ABSTRACT
Objective@#There is limited literature on the knowledge, attitude, and perceptions (KAP) of botulinum toxin (BoNT) treatment among patients and caregivers. The objective of this study was to assess the KAP in patients undergoing BoNT treatment for movement disorders. @*Methods@#One hundred patients with movement disorders from National Institute of Mental Health and Neurosciences Hospital in Bengaluru, South India, were recruited. The patients underwent demographic, clinical, and Patient Knowledge Questionnaire on Botulinum Toxin Use in Movement Disorders (PKQ-BMD)-based evaluations. @*Results@#The mean age of patients at the time of presentation was 47.97 ± 14.19 years (range, 12–79). Of all the patients, 26 (28%) patients were anxious, and 86% of these patients were reassured after appropriate counseling. There were 83 (89%) patients who found BoNT to be a costlier option. Education and previous Internet searches influenced positive performance in the “knowledge” domain and overall PKQ-BMD scores. The “number of injections” was also positively correlated with KAP performance. @*Conclusion@#This study showed that knowledge and perceptions about BoNT treatment need to be further improved. Wider availability of the Internet has provided a positive impact on patients’ and carers’ KAP. Internet-based information, higher educational qualifications of the patients, and a higher number of BoNT injection sessions are the most important predictors of satisfactory KAP related to BoNT injection treatment in patients with movement disorders.
ABSTRACT
Objective@#There is limited literature on the knowledge, attitude, and perceptions (KAP) of botulinum toxin (BoNT) treatment among patients and caregivers. The objective of this study was to assess the KAP in patients undergoing BoNT treatment for movement disorders. @*Methods@#One hundred patients with movement disorders from National Institute of Mental Health and Neurosciences Hospital in Bengaluru, South India, were recruited. The patients underwent demographic, clinical, and Patient Knowledge Questionnaire on Botulinum Toxin Use in Movement Disorders (PKQ-BMD)-based evaluations. @*Results@#The mean age of patients at the time of presentation was 47.97 ± 14.19 years (range, 12–79). Of all the patients, 26 (28%) patients were anxious, and 86% of these patients were reassured after appropriate counseling. There were 83 (89%) patients who found BoNT to be a costlier option. Education and previous Internet searches influenced positive performance in the “knowledge” domain and overall PKQ-BMD scores. The “number of injections” was also positively correlated with KAP performance. @*Conclusion@#This study showed that knowledge and perceptions about BoNT treatment need to be further improved. Wider availability of the Internet has provided a positive impact on patients’ and carers’ KAP. Internet-based information, higher educational qualifications of the patients, and a higher number of BoNT injection sessions are the most important predictors of satisfactory KAP related to BoNT injection treatment in patients with movement disorders.
ABSTRACT
Supranuclear ocular movements comprise mainly vertical and horizontal movements. Vertical movements are controlled by the centres located mainly at the rostral midbrain and horizontal movements at the level of the pons.1 Pontine tegmental lesions usually present with gaze palsies, internuclear ophthalmoplegia (INO), abducens palsy and one and a half syndrome. Usually, one and a half syndrome is produced by a unilateral caudal pontine tegmental lesion that includes the paramedian pontine reticular formation (PPRF) and medial longitudinal fasciculus (MLF) on the same side causing horizontal gaze palsy in one eye and INO in the other eye.2 Similarly, vertical one and a half syndrome has also been described. The literature on co-existence of horizontal and vertical one and a half syndrome is few. The co-existence of horizontal and vertical one and a half syndrome with ocular tilt reaction (OTR) has not been reported so far. Here, we report a patient who presented with left horizontal one and a half syndrome along with bilateral conjugate upgaze palsy and right downward palsy suggestive of vertical one and a half syndrome and left ocular tilt reaction. Magnetic resonance imaging (MRI) brain revealed infarct in left rostral midbrain with sparing of pons