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Krouma M, Soilhi AA, Desnous B, James S, Boulay C, Scavarda D. Intraventricular baclofen for palliative management of acquired generalized dystonia in pediatric patients: a case series and literature review. Childs Nerv Syst 2024; 40:895-903. [PMID: 37975904 DOI: 10.1007/s00381-023-06217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
Dystonia represents a significant source of disability in children. Generalized dystonia, which involves multiple body regions, leads to impaired mobility and motor function, resulting in substantial challenges in daily activities. Surgical treatments are used when medical treatments fail. Intrathecal baclofen (ITB) or deep brain stimulations (DBS) are the most employed surgical therapies. When these options are not feasible or ineffective, some authors have explored the use of intraventricular baclofen (IVB). In this report, we present four cases of pediatric patients with generalized dystonia who underwent treatment with IVB, resulting in notable improvements. To further explore the potential of this treatment modality, we conducted a comprehensive literature review. The findings from our study provide a comprehensive overview that can guide palliative management in similar cases.
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Affiliation(s)
- M Krouma
- Division of Neurosurgery, Department of Pediatric Neurosurgery, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - A Aboudou Soilhi
- Division of Neurosurgery, Department of Pediatric Neurosurgery, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - B Desnous
- Department of Pediatric Neurology, La Timone Hospital, Aix Marseille University, Marseille, France
| | - S James
- Department of Pediatric Neurosurgery, Division of Neurosurgery, Necker Hospital, Paris, France
| | - C Boulay
- Department of Pediatric Neurology, La Timone Hospital, Aix Marseille University, Marseille, France
| | - D Scavarda
- Division of Neurosurgery, Department of Pediatric Neurosurgery, La Timone Hospital, Aix-Marseille University, Marseille, France.
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Bouhamdani N, McConkey H, Leblanc A, Sadikovic B, Amor MB. Diagnostic utility of DNA methylation episignature analysis for early diagnosis of KMT2B-related disorders: case report. Front Genet 2024; 15:1346044. [PMID: 38425714 PMCID: PMC10902455 DOI: 10.3389/fgene.2024.1346044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
The lysine methyltransferase 2B (KMT2B) gene product is important for epigenetic modifications associated with active gene transcription in normal development and in maintaining proper neural function. Pathogenic variants in KMT2B have been associated with childhood-onset Dystonia-28 and Intellectual developmental disorder, autosomal dominant 68 (MRD 68) for cases of neurodevelopmental impairment without dystonia (DYT28; OMIM 617284 and MRD68; OMIM 619934, respectively). Since its first description in 2016, approximately one hundred KMT2B genetic variants have been reported with heterogeneous phenotypes, including atypical patterns of dystonia evolution and non-dystonic neurodevelopmental phenotypes. KMT2B-related disorders share many overlapping phenotypic characteristics with other neurodevelopmental disorders and delayed dystonia, that can appear later in childhood, often delaying clinical diagnosis. Furthermore, conventional genetic testing may not always provide actionable information (e.g., gene panel selection based on early clinical presentation or variants of uncertain significance), which prevents patients and families from obtaining early access to treatments and support. Herein, we describe the early diagnosis of KMT2B-related neurodevelopmental disorder by DNA methylation episignature testing in a 4-year-old patient without features of dystonia at diagnosis, which is reported to develop in more than 80% of KMT2B-related disorder cases. The proband, a 4-year-old female of Jewish-Israeli descent, presented with speech delay, microcephaly, poor weight gain, attention-deficit and hyperactivity disorder, dysmorphism, intellectual disabilities and joint hyperlaxity, but presented no signs of dystonia at initial evaluation. Episignature screening in this pre-symptomatic patient enabled accurate genetic diagnosis and timely and actionable intervention earlier in the natural history of Childhood-onset Dystonia-28.
