Movement disorder

Movement disorders can be defined as neurologic syndromes in which either an excess or movement or a paucity of voluntary and automatic movements, unrelated to weakness or spasticity.^[1] The term movement disorders is used synonymously with basal ganglia or extrapyramidal diseases.^[2] Conventionally movement disorders are divided into two major categories: 1. Hyperkinetic movement disorders also called dyskinesias refers to excessive, often repetitive, involuntary movements that intrude into the normal flow of motor activity. 2. Hypokinetic movement disorders refers to akinesia (lack of movement), hypokinesia (reduced amplitude of movements), bradykinesia (slow movement) and rigidity. In primary movement disorders the abnormal movement is the primary manifestation of the disorder. In secondary movement disorders it is an manifestation of other systemic or neurological disorder.^[3]

History

Vesalius and Piccolomini in 16th century distinguished subcortical nuclei from cortex and white matter. However Willis' conceptualized the corpus striatum as the seat of motor power in the late 17th century. In mid-19th-century movement disorders were localized to striatum by Choreaby Broadbent and Jackson, and athetosis by Hammond. By the late 19th century, many movement disorders were described but for most no pathologic correlate was known.^[4]

Classification

Approach to Diagnosis^[6]

Step I : Decide the dominant type of movement disorder

Step II : Make differential diagnosis of the particular disorder

Step II: Confirm the diagnosis by lab tests

• Metabolic screening
• Microbiology
• Immunology
• CSF examination
• Genetics
• Imaging
• Neurophysiological tests
• Pharmacological tests

Treatment

Treatment depends upon the underlying disorder.^[7] Movement disorders have been known to be associated with a variety of autoimmune diseases.^[8]

References

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External links

• Movement Disorder.org
• Movement disorders Medline Plus
• Movement disorders Mayo Clinic
• Neurosymptoms.org