Movement disorders emergencies: a review

Munhoz, Renato P.; Moscovich, Mariana; Araujo, Patrícia Dare; Teive, Hélio A.G.

doi:10.1590/s0004-282x2012000600013

Cited by 35 publications

(37 citation statements)

References 49 publications

(173 reference statements)

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“…Dystonia can be differentiated from RSS due to the rigidity of the entire body-as opposed to the localised stiffness seen in RSS-and abnormal posture. 17 Stiff person syndrome may be the initial diagnosis given in cases of primary RSS; indeed, one of the patients in the current study was initially diagnosed with stiff person syndrome while abroad. Generalised body stiffness involving even the abdominal muscles helps in making the correct diagnosis.…”

Section: Discussionmentioning

confidence: 66%

“…However, primary RSS needs to be differentiated from other rare conditions such as X-linked Emery-Dreifuss muscular dystrophy, generalised dystonia and stiff person syndrome. 15,17 In cases of Emery-Dreifuss muscular dystrophy, there is proximal wasting of the upper limb muscles with contractures and early cardiac involvement. Serum creatine kinase levels are high and an ECG usually shows abnormal findings.…”

Section: Discussionmentioning

confidence: 99%

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Rigid Spine Syndrome among Children in Oman

Koul

Sankhla

Al-Jahdhami

et al. 2015

Sultan Qaboos Univ Med J

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Objectives: Rigidity of the spine is common in adults but is rarely observed in children. The aim of this study was to report on rigid spine syndrome (RSS) among children in Oman. Methods: Data on children diagnosed with RSS were collected consecutively at presentation between 1996 and 2014 at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. A diagnosis of RSS was based on the patient's history, clinical examination, biochemical investigations, electrophysiological findings, neuro-imaging and muscle biopsy. Atrophy of the paraspinal muscles, particularly the erector spinae, was the diagnostic feature; this was noted using magnetic resonance imaging of the spine. Children with disease onset in the paraspinal muscles were labelled as having primary RSS or rigid spinal muscular dystrophy. Secondary RSS was classified as RSS due to the late involvement of other muscle diseases. Results: Over the 18-year period, 12 children were included in the study, with a maleto-female ratio of 9:3. A total of 10 children were found to have primary RSS or rigid spinal muscular dystrophy syndrome while two had secondary RSS. Onset of the disease ranged from birth to 18 months of age. A family history was noted, with two siblings from one family and three siblings from another (n = 5). On examination, children with primary RSS had typical features of severe spine rigidity at onset, with the rest of the neurological examination being normal. Conclusion: RSS is a rare disease with only 12 reported cases found at SQUH during the study period. Cases of primary RSS should be differentiated from the secondary type.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Rigid Spine Syndrome among Children in Oman

Koul

Sankhla

Al-Jahdhami

et al. 2015

Sultan Qaboos Univ Med J

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“…The implication is that there will certainly be a growing number of PD patients admitted to ERs over the next decades. This conclusion emphasizes the importance of clinicians becoming familiar with the concepts reviewed by Munhoz and colleagues et al 1 .…”

Section: Referencesmentioning

confidence: 67%

“…Recently, there is a growing understand that movement disorders may present with acute problems warranting visits to the emergency rooms. Thus, the comprehensive review of Munhoz et al on movement disorders emergencies in the current issue of Arquivos de Neuropsiquiatria is timely 1 . The authors tackled etiology, clinical features, and management of a vast gamut of emergencies in patients with movement disorders.…”

Section: An Emerging and Growing Problemmentioning

confidence: 99%

An emerging and growing problem

Cardoso¹

2012

Arq. Neuro-Psiquiatr.

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T he vast amount of work produced by David Marsden, Stanley Fahn, and many other investigators in the 1980s and 1990s established the movement disorders as one of the most active and exciting contemporary areas of Neurology. Since its inception in the 19 th century, thanks to the groundbreaking contribution of Jean Martin Charcot, William Gowers, Sir William Osler, among others, this area has been perceived as the realm of chronic and relentlessly progressive disorders, whose care is provided in the setting of outpatient clinics. Recently, there is a growing understand that movement disorders may present with acute problems warranting visits to the emergency rooms. Thus, the comprehensive review of Munhoz et al. on movement disorders emergencies in the current issue of Arquivos de Neuropsiquiatria is timely 1 . The authors tackled etiology, clinical features, and management of a vast gamut of emergencies in patients with movement disorders.In addition to clinical problems related to hyperkinetic and hypokinetic movement disorders in adults reviewed by the authors, there are two issues that should receive the attention of neurologists interested in this field. At least 8% of patients with Parkinson's Disease (PD) and a small, but growing number, of individuals with tremor, dystonia, and other hyperkinetic disorders fail to respond to clinical management. With new advances in functional surgery, many of these subjects are candidates for deep brain stimulation (DBS).As recently reviewed by Morishita et al. 2, more postoperative urgencies and emergencies have emerged. The authors have separated the scenarios into surgery/procedure related (intracranial hemorrhage, dyskinetic storm, postoperative behavioral and cognitive problems, suicide attempt or ideation, others), hardware related (hardware infection, hardware malfunction, lead migration, and lead misplacement), stimulation-induced difficulties (motor or non-motor symptoms), and others. Given their complexity, patients with these movement disorders emergencies should be referred to units where there is a staff comprising neurologists and neurosurgeons experienced with DBS. The second issue is related to pediatric movement disorders. In comparison to adult patients, much less has been published about emergencies in this population. However, a recent review by Kirkham et al. sheds light on this topic 3 . They described 52 patients, and three groups were recognized: psychogenic disorders (n=12), typically >10 years-old, more likely to be female and to have tremor and myoclonus 2 . Inflammatory or autoimmune disorders (n=22), including N-methyl-d-aspartate receptor encephalitis, opsoclonusmyoclonus, Sydenham's chorea, systemic lupus erythematosus, acute necrotizing encephalopathy, and other encephalitis and 3 non-inflammatory disorders (n=18), including drug-induced movement disorder, postpump chorea, metabolic, e.g. glutaric aciduria, and vascular disease, e.g. moyamoya. It noteworthy that, unlike series with adult subjects, there was a significant representation of...

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“…The causative drugs are commonly ant dopaminergic, such as antipsychotics, antiemetic and less frequently, anticonvulsants and antidepressants. Although the pathophysiology of acute dystonic reactions is still unclear, it is believed to be due to a deficit in central dopamine transmission resulting in overactive striatal acetylcholine release [2].…”

Section: Introductionmentioning

confidence: 99%

Methylphenidate-Induced Acute Dystonic Reaction: A case report

Erdoğan¹,

Erdoğan²

2015

J Pharmacovigil

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Dystonia is a syndrome characterized by sustained muscle contractions frequently causing twisting and repetitive movements or abnormal postures. Dystonic reactions may be a complication of many drugs such as antipsychotics, anti-emetics and antidepressants. This report presents a 4-year-old healthy boy who was admitted to an emergency department with acute dystonia following the ingestion of methylphenidate, a stimulant pharmalogical agent used for the treatment for attention-deficit hyperactivity disorder. In conclusion, this report suggests that methylphenidate increase dopaminergic transmission can also trigger dystonic reaction in at healthy child.

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Movement disorders emergencies: a review

Cited by 35 publications

References 49 publications

Rigid Spine Syndrome among Children in Oman

Rigid Spine Syndrome among Children in Oman

An emerging and growing problem

Methylphenidate-Induced Acute Dystonic Reaction: A case report

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