Movement disorders at a university hospital emergency room An analysis of clinical pattern and etiology

• Published in: Journal of neurology Vol. 255; no. 5; pp. 745 - 749
• Main Authors: Yoon, J. H., Lee, P. H., Yong, S. W., Park, H. Y., Lim, T. S., Choi, J. Y.
• Format: Journal Article
• Language: English
• Published: Darmstadt Steinkopff-Verlag 01.05.2008; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Brain Diseases, Metabolic - epidemiology; Brain Diseases, Metabolic - physiopathology; Dyskinesia, Drug-Induced - diagnosis; Dyskinesia, Drug-Induced - epidemiology; Dyskinesia, Drug-Induced - physiopathology; Dystonic Disorders - chemically induced; Dystonic Disorders - epidemiology; Dystonic Disorders - physiopathology; Emergency Service, Hospital - statistics & numerical data; Female; Gait Disorders, Neurologic - chemically induced; Gait Disorders, Neurologic - epidemiology; Gait Disorders, Neurologic - physiopathology; Hospitals, University - statistics & numerical data; Humans; Korea - epidemiology; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Movement Disorders - epidemiology; Movement Disorders - etiology; Movement Disorders - physiopathology; Myoclonus - chemically induced; Myoclonus - epidemiology; Myoclonus - physiopathology; Neurology; Neuroradiology; Neurosciences; Original Communication; Prospective Studies; Psychotropic Drugs - adverse effects; Tremor - chemically induced; Tremor - epidemiology; Tremor - physiopathology; Vascular diseases and vascular malformations of the nervous system; Korea; movement disorder; emergency room; clinical pattern; etiology; Nervous system diseases; Etiology; Hospital; Emergency; Pattern analysis
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-008-0789-7

We prospectively evaluated the clinical features and etiologies of all common categories of movement disorder seen in the emergency room (ER) of an urban university hospital over a period of 12 months. We divided movement disorders according to the presenting phenomenology likely to dominate the clinical presentation, that is, gait disorder, tremor, dystonia, myoclonus, and acute akinetic crisis and classified a specific etiology in the individual phenomenology. In one year, there were 60,002 ER visits; of these, 58 (0.09 %) were diagnosed as a primary movement disorder. The most common clinical presentation was gait disorder (n = 21, 36.2 %), followed by myoclonus (n = 16, 27.6 %), dystonia (n = 10, 17.2 %), tremor (n = 8, 13.8 %), and acute akinetic crisis (n = 3, 5.2 %). Comparing the movement disorders, the mean age of the patients with dystonia was significantly lower than that of patients with other movement disorders (P < 0.001). Of the patients, 37 (63.8 %) had drug-related movement disorders. The contribution of drugs was significantly higher in patients with dystonia compared with the other movement disorders (P < 0.01). Our study showed that a large proportion of the movement disorders seen in the ER are drugrelated. Careful selection of drugs while prescribing would decrease movement disorder-related visits to the ER.