfart and Bates articles, though. SandyGeorgia (Talk) 20:30, 3 November 2011 (UTC)

References

Talk page formatting

Click here to see how I fixed a response above to preserve the bullet formatting (you increase the indents by adding one more period after the pound sign than in the previous line-- that preserves the numbers). G'night! SandyGeorgia (Talk) 03:15, 2 November 2011 (UTC)

As the repair linked to shows, the character to be added is a colon (:), not a period (. = "full stop"). --Thnidu (talk) 23:23, 24 September 2017 (UTC)

Problems

I now have both Bates and Wohlfart, and there are some problems here. Neither Bates nor Wohlfart are recent reviews; in fact, Wohlfart is quite old, so its usefulness here is limited, and good deal of the text associated with these authors might need to be deleted if current secondary reviews contradict them. Tough call, because so little is written, but a recent (2006) review by Jankovic (which I have, and is cited in the article) lists klazomania as associated with other disorders (that is, infectious processes, not with Tourette's). I feel that a good bit of this article needs to be deleted, as it seems to assume that klazomania is associated with TS, while Jankovic (our only recent review) does not. Jankovic is a widely known TS researcher, and the 2006 Volume 99 Advances in Neurology was dedicated to a review of TS, and included all of the best known researchers. Also, a lot of the text here refers generally to TS, not specifically to klazomania, and in fact, cited some articles that didn't even mention klazomania. Also, while the Jankovic article meets WP:MEDRS, Bates and Wohlfart do not. Further, the Wohlfart article does not even mention TS, so it appears that we are verging into original research by using some of the TS literature. SandyGeorgia (Talk) 21:42, 3 November 2011 (UTC)

PMID 17914719 is only a case report, but if anyone can access it, it seems to provide more confirmation that klazomania is not currently viewed as part of the spectrum of tic disorders, rather is thought to be related to an infectious process, specifically, encephalitis lethargica and parkinsonism. SandyGeorgia (Talk) 22:05, 3 November 2011 (UTC)

Lead and other questions

Hi SandyGeorgia, I am also one of the editors of this page. I was wondering if you could clarify the reasons for some of the changes you made to the LEAD and to the current research(now research directions) portion of the article. I am still new to the wikipedia editing process but very interested to learn. Do you think we should focus more on the fact that klazomania has been attributed to encephalitis lethargica(Wolfhardt article) as opposed to the links between this disorder and Tourette's syndrome/other phonic tics, or should we focus more on the Jankovic article that you found and the infectious processes described? Also if you don't mind me asking how did you come by this article? I was on the computer for days trying to find recent research and could only come up with the Bates and Wolfhardt articles. Thank you for all your advice and help and please let me know what you think. Best Regards, User:Adondaki —Preceding undated comment added 19:14, 5 November 2011 (UTC).

Hi, Adondaki; thank you for engaging the article talk page here, and for contacting me on my talk page to let me know you had posted questions here. One thing that will help you understand a lot of my edits is to go back and read this entire talk page. Anyway ...

I've had this page on my watchlist since 2006 (when I created it), so any time anyone posts to the article or to its talk page, I see it. That means you don't have to ping my user talk page when you want to ask me a question here (although it's stil good that you did that, since not all editors watchlist every article they edit).

As to how I came to it, I don't remember specifically in which article I needed to define or look up klazomania or how it first came to my attention on Wikipedia, but it would have been as part of my writing Tourette syndrome and every article on Wikipedia related to tics and tic disorders, or part of my work on autism and Asperger syndrome and a lot of other neuropsychiatric articles.

I created this page as a stub in 2006 (you can see the history of any article by clicking on its "History" tab, for example here for this article), but left it at that since there is essentially nothing to say about it and no research on it.

In fact, speaking of the paucity of research, I'm quite concerned that most of the expansion of this article will eventually need to be deleted as what we call original research or synthesis on Wikipedia, since many of the sources being used here make no mention of either klazomania or tics or Tourette's: it is being assumed that klazomania and TS/tics can be used interchangeably and that sources that are written general to TS that don't even mention klazomania can be used to source text here. That's called original research on Wikipedia-- we can't do that :) In fact, the papers being cited here are either very old (and most likely inaccurate when viewed in the context of current understanding of tics and infectious processes and in relation to more recent journal articles) or simply case reports (and the case reports may be useful for describing the condition, nothing more). The most recent review article (Jankovic-- which I have) has only a few sentences pertaining to klazomania, in a section of a book about tics not related to Tourette's, so the assumptions being made here aren't backed by any research, and sources that don't specifically discuss klazomania (but are general to TS) need to be deleted.

I hope that explains some of my changes and deletions, but if you have other questions, please ask. You'll also find it helpful when viewing the "History" as I showed above, to look at specific diffs where editors explain the reason for their edits in their editsummary. You should always use edit summaries on Wikipedia, since it helps other editors know why you made a certain edit and whether they might need to check it. By reviewing the history here, stepping back through the diffs, you can find reasons for all of my edits. I tend to correct articles by making numerous small edits so that others can step back through each and see my reasoning (other editors make all of their changes in one sweeping edit, which for me, is harder to understand what they did and why they did it, so I work in small steps). Here's a sample.

