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Functional Movement Disorders: Updates and Clinical Overview
Jung E Park
J Mov Disord. 2024;17(3):251-261.   Published online July 1, 2024
DOI: https://doi.org/10.14802/jmd.24126
  • 3,259 View
  • 335 Download
AbstractAbstract PDF
Functional movement disorder (FMD) is a type of functional neurological disorder that is common but often difficult to diagnose or manage. FMD can present as various phenotypes, including tremor, dystonia, myoclonus, gait disorders, and parkinsonism. Conducting a clinical examination appropriate for assessing a patient with suspected FMD is important, and various diagnostic testing maneuvers may also be helpful. Treatment involving a multidisciplinary team, either outpatient or inpatient, has been found to be most effective. Examples of such treatment protocols are also discussed in this review. While recognition and understanding of the disorder has improved over the past few decades, as well as the development of treatments, it is not uncommon for patients and physicians to continue to experience various difficulties when dealing with this disorder. In this review, I provide a practical overview of FMD and discuss how the clinical encounter itself can play a role in patients’ acceptance of the diagnosis. Recent neuroimaging studies that aid in understanding the pathophysiology are also discussed.
Brief communication
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COVID-19 Vaccine-Related Movement Disorders: A Systematic Review
Grace Elysse D. Angeles, Lowrence Precious C. Dichoso, Roland Dominic G. Jamora
J Mov Disord. 2024;17(3):322-327.   Published online March 19, 2024
DOI: https://doi.org/10.14802/jmd.24001
  • 3,651 View
  • 153 Download
  • 2 Comments
AbstractAbstract PDFSupplementary Material
Objective
Since the release of vaccines against coronavirus disease 2019 (COVID-19), there have been reports of vaccine-related neurologic complications. This study aimed to perform a descriptive systematic review of movement disorders associated with COVID-19 vaccines.
Methods
We described the demographics, clinical presentation, management, outcomes, and proposed pathomechanism of the patients. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A standardized tool was used to assess the quality of the cases.
Results
We identified 8 articles that met our inclusion criteria; these articles included 10 patients who developed movement disorders after vaccination. The majority were males (n = 8), with a median age of 64.5 years. The most common movement disorder was hemichorea. The rest presented with generalized chorea with myoclonus, cervical dystonia, and akathisia. Most patients respond to immunotherapy. The standardized tool used showed that most studies had a low risk of bias.
Conclusion
The reported incidence of vaccine-related movement disorders was low based on available published cases.
Review Articles
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Nine Hereditary Movement Disorders First Described in Asia: Their History and Evolution
Priya Jagota, Yoshikazu Ugawa, Zakiyah Aldaajani, Norlinah Mohamed Ibrahim, Hiroyuki Ishiura, Yoshiko Nomura, Shoji Tsuji, Cid Diesta, Nobutaka Hattori, Osamu Onodera, Saeed Bohlega, Amir Al-Din, Shen-Yang Lim, Jee-Young Lee, Beomseok Jeon, Pramod Kumar Pal, Huifang Shang, Shinsuke Fujioka, Prashanth Lingappa Kukkle, Onanong Phokaewvarangkul, Chin-Hsien Lin, Cholpon Shambetova, Roongroj Bhidayasiri
J Mov Disord. 2023;16(3):231-247.   Published online June 13, 2023
DOI: https://doi.org/10.14802/jmd.23065
  • 4,517 View
  • 273 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Clinical case studies and reporting are important to the discovery of new disorders and the advancement of medical sciences. Both clinicians and basic scientists play equally important roles leading to treatment discoveries for both cures and symptoms. In the field of movement disorders, exceptional observation of patients from clinicians is imperative, not just for phenomenology but also for the variable occurrences of these disorders, along with other signs and symptoms, throughout the day and the disease course. The Movement Disorders in Asia Task Force (TF) was formed to help enhance and promote collaboration and research on movement disorders within the region. As a start, the TF has reviewed the original studies of the movement disorders that were preliminarily described in the region. These include nine disorders that were first described in Asia: Segawa disease, PARK-Parkin, X-linked dystonia-parkinsonism, dentatorubral-pallidoluysian atrophy, Woodhouse-Sakati syndrome, benign adult familial myoclonic epilepsy, Kufor-Rakeb disease, tremulous dystonia associated with mutation of the calmodulin-binding transcription activator 2 gene, and paroxysmal kinesigenic dyskinesia. We hope that the information provided will honor the original researchers and help us learn and understand how earlier neurologists and basic scientists together discovered new disorders and made advances in the field, which impact us all to this day.

