Prevalence of Chorea, Dystonia and Athetosis in Assiut, Egypt: A Clinical and Epidemiological Study

Abstract

Involuntary movements originate from different parts of the nervous system. The character of movements depends upon the site of the lesion and the type of pathological change. The presence of more than one type of involuntary movement in a patient can cause confusion and difficulty in the proper classification of movement disorders, which then leads to problems in the differential diagnosis and appropriate treatment. This work was planned to estimate the prevalence and to study the aetiological factors of chorea, dystonia, athetosis and hemiballismus in Assiut, a representative community of Upper Egypt. This study was carried out on 7,000 families (42,000 subjects) representing different types of communities (2,000 families from urban, 2,000 families from suburban and 3,000 families from rural communities). All members of these samples were personally interviewed at home. Full clinical assessment and special investigations required for the diagnosis of different types of chorea, dystonia and athetosis were carried out in Assiut University Hospital. The prevalence rate for rheumatic chorea was 62/100,000 population and it was significantly higher (p < 0.01) among rural than urban and suburban populations, whereas Huntington''s chorea had a prevalence rate of 21/100,000 with no significant difference between different areas studied (urban, suburban and rural). The other two common types of chorea were reported with prevalence rates of 12/100,000 for the encephalitic type and 17/100,000 for the atherosclerotic type. No single case of generalized dystonia was recorded and all cases were of the focal type of dystonia with a prevalence rate of 26/100,000 population. No significant differences were recorded between the different areas studied (urban, suburban and rural). Idiopathic form and drug-induced form were the most prevalent types of focal dystonia (10/100,000). The prevalence rate of athetotic cases (all of which are postencephalitic) in our study was 12/100,000 with no significant difference between different areas studied (urban, suburban and rural).

Late-onset primary dystonia in Zhejiang province of China: a service-based epidemiological study

“…This is consistent with the most studies in western countries and Japan (M:F, 1:1-1:3.8) [6,12,16,20,23]. But it is in contrast to the reports from Singapore (M:F, 1.6:1) [13] and Egypt (M:F, 3:1) [24]. Limb dystonia has a male predominance in majority of the studies [12,23,25,26].…”

Botulinum Toxin Clinic-Based Epidemiologic Survey of Adults with Primary Dystonia in East China

“…This is opposite to what had been reported in Singapore (M : F, 1.6 : 1)17 and Egypt (M : F, 3 : 1) 23. Limb dystonia has a male predominance in the majority of studies that have been reported 4,9,22,24,25.…”

Agreement among neurologists on the clinical diagnosis of dystonia at different body sites

“…It is worth noting that our neurologists reached the highest level of agreement on blepharospasm and cervical dystonia, which are considered to be the most common forms of dystonia. [4][5][6][7][8][9] We ignored the consistency of the neurologists' ability to diagnose dystonia because intraobserver reliability could not be tested. Lack of this information, however, probably does not affect the relevance of the data on interobserver agreement reported here, or their potential implications.…”