Acute hyperkinetic movement disorders in Italian paediatric emergency departments

Raucci, Umberto; Parisi, Pasquale; Vanacore, Nicola; Garone, Giacomo; Bondone, Claudia; Palmieri, Antonella; Calistri, Lucia; Suppiej, Agnese; Falsaperla, Raffaele; Capuano, Alessandro; Ferro, Valentina; Urbino, Antonio; Tallone, Ramona; Montemaggi, Alessandra; Sartori, Stefano; Pavone, Piero; Mancardi, Margherita; Melani, Federico; Ilvento, Lucrezia; Pelizza, Maria Federica; Reale, Antonino

doi:10.1136/archdischild-2017-314464

Cited by 12 publications

(19 citation statements)

References 19 publications

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“…In the present study, ten patients out of 15 with an initial diagnosis of chorea had Sydenham chorea, and two of these were recurrences. In a Italian study evaluating hyperkinetic movement disorders in a pediatric emergency department, tics were the most common cause of admission (44.5%) followed by tremors (21.1%) and chorea (13.7%) (13) ; Sydenham chorea was the only form of chorea identified. As there is no specific biological marker in patients with Sydenham chorea, the diagnosis of Sydenham chorea is based on clinical evaluation and the exclusion of other causes of the chorea (14,15) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Uzunhan¹,

İrdem²

2020

BMJ

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Objective: Our aim is to evaluate patients being referred with an initial diagnosis of chorea according to their clinical, laboratory features and final diagnoses while emphasizing cardiological findings of patients with Sydenham chorea. Method: Children aged 4-18 years who were referred to Okmeydanı Research and Training Hospital Pediatric Neurology department with an initial diagnosis of acute, subacute chorea between January 2017-January 2020 were retrospectively included. Chronic chorea and diseases associated with chronic chorea were excluded from the study. Data concerning clinical, laboratory features, cardiological findings, etiologies, treatments, recurrence rates and follow-ups of patients were recorded. Descriptive statistical analysis were performed using SPSS 21.0. Results: Fifteen patients has been referred with the initial diagnosis of chorea. Mean age of the patients was 11.5±2.2 years. Ten (67%) patients were females, 5 (33%) patients were male. After admission, 8 (54%) patients were diagnosed with Sydenham chorea, and 2 (13%) patients with recurrent Sydenham chorea. During physical examination, 5 (33%) patients did not have chorea, and 3 cases had tic disorder. Out of 8 patients with new diagnosis of Sydenham chorea, 3 (37.5%) patients had subclinical carditis, and 5 (62.5%) patients clinical carditis. Chorea had been treated with one of haloperidol/biperiden, valproic acid and prednisolon options. The treatment of 6 patients attending regular follow-up visits was stopped 2-6 months later. Chorea of two patients recurred during our follow-up, and one of our newly diagnosed Sydenham chorea patients had been recognized as antiphospholipid antibody syndrome after recurrence. Conclusion: Sydenham chorea is the most common cause of acquired chorea in childhood. Most of the time it is self limiting. Differential diagnosis of chorea must be kept in mind especially when there is a recurrence.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Uzunhan¹,

İrdem²

2020

BMJ

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“…The exact mechanism of this sex predilection of FMDs is still not known because of the complex interaction of social, cultural, and biological factors (8,9). FMDs in children tend to have abrupt onset as compared to adults and account for 4-23% of the acute movement disorders (5,10,11). In such cases, history or psychopathology is often absent or misleading, as the emergency room is not an ideal setting for eliciting history related to the psychosocial stressor and a thorough evaluation with standardized questionnaires is also sometimes not feasible (12).…”

Section: Epidemiologymentioning

confidence: 99%

Functional Movement Disorders in Children

Chouksey

Pandey

2020

Front. Neurol.

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Functional movement disorders (FMDs) are not uncommon in children. The age at onset may have a bearing on the phenomenological pattern of abnormal movement, risk factors, and response to different treatment modalities in this age group. FMDs in children resemble their adult counterparts in terms of gender preponderance, but risk factors are quite different, and often influenced by cultural and demographic background. FMDs contribute to a significant proportion of acute pediatric movement disorder patients seen in emergency settings, ranging from 4.3 to 23% in different case series. The most common movement phenomenologies observed in pediatric FMDs patients are tremor, dystonia, gait disturbances, and functional tics. Various social, physical, and familial precipitating factors have been described. Common social risk factors include divorce of parents, sexual abuse, bullying at school, examination pressure, or other education-related issues, death of a close friend, relative, or family members. Physical trauma like minor head injury, immunization, tooth extraction, and tonsillectomy are also known to precipitate FMDs. The response to treatment appears to be better among pediatric patients. We aim to review FMDs in children to better understand the different aspects of their frequency, clinical features, precipitating factors, diagnosis, treatment, and outcome.

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“…Nevertheless, among three other studies in children with acute pathology presenting to the pediatric emergency department, the percentage of children with IEMs was between two and eight percent of all cases. These cases included IEMs as various as ceroidolipofuscinosis, mucopolisacaridosis, pantothenate kinaseassociated neurodegeneration, glutaric aciduria type 1, MELAS, and Leigh syndrome (34)(35)(36). The full-description of all these studies is displayed in Supplementary Table 2.…”

Section: Overview Of Movement Disorders In Inborn Errors Of Metabolismmentioning

confidence: 99%

A Proposed Diagnostic Algorithm for Inborn Errors of Metabolism Presenting With Movements Disorders

Ortigoza‐Escobar

2020

Front. Neurol.

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Acute hyperkinetic movement disorders in Italian paediatric emergency departments

Abstract: This study provides the first large sample of paediatric patients presenting to the ED for AHMDs, helping to elucidate the epidemiology, aetiology and clinical presentation of these disorders.

Cited by 12 publications

References 19 publications

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Evaluation of Patients with an Initial Diagnosis of Chorea: Sydenham Chorea and Differential Diagnoses

Functional Movement Disorders in Children

A Proposed Diagnostic Algorithm for Inborn Errors of Metabolism Presenting With Movements Disorders

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