Background and Objectives: The COVID-19 pandemic triggered significant delays in the treatment of people with movement disorders who depend on face-to-face clinic encounters for receipt of their regular botulinum toxin injections. Against this background, it was the aim of this study to look into pandemic-related characteristics of patients with dystonia and hemifacial spasm treated with botulinum toxin at a tertiary centre in Romania and identify potential correlations between delays in treatment and health perceptions.
Materials and Methods: A cross-sectional, questionnaire-based, study was conducted between May-September 2021 on the 175 patients in the centre’s botulinum toxin database.
Results: Of the 90 patients who qualified for inclusion most were late middle-aged females with long-standing dystonia, of which torticollis and blepharospasm were the most common phenotypes. Treatment was delayed by an average of 8.5 months, whereas the overall quality-of-life health score was 61.1, with 60% of respondents rating themselves above 50. No statistically significant correlation was identified between delays in treatment and overall healthscores. Instead, statistically significant differences were uncovered based on type of disorder (dystonia vs. hemifacial spasm).
Conclusion: The results of this study may go on to show that, in the event of similar pandemic surges, patient micromanagement by type of disorder may be part of a well-balanced restriction-cum-access health policy.

Introduction: Tuberous sclerosis complex (TSC) is a genetic disorder with a heterogenous clinical phenotype, with possible involvement of virtually any organ. Although recent advancement in genetics has allowed a better understanding of the pathophysiology of TSC, enabling a genetic diagnosis, TSC is primarily diagnosed on clinical grounds. Neurological manifestations amount to over 90% of people with TSC. Ensuing surveillance and treatment of TSC imply a multidisciplinary team of specialists. Case reports: We report 2 cases of TSC, both admitted to our Neurology Department on account of poor seizure control. One was diagnosed early in his infancy having a typical onset with infantile spasms and subsequent generalised seizures whereas the other was diagnosed with TSC in our department, at 56 years of age. They both also have skin and renal involvement as major clinical features. Conclusion: Recognition of the clinical hallmarks of TSC, albeit variable, is important for early diagnosis and subsequent multidisciplinary management. Neurological involvement, as illustrated in our case reports, is frequent and is largely responsible for morbidity and mortality in TSC.