124 Real world use of neurophysiology in differentiating hyperkinetic movement disorders. Issue 12 (14th November 2019)

• Record Type: Journal Article
• Authors: Gandhi, Sacha E; Silverdale, Monty A; Mercer, Deborah; Marshall, Andrew G; Kobylecki, Christopher
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 90:Issue 12(2019)
• Page Start: e35
• Page End: e35
• Publication Date: 2019-11-14
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2019-ABN-2.118
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Neurophysiology constitutes a potentially useful aid in differentiating hyperkinetic movement disorders (HMD). Parameters including presence of a Bereitschaftspotential on back-averaged EEG have been demonstrated to help distinguish between these disorders. In 2008, a Movement Disorder neurophysiology service was established in Greater Manchester to aid in the diagnostic process. We retrospectively reviewed records of 39 patients with HMD who underwent EEG back-averaging through this service from January 2009 until January 2018. The aim was to determine how frequently neurophysiology altered the final diagnosis. We reviewed 39 patients (23 females, 16 males), with a mean age at onset of 42.6 years and mean disease duration of 2.0 years. The clinical diagnosis was altered in 23 cases (59%). Distractibility (P=0.001), variability (P=0.002), the presence of a Bereitschaftspotential (P<0.0001), and EMG burst duration > 300 ms (P=0.012) were more frequent in those with a final diagnosis of functional movement disorder than other HMD. Neurophysiology is an invaluable adjunct in complex HMD, altering the diagnosis and treatment options for a significant proportion of patients. We hope these results will be beneficial for other units considering establishing this type of service.