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Affiliation(s)
- Nadia Bouhamdani
- Vitalité Health Network, Moncton, NB, Canada
- Faculty of medicine and health sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Moncton, Moncton, NB, Canada
- Department of Chemistry and Biochemistry, Université de Moncton, Moncton, NB, Canada
| | - Haley McConkey
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry Western University, London, ON, Canada
| | - Amélie Leblanc
- Vitalité Health Network, Moncton, NB, Canada
- Faculty of medicine and health sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Moncton, Moncton, NB, Canada
| | - Bekim Sadikovic
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry Western University, London, ON, Canada
| | - Mouna Ben Amor
- Vitalité Health Network, Moncton, NB, Canada
- Faculty of medicine and health sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Moncton, Moncton, NB, Canada
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3
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Franz D, Richter A, Köhling R. Electrophysiological insights into deep brain stimulation of the network disorder dystonia. Pflugers Arch 2023; 475:1133-1147. [PMID: 37530804 PMCID: PMC10499667 DOI: 10.1007/s00424-023-02845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/02/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
Deep brain stimulation (DBS), a treatment for modulating the abnormal central neuronal circuitry, has become the standard of care nowadays and is sometimes the only option to reduce symptoms of movement disorders such as dystonia. However, on the one hand, there are still open questions regarding the pathomechanisms of dystonia and, on the other hand, the mechanisms of DBS on neuronal circuitry. That lack of knowledge limits the therapeutic effect and makes it hard to predict the outcome of DBS for individual dystonia patients. Finding electrophysiological biomarkers seems to be a promising option to enable adapted individualised DBS treatment. However, biomarker search studies cannot be conducted on patients on a large scale and experimental approaches with animal models of dystonia are needed. In this review, physiological findings of deep brain stimulation studies in humans and animal models of dystonia are summarised and the current pathophysiological concepts of dystonia are discussed.
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Affiliation(s)
- Denise Franz
- Oscar Langendorff Institute of Physiology, University Medical Center Rostock, Rostock, Germany
| | - Angelika Richter
- Institute of Pharmacology, Pharmacy and Toxicology, University of Leipzig, Leipzig, Germany
| | - Rüdiger Köhling
- Oscar Langendorff Institute of Physiology, University Medical Center Rostock, Rostock, Germany.
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4
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Ekmen A, Doulazmi M, Méneret A, Jegatheesan P, Hervé A, Damier P, Gras D, Roubertie A, Piard J, Mutez E, Tarrano C, Welniarz Q, Vidailhet M, Worbe Y, Gallea C, Roze E. Non-Motor Symptoms and Quality of Life in Patients with PRRT2-Related Paroxysmal Kinesigenic Dyskinesia. Mov Disord Clin Pract 2023; 10:1082-1089. [PMID: 37476308 PMCID: PMC10354617 DOI: 10.1002/mdc3.13795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/23/2023] [Accepted: 05/01/2023] [Indexed: 07/22/2023] Open
Abstract
Background Monoallelic pathogenic variants of PRRT2 often result in paroxysmal kinesigenic dyskinesia (PKD). Little is known about health-related quality of life (HrQoL), non-motor manifestations, self-esteem, and stigma in patients with PKD. Objectives We investigated non-motor symptoms and how they related to HrQoL in a genetically homogeneous group of PRRT2-PKD patients. We paid special attention to perceived stigmatization and self-esteem. Methods We prospectively enrolled 21 consecutive PKD patients with a pathogenic variant of PRRT2, and 21 healthy controls matched for age and sex. They were evaluated with dedicated standardized tests for non-motor symptoms, HrQoL, anxiety, depression, stigma, self-esteem, sleep, fatigue, pain, and psychological well-being. Results Patients reported an alteration of the physical aspects of HrQoL, regardless of the presence of residual paroxysmal episodes. Non-motor manifestations were frequent, and were an important determinant of the alteration of HrQoL. In addition, patients perceived a higher level of stigmatization which positively correlated with a delay in diagnosis (ρ = 0.615, P = 0.003) and the fear of being judged (ρ = 0.452, P = 0.04), but not with the presence of paroxysmal episodes (ρ = 0.203, P = 0.379). Conclusions Our findings have important implications for care givers concerning patient management and medical education about paroxysmal dyskinesia. PRRT2-PKD patients should be screened for non-motor disorders in routine care. A long history of misdiagnosis may play a role in the high level of perceived stigmatization. Improving knowledge about diagnostic clues suggestive of PKD is mandatory.
