Characteristic and management motor neuron disease in the largest tertiary hospital in the Philippines: A one-year period cross sectional analytic study.

Autor: Prado MB Jr; Department of Physiology, College of Medicine, University of the Philippines-Manila, Manila, Philippines; Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines-Manila, Manila, Philippines; Section of Adult Neurology, Department of the Neurosciences, Philippine General Hospital, University of the Philippines-Manila, Manila, Philippines. Electronic address: mbprado@alum.up.edu.ph., Hamoy-Jimenez G; Department of Neurology, Asian Hospital and Medical Center, Manila, Philippines. Electronic address: oona.md@gmail.com., Adiao KJ; Section of Adult Neurology, Department of the Neurosciences, Philippine General Hospital, University of the Philippines-Manila, Manila, Philippines. Electronic address: karen.adiao@gmail.com.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2023 Jun; Vol. 112, pp. 68-72. Date of Electronic Publication: 2023 Apr 25.
DOI: 10.1016/j.jocn.2023.04.016
Abstrakt: Background: Motor neuron disease (MND) is largely understudied in many underdeveloped and developing countries, including the Philippines. The practice and management of MND is generally insufficient, and thus, the quality of life of these patients are consequently compromised.
Objectives: The aim of this study is to determine the clinical profile and describe the management of MND patients seen in the largest tertiary hospital in the Philippines for one year.
Methods: This is a cross-sectional study of MND patients diagnosed clinically and via electromyogram-nerve conduction study (EMG NCS) in the Philippine General Hospital (PGH) from January to December 2022. Clinical characteristics, diagnostics and management information were obtained and summarized.
Results: The incidence of MND in our neurophysiology unit was 4.3% (28/648), with amyotrophic lateral sclerosis (ALS) being the most common variant (67.9%, n = 19). Male to Female ratio was 1:1, with the median age of onset of 55 (36-72) years old and median onset duration to diagnosis of 1.5 (0.25-8) years. Limb onset was more prevalent (82.14%, n = 23) with upper limbs initially involved (79.1%, n = 18). Split hand syndrome was found in almost half (53.6%) of the patients. The median ALS functional rating score-revised (ALSFRS-R) and medical research council (MRC) scores were 34 (8-47) and 42(16-60) respectively while the median King's clinical stage was 3 (1-4). Only half of the patients were able to undergo magnetic resonance imaging (MRI) and only one had neuromuscular ultrasound. Only one of the 28 patients was able to take riluzole, and only one was on oxygen support. None had gastrostomy and none used non-invasive ventilation.
Conclusion: This study showed that the management of MND in the Philippines is largely inadequate and further improvement in the health care system in handling rare neurologic cases must be implemented to enhance their quality of life.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding: None.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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