Department of Neurology, Cooper University Hospital, Camden, USA.
Public Health Education Center, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Prague Med Rep. 2024;125(3):195-219. doi: 10.14712/23362936.2024.19.
This study aims to describe movement disorders secondary to cocaine use. To our knowledge, while these presentations have been previously reported in the literature, a comprehensive review has not been published yet. We searched six databases from 1986 to 2022 without language restriction. Case reports, case series, and literature reviews have been analysed to find associations between cocaine use and movement disorders. The present study encompasses epidemiology, clinical manifestations, pathophysiology, and diagnostic challenges of abnormal movements associated with cocaine use. This review highlights the importance of proper initial evaluation and investigation taking into account the broad spectrum of differential diagnoses and exclusion of primary movement disorders. The role of the dopaminergic system in movement disorders is reviewed. Cocaine use is associated with movement disorders such as dystonia, parkinsonism, akathisia, and tics. The complex interaction of multiple factors, including other neurological conditions, such as Tourette syndrome, and additional substances of abuse is discussed. The presentation of these manifestations is often heterogeneous and does not follow a specific pattern. In this way, future research is needed to improve our understanding of the pathophysiological mechanisms and develop novel drug targets for these disorders. Increased awareness among the general public and policymakers could translate into reduced stigma and improved care.
本研究旨在描述可卡因使用引起的运动障碍。据我们所知,虽然这些表现以前在文献中已有报道,但尚未发表全面的综述。我们从 1986 年到 2022 年,在没有语言限制的情况下,检索了六个数据库。分析了病例报告、病例系列和文献综述,以寻找可卡因使用与运动障碍之间的关联。本研究包括与可卡因使用相关的异常运动的流行病学、临床表现、发病机制和诊断挑战。本综述强调了在考虑广泛的鉴别诊断和排除原发性运动障碍的情况下,进行适当的初始评估和调查的重要性。还回顾了多巴胺能系统在运动障碍中的作用。可卡因使用与运动障碍有关,如肌张力障碍、帕金森病、静坐不能和抽动。讨论了多种因素的复杂相互作用,包括其他神经状况,如妥瑞氏综合征和其他滥用物质。这些表现的出现通常是异质的,没有特定的模式。因此,需要进一步的研究来提高我们对这些疾病的病理生理机制的理解,并开发针对这些疾病的新的药物靶点。提高公众和政策制定者的认识可以减少污名化,改善护理。