As an example of the issues I mention above this edit (and a good deal of the text in that section) will need to be removed. The source given for that text does not mention tic disorders or tics or TS or klazomania or encephalitis or anything remotely related to this article, hence is original research. Some of the other text in that paragraph could probably be sourced from TS articles, but scholars disagree that klazomania is part of TS and we have no sources that I'm aware of tying a lot of that text to klazomania specifically. (There's very little TS research I haven't read, but you don't have to take my word for that :)

Part of what I'm saying is that before choosing a topic for college credit editing on Wikipedia, it might have been helpful if your professor had explained WP:MEDMOS and Wikipedia's medical sourcing standards so that you could locate sources that meet Wikipedia's standards beforehand to be sure there were enough to expand the article-- there is, as you probably realize now, just about nothing written about klazomania, and I only created the stub so the term would be defined on Wikipedia. I see on his talk page-- where he never responds-- that your professor included this article in a list from which you could choose topics, which is curious, since there are so few sources complying with Wikipedia standards.

Finally, you asked which sources you should use. Jankovic is hands down without a doubt the most recognized expert in the US on tourettism (tics not related to Tourette's), and his article only has text stating that klazomania is due to encephalitis. There's nothing else there. Wohlfart is too old to be useful, and Bates and Wohlfart are basically old case reports. I think you've already taken everything useful from those articles. Howard is also a case report. I've scoured PubMed and there's nothing else. I don't know where that leaves you all in terms of your course grade, but I would say that your professor didn't guide you very well on topic selection, so you shouldn't be penalized for that ... I feel pretty strongly that if he has students editing neuropsychiatric topics, he should be familiar with MEDRS and let you know if you've chosen a topic about which nothing reliable is written. I hope you've learned valuable lessons about Wikipedia nonetheless, and hopefully your professor can be encouraged to guide student to WP:MEDRS and PubMed in the future. Adding the case reports has been helpful, because it does give our readers an idea of what klazomania "looks like", but there's little more that we can say. Please let me know if I've left anything unanswerd. By the way, you can sign your talk page posts by entering four tildes ( ~~~~ ) after them. SandyGeorgia (Talk) 00:30, 6 November 2011 (UTC)

SandyGeorgia, Thank you very much for clearing that up, I had been over the talk page before but didn't quite understand all the changes/the general flow of them but this clears that up very well. It sounds like there is obviously not a ton more we can do with this page, but I remember reading above that you said maybe a description of klazomaniac appearance and possible photos could improve the article. Do you still think this is a good idea? If so, any ideas on how to locate such information? Thanks again, (Adondaki (talk) 23:02, 7 November 2011 (UTC))

I can't imagine how we might picture Klazomania. Also, the article is still slightly misleading (wrt TS, OCD, etc) and I've been meaning to finish editing it (see section below on Jankovic), but I'm going to be traveling tomorrow and might not edit again until Wednesday. If you're able to work in more of the Jankovic info, please do! SandyGeorgia (Talk) 00:39, 8 November 2011 (UTC)

Ok, I made a few changes to incorporate the Jankovic article into the classification section and the history section, please let me know what you think! (Adondaki (talk) 23:45, 8 November 2011 (UTC))

I've only got a quick moment today, nice start, but I'm not sure this one sentence is a) relevant to this article, or b) supported by Jankovic.

• This pandemic also gave rise to observations of other tics that came to be associated with klazomania such as complex vocalizations of blocking, echolalia, palilalia, and oculogyric crises.

The part that troubles me is "came to be associated with klazomania". I believe that what the source means is that infectious events (like encephalitis) came to be associated with tics-- not that klazomnia came to be associated with other complex tics. I'm not sure if you can reword it to make it fit here ? I'll look tomorrow or so ... SandyGeorgia (Talk) 03:12, 9 November 2011 (UTC)

Also, I don't have time tonight to investigate, but I suspect that 1918 flu pandemic is the article you want to link to in the text to refer to the "pandemic of the encephalitis lethargica from 1916 to 1927" ... if you have time, you could post a query to WT:MED to ask if the 1918 article in fact refers to the pandemic mentioned by Jankovic, and if so, you could wikilink it in this article. SandyGeorgia (Talk) 03:17, 9 November 2011 (UTC)

I requested that information on the page you suggested, and also changed the words in my sentence to state that the other tics were associated with encephalitis lethargica. You were right, what I had did not really make sense in context of the intention of the article. (Adondaki (talk) 03:00, 10 November 2011 (UTC))

Looking better, let me know as your project deadlines near and I'll give one last review of the text-- haven't had time. And let me know how I can commend you to your professor for engaging correctly on talk and working to address the issues in the article with correct representation of sources. I don't think much more can be done with this article because of the shortage of reliable sources, but you've learned what you need to know about how to edit Wikipedia (that is, talk page collaboration is key :) SandyGeorgia (Talk) 17:37, 10 November 2011 (UTC)

The final deadline of the project is December 7, I would definitely appreciate some final editing advice around then. I would also appreciate any positive feedback to my instructor, his user page is User:NeuroJoe, thanks very much! (Adondaki (talk) 00:10, 15 November 2011 (UTC))

SandyGeorgia, do you think that we should possibly altogether get rid of the diagnosis section? While most of the suggestions below are faulty as you said, I was reading over the article again and it does seem that the first sentence of the pathophysiology section contradicts the diagnosis section, perhaps because no EEG abnormalities were observed in the Bates case study(obviously a much older study) but were observed in the Wohlfart study. Please let me know what you think! (Adondaki (talk) 17:37, 16 November 2011 (UTC))

We can fix that without getting rid of it ... I had noticed it earlier but haven't had time to get to it ... as soon as I have a free moment to dig back in to the sources, I'll help you deal with that and anything else outstanding-- surely before or by Thanksgiving, so you'll have this in time for the Dec 7 deadline, just really busy right now :) One thing you might do that I can't ... if you have access to a medical library (eg UMass), you might see if there is anything about klazomania in hard print sources that we can use. I doubt it, so it's not worth a trip unless you happen to have something close by and easily accessible. SandyGeorgia (Talk) 18:50, 16 November 2011 (UTC)

Jankovic

Jankovic (and Mejia) wrote Chapter 5 of the Advances in Neurology tome dedicated to Tourette syndrome-- Volume 99. The statement about klazomania is found on page 66:

• Jankovic J, Mejia NI (2006). "Tics associated with other disorders". Adv Neurol. 99: 66. PMID 16536352.