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  • Genetic heterogeneity of early onset Parkinson disease: The dilemma of clinico-genetic correlation
    Roopa Rajan, Vikram V. Holla, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal
    Parkinsonism & Related Disorders.2024; 129: 107146.     CrossRef
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Historical and More Common Nongenetic Movement Disorders From Asia
Norlinah Mohamed Ibrahim, Priya Jagota, Pramod Kumar Pal, Roongroj Bhidayasiri, Shen-Yang Lim, Yoshikazu Ugawa, Zakiyah Aldaajani, Beomseok Jeon, Shinsuke Fujioka, Jee-Young Lee, Prashanth Lingappa Kukkle, Huifang Shang, Onanong Phokaewvarangkul, Cid Diesta, Cholpon Shambetova, Chin-Hsien Lin
J Mov Disord. 2023;16(3):248-260.   Published online June 9, 2023
DOI: https://doi.org/10.14802/jmd.22224
  • 3,214 View
  • 144 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Nongenetic movement disorders are common throughout the world. The movement disorders encountered may vary depending on the prevalence of certain disorders across various geographical regions. In this paper, we review historical and more common nongenetic movement disorders in Asia. The underlying causes of these movement disorders are diverse and include, among others, nutritional deficiencies, toxic and metabolic causes, and cultural Latah syndrome, contributed by geographical, economic, and cultural differences across Asia. The industrial revolution in Japan and Korea has led to diseases related to environmental toxin poisoning, such as Minamata disease and β-fluoroethyl acetate-associated cerebellar degeneration, respectively, while religious dietary restriction in the Indian subcontinent has led to infantile tremor syndrome related to vitamin B12 deficiency. In this review, we identify the salient features and key contributing factors in the development of these disorders.

Citations

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  • Diabetic striatopathy and other acute onset de novo movement disorders in hyperglycemia
    Subhankar Chatterjee, Ritwik Ghosh, Payel Biswas, Shambaditya Das, Samya Sengupta, Souvik Dubey, Biman Kanti Ray, Alak Pandit, Julián Benito-León, Rana Bhattacharjee
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2024; 18(3): 102997.     CrossRef
  • Tremors in Infantile Tremor Syndrome Mimicking Epilepsia Partialis Continua
    Tonyot Gailson, Pradeep Kumar Gunasekaran, Arushi Gahlot Saini, Chaithanya Reddy
    Journal of Movement Disorders.2024; 17(3): 351.     CrossRef
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Adult-Onset Genetic Leukoencephalopathies With Movement Disorders
Mu-Hui Fu, Yung-Yee Chang
J Mov Disord. 2023;16(2):115-132.   Published online March 7, 2023
DOI: https://doi.org/10.14802/jmd.22127
  • 6,500 View
  • 454 Download
  • 1 Comments
AbstractAbstract PDF
Genetic leukoencephalopathies (GLEs) are a group of white matter abnormalities with heterogeneous radiological and phenotypic features. Although these conditions have mostly been described in children, adult-onset cases are increasingly recognized owing to the widespread use of neuroimaging and advances in molecular genetic testing. The disease course is often progressive with a varied spectrum of presentations, trapping neurologists in the dilemma of differential diagnosis. Movement disorders are among the most common symptoms, and their diversity makes diagnosis challenging. In this review, we focus on adult-onset GLEs with movement disorders and offer a step-by-step diagnostic approach by clarifying the phenomenology of movement, advising investigations for acquired causes, describing the clinical and radiological clues to each disease, emphasizing the limitations of advanced molecular testing, and discussing the future application of artificial intelligence. We provide a list summarizing the leukoencephalopathies associated with different categories of movement disorders. In addition to guiding clinicians on how to narrow the list of differential diagnoses with the tools currently available, another aim of this review is to emphasize the inevitable trend toward applying advanced technology in diagnosing these difficult diseases.
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Treatable Ataxias: How to Find the Needle in the Haystack?
Albert Stezin, Pramod Kumar Pal
J Mov Disord. 2022;15(3):206-226.   Published online September 7, 2022
DOI: https://doi.org/10.14802/jmd.22069
  • 7,587 View
  • 560 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Treatable ataxias are a group of ataxic disorders with specific treatments. These disorders include genetic and metabolic disorders, immune-mediated ataxic disorders, and ataxic disorders associated with infectious and parainfectious etiology, vascular causes, toxins and chemicals, and endocrinopathies. This review provides a comprehensive overview of different treatable ataxias. The major metabolic and genetic treatable ataxic disorders include ataxia with vitamin E deficiency, abetalipoproteinemia, cerebrotendinous xanthomatosis, Niemann-Pick disease type C, autosomal recessive cerebellar ataxia due to coenzyme Q10 deficiency, glucose transporter type 1 deficiency, and episodic ataxia type 2. The treatment of these disorders includes the replacement of deficient cofactors and vitamins, dietary modifications, and other specific treatments. Treatable ataxias with immune-mediated etiologies include gluten ataxia, anti-glutamic acid decarboxylase antibody-associated ataxia, steroid-responsive encephalopathy associated with autoimmune thyroiditis, Miller-Fisher syndrome, multiple sclerosis, and paraneoplastic cerebellar degeneration. Although dietary modification with a gluten-free diet is adequate in gluten ataxia, other autoimmune ataxias are managed by short-course steroids, plasma exchange, or immunomodulation. For autoimmune ataxias secondary to malignancy, treatment of tumor can reduce ataxic symptoms. Chronic alcohol consumption, antiepileptics, anticancer drugs, exposure to insecticides, heavy metals, and recreational drugs are potentially avoidable and treatable causes of ataxia. Infective and parainfectious causes of cerebellar ataxias include acute cerebellitis, postinfectious ataxia, Whipple’s disease, meningoencephalitis, and progressive multifocal leukoencephalopathy. These disorders are treated with steroids and antibiotics. Recognizing treatable disorders is of paramount importance when dealing with ataxias given that early treatment can prevent permanent neurological sequelae.

