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Valadas A, Contarino MF, Albanese A, Bhatia KP, Falup-Pecurariu C, Forsgren L, Friedman A, Giladi N, Hutchinson M, Kostic VS, Krauss JK, Lokkegaard A, Marti MJ, Milanov I, Pirtosek Z, Relja M, Skorvanek M, Stamelou M, Stepens A, Tamás G, Taravari A, Tzoulis C, Vandenberghe W, Vidailhet M, Ferreira JJ, Tijssen MA. Management of dystonia in Europe: a survey of the European network for the study of the dystonia syndromes. Eur J Neurol 2016; 23:772-9. [PMID: 26826067 DOI: 10.1111/ene.12940] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/04/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Dystonia is difficult to recognize due to its large phenomenological complexity. Thus, the use of experts in dystonia is essential for better recognition and management of dystonia syndromes (DS). Our aim was to document managing strategies, facilities and expertise available in various European countries in order to identify which measures should be implemented to improve the management of DS. METHODS A survey was conducted, funded by the Cooperation in Science and Technology, via the management committee of the European network for the study of DS, which is formed from representatives of the 24 countries involved. RESULTS Lack of specific training in dystonia by general neurologists, general practitioners as well as other allied health professionals was universal in all countries surveyed. Genetic testing for rare dystonia mutations is not readily available in a significant number of countries and neurophysiological studies are difficult to perform due to a lack of experts in this field of movement disorders. Tetrabenazine is only readily available for treatment of dystonia in half of the surveyed countries. Deep brain stimulation is available in three-quarters of the countries, but other surgical procedures are only available in one-quarter of countries. CONCLUSIONS Internationally, collaboration in training, advanced diagnosis, treatment and research of DS and, locally, in each country the creation of multidisciplinary teams for the management of dystonia patients could provide the basis for improving all aspects of dystonia management across Europe.
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Affiliation(s)
- A Valadas
- Neurology Service, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Setúbal, Portugal.,Clinical Research Unit, Institute of Molecular Medicine, Lisbon, Portugal
| | - M-F Contarino
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.,Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - A Albanese
- Istituto Clinico Humanitas and Università Cattolica del Sacro Cuore, Milan, Rozzano, Italy
| | - K P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, UK
| | - C Falup-Pecurariu
- Department of Neurology, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - L Forsgren
- Department of Pharmacology and Clinical Neuroscience, Umea University, Umea, Sweden
| | - A Friedman
- Department of Neurology, Medical University of Warsaw, Warszawa, Poland
| | - N Giladi
- Neurological Institute, Tel Aviv Medical Center, Sacker School of Medicine, Sagol School of Neuroscience, Sieratzki Chair in Neurology, Tel Aviv University, Tel Aviv, Israel
| | - M Hutchinson
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - V S Kostic
- Neurology Clinic CCS, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - J K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - A Lokkegaard
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - M J Marti
- Parkinson Disease and Movement Disorders Unit, Neurology Service, Institut d'Investigatió Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Catalonia, Spain
| | - I Milanov
- University Hospital for Neurology and Psychiatry 'St Naum', Sofia, Bulgaria
| | - Z Pirtosek
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - M Relja
- Referral Center for Movement Disorders, Department of Neurology, University Hospital Center Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - M Skorvanek
- Department of Neurology, Safarik University, Kosice, Slovak Republic.,Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - M Stamelou
- Second Department of Neurology, Attiko Hospital, University of Athens, Athens, Greece.,Department of Neurology, Philipps Universität, Marburg, Germany
| | - A Stepens
- Laboratory for Research in Rehabilitation, Riga Stradins University, Riga, Latvia
| | - G Tamás
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - A Taravari
- University Clinic of Neurology - Skopje, University 'St Cyril and Methodius', Skopje, Republic of Macedonia
| | - C Tzoulis
- Department of Neurology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - W Vandenberghe
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - M Vidailhet
- APHP, Department of Neurology, Salpêtriere Hospital, Paris, France.,ICM (Brain and Spine Institute) UPMC/INSERM, UMR 1127, CNRS UMR7225, Pierre Marie Curie Paris-6 University, Paris, France
| | - J J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - M A Tijssen
- Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands
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Taravari A, Panov S, Petrov I, Petrova V, Medziti F, Haliti G. Delta deletion 4977 in mitochondrial DNA in patients with idiopathic Parkinson's disease. ACTA ACUST UNITED AC 2014; 115:7-13. [PMID: 24471895 DOI: 10.4149/bll_2014_002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM To determine the presence of delta deletion 4977 in mitochondrial DNA in patients with Idiopathic Parkinson's disease (IPD). MATERIAL AND METHODS This has been a prospective, clinically genetic study, lasting for whole two years. The clinical part of this study was made at the University Clinic of Neurology in Skopje, Unit for extrapyramidal diseases. The laboratory-genetic part of the study was elaborated at the Laboratory for molecular biology at the Institute for Biology, Faculty of Sciences, University "Sts. Cyril and Methodius". This study comprised a total of 32 subjects with a clinically verified diagnosis for idiopathic Parkinson's disease; 18 men and 14 women (with mean age of 52.7 years). Control group consisted of 31 randomly selected, literally healthy persons, at similar age, with similar gender distribution, and no clinical and anamnestic data for parkinsonism or similar clinical entities. RESULTS Objective neurologic results of all 32 investigated subjects (100%) showed presence of rigor, tremor and bradykinesia.The difference tested between the investigated and control group, concerning the present or absent deletion and heteroplasmia, has been highly statistically significant (p=0.001). CONCLUSION It could be concluded with a great statistical significance that deletion 4977 in mitochondrial genome has been registered more frequently in the group of patients with IPD (Tab. 10, Fig. 6, Ref. 36).
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Taravari A, Traubner P, Gortha S, Petrov I, Petrova V, Ismajli-Marku M. Clinical, neurophysiologic, neuropsychological findings and short genetic analysis in patients with idiopathic Parkinson's disease. BRATISL MED J 2010; 111:156-159. [PMID: 20437827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED The aim of this paper is to analyze the results of correlation of clinical symptoms and their characteristics with the results of neurophysiologic, neuropsycologic investigations and short genetic analyses in patients with Idiopathic Parkinson's disease (IPD). MATERIAL AND METHODS The paper is a prospective and retrospective study of 15 IPD patients and 25 patients with different forms of parkinsonism. RESULTS Patients with idiopathic Parkinson's disease had all cardinal symptoms characteristic for the disease: tremor, rigidity and reduced postural reflexes in 100%. CONCLUSION Clinical, neurophysiologic, neuropsychologic and neuroimaging methods of investigations showed changes that are nonspecific in proportions corresponding to those in available literature (Tab. 3, Fig. 2, Ref. 11).
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Affiliation(s)
- A Taravari
- Public Health Institution, University Clinic of Neurology, Skopje, Republic of Macedonia.
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