Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study
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 d...
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| Format: | Article |
| Language: | English |
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Korean Movement Disorder Society
2019-09-01
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| Series: | Journal of Movement Disorders |
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| Online Access: | http://www.e-jmd.org/upload/jmd-19015.pdf |
| _version_ | 1797715963858124800 |
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| author | Louise Wiblin Rory Durcan Brook Galna Mark Lee David Burn |
| author_facet | Louise Wiblin Rory Durcan Brook Galna Mark Lee David Burn |
| author_sort | Louise Wiblin |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T08:15:33Z |
| format | Article |
| id | doaj.art-1ec15dc63249428f81046716cd8f9f86 |
| institution | Directory Open Access Journal |
| issn | 2005-940X 2093-4939 |
| language | English |
| last_indexed | 2024-03-12T08:15:33Z |
| publishDate | 2019-09-01 |
| publisher | Korean Movement Disorder Society |
| record_format | Article |
| series | Journal of Movement Disorders |
| spelling | doaj.art-1ec15dc63249428f81046716cd8f9f862023-09-02T18:56:14ZengKorean Movement Disorder SocietyJournal of Movement Disorders2005-940X2093-49392019-09-0112317718310.14802/jmd.19015258Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort StudyLouise Wiblin0Rory Durcan1Brook Galna2Mark Lee3David Burn4 Department of Neurosciences, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, UK Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, UK St. Benedict’s Hospice, Sunderland, UK Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, UKObjective 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.http://www.e-jmd.org/upload/jmd-19015.pdfAdvance care planningDelayed diagnosisMultiple System AtrophyProgressive supranuclear palsy |
| spellingShingle | Louise Wiblin Rory Durcan Brook Galna Mark Lee David Burn Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study Journal of Movement Disorders Advance care planning Delayed diagnosis Multiple System Atrophy Progressive supranuclear palsy |
| title | Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study |
| title_full | Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study |
| title_fullStr | Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study |
| title_full_unstemmed | Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study |
| title_short | Clinical Milestones Preceding the Diagnosis of Multiple System Atrophy and Progressive Supranuclear Palsy: A Retrospective Cohort Study |
| title_sort | clinical milestones preceding the diagnosis of multiple system atrophy and progressive supranuclear palsy a retrospective cohort study |
| topic | Advance care planning Delayed diagnosis Multiple System Atrophy Progressive supranuclear palsy |
| url | http://www.e-jmd.org/upload/jmd-19015.pdf |
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