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Movement disorders in emergency settings: a prospective study.

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Title: Movement disorders in emergency settings: a prospective study.
Authors: Dallocchio, Carlo, Matinella, Angela, Arbasino, Carla, Arno', Natale, Glorioso, Margaret, Sciarretta, Massimo, Braga, Massimiliano, Tinazzi, Michele
Source: Neurological Sciences. Jan2019, Vol. 40 Issue 1, p133-138. 6p. 2 Charts.
Subjects: Chorea, Movement disorders, Myoclonus, Dyskinesias, Tremor, Time delay systems, Movement disorder treatments, Hospital emergency services, Longitudinal method, Acute diseases, Diagnosis
Abstract: Introduction: Acute movement disorders (MD) are etiologically heterogeneous entities. Since studies on the relative frequency of different MD and their underlying diseases are limited, we performed a prospective study to investigate the spectrum of various MD and their causes in patients presenting with acute MD in an emergency room (ER) setting.Objective: To describe the spectrum and outcomes of acute MD in a prospective cohort and to guide its management.Methods: We investigated acute MD in 96 consecutive patients admitted to ERs between 2013 and 2017. Time of disease onset, type of MD according to published criteria, diagnostic workup, and outcome were collected.Results: 73.9% of patients had hyperkinetic MD. Tremor was the most common symptom (19.8%), followed by myoclonus (17.7%), dystonia (15.6%), and chorea (11.4%). Other hyperkinetic MD (9.4%) included were gait disorders (imbalance due to involuntary movement), dyskinesia, akathisia, hemiballism, and oculogyric crisis. Hypokinetic MD included acute parkinsonism (15.6%), off-state (4%), akinesia (3%), and rigidity (3%). Co-occurrence of more than one MD was seen in 19.7% of patients. Time delay to medical consultation was between < 24 h and 28 days. Five etiological groups were recognized: drug-induced (29.2%), functional (19.8%), neurodegenerative diseases (15.6%), structural brain damage (11.5%), others (24.0%, metabolic, inflammatory, infective, undetermined). Outcome was better for neurodegenerative diseases and for drug-induced MD. Functional movement disorders (FMD) showed less favorable outcome.Conclusions: Acute MD is a distinct cause of ER admission, and a variety of treatable diseases may be the underlying cause of this symptom. Uncertain course is more probable in FMD and in structural brain lesions. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Movement disorders in emergency settings: a prospective study.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dallocchio%2C+Carlo%22&quot;&gt;Dallocchio, Carlo&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Matinella%2C+Angela%22&quot;&gt;Matinella, Angela&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Arbasino%2C+Carla%22&quot;&gt;Arbasino, Carla&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Arno&#39;%2C+Natale%22&quot;&gt;Arno&#39;, Natale&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Glorioso%2C+Margaret%22&quot;&gt;Glorioso, Margaret&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sciarretta%2C+Massimo%22&quot;&gt;Sciarretta, Massimo&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Braga%2C+Massimiliano%22&quot;&gt;Braga, Massimiliano&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tinazzi%2C+Michele%22&quot;&gt;Tinazzi, Michele&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Neurological+Sciences%22&quot;&gt;Neurological Sciences&lt;/searchLink&gt;. Jan2019, Vol. 40 Issue 1, p133-138. 6p. 2 Charts.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Chorea%22&quot;&gt;Chorea&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Movement+disorders%22&quot;&gt;Movement disorders&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Myoclonus%22&quot;&gt;Myoclonus&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Dyskinesias%22&quot;&gt;Dyskinesias&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Tremor%22&quot;&gt;Tremor&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Time+delay+systems%22&quot;&gt;Time delay systems&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Movement+disorder+treatments%22&quot;&gt;Movement disorder treatments&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospital+emergency+services%22&quot;&gt;Hospital emergency services&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Longitudinal+method%22&quot;&gt;Longitudinal method&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Acute+diseases%22&quot;&gt;Acute diseases&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Diagnosis%22&quot;&gt;Diagnosis&lt;/searchLink&gt;
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  Data: &lt;bold&gt;Introduction: &lt;/bold&gt;Acute movement disorders (MD) are etiologically heterogeneous entities. Since studies on the relative frequency of different MD and their underlying diseases are limited, we performed a prospective study to investigate the spectrum of various MD and their causes in patients presenting with acute MD in an emergency room (ER) setting.&lt;bold&gt;Objective: &lt;/bold&gt;To describe the spectrum and outcomes of acute MD in a prospective cohort and to guide its management.&lt;bold&gt;Methods: &lt;/bold&gt;We investigated acute MD in 96 consecutive patients admitted to ERs between 2013 and 2017. Time of disease onset, type of MD according to published criteria, diagnostic workup, and outcome were collected.&lt;bold&gt;Results: &lt;/bold&gt;73.9% of patients had hyperkinetic MD. Tremor was the most common symptom (19.8%), followed by myoclonus (17.7%), dystonia (15.6%), and chorea (11.4%). Other hyperkinetic MD (9.4%) included were gait disorders (imbalance due to involuntary movement), dyskinesia, akathisia, hemiballism, and oculogyric crisis. Hypokinetic MD included acute parkinsonism (15.6%), off-state (4%), akinesia (3%), and rigidity (3%). Co-occurrence of more than one MD was seen in 19.7% of patients. Time delay to medical consultation was between &lt; 24&#160;h and 28&#160;days. Five etiological groups were recognized: drug-induced (29.2%), functional (19.8%), neurodegenerative diseases (15.6%), structural brain damage (11.5%), others (24.0%, metabolic, inflammatory, infective, undetermined). Outcome was better for neurodegenerative diseases and for drug-induced MD. Functional movement disorders (FMD) showed less favorable outcome.&lt;bold&gt;Conclusions: &lt;/bold&gt;Acute MD is a distinct cause of ER admission, and a variety of treatable diseases may be the underlying cause of this symptom. Uncertain course is more probable in FMD and in structural brain lesions. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10072-018-3601-1
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        Text: English
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    Subjects:
      – SubjectFull: Chorea
        Type: general
      – SubjectFull: Movement disorders
        Type: general
      – SubjectFull: Myoclonus
        Type: general
      – SubjectFull: Dyskinesias
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      – SubjectFull: Movement disorder treatments
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      – SubjectFull: Hospital emergency services
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      – SubjectFull: Longitudinal method
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      – TitleFull: Movement disorders in emergency settings: a prospective study.
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              Text: Jan2019
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