A1 Refereed original research article in a scientific journal
Current opinions and practices in post-stroke movement disorders : Survey of movement disorders society members
Authors: Rodriguez-Porcel Federico, Sarva Harini, Joutsa Juho, Falup-Pecurariu Cristian, Shukla Aparna Wagle, Mehanna Raja, Śmiłowska Katarzyna, Lanza Giuseppe, Filipović Saša R., Shalash Ali, Ferris Margaret, Jankovic Joseph, Espay Alberto J., Pandey Sanjay; Post-Stroke Movement Disorders Study Group from the Movement Disorders Society
Publisher: Elsevier
Publication year: 2024
Journal: Journal of the Neurological Sciences
Journal name in source: Journal of the Neurological Sciences
Volume: 458
ISSN: 0022-510X
eISSN: 1878-5883
DOI: https://doi.org/10.1016/j.jns.2024.122925
Web address : https://www.sciencedirect.com/science/article/pii/S0022510X24000601
Background: Post-stroke movement disorders (PSMD) encompass a wide array of presentations, which vary in mode of onset, phenomenology, response to treatment, and natural history. There are no evidence-based guidelines on the diagnosis and treatment of PSMD.
Objectives: To survey current opinions and practices on the diagnosis and treatment of PSMD.
Methods: A survey was developed by the PSMD Study Group, commissioned by the International Parkinson's and Movement Disorders Society (MDS). The survey, distributed to all members, yielded a total of 529 responses, 395 (74.7%) of which came from clinicians with experience with PSMD.
Results: Parkinsonism (68%), hemiballismus/hemichorea (61%), tremor (58%), and dystonia (54%) were by far the most commonly endorsed presentation of PSMD, although this varied by region. Basal ganglia stroke (76% of responders), symptoms contralateral to stroke (75%), and a temporal relationship (59%) were considered important factors for the diagnosis of PSMD. Oral medication use depended on the phenomenology of the PSMD. Almost 50% of respondents considered deep brain stimulation and ablative surgeries as options for treatment. The lack of guidelines for the diagnosis and treatment was considered the most important gap to address.
Conclusions: Regionally varying opinions and practices on PSMD highlight gaps in (and mistranslation of) epidemiologic and therapeutic knowledge. Multicenter registries and prospective community-based studies are needed for the creation of evidence-based guidelines to inform the diagnosis and treatment of patients with PSMD.
