Movement disorders at a university hospital emergency room An analysis of clinical pattern and etiology
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 cli...
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Published in | Journal of neurology Vol. 255; no. 5; pp. 745 - 749 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Darmstadt
Steinkopff-Verlag
01.05.2008
Springer Springer Nature B.V |
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Abstract | 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. |
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AbstractList | 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 drug-related. Careful selection of drugs while prescribing would decrease movement disorder-related visits to the ER. 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. 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. [PUBLICATION ABSTRACT] |
Author | Choi, J. Y. Yoon, J. H. Lim, T. S. Park, H. Y. Lee, P. H. Yong, S. W. |
Author_xml | – sequence: 1 givenname: J. H. surname: Yoon fullname: Yoon, J. H. organization: Dept. of Neurology, Ajou University School of Medicine – sequence: 2 givenname: P. H. surname: Lee fullname: Lee, P. H. organization: Dept. of Neurology, Yonsei University College of Medicine – sequence: 3 givenname: S. W. surname: Yong fullname: Yong, S. W. organization: Dept. of Neurology, Ajou University School of Medicine – sequence: 4 givenname: H. Y. surname: Park fullname: Park, H. Y. organization: Dept. of Neurology, Ajou University School of Medicine – sequence: 5 givenname: T. S. surname: Lim fullname: Lim, T. S. organization: Dept. of Neurology, Ajou University School of Medicine – sequence: 6 givenname: J. Y. surname: Choi fullname: Choi, J. Y. organization: Dept. of Neurology, Ajou University School of Medicine |
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Keywords | movement disorder emergency room clinical pattern etiology Nervous system diseases Etiology Hospital Emergency Pattern analysis |
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References_xml | – volume: 20 start-page: 322 year: 2005 ident: 789_CR10 publication-title: Mov Disord doi: 10.1002/mds.20325 contributor: fullname: Kipps – volume: 55 start-page: 181 year: 1992 ident: 789_CR9 publication-title: J Neurol Neurosurg Psychiatry doi: 10.1136/jnnp.55.3.181 contributor: fullname: Hughes – volume: 16 start-page: 481 year: 2003 ident: 789_CR16 publication-title: Curr Opin Neurol contributor: fullname: Sethi – volume: 43 start-page: 1 year: 1986 ident: 789_CR6 publication-title: Adv Neurol contributor: fullname: Fahn – volume: 143 start-page: 1374 year: 1986 ident: 789_CR13 publication-title: Am J Psychiatry doi: 10.1176/ajp.143.11.1374 contributor: fullname: Mann – volume: 59 start-page: 406 year: 1995 ident: 789_CR4 publication-title: J Neurol Neurosurg Psychiatry doi: 10.1136/jnnp.59.4.406 contributor: fullname: Factor – volume: 64 start-page: 1162 year: 2005 ident: 789_CR14 publication-title: Neurology doi: 10.1212/01.WNL.0000157058.17871.7B contributor: fullname: Onofrj – volume: 21 start-page: 1047 year: 2006 ident: 789_CR18 publication-title: Mov Disord doi: 10.1002/mds.20880 contributor: fullname: Sugawara – volume: 19 start-page: 630 year: 2004 ident: 789_CR21 publication-title: Mov Disord doi: 10.1002/mds.20083 contributor: fullname: Zijlmans – volume: 52 start-page: 1214 year: 1999 ident: 789_CR1 publication-title: Neurology doi: 10.1212/WNL.52.6.1214 contributor: fullname: Bower – volume: 2 start-page: 307 year: 1965 ident: 789_CR8 publication-title: J Neurol Sci doi: 10.1016/0022-510X(65)90016-X contributor: fullname: Hakim – volume: 73 start-page: 337 year: 1986 ident: 789_CR17 publication-title: Acta Psychiatr Scand doi: 10.1111/j.1600-0447.1986.tb02694.x contributor: fullname: Shalev – volume: 20 start-page: 410 year: 2005 ident: 789_CR20 publication-title: Mov Disord doi: 10.1002/mds.20347 contributor: fullname: Wielinski – volume: 81 start-page: 327 year: 1990 ident: 789_CR11 publication-title: Acta Neurol Scand doi: 10.1111/j.1600-0404.1990.tb01564.x contributor: fullname: Larsson – volume: 8 start-page: 254 year: 2002 ident: 789_CR15 publication-title: Neurologist doi: 10.1097/00127893-200207000-00005 contributor: fullname: Rubino – volume: 4 start-page: 815 year: 2005 ident: 789_CR19 publication-title: Lancet Neurol doi: 10.1016/S1474-4422(05)70226-X contributor: fullname: Wenning – volume: 74 start-page: 565 year: 1999 ident: 789_CR2 publication-title: Mayo Clin Proc doi: 10.4065/74.6.565 contributor: fullname: Caviness – volume: 50 start-page: 431 year: 1988 ident: 789_CR7 publication-title: Adv Neurol contributor: fullname: Fahn – volume: 78 start-page: 1 year: 1998 ident: 789_CR5 publication-title: Adv Neurol doi: 10.1212/WNL.50.5_Suppl_5.S1 contributor: fullname: Fahn – volume: 252 start-page: 1299 year: 2005 ident: 789_CR3 publication-title: J Neurol doi: 10.1007/s00415-005-0006-x contributor: fullname: Dressler – volume: 77 start-page: 372 year: 2006 ident: 789_CR12 publication-title: J Neurol Neurosurg Psychiatry doi: 10.1136/jnnp.2005.073999 contributor: fullname: Lee |
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Snippet | We prospectively evaluated the clinical features and etiologies of all common categories of movement disorder seen in the emergency room (ER) of an urban... |
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SubjectTerms | 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 |
Subtitle | An analysis of clinical pattern and etiology |
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Title | Movement disorders at a university hospital emergency room |
URI | https://link.springer.com/article/10.1007/s00415-008-0789-7 https://www.ncbi.nlm.nih.gov/pubmed/18338197 https://www.proquest.com/docview/218147987/abstract/ |
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