Citations

Citations to this article as recorded by  
  • Genetic Testing of Movements Disorders: A Review of Clinical Utility
    Dennis Yeow, Laura I. Rudaks, Sue-Faye Siow, Ryan L. Davis, Kishore R. Kumar
    Tremor and Other Hyperkinetic Movements.2024;[Epub]     CrossRef
  • Genetically Proven Ataxia With Vitamin E Deficiency With Predominant Cervicobrachial Dystonic Presentation: A Case Report From India
    Vikram V. Holla, Sandeep Gurram, Sneha D. Kamath, Gautham Arunachal, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal
    Journal of Movement Disorders.2024; 17(2): 220.     CrossRef
  • Rehabilitation in Ataxia
    Anupam Gupta, Navin B. Prakash, Hafis Rahman
    Indian Journal of Physical Medicine and Rehabilitation.2023; 33(1): 21.     CrossRef
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Diagnosis and Clinical Features in Autoimmune-Mediated Movement Disorders
Pei-Chen Hsieh, Yih-Ru Wu
J Mov Disord. 2022;15(2):95-105.   Published online May 26, 2022
DOI: https://doi.org/10.14802/jmd.21077
  • 5,763 View
  • 617 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Movement disorders are common manifestations in autoimmune-mediated encephalitis. This group of diseases is suspected to be triggered by infection or neoplasm. Certain phenotypes correlate with specific autoantibody-related neurological disorders, such as orofacial-lingual dyskinesia with N-methyl-D-aspartate receptor encephalitis and faciobrachial dystonic seizures with leucine-rich glioma-inactivated protein 1 encephalitis. Early diagnosis and treatment, especially for autoantibodies targeting neuronal surface antigens, can improve prognosis. In contrast, the presence of autoantibodies against intracellular neuronal agents warrants screening for underlying malignancy. However, early clinical diagnosis is challenging because these diseases can be misdiagnosed. In this article, we review the distinctive clinical phenotypes, magnetic resonance imaging findings, and current treatment options for autoimmune-mediated encephalitis.

Citations

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  • A case of corticobasal syndrome possibly associated with anti-Yo antibodies
    Efthalia Angelopoulou, Vasilios C. Constantinides, Evangelos Koumasopoulos, Evangelia Stanitsa, Efstratios-Stylianos Pyrgelis, Andreas Kyrozis, Elisabeth Kapaki, Leonidas Stefanis, Sokratis G. Papageorgiou
    Current Medical Research and Opinion.2024; 40(10): 1737.     CrossRef
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Gene Therapy for Huntington’s Disease: The Final Strategy for a Cure?
Seulgi Byun, Mijung Lee, Manho Kim
J Mov Disord. 2022;15(1):15-20.   Published online November 17, 2021
DOI: https://doi.org/10.14802/jmd.21006
  • 9,090 View
  • 469 Download
  • 17 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Huntington’s disease (HD) has become a target of the first clinical trials for gene therapy among movement disorders with a genetic origin. More than 100 clinical trials regarding HD have been tried, but all failed, although there were some improvements limited to symptomatic support. Compared to other neurogenetic disorders, HD is known to have a single genetic target. Thus, this is an advantage and its cure is more feasible than any other movement disorder with heterogeneous genetic causes. In this review paper, the authors attempt to cover the characteristics of HD itself while providing an overview of the gene transfer methods currently being researched, and will introduce an experimental trial with a preclinical model of HD followed by an update on the ongoing clinical trials for patients with HD.