This is the most recent secondary review mentioning klazomnia that I'm aware of, and the tome contains chapters written by almost every currently recognized TS expert. Here is everything that article has to say:

QUOTES

p. 61: Tourette syndrome is the most frequent cause of tics ... However, it is important to recognize that tic-like phenomena may be observed in a variety of other conditions including sporadic, genetic, and neurodegenerative disorders, or may be caused by other etiologies such as drugs, infection, stroke, and head trauma. ... This review is organized according to tic mimickers and tics secondary to other causes ...

(editor note) ... Klazomania is under the Other causes section ...

p. 63: ... there are many other etiologies of tics and TS-like features (tourettism).

p. 66 (section dealing with Infections): The encephalitic lethargica pandemic that occurred in Europe between 1916 and 1927 is one of the first reported infectious events to be associated with tics such as complex vocalizations of blocking, compulsive shouting (klazomania), echolalia, palilalia, and oculogyric crises; autopsy data revealed neurofibrillary tangles and neuronal loss in the globus pallidus, hypothalamus, midbrain tegmentum, periaqueductal gray matter, striatum, and the substantia nigra.

That's it. SandyGeorgia (Talk) 21:21, 6 November 2011 (UTC)

Peer Review

Hey guys, obviously you already have a ton of support and help which seems awesome but I just wanted to say that perhaps throwing in a little more about the diagnosis and maybe a section devoted to a prognosis in relation to the "management section" could be helpful. With the limited available research that might be tough but I'll try and spend the next week of the peer review period looking for any information and post it here. Mtportman (talk) 06:16, 8 November 2011 (UTC)

Hi Mtportman,

Thanks alot for the suggestion, we appreciate it. I will look again at our sources, but to my understanding most of them are simply case studies in which an individual exhibited klazomaniac symptoms while under observation for another disease(encephalitis lethargica, post-encephalitic parkinsonism) and it was noted. We could probably include a prognosis section for these diseases but I don't think we could specifically for klazomania. Thanks again for the comment, I will definitely look at our sources again to see if we can include anything along the lines of a prognosis section. (Adondaki (talk) 22:42, 8 November 2011 (UTC))

That will be tricky, because it's likely that all we can say about prognosis will be from the few case reports, and whatever the sources say will more likely be wrt the prognosis of encephalitis lethargica. I seem to recall one of individuals in a case report had died? But that's not because of klazomania ;) SandyGeorgia (Talk) 17:39, 10 November 2011 (UTC)

Peer Review 2

I really enjoyed reading your article; I thought that the topic was really interesting, and I had never heard of it before reading this article. You mention tics and tic disorders several times; I think that it would be helpful to include a longer description of what tics are and how they are similar and how they are different to klazomania. I think you also need to only link the first instance of each of the terms that you wish to link to other Wikipedia pages; for example, "tics", "echolalia", "palilalia", and "coprolalia" are linked multiple times. Also, it may make sense to put the description of the model patient, K.R., in the "History" section, rather than in the section about symptoms. I thought that the "Causes" and "Pathophysiology" sections were comprehensive and informative. If possible, you may want to do further research to expand on the "Diagnosis" section to include what is used to make a diagnosis. Overall, I thought that the structure of your article was great and you included a lot of links to other Wikipedia pages, but you may want to see if you can add to your references.

Ellenmcmahon (talk) 01:40, 15 November 2011 (UTC)

Ellenmcmahon,

Thank you for your suggestions. As for further descriptions about tics and other tic disorders, we originally had a few of these descriptions but with the help of the original creator of this article we realized that these descriptions would be better off in the articles about the specific tic disorders, which is why we have them wikilinked in our article. I did not realize we had the disorders wikilinked multiple times, but I will fix that asap. The description about the model patient is somewhat essential to the "symptoms" section because description of K.R. encompasses a large portion of what is known about the symptoms of klazomania, the case is mentioned briefly in the history section. There is no strict formula to diagnosing klazomania as far as we could find, but the signs and symptoms section gives everything we could find about characterization of the disease by physicians in the few cases recorded. Unfortunately there is not much more research that can be included to expand the references section, we originally had more research in the article but it was determined by the articles creator and the group that it was "original research" and drew undetermined conclusions that had not yet been proven, a wikipedia taboo. Again thank you for your suggestions, we appreciate it! (Adondaki (talk) 15:02, 15 November 2011 (UTC))

Well stated and addressed, Adondaki. Ellenmcmahon, you don't appear to have read the talk page (which isn't that long). There are similar problems in the remaining "peer reviews" listed below from editors who don't appear to have read the talk page or understand Wikipedia's sourcing policies, but since Adondaki handled this first "review" fine, I'll hold off until s/he responds to the others. SandyGeorgia (Talk) 14:59, 16 November 2011 (UTC)

