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Although the disease in patients with treated PD was more severe than in the untreated group, no significant difference in the thickness of retina was found between the 2 groups. Therefore, we thought that levodopa might have a protective effect on retina in patients with PD.

BACKGROUNDOrganization and management of neurological emergencies differs among hospitals. Some have specialized neurological emergency rooms (ER).OBJECTIVESThe purpose of this study was to determine the characteristics, diagnosis and outcome of patients referred to a specialized emergency neurology clinic.DESIGNProspective, observational study of consecutive patients presenting between March 2014 and July 2014.SETTINGNeurologicaler of a training and research neuropsychiatric hospital.PATIENTS AND METHODSPatients older than 16 years of age with a neurological complaint were assessed by neurological exam, laboratory and imaging tests including brain computed tomography (CT), brain magnetic resonance imaging (MRI), cerebrospinal fluid analysis, electroencephalography or electromyography.MAIN OUTCOME MEASURESTypes of diagnosis.RESULTSOf 4500 patients, 2602 (57.8%) were female, and the mean age was 49.2 (23.6) years. The most common symptom was headache, which presented in 30.8% of all patients. The three most common diagnoses after emergency work-up were headache (27.8%), stroke (20.6%) and peripheral vertigo (13%). In the ER, CT was performed on 65.5% of patients and MRI on 66.9%. After emergency work-up, 72.2% patients were discharged home.CONCLUSIONSNeurological diseases are common, with headache and cerebrovascular diseases being the most frequent diagnosis in this specialized ER. CT and MRI are most often used to diagnose or exclude neurological diseases. Many patients do not require immediate hospitalization. The two most frequent diagnoses for hospitalization were stroke and demyelinating disease.LIMITATIONSAbsence of follow up data on patients discharged home.

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Repeated injections of BoNT-A are safe and effective in treating sialorrhea in patients with PD. Based on our results, it seems that there is a maintenance of efficacy after a three-year period and an increase in the mean duration of efficacy with the number of injections. Further prospective clinical studies with larger number of patients and more longer duration of follow-up are needed to confirm our results.

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