Citations

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  • Bioinspired Approaches for Central Nervous System Targeted Gene Delivery
    Jyotish Kumar, Afroz Karim, Ummy Habiba Sweety, Hemen Sarma, Md Nurunnabi, Mahesh Narayan
    ACS Applied Bio Materials.2024; 7(8): 4975.     CrossRef
  • The Huntington's Disease Gene Discovery
    Gustavo L. Franklin, Hélio A.G. Teive, Fernando Spina Tensini, Carlos Henrique Ferreira Camargo, Nayra de Souza Carvalho de Lima, Diego de Castro de dos Santos, Alex T. Meira, Sarah J. Tabrizi
    Movement Disorders.2024; 39(2): 227.     CrossRef
  • Optimizing Screening for Intrastriatal Interventions in Huntington's Disease Using Predictive Models
    Matthew J. Barrett, Ahmed Negida, Nitai Mukhopadhyay, Jin K. Kim, Huma Nawaz, Jefin Jose, Claudia Testa
    Movement Disorders.2024; 39(5): 855.     CrossRef
  • Exosomes for neurodegenerative diseases: diagnosis and targeted therapy
    Hui Tao, Bo Gao
    Journal of Neurology.2024; 271(6): 3050.     CrossRef
  • Emerging Perspectives on Prime Editor Delivery to the Brain
    Eli BenDavid, Sina Ramezanian, Yaoyao Lu, Joël Rousseau, Avi Schroeder, Marc Lavertu, Jacques P. Tremblay
    Pharmaceuticals.2024; 17(6): 763.     CrossRef
  • Exploring molecular mechanisms, therapeutic strategies, and clinical manifestations of Huntington’s disease
    Alaa Shafie, Amal Adnan Ashour, Saleha Anwar, Farah Anjum, Md. Imtaiyaz Hassan
    Archives of Pharmacal Research.2024; 47(6): 571.     CrossRef
  • A comprehensive review of AAV-mediated strategies targeting microglia for therapeutic intervention of neurodegenerative diseases
    Livia Zhou, Yafeng Wang, Yiran Xu, Yaodong Zhang, Changlian Zhu
    Journal of Neuroinflammation.2024;[Epub]     CrossRef
  • Efficacy and Safety of Tetrabenazine in Reducing Chorea and Improving Motor Function in Individuals With Huntington's Disease: A Systematic Review
    Nandini Vadlamani, Sabina Ibrahimli, Farees Ahmad Khan, Jason A Castillo, Kavya Sai Satya Amaravadi, Poornachandra Nalisetty, Safeera Khan
    Cureus.2024;[Epub]     CrossRef
  • Neurofilament light chain: a biomarker at the crossroads of clarity and confusion for gene-directed therapies
    Michael Christian A Virata, Jesus Alfonso Catahay, Giuseppe Lippi, Brandon M Henry
    Neurodegenerative Disease Management.2024; : 1.     CrossRef
  • Positron Emission Tomography Quantitative Assessment of Off-Target Whole-Body Biodistribution of I-124-Labeled Adeno-Associated Virus Capsids Administered to Cerebral Spinal Fluid
    Jonathan B. Rosenberg, Edward K. Fung, Jonathan P. Dyke, Bishnu P. De, Howard Lou, James M. Kelly, Layla Reejhsinghani, Rodolfo J. Ricart Arbona, Dolan Sondhi, Stephen M. Kaminsky, Nathalie Cartier, Christian Hinderer, Juliette Hordeaux, James M. Wilson,
    Human Gene Therapy.2023;[Epub]     CrossRef
  • CRISPR: a tool with potential for genomic reprogramming in neurological disorders
    Yogesh K. Dhuriya, Aijaz A. Naik
    Molecular Biology Reports.2023; 50(2): 1845.     CrossRef
  • Gene therapy for selected neuromuscular and trinucleotide repeat disorders – An insight to subsume South Asia for multicenter clinical trials
    Nalaka Wijekoon, Lakmal Gonawala, Pyara Ratnayake, Darshana Sirisena, Harsha Gunasekara, Athula Dissanayake, Sunethra Senanayake, Ajantha Keshavaraj, Yetrib Hathout, Harry W.M. Steinbusch, Chandra Mohan, Ashwin Dalal, Eric Hoffman, K.Ranil D de Silva
    IBRO Neuroscience Reports.2023; 14: 146.     CrossRef
  • Huntington’s Disease Drug Development: A Phase 3 Pipeline Analysis
    Hannah J. Van de Roovaart, Nguyen Nguyen, Timothy D. Veenstra
    Pharmaceuticals.2023; 16(11): 1513.     CrossRef
  • Mitochondrial organization and structure are compromised in fibroblasts from patients with Huntington’s disease
    Marie Vanisova, Hana Stufkova, Michaela Kohoutova, Tereza Rakosnikova, Jana Krizova, Jiri Klempir, Irena Rysankova, Jan Roth, Jiri Zeman, Hana Hansikova
    Ultrastructural Pathology.2022; 46(5): 462.     CrossRef
  • Pathogenesis of Huntington’s Disease: An Emphasis on Molecular Pathways and Prevention by Natural Remedies
    Zainab Irfan, Sofia Khanam, Varnita Karmakar, Sayeed Mohammed Firdous, Bothaina Samih Ismail Abou El Khier, Ilyas Khan, Muneeb U. Rehman, Andleeb Khan
    Brain Sciences.2022; 12(10): 1389.     CrossRef
Brief communication
Article image
Clinical and Imaging Profile of Patients with Joubert Syndrome
Bharath Kumar Surisetti, Vikram Venkappayya Holla, Shweta Prasad, Koti Neeraja, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal
J Mov Disord. 2021;14(3):231-235.   Published online September 16, 2021
DOI: https://doi.org/10.14802/jmd.21066
  • 5,076 View
  • 133 Download
  • 8 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary Material
Objective
Joubert syndrome (JS) is a rare syndrome characterized by ataxia and the molar tooth sign (MTS) on imaging. The present study aims to explore the clinical and radiological features in a cohort of patients with JS.
Methods
This was a retrospective chart review of patients with JS evaluated by movement disorder specialists.
Results
Nine patients were included in the study. All patients had facial dysmorphism and ocular abnormalities, and 4 patients had dystonia. Ocular tilt reaction and alternate skew deviation (66%) were the most common ocular abnormalities. Horizontally aligned superior cerebellar peduncles were observed in all four patients with diffusion tensor imaging, with a lack of decussation in three. Exome sequencing performed in four patients revealed novel variants in the MKS1, CPLANE1, and PIBF1 genes.
Conclusion
Facial dysmorphism, ocular abnormalities and classical imaging findings were observed in all patients with JS. Apart from ataxia, dystonia and myoclonus are other movement disorders observed in JS.

