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J Stroke Cerebrovasc Dis ; 27(1): 153-161, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28986199

RESUMO

OBJECTIVES: To determine the prevalence of vascular parkinsonism (VasP) in a stroke prevention clinic (SPC). BACKGROUND: VasP can be defined by an onset of parkinsonism with prominent gait problems occurring within 1 year of stroke. METHODS: We created a screening strategy based on the Tanner Questionnaire (TQ), a validated scale for parkinsonism, and the creation of a 4-point Five-Minute Assessment Scale (FMAS) operationalizing Zijlmans' criteria for the diagnosis of VasP. Consecutive stroke patients were screened over a 12-month period using the TQ and the FMAS. SAS statistical software was used. RESULTS: Two hundred forty patients (52.5% females) were screened (mean age of 65 years, standard deviation, 14.5). Twenty-five percent of patients had a TQ score ≥ 4 with a median FMAS of 2. In this group, 32.6% (15/46) were found to have parkinsonism. Seventeen percent (8/46) were diagnosed with VasP having an FMAS of 4. Seventy-five of the participants obtained a TQ ≤ 3, with a median FMAS of 1. Only 1 patient in this group had parkinsonism (1.9%; 1/194). Using a cutoff of 4 points in the TQ resulted in a sensitivity of 93.8%, a specificity of 86.2% for parkinsonism, and a sensitivity of 100% with a specificity of 83% for VasP. Patients with FMAS = 4 (VasP) attained higher scores in the TQ with a median of 5 (Spearman rank correlation coefficient for the TQ and the FMAS (rs) = .447, P < .0005). CONCLUSIONS: We documented a prevalence of 3% (8/240) for VasP in an SPC. We propose a new, easier, and unified 2-step TQ-FMAS screening strategy for this condition.


Assuntos
Ambulatório Hospitalar , Doença de Parkinson Secundária/diagnóstico , Doença de Parkinson Secundária/epidemiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto , Idoso , Idoso de 80 Anos ou mais , Alberta/epidemiologia , Estudos Transversais , Feminino , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson Secundária/fisiopatologia , Valor Preditivo dos Testes , Prevalência , Desenvolvimento de Programas , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/prevenção & controle
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