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Affiliation(s)
- Asya Ekmen
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Mohamed Doulazmi
- Sorbonne University, Adaptation Biologique et Vieillissement (UMR8256), Institut de Biologie Paris Seine, CNRSParisFrance
| | - Aurélie Méneret
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Prasanthi Jegatheesan
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Anais Hervé
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
| | | | - Domitille Gras
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
| | - Agathe Roubertie
- Département NeuropédiatrieINM, Université de Montpellier, INSERM, CHU MontpellierMontpellierFrance
| | - Juliette Piard
- Centre de Génétique Humaine, CHUBesançonFrance
- INSERM UMR1231, Génétique des Anomalies du DéveloppementUniversité de BourgogneDijonFrance
| | - Eugenie Mutez
- Univ. Lille, Inserm, CHU Lille, U1172—LilNCog—Lille Neuroscience and CognitionLilleFrance
| | - Clément Tarrano
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Quentin Welniarz
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Marie Vidailhet
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Yulia Worbe
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
| | - Cécile Gallea
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
| | - Emmanuel Roze
- Sorbonne Université, INSERM, CNRS, Paris Brain InstituteParisFrance
- APHP Hôpital de La Pitié Salpetriêre et Saint‐AntoineParisFrance
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Painous C, Martí MJ, Graessner H, Camargo AP, El-Jaafary SI, Martínez-Ramírez D, Ojo OO, Taiwo FT, Rajan R, Cornejo-Olivas M, Ayele BA, Tibar H, Kearney M, Gatto E, Tijssen MA. Management of rare movement diseases in different world regions. Parkinsonism Relat Disord 2023; 108:105286. [PMID: 36669905 DOI: 10.1016/j.parkreldis.2023.105286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 01/08/2023] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
To evaluate the management of rare movement disorders (RMD) at the international level and identify care needs to be addressed, the Rare Movement Disorders Study Group of the International Parkinson and Movement Disorders Society (MDS) has conducted an exploratory survey. We sent an online survey to experts in Africa, Asia, Oceania and American continents following the classification of the MDS Regional Sections: Africa, Asia and Oceania (A&O), and Pan-America. We did not include Europe as the European Reference Network for Rare Neurological Diseases recently performed a similar care needs survey across European countries. We obtained responses from experts from 20 African, 26 A&O and 19 Pan-American countries. According to the respondents, only 55% of African countries had movement disorders experts, while these were present in 96% of A&O and 91% of Pan-American. Access to care for patients with RMD was stated difficult in 70% of African, 54% of A&O, and 65% of Pan-American countries. Africa was the region with greatest difficulties in accessing diagnostic tests. However, in Pan-America and A&O, large inequalities were observed between countries with quite variable access to therapeutic options such as deep brain stimulation. The survey results reflect wide variability in the management of RMD and provide evidence that a worldwide care-focused network is highly warranted. Scientific and medical organisations should raise awareness of deficits in managing RMD and care disparities among regions. The goals should be to facilitate the training of professionals, establish improvement strategies, and increase support and budgeting for these diseases.