Citations

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  • Joubert Sendromlu Hastanın Diş Tedavilerinde Anestezi Yönetimi: Olgu Sunumu
    Mehmet Akif Yılmaz, Feyza Şimşek, Havva Yavuz, Nuray Uzun, Murat Büyüksefil, Fatih Şengül, Elif Oral Ahıskalıoğlu
    Atatürk Üniversitesi Tıp Fakültesi Cerrahi Tıp Bilimleri Dergisi.2024; 3(1): 15.     CrossRef
  • Joubert Syndrome Presenting With Levodopa-Responsive Parkinsonism
    Jin Hwangbo, Ki-Seok Park, Hyun Sung Kim, Jae-Hwan Choi, Jae-Hyeok Lee
    Journal of Movement Disorders.2024; 17(3): 339.     CrossRef
  • Progressive Dysphagia in Joubert Syndrome: A Report of a Rare Case
    Courteney Castellano, Jomaries O Gomez Rosado, Alexandra Witt, Rebecca Simon, Dyadin Esharif
    Cureus.2024;[Epub]     CrossRef
  • A Novel Homozygous Variant in CPLANE1 Gene in a Patient with Developmental Deficits
    Bhagyalakshmi Shankarappa, Vishnu P. Prasad, Sujith Kumar, Ravi Shankar Rao, Angel Beula Royal, Mahadeva Swamy, Pannaga Prasad, Ashitha S. Niranjana Murthy, Suhas Ganesh, Biju Viswanath, Sanjeev Jain, Meera Purushottam, Murali Thyloth
    Molecular Syndromology.2024; : 1.     CrossRef
  • Clinical and genetic characteristics of 36 children with Joubert syndrome
    Yan Dong, Ke Zhang, He Yao, Tianming Jia, Jun Wang, Dengna Zhu, Falin Xu, Meiying Cheng, Shichao Zhao, Xiaoyi Shi
    Frontiers in Pediatrics.2023;[Epub]     CrossRef
  • CEP104 gene may involve in the pathogenesis of a new developmental disorder other than joubert syndrome
    Reza Shervin Badv, Mojdeh Mahdiannasser, Maryam Rasoulinezhad, Laleh Habibi, Ali Rashidi-Nezhad
    Molecular Biology Reports.2022; 49(8): 7231.     CrossRef
  • Congenital Brain Malformations: An Integrated Diagnostic Approach
    Bimal P. Chaudhari, Mai-Lan Ho
    Seminars in Pediatric Neurology.2022; 42: 100973.     CrossRef
Original Articles
Article image
Patient Knowledge, Attitude and Perceptions towards Botulinum Toxin Treatment for Movement Disorders in India
Thavasimuthu Nisha Mol, Nitish Kamble, Vikram V. Holla, Rohan Mahale, Pramod Kumar Pal, Ravi Yadav
J Mov Disord. 2021;14(2):126-132.   Published online April 26, 2021
DOI: https://doi.org/10.14802/jmd.20094
  • 5,277 View
  • 106 Download
AbstractAbstract PDFSupplementary Material
Objective
There is limited literature on the knowledge, attitude, and perceptions (KAP) of botulinum toxin (BoNT) treatment among patients and caregivers. The objective of this study was to assess the KAP in patients undergoing BoNT treatment for movement disorders.
Methods
One hundred patients with movement disorders from National Institute of Mental Health and Neurosciences Hospital in Bengaluru, South India, were recruited. The patients underwent demographic, clinical, and Patient Knowledge Questionnaire on Botulinum Toxin Use in Movement Disorders (PKQ-BMD)-based evaluations.
Results
The mean age of patients at the time of presentation was 47.97 ± 14.19 years (range, 12–79). Of all the patients, 26 (28%) patients were anxious, and 86% of these patients were reassured after appropriate counseling. There were 83 (89%) patients who found BoNT to be a costlier option. Education and previous Internet searches influenced positive performance in the “knowledge” domain and overall PKQ-BMD scores. The “number of injections” was also positively correlated with KAP performance.
Conclusion
This study showed that knowledge and perceptions about BoNT treatment need to be further improved. Wider availability of the Internet has provided a positive impact on patients’ and carers’ KAP. Internet-based information, higher educational qualifications of the patients, and a higher number of BoNT injection sessions are the most important predictors of satisfactory KAP related to BoNT injection treatment in patients with movement disorders.
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Telemedicine in an Academic Movement Disorders Center during COVID-19
Christine Doss Esper, Laura Scorr, Sosi Papazian, Daniel Bartholomew, Gregory Jacob Esper, Stewart Alan Factor
J Mov Disord. 2021;14(2):119-125.   Published online March 18, 2021
DOI: https://doi.org/10.14802/jmd.20099
  • 7,470 View
  • 150 Download
  • 15 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Objective
Telemedicine has rapidly gained momentum in movement disorder neurology during the coronavirus disease (COVID-19) pandemic to preserve clinical care while mitigating the risks of in-person visits. We present data from the rapid implementation of virtual visits in a large, academic, movement disorder practice during the COVID-19 pandemic.
Methods
We describe the strategic shift to virtual visits and retrospectively examine elements that impacted the ability to switch to telemedicine visits using historical prepandemic in-person data as a comparator, including demographics, distance driven, and diagnosis distribution, with an additional focus on patients with deep brain stimulators.
Results
A total of 686 telemedicine visits were performed over a five-week period (60% of those previously scheduled for in-office visits). The average age of participants was 65 years, 45% were female, and 73% were Caucasian. Men were more likely to make the transition (p = 0.02). Telemedicine patients lived farther from the clinic than those seen in person (66.47 km vs. 42.16 km, p < 0.001), age was not associated with making the switch, and patient satisfaction did not change. There was a significant shift in the distribution of movement disorder diagnoses seen by telemedicine compared to prepandemic in-person visits (p < 0.001). Patients with deep brain stimulators were more likely to use telemedicine (11.5% vs. 7%, p < 0.001).
Conclusion
Telemedicine is feasible, viable and relevant in the care of movement disorder patients, although health care disparities appear evident for women and minorities. Patients with deep brain stimulators preferred telemedicine in our study. Further study is warranted to explore these findings.

