Adult-onset sporadic chorea: real-world data from a single-centre retrospective study
Autor: | Alessandro Stefani, Matteo Conti, Antonio Pisani, Roberta Bovenzi, Nicola Biagio Mercuri, Tommaso Schirinzi, Mariangela Pierantozzi, Rocco Cerroni |
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Rok vydání: | 2021 |
Předmět: |
Adult
Pediatrics medicine.medical_specialty Movement disorders Ballism Physical examination Dermatology Settore MED/26 Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Secondary movement disorders Chorea medicine Humans Athetosis Retrospective Studies Movement Disorders medicine.diagnostic_test business.industry Retrospective cohort study General Medicine medicine.disease Cerebrovascular Disorders Psychiatry and Mental health Sporadic chorea 030220 oncology & carcinogenesis Cohort Etiology Original Article Female Neurology (clinical) Differential diagnosis medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | Neurological Sciences |
ISSN: | 1590-3478 1590-1874 |
Popis: | Background Adult-onset sporadic chorea includes a wide and heterogeneous group of conditions whose differential diagnosis and treatments are often challenging and extensive. Objectives To analyse retrospectively cases of adult-onset sporadic chorea from a single Italian centre to provide insights for a practical approach in the management of these patients. Methods A total of 11,071 medical charts from a 9-year period (2012–2020) were reviewed, identifying 28 patients with adult-onset sporadic chorea (genetic forms excluded). All available data regarding phenomenology, diagnostic workup, aetiology, treatments, and long-term outcome from this cohort were collected and analysed. Results Adult-onset sporadic chorea occurred more frequently in females and presented with an acute-subacute onset. Cerebrovascular diseases accounted for 68% of aetiology; further causes were structural brain lesions, internal diseases, and other movement disorder syndromes. Clinical course was mild, with spontaneous resolution or minimal disturbances in 82% of cases. Neuroimaging was fundamental to diagnose 76% of adult-onset sporadic chorea, an appropriate clinical examination contributed to the 14% of diagnoses, whereas basic laboratory tests to the 10%. Conclusions Revision of real-world data of adult-onset sporadic chorea patients from a single Italian cohort suggests that an accurate clinical examination, neuroimaging, and routine laboratory tests are useful to identify those cases underlying potentially severe but treatable conditions. Although in the majority of cases adult-onset sporadic chorea has mild clinical course and good response to symptomatic treatments, it is essential to run a fast diagnostic workup. |
Databáze: | OpenAIRE |
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