Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study
Journal of Movement Disorders
;
: 177-183, 2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-765861
ABSTRACT
OBJECTIVE:
Multiple System Atrophy (MSA) and progressive supranuclear palsy (PSP) are rapidly progressive forms of degenerative Parkinsonism. The difficulties of diagnosing MSA and PSP in their early stages may lead to delayed referral to appropriate specialists and distress to patients, as well as delaying symptomatic treatment and participation in clinical trials. This work aimed to describe the symptoms that patients with MSA and PSP developed and plot their emergence relative to final diagnosis using a median onset in months.METHODS:
Forty-seven patients from the United Kingdom with MSA or PSP diagnosed by a movement disorder specialist were interviewed with carers or relatives to establish milestone onset. This was corroborated using clinical notes and letters.RESULTS:
In the MSA cohort (n = 23), autonomic symptoms (median 5.5 months before diagnosis) and falls (median 1 month before diagnosis) were the two clinical milestones which occurred before diagnosis. In the PSP cohort (n = 24), falling was the only milestone which occurred before diagnosis (median of 18.5 months).CONCLUSION:
This study shows that PSP patients experience falling more than a year and a half an average before receiving a diagnosis and although MSA patients also tended to fall, this was much closer to the time of diagnosis. Further work with larger cohorts may illustrate whether these preliminary findings can be generalised to guide diagnosis and management.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Encaminhamento e Consulta
/
Especialização
/
Acidentes por Quedas
/
Paralisia Supranuclear Progressiva
/
Estudos Retrospectivos
/
Estudos de Coortes
/
Cuidadores
/
Atrofia de Múltiplos Sistemas
/
Transtornos Parkinsonianos
/
Planejamento Antecipado de Cuidados
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Pesquisa qualitativa
/
Fatores de risco
Limite:
Humanos
País/Região como assunto:
Europa
Idioma:
Inglês
Revista:
Journal of Movement Disorders
Ano de publicação:
2019
Tipo de documento:
Artigo
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