Citations

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  • Interest and Satisfaction of Telemedicine Use Among Ambulatory Neurology Patients in Western North Carolina During the COVID-19 Pandemic
    K. Alexander Soltany, Reyna Segovia Molina, Carly Pappo, Sharon Thomson, Kelly Pring, Siobhan Cox, Rebecca Merrill, Emily Fishman, Alexander Ambrosini, Gabby Bognet, Kristen Dodenhoff, Heidi Munger Clary, Lauren Strauss, Rachel Graham, Amy K. Guzik, Roy E
    Telemedicine and e-Health.2024; 30(4): e1071.     CrossRef
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    Christine D. Esper, Blanca Y. Valdovinos, Ruth B. Schneider, Elke Kalbe, Bastiaan R. Bloem, Lorraine V. Kalia, Alice Nieuwboer
    Journal of Parkinson's Disease.2024; 14(s1): S181.     CrossRef
  • Neurological Examination via Telemedicine: An Updated Review Focusing on Movement Disorders
    Efthalia Angelopoulou, Christos Koros, Evangelia Stanitsa, Ioannis Stamelos, Dionysia Kontaxopoulou, Stella Fragkiadaki, John D. Papatriantafyllou, Evangelia Smaragdaki, Kalliopi Vourou, Dimosthenis Pavlou, Panagiotis D. Bamidis, Leonidas Stefanis, Sokrat
    Medicina.2024; 60(6): 958.     CrossRef
  • Long‐Lasting Impact of the COVID‐19 Pandemic on Patients with Parkinson's Disease and Their Relatives
    Andreas Wolfgang Wolff, Bernhard Haller, Antonia Franziska Demleitner, Dominik Pürner, Johanna Niederschweiberer, Isabell Cordts, Erica Westenberg, Paul Lingor
    Movement Disorders Clinical Practice.2023; 10(5): 819.     CrossRef
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    Esmaeil Mehraeen, SeyedAhmad SeyedAlinaghi, Mohammad Heydari, Amirali Karimi, Abdollah Mahdavi, Mehrnaz Mashoufi, Arezoo Sarmad, Peyman Mirghaderi, Ahmadreza Shamsabadi, Kowsar Qaderi, Pegah Mirzapour, Amirata Fakhfouri, Hadiseh Azadi Cheshmekabodi, Kimia
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    Michael Frassica, Drew S. Kern, Mitra Afshari, Allison T. Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason
    Frontiers in Neurology.2023;[Epub]     CrossRef
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    Marta Magriço, Miguel Serôdio, Rita Ventura, Paulo Bugalho
    Journal of Neural Transmission.2023; 130(12): 1547.     CrossRef
  • Telemedicine in Neurology: A Scoping Review of Key Outcomes in Movement Disorders
    Emily Houston, Amanda G. Kennedy, Donna O'Malley, Terry Rabinowitz, Gail L. Rose, James Boyd
    Telemedicine and e-Health.2022; 28(3): 295.     CrossRef
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    Tagore Nakornchai, Elena Conci, Anke Hensiek, J William L Brown
    Postgraduate Medical Journal.2022; 98(1161): 533.     CrossRef
  • Moving Forward from the COVID-19 Pandemic: Needed Changes in Movement Disorders Care and Research
    B. Y. Valdovinos, J. S. Modica, R. B. Schneider
    Current Neurology and Neuroscience Reports.2022; 22(2): 113.     CrossRef
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    Shadi Ghourchian, Yasar A. Torres-Yaghi, Stuart H. Isaacson, Fernando Pagan, Kelly E. Lyons, Brian James Nagle, Sanskruti Patel, Rajesh Pahwa
    Telemedicine and e-Health.2022; 28(11): 1651.     CrossRef
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    Yaqian Xu, Megan P. Feeney, Matthew Surface, Dan Novak, Michelle S. Troche, James C. Beck, Roy N. Alcalay
    Movement Disorders.2022; 37(6): 1289.     CrossRef
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    Esther Cubo, Pedro David Delgado-López
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    Rimal Bera, Morgan Bron, Betsy Benning, Samantha Cicero, Heintje Calara, Diane Darling, Ericha Franey, Kendra Martello, Charles Yonan
    Neuropsychiatric Disease and Treatment.2022; Volume 18: 2945.     CrossRef
Article image
Clinical Characteristics of Involuntary Movement in Hospitalized Patients
Kyum-Yil Kwon, Hye Mi Lee, Seon-Min Lee, Seong-Beom Koh
J Mov Disord. 2019;12(1):31-36.   Published online December 20, 2018
DOI: https://doi.org/10.14802/jmd.18040
  • 7,704 View
  • 216 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Objective
Neurological symptoms in hospitalized patients are not rare, and neurological consultation for movement disorders is especially important in evaluating or managing those with various movement disorders. Therefore, we investigated a clinical pattern of in-hospital consultations for various movement disorders in a tertiary care university hospital.
Methods
Over two years, a total of 202 patients (70.7 ± 11.8 years of age) presenting with movement disorders referred to movement disorder specialists were investigated.
Results
The main symptoms referred by nonneurologists were tremor (56.9%), parkinsonism (16.8%), and gait disturbance (8.9%). The most frequent diagnostic category was toxic/metabolic-caused movement disorder (T/MCMD) (35%) with regard to medications, followed by Parkinson’s disease (PD) (16%). Regarding the mode of onset, T/MCMD was the leading cause for acute (68%) and subacute onset (46%), while PD was the leading disorder (31%) for chronic onset.
Conclusion
The current study showed a characteristic pattern of inpatients presenting with movement disorders. Furthermore, our findings highlighted the clinical significance of drug use or metabolic problems for treating this patient population.

