Clinical and epidemiological aspects of patients attended at a reference center for movement disorders

Background: Movement disorders are neurological conditions characterized by involuntary movements that significantly impact patients‘ quality of life. These disorders are commonly divided into hyperkinetic and hypokinetic categories. Hyperkinetic disorders include a variety of uncontrollable movements such as dystonias, tremors, myoclonus, and athetosis. Hypokinetic disorders are primarily characterized by parkinsonian syndromes, with Parkinson‘s disease (PD) being the most prominent and the second most common neurodegenerative disease. The prevalence of movement disorders in the general population is low and specific data on the Brazilian population are scarce, so studies exploring the characteristics of affected populations are crucial for developing better therapeutic strategies. Objective: To describe the frequencies of the different diagnoses among patients at the movement disorders clinic and their clinical manifestations, as well as their epidemiological data. Methods: This is a retrospective descriptive epidemiological study that analyzed medical records of patients seen at a referral movement disorders outpatient clinic from January 2019 to May 2024. Results: Among the 279 patients followed during the period, 57.6% were male, with a mean age of 65.1 years (±14.4). The most frequent diagnosis was PD (48.7%), followed by other forms of parkinsonism (11%), essential tremor (3.6%), Huntington‘s disease (2.2%), cervical dystonia (1.8%), Segawa‘s disease (1.1%), Wilson‘s disease (1.1%), and other diagnoses (9.3%). Additionally, 59 patients (21.2%) remained under investigation. Of the PD patients (136), 94.1% had bradykinesia, 91.1% were rigid, 73.5% had rest tremor and 29.4% had gait block. Regarding non-motor symptoms: 35.2% of patients had REM sleep behavior disorder, 28.6% had insomnia, 33% had constipation and 16% had orthostatic hypotension. Tremor was reported as the first symptom by 53 of these patients (38.9%). The mean Levodopa Equivalent Daily Dose (LEDD) was 638 mg (±677), with 64.3% of patients using levodopa-benserazide. Conclusion: The gender distribution and average age of the sample are in line with known epidemiological trends for PD, which suggests an accurate representation of the patient population. The predominance of PD among the diagnoses reflects its high prevalence. The high proportion of undiagnosed cases indicates the challenges of diagnosing movement disorders and scarce resources. Tremor was the most frequently reported initial symptom, which highlights its importance in early diagnosis and patient management. The frequencies of rigidity, bradykinesia, postural instability, insomnia, and REM sleep behavior disorder indicate a relevant prevalence of conditions that can potentially affect patients‘ quality of life. The average LEDD reflects typical therapeutic practices, and its variability suggests different stages of the disease, necessitating personalized therapeutic approaches.