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神经内科门诊神经退行性疾病谱:一项横断面研究。

Spectrum of neurodegenerative disorders in neurology outpatient department: A cross-sectional study.

作者信息

Rayamajhi Aadesh, Agrawal Saurav, Acharya Sabin, Karki Susmin, Ojha Rajeev

机构信息

Maharajgunj Medical Campus Tribhuvan University, Institute of Medicine Kathmandu Nepal.

Department of Neurology Tribhuvan University Teaching Hospital Kathmandu Nepal.

出版信息

Health Sci Rep. 2024 Jun 12;7(6):e2189. doi: 10.1002/hsr2.2189. eCollection 2024 Jun.

Abstract

BACKGROUND AND AIMS

Neurodegenerative disorders (NDDs) are a growing global health concern with a rise in prevalence with the aging population, leading to increased healthcare utilization and costs. Understanding its prevalence is crucial for effective diagnostics and resource allocation, especially in developing nations with limited resources. This study aims to explore the frequency and types of NDDs, while also collecting demographic, clinical, and neuro-radiological data from patients with NDDs attending a tertiary care hospital in Nepal.

METHODS

This was a single-center based cross-sectional descriptive study conducted at a Neurology outpatient department in a tertiary level hospital in Nepal in which patients aged 18 and above diagnosed with NDDs (May 2023-July 2023) were included. Data were collected and analyzed in SPSS Inc. This study has been presented by the STROBES guidelines.

RESULTS

The mean age of the 71 patients included in the study was 65.6 ± 13.3 years. Parkinsonian disorder ( = 41, 57.7%) was the most common NDD diagnosed. Patients belonging to the age group 60-79 years represented 62% of all outpatient visits. Tremors of the upper extremity and impairment of memory were the most commonly encountered first symptoms at onset. Predominant cognitive changes in our study were memory impairment and mood changes. Extrapyramidal features such as gait disturbance, resting tremor, rigidity, and bradykinesia were present. More than half of the patients had age-related cerebral atrophy on neuroimaging followed by chronic small vessel ischemic changes.

CONCLUSION

Diagnosing NDDs poses challenges, and our study underscores Parkinsonian disorder, specifically Parkinson's disease, as the prevailing neurodegenerative condition in our population. Emphasizing its prevalence among the elderly, particularly with tremors as the primary presenting symptom, highlights the necessity for targeted interventions in this demographic.

摘要

背景与目的

神经退行性疾病(NDDs)是一个日益引起全球健康关注的问题,随着人口老龄化患病率上升,导致医疗保健利用率和成本增加。了解其患病率对于有效的诊断和资源分配至关重要,特别是在资源有限的发展中国家。本研究旨在探讨神经退行性疾病的发病率和类型,同时收集尼泊尔一家三级医院就诊的神经退行性疾病患者的人口统计学、临床和神经放射学数据。

方法

这是一项基于单中心的横断面描述性研究,在尼泊尔一家三级医院的神经科门诊进行,纳入了2023年5月至2023年7月诊断为神经退行性疾病的18岁及以上患者。数据在SPSS Inc.中进行收集和分析。本研究遵循STROBES指南。

结果

纳入研究的71名患者的平均年龄为65.6±13.3岁。帕金森氏症(n = 41,57.7%)是最常见的神经退行性疾病诊断类型。60 - 79岁年龄组的患者占所有门诊就诊人数的62%。上肢震颤和记忆障碍是最常见的首发症状。我们研究中主要的认知变化是记忆障碍和情绪变化。存在锥体外系特征,如步态障碍、静止性震颤、僵硬和运动迟缓。超过一半的患者在神经影像学上有与年龄相关的脑萎缩,其次是慢性小血管缺血性改变。

结论

诊断神经退行性疾病具有挑战性,我们的研究强调帕金森氏症,特别是帕金森病,是我们人群中主要的神经退行性疾病。强调其在老年人中的患病率,特别是以震颤为主要表现症状,突出了针对这一人群进行有针对性干预的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bee/11169268/bc2b39661e2a/HSR2-7-e2189-g004.jpg

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