Citations

Citations to this article as recorded by  
  • Pattern and frequency of involuntary movements: hospital-based study
    H. N. El Tallawy, A. S. Shalash, M. A. Abdelhamed, R. E. Elsabrout
    The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.2023;[Epub]     CrossRef
  • Clinical Spectrum of Movement Disorders in Neurology Inpatients in a Tertiary Care Centre
    Shabeer Ahmad Paul, Gouranga Prasad Mondal, Ramesh Bhattacharyya, Kartik Chandra Ghosh, Sarbajit Das, Suman Das, Hema Krishna, Chandrakanta Patra
    Journal of Neurosciences in Rural Practice.2021; 12: 581.     CrossRef
Oromandibular Dystonia: Demographics and Clinical Data from 240 Patients
Linda Slaim, Myriam Cohen, Patrick Klap, Marie Vidailhet, Alain Perrin, Daniel Brasnu, Denis Ayache, Marie Mailly
J Mov Disord. 2018;11(2):78-81.   Published online May 30, 2018
DOI: https://doi.org/10.14802/jmd.17065
  • 7,996 View
  • 233 Download
  • 23 Web of Science
  • 27 Crossref
AbstractAbstract PDF
Objective
To report demographic data from a large cohort of patients with oromandibular dystonia (OMD).
Methods
This is a retrospective review of patients with OMD referred to our institution between 1989 and 2015. Demographic (age of onset, gender, and familial history of dystonia) and clinical (type of OMD, associated dystonia, and etiology of dystonia) data were collected from a cohort of 240 individuals.
Results
The mean age of onset of OMD was 51.6 years old, with a female predominance (2:1). A family history of dystonia was found in 6 patients (2.5%). One hundred and forty-nine patients (62.1%) had the jaw-opening type of OMD, 48 patients (20.0%) had the jaw-closing type, and 43 patients (17.9%) had a mixed form of OMD. Lingual dystonia was also present in 64 (26.7%) of these patients. Eighty-two patients (34.2%) had a focal dystonia, 131 patients (54.6%) had a segmental dystonia, and 27 patients (11.3%) had a generalized dystonia. One hundred and seventy-one patients (71.3%) had idiopathic OMD.
Conclusion
OMD is a chronic and disabling focal dystonia. Our study found a prevalence of female patients, an onset in middle age and a predominantly idiopathic etiology. Unlike other studies, jaw-opening was found to be the most frequent clinical type of OMD.

