Abstract Details

Title Immune-mediated movement disorders: clinical manifestations, treatment, and evolution. A multicenter study

Topic Movement Disorders

Presentation(s) Movement Disorders Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 164

Objective

To evaluate the clinical characteristics, etiologies, treatment, and evolution of patients with immune-mediated movement disorders (IMMD).

Background The highly variable and complex phenomenology of immune-mediated movement disorders (IMMD) and the increasing number of related autoantibodies being described significantly hinder its diagnosis. At this moment, IMMD prevalence is unknown. Since these diseases are potentially treatable and can be associated with several occult neoplasms, early diagnosis may be crucial to modify its prognosis.

Design/Methods We performed a multicenter, retrospective, and descriptive case series. Fourteen centers from Argentina participated (period analyzed: 2008-2020). Patients had to be ≥15 years-old. Inclusion criteria: clinical, immunological, imaging, CSF. Clinical syndromes were divided into hyperkinetic or hypokinetic. We assessed differences according to age (≤ 50 vs. >50 years).

Results Thirty-nine patients were included (female: 23). Mean age (SD): 51.5 (18.8); ≤50 years: 43.6%. Acute/subacute clinical presentation: 67%. Hyperkinetic syndromes (79.6%) and generalized forms (69.2%) were more frequent. We found an association with cancer in 28.2%. Pathological brain MRI: 30.8%, pathological CSF: 48.7%, positive autoantibodies: 53.8%, most frequent treatment: intravenous corticosteroids. Variation of the modified Rankin scale before and after treatment: p <0.01. Nine patients died (7 were >50 years). Hypokinetic syndromes: more frequent in >50 years, higher prevalence of cancer and relapse of the IMMD, greater delay in diagnosis; epilepsy and polyneuropathy were more frequent. Hyperkinetic syndromes: higher prevalence of pathological CSF and brain MRI.

Conclusions

The diagnosis of an IMMD should be considered when symptoms present an acute or subacute onset, are associated with other neurological manifestations, autoimmune diseases and/or cancer, and with a pathological CSF. A substantial percentage of our sample presented positive autoantibodies. We observed a delay in the diagnosis of hypokinetic syndromes. Patients >50 years had a worse prognosis.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Francisco Caiza Zambrano, MD (Hospital Británico de Buenos Aires)	Dr. Caiza Zambrano has nothing to disclose.
Lucrecia Bandeo	Lucrecia Bandeo has nothing to disclose.
Luciana V. Leon Cejas, MD (Hospital Britanico)	Dr. Leon Cejas has nothing to disclose.
	No disclosure on file
Gabriel M. Napoli, MD	Dr. Napoli has nothing to disclose.
Pablo Bonardo, MD	Dr. Bonardo has nothing to disclose.
	No disclosure on file
	No disclosure on file
Carlos Rugilo	Carlos Rugilo has nothing to disclose.
Cristian Calandra, MD (Merck Serono Argentina)	Dr. Calandra has nothing to disclose.
Luis Pellene	Luis Pellene has nothing to disclose.
Gabriela Raina	No disclosure on file
Zulema Salazar Salazar, MD (Hospital Gutiérrez)	Dr. Salazar Salazar has nothing to disclose.
	No disclosure on file
Jorge Gustavo Jose	Jorge Gustavo Jose has received personal compensation for serving as an employee of hospital padilla. Jorge Gustavo Jose has received personal compensation in the range of $0-$499 for serving as a Consultant for Novartis, . Jorge Gustavo Jose has received personal compensation in the range of $0-$499 for serving as a Consultant for RAFFO. Jorge Gustavo Jose has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NOVARTIS. Jorge Gustavo Jose has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for roche. Jorge Gustavo Jose has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SANOFI. Jorge Gustavo Jose has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for MERCK. Jorge Gustavo Jose has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for ROCHE. The institution of Jorge Gustavo Jose has received research support from NOVARTIS. Jorge Gustavo Jose has received research support from ROCHE. Jorge Gustavo Jose has received research support from SANOFI.
	No disclosure on file
	No disclosure on file
Anibal Chertcoff (University of British Columbia)	Anibal Chertcoff has nothing to disclose.
Diego Ballesteros	No disclosure on file
	No disclosure on file
Jorge D. Amor, MD (mar caribe clinic)	Jorge Amor has nothing to disclose.
	No disclosure on file
	No disclosure on file
Alfredo H. Laffue, MD	Dr. Laffue has nothing to disclose.
Alejandro Kohler	No disclosure on file
Nelida Garretto, MD	No disclosure on file
Tomoko Arakaki	No disclosure on file
	No disclosure on file
Oscar Martinez, MD	No disclosure on file
	No disclosure on file
Ricardo C. Reisin, MD (Hospital Britanico)	Dr. Reisin has nothing to disclose.
Marcela Uribe Roca (Hospital De Clinicas)	The institution of Marcela Uribe Roca has received research support from Roche.

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Abstract Details