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espanolResumen Las urgencias en trastornos del movimiento hacen referencia a aquellos movimientos anormales de aparicion rapida y que, por tanto, podemos encontrarnos en la practica clinica hospitalaria y en el Servicio de Urgencias. Incluyen diferentes entidades (parkinsonismo, distonia, corea, temblor y mioclonias) fenomenologicamente similares y para las que no existe prueba diferencial mas que una valoracion clinica minuciosa, lo que las convierte en un verdadero reto diagnostico para el medico poco experimentado, e incluso para el neurologo general. La gran mayoria son secundarias a tratamientos farmacologicos, generalmente pautados por otros motivos. Es un aspecto fundamental del que debemos concienciarnos, considerando la creciente poblacion anciana y polimedicada de nuestro medio. Mantener un alto indice de sospecha es imprescindible para evitar la iatrogenia. Bien manejados, son por lo general cuadros de buen pronostico. Esta revision describe los principales trastornos del movimiento, los aspectos clinicos, diagnosticos y terapeuticos mas relevantes en el ambito hospitalario y de urgencias. EnglishMovement disorders emergencies are those related with abnormal movements characterized by their rapid onset, and appearing both in usual clinical practice and emergency department. Different entities, phenomenological similar, are included (parkinsonism, dystonia, chorea, tremor and myoclonus). Detailed clinical assessment is the only differential diagnosis test, becoming their diagnosis a challenge for the inexperienced physician, and even for general neurologist. Most of them are drug-induced movement disorders. Today this is a key feature, due to the fact that the aging population is growing and it is a population highly polymedicated. In order to avoid iatrogenic harm, high suspicious index has to be maintained. A proper management usually ensures a good prognosis. Main movement disorders and their clinical, diagnostic and therapeutic features, both in hospitals and in emergency departments are described in current review. |
