EAN 2025 | Management strategies for movement disorders encountered in emergency care
Gary Álvarez Bravo, MD, University of Girona, Girona, Spain, discusses management strategies for hypokinetic and hyperkinetic movement disorders encountered in emergency care. Dr Álvarez Bravo highlights the importance of identifying the underlying cause, then gives advice for the immediate steps in treating the disorder. This interview took place at the 11th Congress of the European Academy of Neurology (EAN 2025) in Helsinki, Finland.
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Transcript
There should be a structure too. Step one, consisting of identifying the primary cause. Once we got the etiology, we move to the second step, which is to treat the underlying condition. For example, if a metabolic disorder is detected, we have to correct it. If there is a structural lesion, we should treat it. Or if there is an immune-mediated disorder, we give the patient immunotherapy like intravenous immunoglobulin, plasma exchange, or methylprednisolone...
There should be a structure too. Step one, consisting of identifying the primary cause. Once we got the etiology, we move to the second step, which is to treat the underlying condition. For example, if a metabolic disorder is detected, we have to correct it. If there is a structural lesion, we should treat it. Or if there is an immune-mediated disorder, we give the patient immunotherapy like intravenous immunoglobulin, plasma exchange, or methylprednisolone. But in case that the movement disorder persisted even after correction of the primary disorder, we give the patients symptomatic treatment, levodopa or dopaminergic therapy for Parkinsonism, levetiracetam, clonazepam, benzodiazepine for myoclonus, antipsychotics, dopamine-depleting drugs or tetrabenazine for chorea, athetosis, ballism, and so on. There are not always neurologists on call at the emergency room. We should also train the doctors at the ER department to be able to recognize the ER movement disorder. In case that there are neurologists on call, they should be ready to ask for our specific support that helps the patient to solve the problem.
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