Tags

Type your tag names separated by a space and hit enter

Movement disorders in early MS and related diseases: A prospective observational study.
Neurol Clin Pract 2019; 9(1):24-31NC

Abstract

Background

Little is known about the true prevalence and clinical characteristics of movement disorders in early multiple sclerosis (MS) and related demyelinating diseases. We conducted a prospective study to fill this knowledge gap.

Methods

A consecutive patient sample was recruited from the MS clinic within a 1-year-period. Patients diagnosed over 5 years before the study start date were excluded. Each eligible patient was interviewed by a movement disorder neurologist who conducted a standardized movement disorder survey and a focused examination. Each patient was followed prospectively for 1-4 follow-up visits. Movement disorders identified on examination were video-recorded and videos were independently rated by a separate blinded movement expert.

Results

Sixty patients were included (56.6% female, mean age 38.3 ± 12.7 years). Eighty percent reported one or more movement disorders on the survey and 38.3% had positive findings on examination. After excluding incidental movement disorders (e.g., essential tremor), 58.3% were thought to have demyelination-related movement disorders. The most common movement disorders in a descending order were restless legs syndrome, tremor, tonic spasms, myoclonus, focal dystonia, spontaneous clonus, fasciculations, pseudoathetosis, hyperekplexia, and hemifacial spasm. The movement disorder started 5 months following a relapse on average but in 8 patients it was the presenting symptom of a new relapse or the disease itself. The majority of movement disorders occurred secondary to spinal (85.7%) or cerebellar/brainstem lesions (34.2%). Spinal cord demyelination was the only statistically significant predictor of demyelination-related movement disorders.

Conclusion

Movement disorders are more common than previously thought even in early MS. They typically begin a few months after spinal or brainstem/cerebellar relapses but may occasionally be the presenting symptom of a relapse.

Authors+Show Affiliations

Multiple Sclerosis and Neuroimmunology Program (HA), University Hospitals of Cleveland; Case Western Reserve University School of Medicine (HA, KK), Cleveland; and Center for Neurological Restoration (XXY, HHF) and The Mellen Center for Multiple Sclerosis Treatment and Research (JAC), Cleveland Clinic, OH.Multiple Sclerosis and Neuroimmunology Program (HA), University Hospitals of Cleveland; Case Western Reserve University School of Medicine (HA, KK), Cleveland; and Center for Neurological Restoration (XXY, HHF) and The Mellen Center for Multiple Sclerosis Treatment and Research (JAC), Cleveland Clinic, OH.Multiple Sclerosis and Neuroimmunology Program (HA), University Hospitals of Cleveland; Case Western Reserve University School of Medicine (HA, KK), Cleveland; and Center for Neurological Restoration (XXY, HHF) and The Mellen Center for Multiple Sclerosis Treatment and Research (JAC), Cleveland Clinic, OH.Multiple Sclerosis and Neuroimmunology Program (HA), University Hospitals of Cleveland; Case Western Reserve University School of Medicine (HA, KK), Cleveland; and Center for Neurological Restoration (XXY, HHF) and The Mellen Center for Multiple Sclerosis Treatment and Research (JAC), Cleveland Clinic, OH.Multiple Sclerosis and Neuroimmunology Program (HA), University Hospitals of Cleveland; Case Western Reserve University School of Medicine (HA, KK), Cleveland; and Center for Neurological Restoration (XXY, HHF) and The Mellen Center for Multiple Sclerosis Treatment and Research (JAC), Cleveland Clinic, OH.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30859004

Citation

Abboud, Hesham, et al. "Movement Disorders in Early MS and Related Diseases: a Prospective Observational Study." Neurology. Clinical Practice, vol. 9, no. 1, 2019, pp. 24-31.
Abboud H, Yu XX, Knusel K, et al. Movement disorders in early MS and related diseases: A prospective observational study. Neurol Clin Pract. 2019;9(1):24-31.
Abboud, H., Yu, X. X., Knusel, K., Fernandez, H. H., & Cohen, J. A. (2019). Movement disorders in early MS and related diseases: A prospective observational study. Neurology. Clinical Practice, 9(1), pp. 24-31. doi:10.1212/CPJ.0000000000000560.
Abboud H, et al. Movement Disorders in Early MS and Related Diseases: a Prospective Observational Study. Neurol Clin Pract. 2019;9(1):24-31. PubMed PMID: 30859004.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Movement disorders in early MS and related diseases: A prospective observational study. AU - Abboud,Hesham, AU - Yu,Xin Xin, AU - Knusel,Konrad, AU - Fernandez,Hubert H, AU - Cohen,Jeffrey A, PY - 2018/08/06/received PY - 2018/09/17/accepted PY - 2020/02/01/pmc-release PY - 2019/3/13/entrez PY - 2019/3/13/pubmed PY - 2019/3/13/medline SP - 24 EP - 31 JF - Neurology. Clinical practice JO - Neurol Clin Pract VL - 9 IS - 1 N2 - Background: Little is known about the true prevalence and clinical characteristics of movement disorders in early multiple sclerosis (MS) and related demyelinating diseases. We conducted a prospective study to fill this knowledge gap. Methods: A consecutive patient sample was recruited from the MS clinic within a 1-year-period. Patients diagnosed over 5 years before the study start date were excluded. Each eligible patient was interviewed by a movement disorder neurologist who conducted a standardized movement disorder survey and a focused examination. Each patient was followed prospectively for 1-4 follow-up visits. Movement disorders identified on examination were video-recorded and videos were independently rated by a separate blinded movement expert. Results: Sixty patients were included (56.6% female, mean age 38.3 ± 12.7 years). Eighty percent reported one or more movement disorders on the survey and 38.3% had positive findings on examination. After excluding incidental movement disorders (e.g., essential tremor), 58.3% were thought to have demyelination-related movement disorders. The most common movement disorders in a descending order were restless legs syndrome, tremor, tonic spasms, myoclonus, focal dystonia, spontaneous clonus, fasciculations, pseudoathetosis, hyperekplexia, and hemifacial spasm. The movement disorder started 5 months following a relapse on average but in 8 patients it was the presenting symptom of a new relapse or the disease itself. The majority of movement disorders occurred secondary to spinal (85.7%) or cerebellar/brainstem lesions (34.2%). Spinal cord demyelination was the only statistically significant predictor of demyelination-related movement disorders. Conclusion: Movement disorders are more common than previously thought even in early MS. They typically begin a few months after spinal or brainstem/cerebellar relapses but may occasionally be the presenting symptom of a relapse. SN - 2163-0402 UR - https://www.unboundmedicine.com/medline/citation/30859004/Movement_disorders_in_early_MS_and_related_diseases:_A_prospective_observational_study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=30859004.ui DB - PRIME DP - Unbound Medicine ER -