RECOGNIZING MOVEMENT DISORDER EMERGENCIES - A PRACTICAL REVIEW FOR NON-NEUROLOGIST

Authors

  • Haris Hakeem Section of Neurology, Department of Medicine, Aga Khan University Hospital, Karachi
  • Memoona Nasir Department of Medicine and Allied Services, Pakistan Kidney and Liver Institute and Research Center, Lahore
  • Muhammad Farhan Khan Division of Neurology, Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad
  • Nabeel Muzaffar Syed Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE
  • Haris Majid Rajput Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad
  • Arsalan Ahmad Division of Neurology, Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad
  • Muhammad Athar Javed Department of Neurology, King Edwards Medical University, Lahore
  • Danish Ejaz Bhatti Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE

Abstract

Neurology still remains one of the most underserved specialties of medicine in Pakistan with roughly one neurologist per million people. Movement disorders (MD) are neurological problems that interfere with patient's motor abilities and diagnosis is typically clinical. In this review, we describe a practical approach to common MD emergencies that may be encountered by a non-neurologist physician, emphasizing on formulating a working diagnosis and their immediate management. Movement disorder emergencies can be classified based on MD phenomenology and we will provide a brief overview of dystonia including acute dystonic reaction, PAID syndrome and dystonic storm; chorea, myoclonus including serotonin syndrome and startle disease; and rigidity including neuroleptic malignant syndrome and malignant hyperthermia.

Keywords: Movement Disorders; Emergency; Neurology; Dystonia; Tardive; Serotonin Syndrome; Neuroleptic Malignant Syndrome

References

Moulin T, Sablot D, Vidry E, Belahsen F, Berger E, Lemounaud P, et al. Impact of emergency room neurologists on patient management and outcome. Eur Neurol 2003;50(4):207-14.

Awan T, Ahmad A, Javed A, Wasay M, Babar Khan M, Awan H. Neurological health profile in pakistan-A health systems based needs assessment. Pak J Neurol Sci 2016;11(4):43-56.

Abdo WF, Van De Warrenburg BP, Burn DJ, Quinn NP, Bloem BR. The clinical approach to movement disorders. Nat Rev Neurol 2010;6(1):29-37.

Munhoz RP, Scorr LM, Factor SA. Movement disorders emergencies. Curr Opin Neurol 2015;28(4):406-12.

Park HW, Kwak JR, Lee JS. Clinical characteristics of acute drug-induced dystonia in pediatric patients. Clin Exp Emerg Med 2017;4(3):133-7.

Jimenez-Jimenez FJ, Garcia-Ruiz PJ, Molina JA. Drug-induced movement disorders. Drug Saf 1997;16(3):180-204.

Fahn S. The varied clinical expressions of dystonia. Neurol Clin 1984;2(3):541-54.

Bendigo V. The management of acute dystonic reactions. Aust Presc. 2001;24(1):19-20.

Kapoor D, Singla D, Singh J, Jindal R. Paroxysmal autonomic instability with dystonia (PAID) syndrome following cardiac arrest. Singapore Med J 2014;55(8):e123-5.

Baguley IJ. Autonomic complications following central nervous system injury. Semin Neurol 2008;28(5):716-25.

Lee S, Jun GW, Jeon SB, Kim CJ, Kim JH. Paroxysmal sympathetic hyperactivity in brainstem-compressing huge benign tumors: clinical experiences and literature review. Springerplus 2016;5:340.

Ruiz-Lopez M, Fasano A. Rethinking status dystonicus. Mov Disord 2017;32(12):1667-76.

Termsarasab P, Frucht SJ. Dystonic storm: a practical clinical and video review. J Clin Mov Disord 2017;4:10.

Frucht SJ. Treatment of movement disorder emergencies. Neurotherapeutics 2014;11(1):208-12.

Cossu G, Colosimo C. Hyperkinetic movement disorder emergencies. Curr Neurol Neurosci Rep 2017;17(1):6.

Patankar AP. Hemi-chorea: an unusual presentation of brainstem glioma. Br J Neurosurg 2013;27(2):256-8.