Peer Review 3

You guys did a nice job with the article providing both a description of the disease and the scientific background. I have a couple of suggestions though. First, I think the first paragraph that's before all other headings should include a very brief hypothesis of the cause of the disease. Also, this should be a single paragraph. That way it forces you to be concise and create a nice sounding paragraph. My next suggestion would be to avoid being repetitive. You use the term "tic disorders" very often. Perhaps reword it. Also, you don't need to "hyperlink" the word every time you use it. Next, in the classifications section, only focus on klazomania. I know it's necessary to discuss its difficulty in being classified but make sure every sentence focuses on the disease itself and doesn't deviate from he article when you can just use hyperlinks for that. Next, I think the report about the postman K.R. should be in a different section other than Signs and Symptoms - maybe History or create a different "Cases" section. Next, I would advise to elaborate on the diagnosis section. If this is not possible, maybe you should find a section that it would fit in to and put it there instead. Also, I was very confused when I read the diagnosis section after reading the Pathophysiology section. The first sentences in each completely contradict each other. And if you guys can think of a relevant picture, I think that would make the article more attractive. Overall, the article was nicely written and very informative. Good job with this. Grant.vandervoort (talk) 21:01, 15 November 2011 (UTC)

Thank you for your suggestions. We have a section that includes known hypotheses for the causes of the disorder, but cannot include a hypothesis of our own because this would be original research. I don't think it is possible to reword "tic disorders", and I don't feel it is necessary to reword this because it is a scientific term that is exactly what we mean. The classification section has been made to be more concise by User:SandyGeorgia, and while it mentions other disorders they are only mentioned in their relation to klazomania and because they were observed alongside it in a patient. The amount of hyperlinks in the article have also been decreased since this review. The diagnosis section again was revised by SandyGeorgia in order to include information from our sources, while there is no diagnostic formula for klazomania it must be determined not to be Tourette's before it is "diagnosed". The pathophysiology section contradiction you noticed was a mistake and has since been fixed, thank you for pointing this out. Finding a picture to match this article has proven difficult, and a truly relevant picture for the article does not seem to be available, but we will continue to search. (Adondaki (talk) 20:25, 28 November 2011 (UTC))

Peer Review 4

You are off to a great start! I have just a few suggestions. The first sentence confused me in that you say “this classification is difficult” but there is no reference to what the classification is. You mention features, but not a classification. A more specific adjective than “difficult” may be better to use, such as “problematic”.

Since the case study of K.R. is in individual case and is often used as a model for the disease, it may be more effective to include this information in the “History” section rather than with the description of the general signs and symptoms .

One sentence is very short for a section, so the “Daignosis” section should probably be expanded. Rather than just saying what does not work as a form of diagnosis, it may help to include what tests are performed that lead to an actual positive diagnosis of Klazomania. There also seems to be inconsistancey when you say that “Changes are observed on EEG in the substantia nigra and the globus pallidus with klazomania” in regards to pathophysiology but then later say that “EEG abnormalities are not observed during klazomania” when speaking about diagnosis.

I would also recommend citing more sources. Good luck as you continue editing! Coopersk (talk) 22:53, 15 November 2011 (UTC)

Thank you for your suggestions. The original creator of this page User:SandyGeorgia made a lot of changes to this page and one of those changes included rewriting the first sentence that you had a suggestion on so that is taken care of! On your comment about the case study of K.R., I think if we moved it to the history section the article would be more difficult to understand because the symptoms are mentioned before history and it would be more difficult to use that case study to describe the symptoms if it was discussed after the symptoms. User:SandyGeorgia has also fixed our diagnosis section and taken out the part about the substantia nigra and the globus pallidus so that should be cleared up. It was very difficult finding sources on Klazomania and the few we could find were primary sources, so the few helpful sources that User:SandyGeorgia found are most likely the best sources we could find on Klazomania. Thanks again for your comments! Goverman (talk) 19:38, 4 December 2011 (UTC)

Peer Review 5

I think your article is off to a great start and it is a very interesting topic. I actually had this article on my list of topics I wanted to do. Anyway, I just had a couple suggestions .

In the causes section you explained that the motor circuit between the substantia nigra to the globus pallidus becomes overstimulated during the mesencephalic fit and later mention in the pathophysiology section that the "mesostriatal pathway involving the substantia nigra and the globus pallidus are both dopaminergic pathways." I think it would be beneficial to explain how this dopaminergic pathway works and how alterations to the normal pathway can cause symptoms seen in Klazomania and other related disorders. If research specifically to Klazomania doesn't exist, is there a similar pathway seen in other disorders that Klazomania is related to?

Also, in the current research section are there any other research initiatives in any disorder related to Klazomania that may further the understanding of Klazomania itself?

