Categorizing Movement Disorders Associated with Toxic Exposures at Camp Lejeune Military Base (P5-11.003)

Abstract

<h3>Objective:</h3> To further characterize the neurologic deficits and movement disorders experienced by Veterans exposed to toxic chemicals while at Camp Lejeune military base. <h3>Background:</h3> Recent reports revealed that drinking water in the Camp Lejeune military base in North Carolina was contaminated with volatile organic compounds including tricholoroethylene and tetrachloroethylene, among others between 1950’s–1987. Exposure to these agents has been linked to development of Parkinson’s disease (PD). However, in the clinical setting at Hines VA Hospital, Veterans displayed not only parkinsonism, but also a variety of other movement and neurological disorders. <h3>Design/Methods:</h3> A retrospective chart review of Camp Lejeune Veterans seen in the Hines VA neurology clinic within the last year was conducted; this included relevant laboratory and imaging studies, and history and physical examination data. <h3>Results:</h3> Among 22 Veterans reviewed, 36% had a diagnosis of PD and 13.6% had atypical parkinsonism (PD-ism). Another 23% had primary non-parkinsonian movement disorders, with 63% also having co-incident other movement disorders, the majority of which were hyperkinetic (chorea, dystonia, essential tremor). Within the PD and PD-ism population, 75% of Veterans had another co-incident movement disorder, including essential tremor and dystonia. Of Veterans without PD or movement disorder diagnosis, 92% had symptoms of another neurologic condition, including neuropathy and myasthenia gravis. Autoimmune screens were positive in 13.64% of the total cases reviewed. <h3>Conclusions:</h3> While half of the Veterans reviewed carried a diagnosis of PD or PD-ism, almost a quarter had a primary diagnosis of another movement disorder, most with hyperkinetic features. Further, there was a high prevalence of co-incident neurologic conditions in both the PD and non-PD populations. While we cannot imply causality with exposure to toxins at Camp Lejeune, these data suggest exposure to these toxins are associated with a broader spectrum of neurologic symptoms than previously thought and warrants further study. <b>Disclosure:</b> Dr. Hirschey has nothing to disclose. Dr. Colletta has nothing to disclose. Dr. Siddiqui has nothing to disclose. Dr. Raedy has nothing to disclose. Frances Weaver has received personal compensation for serving as an employee of PCORI. Sandra Kletzel has received personal compensation for serving as an employee of Edward Hines Jr VA Hospital. Sandra Kletzel has received research support from VAH.