Clinical trial NCT04083586: Pattern and Frequency of Non-epileptic Involuntary Movements
Official title: Pattern and Frequency of Non-epileptic Involuntary Movements. Hospital-based Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Involuntary Movements
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2019-09-10
Enrollment: 144
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CROSSOVER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients with movement disorders attending Assiut University neurology outpatient clinic and internal department, from Jan 2020 to Jan 2021.

sample size: regarding previously estimated prevalence in (kwon KY et al,2019), was 292, so our sample size as calculated: Sample Size(n) for Various Confidence Levels ________________________________________ Confidence Level(%) Sample Size 95% 167 80% 106 90% 141 97% 181 99% 203 99.9% 231 99.99% 245

________________________________________ Equation Sample size n = \[DEFF\*Np(1-p)\]/ \[(d2/Z21-α/2\*(N-1)+p\*(1-p)\]

Results from OpenEpi, Version 3, open source calculator--SSPropor

Brief summary: We will perform a medical record review of all patients seen in Assiut University hospital, Egypt, to determine the frequency of movement disorders seen, disease characteristics, diagnostic evaluations.

Detailed description: Movement disorders are conventionally divided into major categories: 1) Hyperkinetic movement disorders (also called dyskinesias) refer to excessive, often repetitive, involuntary movements that intrude into the normal flow of motor activity. This category includes chorea, dystonia, myoclonus, stereotypies, tics, and tremor. 2) Hypokinetic movement 3) Ataxia.

Hyperkinetic movements any unwanted excess movement. Together with hypertonia (abnormally increased resistance to externally imposed movement) and negative signs (insufficient muscle activity or insufficient control of muscle activity).

Tremor: Tremor is a rhythmic back-and-forth or oscillating purposeless involuntary movement about a joint axis. Tremor occurs at rest (the pill-rolling tremor of Parkinsonism). Postural tremor (the fine tremor of hyperthyroidism), Action tremor (intention tremor) occurs near the end of a goal-directed movement.

Chorea : is a series of brief, jerky, explosive ongoing random-appearing sequence of one or more discrete involuntary movements, or "fidgeting; there are different causes of chorea, Sydenham's chorea. Lesions in the sub thalamic nucleus. Encephalitis with diffuse gray-matter. Motor impersistence is a common association.

Athetosis is a slow, continuous, writhing, sinuous movement, especially marked in the digits and extremities, prevents maintenance of a stable posture.

Myoclonus consists of sequence of repeated, often non-rhythmic sudden brief twitches or jerks or involuntary contraction or relaxation of one or more muscles as seen in metabolic encephalopathies such as uremic encephalopathy. It can be categorized as "action myoclonus", "postural myoclonus", or "rest myoclonus" based on the condition when it is observed Asterixis :is an intermittency of sustained posture, illustrated by "flapping" of the hands when the arms are outstretched and wrists dorsiflexed, as in hepatic encephalopathy.

Stereotypies are repetitive, simple movements that can be voluntarily suppressed. Stereotypies do not necessarily hold the person's attention.

Tics are repeated, individually recognizable, intermittent movements that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement.

Dystonia: a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. Dystonic postures are often triggered by attempts at voluntary movement or voluntary posture, as may occur in task-specific dystonia.

Hypokinetic movements: include bradykinesia (slowness of movement) and hypokinesia (poverty of movement, and movements that are smaller than intended), but also crucially and fundamentally the progressive fatiguing and decrement of repetitive alternating movements seen during finger or foot tapping. The best known cause and example is Parkinson's disease.

Ataxia: Ataxia is a degenerative disorder affecting the brain, brainstem or spinal cord. This can result in clumsiness, inaccuracy, instability, imbalance, tremor or a lack of coordination while performing voluntary movements. Ataxia also can affect speech and movement of the eyes.

Previous epidemiological studies in Egypt showed that the Overall the recorded Crude Prevalence Rate (CPR) of Parkinson's disease in Egypt was varied in different governorates and ranged from 53 to 557/105 inhabitants Another study was planned to estimate the prevalence and to study the aetiological factors of chorea, dystonia, athetosis and hemiballismus in Assiut. The prevalence rate for rheumatic chorea was 62/100,000 population, whereas Huntington's chorea had a prevalence rate of 21/100,000. The other two common types of chorea were reported with prevalence rates of 12/100,000 for the encephalitic type and 17/100,000 for the atherosclerotic type. No single case of generalized dystonia was recorded and all cases were of the focal type of dystonia with a prevalence rate of 26/100,000 population, but there's no available data about other movement disorders in Egypt

Eligibility criteria: Inclusion Criteria:

* Patients with movement disorders attending Assiut University neurology outpatient clinic and internal department, from Jan 2020 to Jan 2021.

Exclusion Criteria:

* 1) involuntary movements epileptic in origin 2) refusal of patient to give consent to join the study

Primary outcomes:
measure: •Detect pattern and clinical characteristics of patients with different forms of movement disorders attending Assiut University neurology outpatient clinic and internal department as parkinson's disease
timeFrame: from Dec15th 2019 to June15th 2020.
measure: •Detect pattern and clinical characteristics of patients with different forms of movement disorders attending Assiut University neurology outpatient clinic and internal department as dystonia
timeFrame: from Dec15th 2019 to June15th 2020.
measure: •Detect pattern and clinical characteristics of patients with different forms of movement disorders attending Assiut University neurology outpatient clinic and internal department as essential tremors
timeFrame: from Dec15th 2019 to June15th 2020.
Secondary outcomes:
Other outcomes:
Locations:
city: Assiut
country: Egypt
facility: AssiutU
Study officials:
affiliation: Professor of Neurology Faculty of Medicine, Assiut University
name: Hamdy El-Tallawy, professor
role: STUDY_CHAIR
affiliation: Professor of Neurology Faculty of Medicine, Ain Shams University
name: Ali Shalash, professor
role: STUDY_DIRECTOR
affiliation: Assistant professor of Neurology Faculty of Medicine, Assiut University
name: mohamed abdelhameed, assist prof
role: STUDY_DIRECTOR
affiliation: Resident at neuropsychiatry department Assiut University
name: roaa elsabrout, postgraduate
role: PRINCIPAL_INVESTIGATOR
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