Kierak33 (talk) 20:06 PM, 15 November 2011 (UTC)

Thank you for your suggestions. The original creator of this page made a lot of changes to it and took out the part about the mesostriatal pathway involving the substantia nigra and dopaminergic pathways in the pathophysiology section. Also, the pathway from the substantia nigra to the globus pallidus and what symptoms it causes are explained in great detail in other articles about tics and tourrettes. The original creator of this page, User:SandyGeorgia, suggested we leave those details in the articles about tics and tourrettes and put a link to those pages, which we did. She suggested this because the connection between tics and tourrettes and klazomania is not proven and the general cause for klazomania is still unknown at this time. Professor Burdo and User:SandyGeorgia both suggested we do not put anything in our article that is not proven by outside sources. There is very little on current research in Klazomania that we could find. Thanks again. Goverman (talk) 19:59, 4 December 2011 (UTC)

Peer Review 6

In the introduction, maybe you can explain what tic orders are and how they differ from compulsions. Are all compulsions tic orders? I think the paragraph from 'Classification' is a good start and actually the 'Classification' paragraph can go more in depth about the topic. Also, under 'Classifications' does TS refer to Tourette Syndrome? If it does, (TS) should be included after Tourette Syndrome to minimize confusion. Then you list several tic orders, but specifically how are they similar to Klazomania? Under 'Signs and Symptoms', I understood the relevance of K.R.'s story in portraying the symptoms involved, but I am not sure if it is appropriate in this section. Maybe you can have another section that talks about people's experiences. The story might fit under that category better. In addition, under 'Causes' elaborate on the statement that talks about how Klazomania is linked to brain damage from alcoholism and encephalitis. Again, specifically how does Klazomania link in with brain damage from alcoholism and encephalitis? Does brain damage from other sources also contribute to Klazomania? Finally, please elaborate on how klazomania is diagnosed. You explain how klazomania is not associated with seizures, but how is it diagnosed? Overall, every interesting article. I didn't know what Klazomania was, but gained useful information. Stephanie Lee (talk) 03:47, 16 November 2011 (UTC)

The clarification regarding (TS) is present at the time of my viewing. The article no longer includes a reference to compulsions. Viewing the articles themselves, which are wiki-linked is probably a better way to understand the related tics. The case report of patient K.R provides a rare description of what occurs before, during, and after a Klazomaniac attack so we thought it useful to include a much information about the circumstances. There is no information to my knowledge in literature we have about how alcoholism and encephalitis related brain damage specifically or directly leads to the condition. We'd love to know just as much as you. There is no further diagnostic criteria for Klazomania specifically than what is present. Baumannd (talk) 01:58, 7 December 2011 (UTC)

Peer Review 6

Hey guys interesting stuff. I just noticed a couple things when reading that you may want to look at. In the first section you say it is hard to classify and resembles tics a bunch of times. You can probably condense that down, it seems a little repetitive.

The signs and symptoms section was informative and interesting. I just was wondering, you used the one case example to describe the disease: is it just that uncommon of a disease that there are few cases to report or did you just choose to look closely into one? It would be interesting to note the rate of occurrence of the disorder somewhere.

Finally, to echo Coopersk, I was confused when you go into detail about EEG abnormalities in the pathophysiology section and then right after say it isn't related to epilepsy because there are no EEG abnormalities. Did you just mean the same abnormalities are not seen? I would just reword that and either eliminate or expand that section.

Anyway, it was interesting and informative. Tyler8014 (talk) 01:19, 16 November 2011 (UTC)

Thank you for your suggestions. The original creator of this page, User:SandyGeorgia, made a lot of changes to our article and one of them included changing the first section that you said was confusing so that is taken care of. She also changed the pathophysiology section so that it is more clear. We used the one case example to describe the disease because Klazomania is extremely rare and there are very few documented examples or discussions/explanations of Klazomania.Goverman (talk) 20:10, 4 December 2011 (UTC)

Peer Review 7

Good start on the article- I felt that it was very informative. I had never heard of Klazomania before, I now have a good background of it. However, a few suggestions:

In the intro section and then first section you do mention tics a lot (as the peer review above me says), but I think that it would be helpful to give a short definition of what tics are in the first place. Obviously people can click on the tics link, but in order to keep them reading your article, I feel that a short definition or explanation would be helpful.

Also, there seems to be some contradiction as to EEG abnormalities presented with klazomania. In the Pathophysiology section, you state that changes on the EEG are observed, and then in the Diagnosis section, you state that they are not observed. Furthermore, I think that the Diagnosis section could be expanded in general. Maybe you could state some of the obvious signs of Klazomania, and then relate them to concrete medical diagnoses (such as the EEG, when that is straightened out).

Lastly, perhaps the Management section (which could be renamed Treatment?) could be expanded. Although you cite some of the sources you got your information from, some background and explanation of the effects of such treatment would benefit the article (especially in relation to future research). Maybe explain how and when these treatments were tested and had their effects (or didn't have any effects). You reference specific examples in the rest of the article, so I feel like this section would benefit from the citing of concrete evidence as well. martaak (talk) 08:26, 16 November 2011 (UTC)

Hi martaak! I'm glad you enjoyed this article and found it informative. As has been mentioned in earlier peer reviews, the original creator of this page made a significant number of changes to the draft that we posted, particularly to the first section to which you refer. The word "tics" is indeed repeated quite a bit at the beginning, but it is relevant to the article in question as it is really the only applicable term to describe klazomania. As to the EEG discrepancy, the Diagnosis section is simply stating that no abnormalities have been observed, though it has been speculated that certain abnormalities could cause klazomania (that is what the Pathophysiology section is referring to). As for the suggestion to expand the Diagnosis section, there really are no tools for diagnosing klazomania, and the obvious signs of klazomania can apply to many other disorders and diseases. Moreover, those who suffer from klazomania can present unique symptoms, making it difficult to nail down a particular diagnostic technique. As for the Management section, that name has already been changed, thanks for the suggestion! In addition, there is not much information on the treatment of klazomania, so the section cannot be expanded significantly. Moreover, the information you cite that is present in the rest of the article would become too repetitive if added here. The original creator helped us cut it down. Once again, thank you for your suggestions. Fowlerta (talk) 16:42, 7 December 2011 (UTC)

