Objective: To describe the diagnosis and treatment of dystonic patients prior and after neurological consultation
Background: Although dystonia is socially and professionally disabling because of its functional and aesthetic consequences, it is not well known in Madagascar. So we wanted to know what diagnosis and treatment patients with dystonia received before seeing a neurologist. In order to see how to teach general practitioners and patients about dystonia and its treatment. We also wanted to know if patients were satisfied with the oral treatment of dystonia, the only treatment available for dystonia in Madagascar.
Method: This is a cross-sectional and descriptive study from January 2018 to December 2019 at the neurology department of Befelatanana. For our dystonic patients, data regarding demographic and clinical characteristics, diagnosis, and treatment prior and after consultation with a neurologist were collected, using a pre-established questionnaire.
Results: In this study, 37 patients were retained, that was 11.63% (37/318) of the patients hospitalized in the day hospital and 3.43% (37/1080) of the patients hospitalized in the neurology department during the study period. Among them, 70% (26/37) were men, with a mean age of 44.29 years. The patients had a university level in 48% (13/37) and 64.86% (24/37) were workers. A diagnostic delay of 24 to 30 months was observed in 48% (13/37). Before the visit to a neurologist, patients with dystonia were diagnosed as having infectious disease and received antibiotics in 95% (35/37) of cases. After the neurological consultation, we observed that patients had permanent dystonia in 81% (30/37), focal in 75.68% (28/37), represented mainly by left cervical dystonia with 42.86% of cases (12/37). The treatment was clonazepam in 68% (25/37) with an average duration of 27 months but 56% (21/37) of patients noted little improvement.
Conclusion: Dystonia exists in Madagascar, information on its diagnosis and management is needed to improve the quality of life of dystonia patients. Collaboration with other countries is needed to make appropriate treatments, such as botulinum toxin, available in Madagascar.
To cite this abstract in AMA style:
NF. Rasaholiarison, JL. Rakotomanana, LA. Rajaonarison, F. Razafizandry, J. Razafimahefa, AD. Tehindrazanarivelo. Dystonia prior and after seeing a Neurologist at the Neurology department of Befelatanana University Hospital, Antananarivo, Madagascar [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/dystonia-prior-and-after-seeing-a-neurologist-at-the-neurology-department-of-befelatanana-university-hospital-antananarivo-madagascar/. Accessed June 15, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/dystonia-prior-and-after-seeing-a-neurologist-at-the-neurology-department-of-befelatanana-university-hospital-antananarivo-madagascar/