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

Authors
Yoon, JH; Lee, PH; Yong, SW; Park, HY; Lim, TS; Choi, JY
Citation
Journal of neurology, 255(5):745-749, 2008
Journal Title
Journal of neurology
ISSN
0340-53541432-1459
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 drug-related. Careful selection of drugs while prescribing would decrease movement disorder-related visits to the ER.
MeSH terms
AdolescentAdultAge FactorsAgedAged, 80 and overBrain Diseases, Metabolic/epidemiologyBrain Diseases, Metabolic/physiopathologyDyskinesia, Drug-Induced/diagnosisDyskinesia, Drug-Induced/epidemiology*Dyskinesia, Drug-Induced/physiopathologyDystonic Disorders/chemically inducedDystonic Disorders/epidemiologyDystonic Disorders/physiopathologyEmergency Service, Hospital/statistics & numerical data*FemaleGait Disorders, Neurologic/chemically inducedGait Disorders, Neurologic/epidemiologyGait Disorders, Neurologic/physiopathologyHospitals, University/statistics & numerical data*HumansKorea/epidemiologyMaleMiddle AgedMovement Disorders/epidemiology*Movement Disorders/etiology*Movement Disorders/physiopathologyMyoclonus/chemically inducedMyoclonus/epidemiologyMyoclonus/physiopathologyProspective StudiesPsychotropic Drugs/adverse effects*Tremor/chemically inducedTremor/epidemiologyTremor/physiopathology
DOI
10.1007/s00415-008-0789-7
PMID
18338197
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
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