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Affiliation(s)
- Celia Painous
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Catalonia Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Spain
| | - Maria J Martí
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Catalonia Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Spain
| | - Holm Graessner
- Institute for Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany; Centre for Rare Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Andrea Paola Camargo
- Fundación universitaria ciencias de la salud, Hospital de San José, Bogotá, Colombia
| | - Shaimaa Ibrahim El-Jaafary
- Neurology Department, Cairo University, Egypt; Global Brain Health Institute.Trinity College Dublin, Ireland
| | | | - Oluwadamilola O Ojo
- Neurology Unit, Department of Medicine, College of Medicine of the University of Lagos & Lagos University Teaching Hospital, Lagos, Nigeria
| | | | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Carrera de Medicina, Universidad Científica del Sur, Lima, Peru
| | - Biniyam A Ayele
- Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Houyam Tibar
- Service de Neurologie B et de Neurogénétique, Hôpital des spécialités OTO-Neuro-Ophtalmologique. Ibn Sina University Hospital Mohamed 5 University, Medical School of Rabat, Rabat, Morocco
| | - Mary Kearney
- Irish College of General Practitioners and Primary Care Physician, Dublin, Ireland; ERN-RND European Patient Advocacy Group Representatives, Germany
| | - Emilia Gatto
- Department of Neurology, Sanatorio de la Trinidad Mite. Department of Parkinson's Disease and Movement Disorders, INEBA Affiliated University of Buenos Aires, Buenos Aires, Argentina
| | - Marina Aj Tijssen
- University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, the Netherlands.
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6
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McClelland VM, Lin JP. Dystonia in Childhood: How Insights from Paediatric Research Enrich the Network Theory of Dystonia. ADVANCES IN NEUROBIOLOGY 2023; 31:1-22. [PMID: 37338693 DOI: 10.1007/978-3-031-26220-3_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Dystonia is now widely accepted as a network disorder, with multiple brain regions and their interconnections playing a potential role in the pathophysiology. This model reconciles what could previously have been viewed as conflicting findings regarding the neuroanatomical and neurophysiological characteristics of the disorder, but there are still significant gaps in scientific understanding of the underlying pathophysiology. One of the greatest unmet challenges is to understand the network model of dystonia in the context of the developing brain. This article outlines how research in childhood dystonia supports and contributes to the network theory and highlights aspects where data from paediatric studies has revealed novel and unique physiological insights, with important implications for understanding dystonia across the lifespan.
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Affiliation(s)
- Verity M McClelland
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Children's Neurosciences Department, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | - Jean-Pierre Lin
- Children's Neurosciences Department, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Women and Children's Institute, Faculty of Life Sciences and Medicine (FolSM), King's College London, London, UK
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7
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Centen LM, Pinter D, van Egmond ME, Graessner H, Kovacs N, Koy A, Perez-Dueñas B, Reinhard C, Tijssen MAJ, Boesch S. Dystonia management across Europe within ERN-RND: current state and future challenges. J Neurol 2023; 270:797-809. [PMID: 36201015 PMCID: PMC9540051 DOI: 10.1007/s00415-022-11412-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Since the first European-wide evaluation of dystonia management in 2016, several efforts have been made to improve dystonia-care. One of these was the development of the Dystonia Disease Group as a part of the European Reference Network for Rare Neurological Diseases (ERN-RND) that implemented several initiatives based on the recommendations made in 2016. AIM To evaluate the current state of dystonia management across Europe. METHODS Twenty-four countries were surveyed via 62 dystonia-experts from 44 ERN-RND-related centers. RESULTS Dystonia-experts for adult patients were available in all surveyed countries. However, almost half of the countries evaluated accessibility as merely 'satisfactory'. Access to genetic and neurophysiological testing was challenging to varying degrees in over half of countries. Main oral medications and botulinum toxin were available in all countries. Deep brain stimulation (DBS) was easily accessible in one-third of the countries. Dystonia research was conducted in 20/24 countries. Trainings on dystonia for general practitioners (GPs) were available in 11/24 countries. However, lack of trainings for other professionals was almost general. For pediatric dystonia, experts and specific training were available in over half of the countries. CONCLUSIONS In this overview, we present the current state of dystonia management within ERN-RND. Management has slightly improved since 2016 in several fields, including diagnostics, availability of DBS, and research. The results highlight that future challenges in dystonia management are accessibility of experts, and diagnostic tools and treatments, education on adult and childhood dystonia, and optimization of referral pathways. These findings are important for improving dystonia care across Europe.
