Alberto Albanese (Italy)
Department of Neurology, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy N/AAuthor Of 2 Presentations
SPREAD OF SEGMENTAL/MULTIFOCAL IDIOPATHIC ADULT-ONSET DYSTONIA TO A THIRD BODY SITE, DATA FROM THE ITALIAN DYSTONIA REGISTRY
- Tommaso Ercoli (Italy)
Abstract
Background and Aims:
Adult-onset focal dystonia can spread to involve one, or less frequently, two additional regions of the body (segmental/multifocal dystonia). Several studies indicated that the site of dystonia onset may affect the risk of initial spread. While prior studies have advanced our understanding of spread of focal dystonia to a second body site, no study has fully characterized spread of segmental/multifocal dystonia to a third body site. The aim of the study is to fully characterize the spread of segmental/multifocal dystonia to a third body site in idiopathic adult-onset patients.
Methods:
We retrospectively analyzed data from the Italian Dystonia Registry, including patients with a diagnosis of segmental/multifocal dystonia involving at least two parts of the body or more.
Results:
We identified 340 patients with segmental/multifocal dystonia involving at least two parts of the body. Spread of dystonia to a third body site occurred in 10/99 (10.1%) patients with segmental/multifocal dystonia and in 42/241 (17.4%) patients with focal onset. Patients with focal dystonia onset had a greater tendency to spread, but gender, years of schooling, comorbidity, family history of dystonia/tremor, age at dystonia onset, and disease duration did not affect the risk of spread to a third body site.
Conclusions:
Spread to a third body site seems to occur in a relative low percentage of adult patients who develop idiopathic dystonia in two parts of the body. Neither the site of dystonia onset nor any other relevant demographic/clinical variable affected spread to a third body site in patients with focal onset.
COVID-19-ASSOCIATED GUILLAIN-BARRÉ SYNDROME IN THE FIRST WAVE OF COVID-19 PANDEMIC IN LOMBARDIA: INCREASED INCIDENCE OR INCREASED SEROPREVALENCE?
- Filippo G. Martinelli Boneschi (Italy)
Abstract
Background and Aims:
Several studies reported increased incidence of Guillain-Barre’ Syndrome (GBS) after Zika
epidemic, SARS-CoV and MERS, and more recently SARS-CoV-2 infection. We estimate
incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients in
one of the most affected regions by COVID-19 of the world, Lombardia.
Methods:
A multi-center observational study on neurological complications in COVID-19 patients was conducted in 20 Neurology Departments by the Italian society of Hospital Neuroscience (SNO). Adult patients admitted to Neurological units between February-April 2020 with COVID19-GBS were included.
Results:
38 COVID19-GBS patients had mean age of 60.7 years and male frequency of 86.8%. Mean interval between COVID-19 onset and GBS onset was 15.1 days. CSF albuminocytologic dissociation was detected in 71.4% of cases, PCR for SARS-CoV-2 negative in all 15 tested patients, and anti-ganglioside antibodies positive in 43.7%. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP diagnosis, 12.1% AMSAN and 6% AMAN. 29 patients have been treated with intravenous Immunoglobulin (IVIg), 2 with plasma exchange (PE), 2 with PE followed by IVIg and 5 untreated. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.1% worsened, of which 3 died. The estimated occurrence rate in Lombardia is 0.5 GBS cases per 1000 COVID-19 infections.
Conclusions:
We detected an increased incidence of GBS in COVID-19 patients which can reflect a higher risk of GBS in COVID-19 patients or be secondary to a higher seroprevalence of COVID-19 in this geographic area during the first pandemic wave.