Objective: To describe the spectrum of acute movement disorders in paediatric population encountered in a tertiary care neurology center in Malaysia for the duration of 2 years.

Background: Movement disorders are etiologically heterogeneous and complex entities which has been poorly recognised and acute movement disorders is no exception. They pose a diagnostic challenge to most clinicians. As a result, the management is far from ideal and usually delayed. Hence, there is a pressing need for more reports on the incidences of acute movement disorders in children as an essential early step for better understanding. The first paediatric movement disorder clinic was started in Sultan Ismail Hospital in the year 2014.Since the inception, a detailed database was kept for all the patients encountered with either a primary diagnosis of movement disorders or movement disorder as an associated diagnosis.

Methods: Retrospective analysis of case sheets of children (1 month – <18years old) presenting with acute movement disorders managed at the centre for 2 years was conducted (January 2014- December 2015).

Results: Total 78 cases were captured; which constituted 27% (n=284) of the total number cases with movement disorders seen over 2 years. Cases were categorised broadly into hyperkinetic (n= 64, 82%) and hypokinetic (14,18%) movement disorders. Majority of the cases were males (64%, n=50) with median age of presentation 7 years old. In order of frequency ,based on phenomenology ,they constituted of dystonia (28%,n=22), followed by chorea (23%, n=18),motor tics (17%,n=13), stereotypy (8% ,n=6), parkinsonism (8%,n=6),and the rest were tremor, myoclonus, psychogenic movements , and ataxia .The 3 most common etiological diagnosis were cerebral palsy, autoimmune movement disorder and drug induced movement disorder. Four patients were diagnosed with paroxysmal movement disorders. Interestingly, only 8 patients were referred as cases of movement disorder. Twenty two patients (28%) had a referral impression of epilepsy, of which, nine of them were already commenced on anticonvulsants prior to referral. Eleven patients needed intensive care, of which four did not improve and two succumbed.

Conclusions: Acute movement disorders in children are an important and constitute a substantial proportion of cases diagnosed with movement disorders. Recognition is important for focussed treatment and to avoid unnecessary extensive investigations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spectrum-of-acute-movement-disorders-in-a-pediatric-movement-disorder-clinic-malaysian-experience/