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Affiliation(s)
- Liesanne M. Centen
- Department of Neurology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands ,Expertise Center Movement Disorders Groningen, University of Groningen, University Medical Centre Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - David Pinter
- Department of Neurology, Medical School, University of Pécs, Rét Utca 2, Pécs, 7623 Hungary
| | - Martje E. van Egmond
- Department of Neurology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands ,Expertise Center Movement Disorders Groningen, University of Groningen, University Medical Centre Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Holm Graessner
- Centre for Rare Diseases and Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Calwerstr. 7, 72076 Tübingen, Germany
| | - Norbert Kovacs
- Department of Neurology, Medical School, University of Pécs, Rét Utca 2, Pécs, 7623 Hungary
| | - Anne Koy
- Department of Pediatrics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Belen Perez-Dueñas
- Paediatric Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain
| | - Carola Reinhard
- Centre for Rare Diseases and Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Calwerstr. 7, 72076 Tübingen, Germany
| | - Marina A. J. Tijssen
- Department of Neurology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands ,Expertise Center Movement Disorders Groningen, University of Groningen, University Medical Centre Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands
| | - Sylvia Boesch
- Department of Neurology, Center for Rare Movement Disorders Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
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Khan S, Sowemimo N, Alty J, Cosgrove J. Increased Knowledge of Adult-Onset Dystonia Amongst Medical Students via Brief Video Education: A Systematic Review and Cohort Study. Geriatrics (Basel) 2022; 7:geriatrics7030058. [PMID: 35645281 PMCID: PMC9149868 DOI: 10.3390/geriatrics7030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Most doctors have limited knowledge of dystonia, a movement disorder that can affect people of all ages; this contributes to diagnostic delay and poor quality of life. We investigated whether a brief educational intervention could improve knowledge of dystonia amongst medical students. We conducted a systematic review on undergraduate knowledge of dystonia and created an eight-minute video on the condition. We invited medical students at the University of Leeds, UK, to answer 15 multiple choice questions before and immediately after watching the video, and again one month later. Only one previous study specifically assessed medical students’ knowledge of dystonia whilst five others tested their knowledge of movement disorders, or neurology generally, with some questions on dystonia. Of the University of Leeds medical students, 87 (100%), 77 (89%) and 40 (46%) completed the baseline, immediate-recall and delayed-recall questionnaires, respectively. The mean score for students who completed all three questionnaires increased from 7.7 (out of 15) to 12.5 on the immediate-recall questionnaire (p < 0.001), and to 10.1 on the delayed-recall questionnaire (p < 0.001). At baseline, 76% of students rated their confidence in recognising dystonia as low. After watching the video, 78% rated their confidence as a high, and none rated it low. A brief video improved their knowledge substantially, with sustained effects. This method could be incorporated into medical curricula to reduce diagnostic delays.
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Affiliation(s)
- Sana Khan
- School of Medicine, University of Leeds, Worsley Building, Leeds LS2 9JT, UK; (S.K.); (N.S.)
| | - Nina Sowemimo
- School of Medicine, University of Leeds, Worsley Building, Leeds LS2 9JT, UK; (S.K.); (N.S.)
| | - Jane Alty
- Department of Neurology, Great George Street, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK;
- Wicking Dementia Research Centre, University of Tasmania, Hobart 7001, Australia
| | - Jeremy Cosgrove
- Department of Neurology, Great George Street, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK;
- Correspondence: ; Tel.: +44-113-3928-287
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9
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Sadnicka A, Meppelink AM, Kalinowski A, Oakeshott P, van den Dool J. Dystonia. BMJ 2022; 377:e062659. [PMID: 35410890 PMCID: PMC9070304 DOI: 10.1136/bmj-2020-062659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Sadnicka
- St George's University of London, London, UK
- University College London, London, UK
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