Onwuamaegbu ME, Henein M, Coats AJ. Cachexia in malaria and heart failure: therapeutic considerations in clinical practice. Postgrad Med J 2004;80(949):642-9.

Poston KL, Frucht SJ. Movement disorder emergencies. J Neurol 2008;255(Suppl 4):2-13.

Deardorff OG, Khan T, Kulkarni G, Doisy R, Loehr C. Serotonin syndrome: Prophylactic treatment with cyproheptadine. Prim Care Companion CNS Disord 2016;18(4).

James J. Lamberg, Vitaly N. Gordin. Serotonin Syndrome in a Patient with Chronic Pain Polypharmacy. Pain Med 2014;15(8):1429-31.

Hiraga A, Kuwabara S. Malignant Syndrome and Serotonin Syndrome in a General Hospital Setting: Clinical Features, Frequency and Prognosis. Intern Med 2017;56(21):2865-9.

Kallem VR, Kiran S, Murki SR. Nose-tapping Test in Hyperekplexia. Indian Pediatr 2018;55(5):432.

Tse L, M Barr A, Scarapicchia V, Vila-Rodriguez F. Neuroleptic malignant syndrome: a review from a clinically oriented perspective. Curr Neuropharmacol 2015;13(3):395-406.

Strawn JR, Keck Jr, MD PE, Caroff SN. Neuroleptic malignant syndrome. Am J Psychiatry 2007;164(6):870-6.

Belvederi Murri M, Guaglianone A, Bugliani M, Calcagno P, Respino M, Serafini G, et al. Second-generation antipsychotics and neuroleptic malignant syndrome: systematic review and case report analysis. Drugs R D 2015;15(1):45-62.

Modi S, Dharaiya D, Schultz L, Varelas P. Neuroleptic malignant syndrome: complications, outcomes, and mortality. Neurocrit Care 2016;24(1):97-103.

Pileggi DJ, Cook AM. Neuroleptic Malignant Syndrome: Focus on treatment and rechallenge. Ann Pharmacother 2016;50(11):973-81.

Lang FU, Lang S, Becker T, Jäger M. Neuroleptic malignant syndrome or catatonia? Trying to solve the catatonic dilemma. Psychopharmacology (Berl) 2015;232(1):1-5.

Rosenberg H, Pollock N, Schiemann A, Bulger T, Stowell K. Malignant hyperthermia: a review. Orphanet J Rare Dis 2015;10:93.

Schneiderbanger D, Johannsen S, Roewer N, Schuster F. Management of malignant hyperthermia: diagnosis and treatment. Ther Clin Risk Manag 2014;10:355-62.

Smith JL, Tranovich MA, Ebraheim NA. A comprehensive review of malignant hyperthermia: Preventing further fatalities in orthopedic surgery. J Orthop 2018;15(2):578-80.

Burns A, Gallagley A, Byrne J. Delirium. J Neurol Neurosurg Psychiatry 2004;75(3):362-7.

Kalabalik J, Brunetti L, El-Srougy R. Intensive care unit delirium: a review of the literature. J Pharm Pract 2014;27(2):195-207.

Vardy ER, Teodorczuk A, Yarnall AJ. Review of delirium in patients with Parkinson's disease. J Neurol 2015;262(11):2401-10.

Seppi K, Weintraub D, Coelho M, Perez-Lloret S, Fox SH, Katzenschlager R, et al. The movement disorder society evidence-based medicine review update: treatments for the non-motor symptoms of Parkinson's disease. Mov Disord 2011;26(Suppl 3):S42-80.

Downloads

Published

2019-07-10

How to Cite

Hakeem, H., Nasir, M., Khan, M. F., Syed, N. M., Rajput, H. M., Ahmad, A., … Bhatti, D. E. (2019). RECOGNIZING MOVEMENT DISORDER EMERGENCIES - A PRACTICAL REVIEW FOR NON-NEUROLOGIST. Journal of Ayub Medical College Abbottabad, 31(3), 448–453. Retrieved from https://demo.ayubmed.edu.pk/jamc/index.php/jamc/article/view/5798

Issue

Vol. 31 No. 3 (2019): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

REVIEW ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.