Peer Review 8

Awesome job on the article! I just have a few suggestions for you. I would try to expand on the diagnosis section if possible, having a section with only one line doesn't seem useful, however I know it is tough to find information on the subject. Also, there seems to be some confusion with whether or not EEG abnormalities are seen in patients with klazomania. In the Diagnosis section it is stated that there are no abnormalities seen, while in the Pathophysiology section it is stated that there are changes seen. I would just try to clear this up. Also, I think having a few more references might be helpful in expanding your article. Another thing I would suggest is adding an image if you can find one related to the subject. But overall this is a great article! Ivesm (talk) 18:45, 16 November 2011 (UTC)

Thank you for your suggestions! The original creator of this article cut a lot of information down, including the Diagnosis section, so that will be left as is. Truth be told, there really is no information on the diagnosis of klazomania, but we wanted to include what little there is. Again, as to the discrepancy between the Pathophysiology and Diagnosis section, there were no abnormalities observed on the EEG, but it had been speculated previously that certain physical changes occur (which is what is referenced in the Pathophysiology section). The article is simply stating that electrical firing is not irregular in patients with klazomania. As to the references, there simply are no more out there for us to find, but thank you for the suggestion. I wish there was more material. Unfortunately, the case is the same for the images. Fowlerta (talk) 16:42, 7 December 2011 (UTC)

Peer Review 9

There are just a few mistakes that I found inside the classification section of the article. The last two sentences of the paragraph should be reworded just a bit, so that the sentences could flow better. Are there any articles that you have found that talk about how the lesions are created in the mesencephalon. If so, I suggest you add details on how such lesions are formed within the brain.

In the Pathophysiology section you talk about an EEG. You should explain what this and also hyperlink it to its wikipedia article. In the same section, the second sentence of the second paragraph should be corrected to read, “The vocalizing center in animals are…” The diagnosis section of the article should really be expanded because it doesn’t really state how someone is diagnosed with klazomania. Kiki522 (talk) 19:42, 16 November 2011 (UTC)

Thank you for your suggestions! The wording that you are speaking about was corrected by the original creator of this article, so that will be left as is. Unfortunately, there was no information on how the lesions are created, but should anything come up, it will definitely be added. We have now hyperlinked the EEG section, so thank you for that suggestion. As to the sentence you would like to correct, it is grammatically accurate as is (vocalizing center is singular), but thank you for reading so closely. Also, klazomania cannot really be diagnosed, so that is why that section is so short. There simply is no information. Thank you! Fowlerta (talk) 16:42, 7 December 2011 (UTC)

Peer Review 10

Cool article. I chose to peer review simply on the intro. With one quick glance, I see the article is well hyperlinked, which is not the case in some other classmates' articles. I don't think anything should be quoted in the intro, especially the first sentence. That already shows that you have taken someone's words directly. Also some of the wording doesn't seem to follow an encyclopedia's, namely "other infectious (encephalitic) processes." I would hyperlink encephalitic. I like the differing sources there. Cool.

The story about the patient is also very interesting, but there should be some sentence telling people why you put it in. Was he the first person fully studied? I know at the end that he was observed, but put something in the beginning that let's us know why we are reading the whole story. The Diagnosis section seems a little off. There is only one sentence for this huge title - any other things to mention in that section?

The history section should be after the intro, not at the bottom, and is missing many hyperlinks.

Can a "See Also" section be created to direct readers to related articles (maybe Tourettes or encephalitis)

Pmcronin (talk) 22:29, 16 November 2011 (UTC)

Please read WP:MEDMOS on sections-- as to all of the other comments here, we can't do original research on Wikipedia, and we can't invent information that doesn't exist in sources. SandyGeorgia (Talk) 07:39, 24 November 2011 (UTC)

Pmcronin

Thanks for the suggestions. Our Diagnosis section is developed more than when you read it. The case study discussed in the Signs and Symptoms section provided a good sense of what occurs during an "attack", which is why it was featured. I'll look into the wiki linking for the history section and see if moving history is a good idea. Quoting and sourcing is a necessary part of any article. For your comment on the lack of a 'See Also' section, see WP:LAYOUT-- when other articles are already linked in the text, we don't also list them in See also, which is better used for articles being expanded that haven't yet had all terms included and linked.Baumannd (talk) 00:09, 7 December 2011 (UTC)

Baumannd, we edit conflicted as I was trying to correct the last (IP) edit-- I can't decipher what was added, what was lost, if anything. SandyGeorgia (Talk) 00:12, 7 December 2011 (UTC)

I don't think we lost anything I had what I was typing copied. Baumannd (talk) 01:11, 7 December 2011 (UTC)

Peer Review 11

The page has started out on the right track. It is easy to read and very informative. However there are some suggestions I would make to make the page better. To start with, Diagnosis seems unneccesary. I think it would be better suited to include a small augmented section into the Causes section. Also, I would suggest rearranging the sections to be; History, Classification, Pathophysiology, Signs and symptoms (with Diagnosis augmented in), Causes, Managements, and finally Research directions. This order gives the reader a somewhat more direction idea of what to expect. As it stands now, the sections seems to be somewhat random. Though this is just a suggestion, so you are free to leave it as is. Also, after reading your page, I was confused as to how frequent this condition is. Your page makes specific references, making it seem as though the condition is very sparse. If there was a statistic about how frequent this condition occurs, that would help to clarify how often people contract this condition. Additionally, the Classifications section could use a little more direction. After reading it, I don’t feel as though I know what the actual classifications of the condition are. In the classification, it seems to be more an argument as to what type of condition klazomania is considered. A summarizing introductory sentence stating that klazomania’s classification in terms of other diseases and conditions is under scrutiny, and you will be discussing those different classifications and the justifications behind each; would make the classification section more unified and comprehensible. Finally, an easy way to make the page more interactive would be to add some pictures. The page is definitely a good start, and looks good so far! Keep up the good work! LukestarrrR (talk) 04:49, 17 November 2011 (UTC)

