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Kumar N, Desai I, Kumar M, Singh J, Tiwari A, Dhar N, Madhaw G, Manchanda R, Jatale V, Radhakrishnan DM, Warrier AR, Shree R, Kumari S. Phenomenological patterns and aetiological spectrum in patients visiting a tertiary care Movement disorders service in India: An observational study. Clin Neurol Neurosurg 2024; 245:108492. [PMID: 39146723 DOI: 10.1016/j.clineuro.2024.108492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/18/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVE Although previous studies have described phenomenological diagnoses, they lacked description of aetiological spectrum in patients visiting movement disorders (MD) service. Herein, we classify the MD phenomenology and describe aetiology wise distribution of each phenomenology in patients visiting a tertiary care movement disorders service. METHODS Collected information included demographic profile (age of onset, age at presentation, gender, duration of illness before presentation), predominant MD phenomenology [such as parkinsonism, dystonia, ataxia, tremor, chorea, ballism, myoclonus, tics, stereotypy, restless legs syndrome (RLS) and others], diagnostic evaluations and detected aetiology. RESULTS This observational study included 1140 MD patients over a span of 5 years. The median (IQR) age of onset was 49 (35-60) years and age at presentation was 54 (40-65) years, with median duration of illness being 36 (18-72) months. Nearly two-third of patients were males (M:F=731:409). Parkinsonism (n=494, 43.3 %) was the most common MD phenomenology observed, followed by dystonia (n=219, 19.2 %), ataxia (n=125, 11 %), tremor (n=118, 10.4 %), myoclonus (n=73, 6.4 %), chorea (n=40, 3.5 %), spasticity (n=22, 1.9 %), tics (n=8, 0.7 %), and RLS (n=8, 0.7 %). Thirty-three (2.9 %) patients were grouped under miscellaneous MDs. Overall, neurodegenerative disorders (57.4 %) were the most common cause of MDs. Parkinson's disease, genetic dystonia, essential tremor, genetic ataxias, hemifacial spasm, and Huntington's disease were the most common aetiologies for parkinsonism, dystonia, tremor, ataxia, myoclonus, and chorea, respectively. CONCLUSION Parkinsonism was the most common phenomenology observed in MD patients, and was followed by dystonia, ataxia and tremor. Neurodegenerative disorders were the most common aetiology detected.
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Affiliation(s)
- Niraj Kumar
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India; Dept. of Neurology, All India Institute of Medical Sciences, Bibinagar, Metropolitan Region, Hyderabad, India.
| | - Ishita Desai
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Mritunjai Kumar
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Jagbir Singh
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashutosh Tiwari
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Nikita Dhar
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Govind Madhaw
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Rajat Manchanda
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Vinayak Jatale
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Divya M Radhakrishnan
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India; Dept. of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Anand R Warrier
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India; Dept. of Neurology & Neuro-intervention, Baby Memorial Hospital, Calicut, Kerala, India
| | - Ritu Shree
- Dept. of Neurology, All India Institute of Medical Sciences, Rishikesh, India; Dept. of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sweety Kumari
- Dept. of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, India; Dept. of Ophthalmology, MediCiti Institute of Medical Sciences, Hyderabad, India
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Mol TN, Kamble N, Holla VV, Mahale R, Pal PK, Yadav R. Patient Knowledge, Attitude and Perceptions towards Botulinum Toxin Treatment for Movement Disorders in India. J Mov Disord 2021; 14:126-132. [PMID: 33896146 PMCID: PMC8175816 DOI: 10.14802/jmd.20094] [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: 08/19/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
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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Affiliation(s)
- Thavasimuthu Nisha Mol
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Vikram V Holla
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Rohan Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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