Objective: The purpose of our study was to identify the main problems faced by general neurologists (GN) when diagnosing movement disorders (MD) in Ukraine.

Background: Movement disorders are one of the most difficult areas of neurology.

Method: 13 GN from outpatient and inpatient clinics (4 men and 9 women) from different cities of Ukraine agreed to take part in an anonymous survey. The work experience in neurology ranged from 8 to 48 years (21.7±11.8), of whom 53.8% were consultants.

The inclusion criteria were GN practicing in Ukraine and not specialized in any field of neurology.

Limitations. All GN who participated in the study work in large cities. The situation with the diagnosis of MD in small towns may be worse.

Results: 69.2% of GN indicated that MD are the most difficult area of neurology, while 15.4% consider neuromuscular diseases to be the most difficult, and only 7.7% consider both demyelinating and infectious diseases of the nervous system to be the most complicated.

GN indicated that from 5% to 40% of their patients have MD (16.0%±9.6) and, on average, they are given 20 to 30 minutes to examine a primary or follow-up patient in an out-patient clinic and 45 to 60 minutes in an inpatient department. In a private clinic, the examination may take longer. At the same time, it used to be only 12 minutes in the 90s and 2000s.

All GN had the opportunity to refer the patient for an MRI, while the availability of genetic tests in Ukraine remains low, primarily due to their cost [figure1].

92.3% of respondents indicated that a general neurologist must be able to diagnose and follow-up patients with Parkinson’s disease and essential tremor, and approximately half of respondents believe that a family physician should also be able to do this.

Conclusion: Most GN in Ukraine consider MD to be the most difficult part of neurology, and the proportion of their patients with MD ranges from 5 to 40%.

When we asked about the biggest problems associated with the diagnosis of MD, the following answers were given: lack of sufficient experience and low level of awareness of MD; diagnostic difficulties associated with a wide variety of phenotypes and clinical forms, the lack of specific investigation methods to confirm the diagnosis. Genetic tests that can improve the diagnosis of many hereditary MD are expensive and cannot be widely used.

Another problem is the insufficient amount of time for the examination of a primary patient at the outpatient clinic.

Figure 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-challenges-for-diagnosis-of-movement-disorders-in-ukraine/