Changing Profile of 7,519 Neurologic Outpatients Evaluated over 20 Years

Abstract

Introduction: There is scarce information on the demographic profile and diseases affecting neurologic outpatients. Methods: We evaluated 7,519 neurologic outpatients over 20 years at the outpatient clinic of the Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador. Results: Mean age was 48 ± 19.4 years, and 57.8% were women. Common reasons for consultation included headache (33.2%), focal deficits (10.7%), and seizures (9%). The most common categories of neurologic diseases were cerebrovascular (10.6%), degenerative (7.6%), and traumatic (7.1%). Diseases of uncertain/unknown etiology accounted for 50.2% of cases. Young patients were most often evaluated for headache and seizures, while elderly patients usually presented with focal deficits, movement disorders, or cognitive decline. We also found significant variations in the prevalence of neurologic diseases over the study years. While the prevalence of degenerative diseases increased from 5.7% in 1990–1994 to 10.2% in 2005–2009, that of infectious diseases steadily decreased from 3.7 to 2.1% over the study years. Conclusion: There was a dynamic pattern of neurologic diseases over the years. Nowadays, distribution of neurologic symptoms and diseases in our population is more similar to that reported from the developed world than it was 20 years ago.

Movement disorders among adult neurological outpatients evaluated over 20 years in Guayaquil, Ecuador

“…Indeed, current distribution of degenerative diseases of the nervous system in our population is now more similar to that reported from the developed world than it was 20 years ago. 11,12 Contrary to what could have been expected, we did not have a significant number of patients with infections of the nervous system or with tropical toxic conditions responsible for the occurrence of movement disorders in our series.…”

“…In addition, methodology and operational definitions of this study have been described elsewhere 12 . In brief, patients were prospectively admitted using a unified format of clinical history which allowed comparisons by the end of the study.…”

Pilot of integrated, colocated neurology in a primary care medical home

“…Strengths of this study include assessment of a novel model of integrated neurology care in a PCMH and the prospective ascertainment of consultations from a defined community population with demographics and burden of disease similar to prior reports supporting potential generalizability of our findings. Use of a shared EHR also allowed for effective capture of use data as our population of patients primarily receives care within Mayo Clinic.…”

Video Anthology of Movement Disorders Due to Infections in South Asia

“…Several infections are associated with movement disorders. These accounted for 20% of non‐neurodegenerative disorders seen by movement disorder specialists at a center in South Asia; a larger proportion than reported outside the region 46–49 . Infection‐related neuronal injury or dysfunction results either from direct neuro‐invasion or release of neuro‐toxins by the pathogen, or are induced by the immune response 35,50,51 .…”