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Spinal Movement Disorders in Neuromyelitis Optica: An Under-recognized Phenomenon.
Mov Disord Clin Pract 2016 Nov-Dec; 3(6):596-602MD

Abstract

Background

Spinal cord demyelination can cause several movement disorders. Although these abnormal movements could be the presenting symptom of the disease and, at times, the major source of disability, they are often overlooked, mislabeled, or undertreated. The aims of this study were to clearly define and establish common terminology for spinal movement disorders (SMDs) and characterize their full spectrum in patients with neuromyelitis optica (NMO).

Methods

We chart reviewed 37 patients with NMO or NMO spectrum disorder. We classified spinal movement disorders under five categories: tonic spasms; focal dystonia; spinal myoclonus; spontaneous clonus; and tremors of spinal origin. We examined clinical, MRI, and medication data of symptomatic patients.

Results

Of the 37 patients (86.4% female; mean age: 51 ± 17 years; mean disease duration: 9.4 ± 5.3 years), 16 (43.2%) had one or more form of SMDs. Compared to those without SMDs, patients with SMDs were generally older at presentation and were less likely to be African Americans. An abnormal movement was the main complaint in at least one posthospitalization visit in all symptomatic patients. Thirteen (35.1%) patients had paroxysmal tonic spasms, 2 (5.4%) had focal dystonia, 3 (8%) had postural/action tremors, and no patient had spinal myoclonus or spontaneous clonus. In 9 patients, spasms were painful. There was no signal abnormality in the basal ganglia or the brainstem/cerebellum in any of the symptomatic patients.

Conclusions

SMDs are common in NMO and are often a major source of disability. Using clear, unified terminology to describe SMDs is crucial for both clinical and research purposes.

Authors+Show Affiliations

Cleveland Clinic Cleveland Ohio USA. Alexandria University Alexandria Egypt.Cleveland Clinic Cleveland Ohio USA.Johns Hopkins University Baltimore Maryland USA.Johns Hopkins University Baltimore Maryland USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30838252

Citation

Abboud, Hesham, et al. "Spinal Movement Disorders in Neuromyelitis Optica: an Under-recognized Phenomenon." Movement Disorders Clinical Practice, vol. 3, no. 6, 2016, pp. 596-602.
Abboud H, Fernandez HH, Mealy MA, et al. Spinal Movement Disorders in Neuromyelitis Optica: An Under-recognized Phenomenon. Mov Disord Clin Pract. 2016;3(6):596-602.
Abboud, H., Fernandez, H. H., Mealy, M. A., & Levy, M. (2016). Spinal Movement Disorders in Neuromyelitis Optica: An Under-recognized Phenomenon. Movement Disorders Clinical Practice, 3(6), pp. 596-602. doi:10.1002/mdc3.12321.
Abboud H, et al. Spinal Movement Disorders in Neuromyelitis Optica: an Under-recognized Phenomenon. Mov Disord Clin Pract. 2016;3(6):596-602. PubMed PMID: 30838252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal Movement Disorders in Neuromyelitis Optica: An Under-recognized Phenomenon. AU - Abboud,Hesham, AU - Fernandez,Hubert H, AU - Mealy,Maureen A, AU - Levy,Michael, Y1 - 2016/02/11/ PY - 2015/10/08/received PY - 2015/12/04/revised PY - 2015/12/08/accepted PY - 2019/3/7/entrez PY - 2016/2/11/pubmed PY - 2016/2/11/medline KW - movement disorders KW - neuromyelitis optica KW - neuromyelitis optica spectrum disorders KW - spinal movement disorders KW - tonic spasms SP - 596 EP - 602 JF - Movement disorders clinical practice JO - Mov Disord Clin Pract VL - 3 IS - 6 N2 - Background: Spinal cord demyelination can cause several movement disorders. Although these abnormal movements could be the presenting symptom of the disease and, at times, the major source of disability, they are often overlooked, mislabeled, or undertreated. The aims of this study were to clearly define and establish common terminology for spinal movement disorders (SMDs) and characterize their full spectrum in patients with neuromyelitis optica (NMO). Methods: We chart reviewed 37 patients with NMO or NMO spectrum disorder. We classified spinal movement disorders under five categories: tonic spasms; focal dystonia; spinal myoclonus; spontaneous clonus; and tremors of spinal origin. We examined clinical, MRI, and medication data of symptomatic patients. Results: Of the 37 patients (86.4% female; mean age: 51 ± 17 years; mean disease duration: 9.4 ± 5.3 years), 16 (43.2%) had one or more form of SMDs. Compared to those without SMDs, patients with SMDs were generally older at presentation and were less likely to be African Americans. An abnormal movement was the main complaint in at least one posthospitalization visit in all symptomatic patients. Thirteen (35.1%) patients had paroxysmal tonic spasms, 2 (5.4%) had focal dystonia, 3 (8%) had postural/action tremors, and no patient had spinal myoclonus or spontaneous clonus. In 9 patients, spasms were painful. There was no signal abnormality in the basal ganglia or the brainstem/cerebellum in any of the symptomatic patients. Conclusions: SMDs are common in NMO and are often a major source of disability. Using clear, unified terminology to describe SMDs is crucial for both clinical and research purposes. SN - 2330-1619 UR - https://www.unboundmedicine.com/medline/citation/30838252/Spinal_Movement_Disorders_in_Neuromyelitis_Optica:_An_Under_recognized_Phenomenon_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30838252/ DB - PRIME DP - Unbound Medicine ER -