Please se WP:MEDMOS on sections in medical articles on Wikipedia. Pictures that don't exist can't be added. And the sum total of what is written in sources that comply with Wikipedia's medical sourcing policies is at Talk:Klazomania#Jankovic; Wikipedia can't report information that doesn't exist, although this article is using primary studies (Wohlfart and Bates) to describe the few cases that are documented. SandyGeorgia (Talk) 07:43, 24 November 2011 (UTC)

The important aspect of the Diagnosis section is in Klazomania as a tourettism and its difference from Tourette's syndrome itself. Also as said elsewhere on the page we are following WP:MEDMOS for arranging the sections. The lead specifically mentions the rarity of the disorder, but no statistics about it exist to my knowledge. No pictures for describing the condition exist to my knowledge. The classification section gives different ways the disorder has been described in literature. The article states it is described as a vocal tic and a tourrettism. I'm not sure how else we could clarify that. Baumannd (talk) 01:42, 7 December 2011 (UTC)

Notes on peer reviews

There are quite a few faulty suggestions above, mostly entered by folks who don't appear to have engaged Wikipedia's sourcing policies at all, or to have read the talk page. It will take some time to address all of the faulty reviews, but for starters, I suggest these peer reviewers read WP:OWN and refrain from referring to "your article", and understand that Wikipedia articles can only reflect what is already published in reliable sources (not whatever we want to include). Further, klazomania is not "a disease" as (mis)stated by several reviewers; that should be apparent to anyone reading the article, and if it's not, then that needs work.

Folks, Wikipedia article talk pages are for discussion of ways to improve articles based on reliable sources (not wish lists or ILIKEIT)-- if you have a source calling this symptom a disease, discussing management of it, or discussing any other aspect suggested for article expansion by these "Reviews", by all means, provide it. SandyGeorgia (Talk) 15:06, 16 November 2011 (UTC)

It would also be helpful if the professor of this course would tune in-- nine peer reviews saying the same thing (most of it unactionable) isn't really helpful. SandyGeorgia (Talk) 20:14, 16 November 2011 (UTC)

Hi Sandy, by "research" I believe that the other students are referring to "reviewing" the secondary (which doesn't really exist) and primary (if absolutely necessary) literature and using that information already published in refereed sources to improve the article. They're not suggesting that the students working on this topic actually perform any clinical research and use those findings here. Thanks, NeuroJoe (talk) 20:28, 6 December 2011 (UTC)

And, we are now up to 11 peer reviews that mostly contain no actionable or helpful commentary, and show little understanding of what talk pages are for and how Wikipedia works (articles are built from reliable sources, secondary medical reviews in this case, and we can't add material that doesn't exist). No, we can't just make stuff up to add to the article-- AFAIK, there is exactly one source meeting Wikipedia's medical sourcing standards on klazomania, it is discussed on this very talk page, and it contains one sentence on klazomania. No, we can't invent a picture of klazomania (exactly what would that picture be)? No, we can't say things here that aren't stated in the three sources (two that don't meet MEDRS) that discuss the topic. And we don't need 11 peer reviews (from editors who don't seem to have read the talk page) saying the same thing-- would you all please ask your professor to make it stop, or read the talk page before adding to it, and ask your instructor why he accepted for a class project a topic about which there is, to my knowledge, one sentence from one source that is compliant with Wikipedia policies?

Adondaki and peers, I've reread the two sources about case studies-- which really shouldn't have been used here anyway since they don't meet MEDRS, one is extremely outdated, the other is hypothesizing based on one case-- but since they're all we've got, we can use them carefully and I do see some things we can do to improve what little we can write. I could do it myself, but I'd prefer to guide you as you do the work so you can get the grade for the work you have done so far. Please let me know your timing, as I'm quite swamped right now, but when you're ready, I see some ways to advance the article. Regards, SandyGeorgia (Talk) 15:32, 17 November 2011 (UTC)

On another note, before attempting to add images to this article, here is some good reading explaining Wikipedia's image policies:

• Wikipedia:Wikipedia Signpost/2008-08-11/Dispatches
• Wikipedia:Wikipedia Signpost/2008-09-22/Dispatches

SandyGeorgia (Talk) 06:56, 24 November 2011 (UTC)

Remissions

The word "remissions" is used twice in the article. I'm wondering if the right word isn't "recurrences." I haven't read the sources, so perhaps I've misunderstood. --Anthonyhcole (talk) 17:25, 12 November 2011 (UTC)

I haven't checked the writing here closely yet, but a search on Wohlfart for "remission" turns up this passage:

• The intensity then decreased with intermittent remissions for a couple of minutes with alternating periods of screaming and violent movements. The symptoms gradually subsided, howcver, the quiet intervals became longer, and about an hour and a half after the onset the attack was over.

