Movement disorders at a university hospital emergency room. An analysis of clinical pattern and etiology.
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.
Yoon
Jung Han
JH
Dept. of Neurology, Ajou University School of Medicine, South Korea.
Lee
Phil Hyu
PH
Yong
Seok Woo
SW
Park
Hee Young
HY
Lim
Tae Sung
TS
Choi
Jun Young
JY
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001928:Brain Diseases, Metabolic / Q000453:epidemiology / Q000503:physiopathology; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D020821:Dystonic Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D009207:Myoclonus / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects*; D014202:Tremor / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology
D011619:Psychotropic Drugs