Keywords:
metabolic encephalopathy, movement disorders, myoclonus, hypoxic-ischemic encephalopathy, tremor, parkinsonism
Abstract
Background & Objectives: The objective of this study was to determine the prevalence and characteristics of movement disorders in adult patients diagnosed with various types of metabolic encephalopathies in the Philippines.
Methods: This is a descriptive cross-sectional study based on a 7-year chart review of admitted adult patients diagnosed with any of the fifteen different types of metabolic encephalopathy who experienced movement disorders during their hospital stay. Movement disorders were characterized based on phenomenology, onset, and distribution.
Results: Out of 9,773 neurologic referrals, 2,055 patients (17%) were diagnosed with metabolic encephalopathy, mainly the hypoxic-ischemic type. Only 4% (76) exhibited involuntary movements, primarily linked to hypoxic-ischemic encephalopathy. Three movement disorders were reported: myoclonus (64), tremor (10), and parkinsonism (2). The 6th decade was the most common age for these disorders, predominantly in males. Most cases appeared acutely within 7 days after onset of encephalopathy and were mostly diffuse and multifocal.
Conclusion: The findings highlight myoclonus as the predominant movement disorder in metabolic encephalopathy, particularly in hypoxic-ischemic and uremic types.
Author Biographies
Paulo Cataniag, Makati Medical Center
Dr. Paulo Cataniag is currently a second year Movement Fellow at the Makati Medical Center, with simultaneous training in clinical and research aspects of movement disorders. Aside from managing patients at the Movement Disorders Clinic, he is also actively teaching the interns and residents of the hospital through bedside rounds and lectures. He has delivered lectures in many community outreach activities for patients with Parkinson’s disease, Hemifacial spasm and Tourette’s syndrome. With regards to research, Dr. Cataniag has recently participated in a collaborative research with the University of Lubeck regarding XDP. He has published studies on XDP, Tourette syndrome, PSP and Hemifacial spasm. He has ongoing research projects involving caregiver burden in XDP, non-motor symptoms of XDP, deep brain stimulation and other topics.
Jed Noel Ong, Makati Medical Center
Dr. Jed Noel Ong is an Adult Neurologist at the Makati Medical Center and Chinese General Hospital and Medical Center with the subspecialty in Parkinson’s Disease and Movement Disorders. He is currently the Training Officer of the Movement Disorders Fellowship of Makati Medical Center. Dr. Ong has been active in the field of Movement Disorders in the Philippines as he is the current Treasurer of the Movement Disorder Society of the Philippines, a member of the Movement Disorders Council of the Philippine Neurological Association and the head of the Movement Disorders Database of the Philippine Neurological Association. He is also the current representative of the Philippines for Asian Oceanian Association of Neurology Young Members Group and is part of the organizing committee of the upcoming lecture series in Movement Disorders. He is likewise an active member of the International Parkinson’s Disease and Movement Disorders Society and is part of the MDS Movement Disorders in Asia Study Group. He is also part of the faculty of San Beda University College of Medicine and teaches Neuroscience and Neuroanatomy. His research interests are on different movement disorders particularly on Parkinson’s Disease, Atypical Parkinsonism and X-Linked Dystonia Parkinsonism. He is part of the ongoing collaborative studies on X-Linked Dystonia Parkinsonism between with Makati Medical Center and University of Lübeck in Germany.
Cid Czarina Diesta, Makati Medical Center
Dr. Cid Czarina Diesta is a Neurology consultant at the Makati Medical Center and Asian Hospital and Medical Center with subspecialty in Movement Disorder and heads the Movement Disorder Center of the Makati Medical Center and the Asian Hospital and Medical Center. She teaches on special topics at the following medical schools: San Beda College of Medicine, Ateneo College of Medicine and Lyceum College of Medicine. She has lectureships on different topics of Neurology and Movement Disorders. Dr. Diesta has been active in the Movement Disorder Society of the Philippines. She previously served as vice president and currently a member of the organization. Her research interests are on different movement Disorders such as X linked dystonia parkinsonism (XDP), Parkinson’s disease, Spinocerebellar ataxia, Hemifacial spasms and DRPLA. She has ongoing collaborative researches with University of Lubeck in Germany and Massachusetts General Hospital, in Boston on X-linked dystonia Parkinsonism. Her interests has led to recent significant publications on X-linked Dystonia Parkinsonism as follows: Basal Ganglia Atrophy as a Marker for Prodromal X-linked Dystonia-Parkinsonism, Elucidating Hexanucleotide Repeat Number and Methylation within the X-Linked Dystonia-Parkinsonism (XDP)-Related SVA Retrotransposon in TAF1 with Nanopore Sequencing.