SandyGeorgia (Talk) 20:33, 12 November 2011 (UTC)

Thanks. That's clear but the present wording doesn't convey that to me. I'll revisit once I've had some sleep. --Anthonyhcole (talk) 20:42, 12 November 2011 (UTC)

Anthonyhcole, I added in a few sentences to clear up what was meant by remissions in the context of the article. Please let us know if you have any more questions. (Adondaki (talk) 00:04, 15 November 2011 (UTC))

Thanks, Adondaki. --Anthonyhcole (talk) 08:14, 20 November 2011 (UTC)

Non-peer review

Well done, guys, I think you have made a lot of important revisions since the first time I looked over the article. In addition, I think you have made great use of the Wikipedia community, and have engaged in the spirit of collaboration. Many of the suggestions I would have made have already been addressed here--my only concern is that you sit down with the suggestions and take the time to hash them out one by one. Also, you have only cited 6 sources; if you are having trouble with the edits, perhaps an additional source would help to fill in some of the gaps. Otherwise, I think that you are on the right track.
Good luck, and great job so far! Stempera (talk) 17:50, 5 December 2011 (UTC)

Yes, this group of students has done a commendable job of engaging on talk, working with "the community", and understanding Wikipedia policies-- even more so when considering they had to expand stub about which almost nothing is written. The six sources used are a stretch, as they had to employ primary sources for some parts of the article-- sources that don't meet WP:MEDRS. If you are aware of any additional untapped sources, please bring them forward-- I haven't found anything else written on this symptom. SandyGeorgia (Talk) 15:27, 6 December 2011 (UTC)

Sources

If the students working on this article can gain access to the full text of any of these sources, they mention (briefly, in passing) klazomania. Some of them are old, none are secondary reviews, I doubt that any of them contain anything useful, they are only case reports (which we shouldn't be using anyway, but we already are), but for what it's worth, in case you can access them via your university library, you may glean one or two new sentences. Caution, though, that we shouldn't use old sources, or case reports, to contradict what is in the only secondary recent review we have (Jankovic), so if you find anything useful, you might run it be the talk page where I can help with it. (By the way, I removed a See also section. See WP:LAYOUT-- when other articles are already linked in the text, we don't also list them in See also, which is better used for articles being expanded that haven't yet had all terms included and linked.)

• Northam RS, Singer HS (1991). "Postencephalitic acquired Tourette-like syndrome in a child". Neurology. 41 (4): 592–3. PMID 1849241. {{cite journal}}: Unknown parameter |month= ignored (help)
• Pulst SM, Walshe TM, Romero JA (1983). "Carbon monoxide poisoning with features of Gilles de la Tourette's syndrome". Arch. Neurol. 40 (7): 443–4. PMID 6574730. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Bonvin C, Horvath J, Christe B, Landis T, Burkhard PR (2007). "Compulsive singing: another aspect of punding in Parkinson's disease". Ann. Neurol. 62 (5): 525–8. doi:10.1002/ana.21202. PMID 17696122. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Dietl T, Auer DP, Modell S, Lechner C, Trenkwalder C (2003). "Involuntary vocalisations and a complex hyperkinetic movement disorder following left side thalamic haemorrhage". Behav Neurol. 14 (3–4): 99–102. PMID 14757985.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Kumar R, Lang AE (1997). "Coexistence of tics and parkinsonism: evidence for non-dopaminergic mechanisms in tic pathogenesis". Neurology. 49 (6): 1699–701. PMID 9409371. {{cite journal}}: Unknown parameter |month= ignored (help)
• Dale RC, Webster R, Gill D (2007). "Contemporary encephalitis lethargica presenting with agitated catatonia, stereotypy, and dystonia-parkinsonism". Mov. Disord. 22 (15): 2281–4. doi:10.1002/mds.21664. PMID 17914719. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

Here is one review (almost 20 years old) that mentions klazomania in passing, in case you can access it-- again, because it's old, it shouldn't be used to contradict Jankovic, but may have a bit of info that can be added:

• Lebrun Y (1994). "Ictal verbal behaviour: a review". Seizure. 3 (1): 45–54. PMID 7519109. {{cite journal}}: Unknown parameter |month= ignored (help)

SandyGeorgia (Talk) 16:02, 6 December 2011 (UTC)

Thanks a lot for finding these. Of the few I was able to access the only part that seemed like it could possibly be useful is from the Kumar article. The important bit was, "Small open-label trials of L-dopa in TS have produced variable results an increase in movements different from the patient's pretreatment tics occurred in one of three patients treated with 1,000 to 3,000 mg/d of plain L-dopa; simultaneous treatment with 6 g/d of plain L-dopa and 900 mg/d of chlorpromazine had no effect in a single patient; and a unique patient recovering from a severe head injury demonstrated symptoms similar to klazomania (compulsive shouting) and TS reproducibly elicited by L-dopa". I can't find the article that is cited as the source. I'm also not sure how relevant it is that Klazomaniac attacks can be produced using L-Dopa. Baumannd (talk) 01:06, 7 December 2011 (UTC)

I'm not sure how to work that in either; I'll ping WT:MED to see if one of our resident docs will come over and have a look. Nice work so far! SandyGeorgia (Talk) 03:25, 7 December 2011 (UTC)

I am also having trouble accessing almost all of these sources, I was able to read the second one and it does not appear to have anything useable. Perhaps we could include this information in the history section simply as another case in which klazomania was observed. I'm not sure how else we would incorporate it without making unfounded assumptions, but I am interested to hear if one of the resident doctors has any ideas. (Adondaki (talk) 03:48, 7 December 2011 (UTC))

One case report? Does not really seem significant here.Doc James (talk · contribs · email) 04:03, 7 December 2011 (UTC)

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