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    Jae-Hyung Kim, Byung-Gook Kim, Yeong-Gwan Im
    CRANIO®.2024; 42(3): 316.     CrossRef
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    Farid Shamlou, Narges Ebrahimi, Ahmad Chitsaz
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    Assunta Trinchillo, Marcello Esposito, Carmen Terranova, Vincenzo Rizzo, Giovanni Fabbrini, Gina Ferrazzano, Daniele Belvisi, Roberto Erro, Paolo Barone, Francesco Bono, Francesca Di Biasio, Anna Rita Bentivoglio, Christian Lettieri, Maria Concetta Altavi
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    Kyeong-hwa Lee, Hye-min Heo, Dong-joo Kim, Min-jae Kwak, Ye-chae Hwang, Seung-yeon Cho, Jung-mi Park, Chang-nam Ko, Seong-uk Park
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    Mehmet Balal, Meltem Demirkiran
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    Helio van der Linden Jr., Christiane Cobas, Andre Felipe Pinto Duarte, Marcelo Rodrigues Masruha
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    Udit Saraf, Mitesh Chandarana, K. P Divya, Syam Krishnan
    Annals of Indian Academy of Neurology.2022; 25(1): 26.     CrossRef
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    Kazuya Yoshida
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    Sena Ünal, F. Tugra Karaarslan-Turk, Muhittin Cenk Akbostanci, Elif Peker, Rezzak Yilmaz
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    Fatma KARA, Mehmet Fatih GÖL, Ayhan VARLIBAŞ
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  • Dystonia, chorea, hemiballismus and other dyskinesias
    Matteo Bologna, Josep Valls-Solè, Nitish Kamble, Pramod Kumar Pal, Antonella Conte, Andrea Guerra, Daniele Belvisi, Alfredo Berardelli
    Clinical Neurophysiology.2022; 140: 110.     CrossRef
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    C. M. Ghadery, L. V. Kalia, B. S. Connolly
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    Charenya Anandan, Joseph Jankovic
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    Kazuya Yoshida
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    Rok Berlot, Kailash P. Bhatia, Maja Kojović
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Case Report
Paroxysmal Kinesigenic Dyskinesia as the Presenting and Only Manifestation of Multiple Sclerosis after Eighteen Months of Follow-Up
Marius Baguma, Michel Ossemann
J Mov Disord. 2017;10(2):96-98.   Published online March 24, 2017
DOI: https://doi.org/10.14802/jmd.16055
  • 9,671 View
  • 181 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Other than tremor, movement disorders are uncommon in multiple sclerosis. Among these uncommon clinical manifestations, paroxysmal kinesigenic dyskinesia is the most frequently reported. It is characterized by episodic attacks of involuntary movements that are induced by repetitive or sudden movements, startling noise or hyperventilation. The diagnosis is essentially clinical and based on a good observation of the attacks. It is very easy to misdiagnose it. We describe the case of a young female patient who presented paroxysmal kinesigenic dyskinesia as the first and only clinical manifestation of multiple sclerosis, with no recurrence of attacks nor any other neurologic symptom after eighteen months of follow-up.

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  • Tongue dystonia as CIS and presenting symptom of multiple sclerosis
    Farid Shamlou, Narges Ebrahimi, Ahmad Chitsaz
    Neuroimmunology Reports.2024; 5: 100191.     CrossRef
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    Zi‐yi Li, Wo‐tu Tian, Xiao‐jun Huang, Li Cao
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    Rashmi Singh, Sanjay Pandey
    Annals of Indian Academy of Neurology.2022; 25(5): 821.     CrossRef
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    Li Cao, Xiaojun Huang, Ning Wang, Zhiying Wu, Cheng Zhang, Weihong Gu, Shuyan Cong, Jianhua Ma, Ling Wei, Yanchun Deng, Qi Fang, Qi Niu, Jin Wang, Zhaoxia Wang, You Yin, Jinyong Tian, Shufen Tian, Hongyan Bi, Hong Jiang, Xiaorong Liu, Yang Lü, Meizhen Sun
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    M. Béreau, C. Tranchant
    La Revue de Médecine Interne.2018; 39(8): 641.     CrossRef
  • Lesion correlates of secondary paroxysmal dyskinesia in multiple sclerosis
    Kilian Fröhlich, Klemens Winder, Ralf A. Linker, Konstantin Huhn, Tobias Engelhorn, Arnd Dörfler, De-Hyung Lee, Stefan Schwab, Frank Seifert
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Original Article
Psychodynamic Psychotherapy for Functional (Psychogenic) Movement Disorders
Vibhash D. Sharma, Randi Jones, Stewart A. Factor
J Mov Disord. 2017;10(1):40-44.   Published online December 27, 2016
DOI: https://doi.org/10.14802/jmd.16038
  • 13,166 View
  • 199 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Objective
As the literature for the treatment of functional (psychogenic) movement disorders (FMD) is sparse, we assessed clinical outcomes in patients with FMD who underwent treatment with psychodynamic psychotherapy (PDP).
Methods
A retrospective analysis of the data of patients with FMD who were referred for PDP from 2008−2014 at Emory University Medical Center was performed.
Results
Thirty patients were included, mean age at presentation was 50 years (SD 13.9) and majority were female (27/30). Most common movement disorder was involuntary shaking/jerky movements (50%) and tremor (43%). Mean duration of symptoms was 3.2 years and mean number of PDP visits was 4.9. PDP lead to good outcomes in 10, modest in 8, and poor in 9. Three patients lost to follow up. Mean duration of symptoms between two groups (good vs. poor) was not statistically significant (p = 0.11), mean number of PDP visits showed a trend towards significance (p = 0.053). In all cases of good outcomes precipitants of the movement disorder were identified and a majority (60%) was receptive of the diagnosis and had good insight.
Conclusion
PDP lead to improvement in 60% of the patients which is encouraging as the treatment is challenging. This study supports heterogeneous causes of FMD including varied roles of past/recent events and demonstrates importance of psychological approaches such as PDP. Treatment with PDP should be considered in some patients with FMD but predicting who will respond remains a challenge. Further long term prospective studies with large sample size and placebo control are needed.

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