Objective: To describe clinical, imaging and therapeutic features in 80 children with acute movement disorders.

Background: Acute movement disorders are usually misdiagnosed in childhood. Our study is the first to describe movement disorders seen in emergency in Tunisian children.

Methods: We conducted a descriptive study over an 8-year period (2007-2014) including all children diagnosed with acute movement disorders. Clinical characteristics, etiologies and management were analyzed.

Results: Eighty patients were included (sex-ratio: 1.05, mean age: 10.7 years, mean age of onset: 4.8 years).The main movement disorders were dystonia (41%), myoclonus (16%), chorea (15%), tremor (9%) and parkinsonism (7%). Brain MRI was abnormal in 35%, showing basal ganglia abnormalities. Main etiologies were: inborn metabolic diseases (25%), infectious and post-infectious origin (24%).Several symptomatic treatments were used (benzodiazepines (52.5%), antiepileptic drugs (45%) and dopaminergic agents (25%). Disease specific-therapies were antibiotics (27.5%), and acyclovir (23.7%) and corticosteroids (21.2%) and intravenous immunoglobulins in 7.5%.

Conclusions: Diagnosis of acute movement disorders in childhood is based on history and phenomenology. Our series is characterized by the prevalence of hyperkinetic movement disorders mainly dystonia. Status dystonicus remains the most life-threatening condition and mortality is usually due to renal failure from rhabdomyolysis. Treatment should be start early and is based on the type of abnormal movement and its etiology.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/acute-movement-disorders-in-tunisian-childhood/