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Acute hyperkinetic movement disorders in Italian paediatric emergency departments

Umberto Raucci1, Pasquale Parisi2, Nicola Vanacore3

  • 1Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Archives of Disease in Childhood
|March 10, 2018
PubMed

Insights

This study analyzed 256 children with acute hyperkinetic movement disorders (AHMD) in Italian emergency departments. Neuropsychiatric disorders were the most common cause, with varied prevalence by age group.

Area of Science:

  • Pediatric Neurology
  • Movement Disorders
  • Emergency Medicine

Background:

  • Limited data exist on the epidemiology, clinical presentation, and management of acute hyperkinetic movement disorders (AHMD) in pediatric emergency departments (pED).
  • Understanding these disorders is crucial for timely diagnosis and appropriate care in emergency settings.

Purpose of the Study:

  • To investigate the epidemiology, clinical presentation, and etiology of AHMD in children presenting to pediatric emergency departments.
  • To provide insights into the diagnostic challenges and management patterns of AHMD in a large pediatric cohort.

Main Methods:

  • Retrospective analysis of a case series of 256 children (2 months to 17 years) with AHMD.
  • Data collected from six Italian tertiary care hospitals over a 2-year period (January 2012 to December 2013).

Main Results:

  • Tics were the most common AHMD (44.5%), followed by tremors (21.1%) and chorea (13.7%).
  • Neuropsychiatric disorders were the leading cause (51.2%), with inflammatory (17.6%) and non-inflammatory (31.2%) conditions also significant.
  • Age-specific prevalence varied: neuropsychiatric disorders in preschoolers/schoolers, non-inflammatory in infants/toddlers, and inflammatory in schoolers. Sydenham's chorea presented diagnostic challenges.
  • Inflammatory disorders correlated with longer hospital stays and increased neuroimaging use.

Conclusions:

  • This study offers the first large-scale data on pediatric AHMD in the ED, clarifying epidemiology and presentation.
  • Findings aid in understanding the diverse causes and age-related patterns of AHMD in children.
  • Highlights the need for early recognition, especially for conditions like Sydenham's chorea, and informs management strategies.
Abstract

Keywords:
childchoreadystoniaemergency departmentmovement disorderneurologytics

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