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Seminars in Neurology Feb 2019Many acute and potentially life-threatening medical conditions have hyperkinetic or hypokinetic movement disorders as their hallmark. Here we review the clinical... (Review)
Review
Many acute and potentially life-threatening medical conditions have hyperkinetic or hypokinetic movement disorders as their hallmark. Here we review the clinical phenomenology, and diagnostic principles of neuroleptic malignant syndrome, malignant catatonia, serotonin syndrome, Parkinsonism hyperpyrexia, acute parkinsonism, acute chorea-ballism, drug-induced dystonia, and status dystonicus. In the absence of definitive lab tests and imaging, only a high index of clinical suspicion, awareness of at-risk populations, and variations in clinical presentation can help with diagnosis. We also discuss the principles of management and rationale behind treatment modalities in the light of more recent evidence.
Topics: Emergencies; Humans; Movement Disorders
PubMed: 30743298
DOI: 10.1055/s-0038-1677050 -
Revue Neurologique 2016Stroke may be associated with different types of movement disorders, such as hyperkinetic syndromes (hemichorea-hemiballism, unilateral asterixis, limb-shaking,... (Review)
Review
Stroke may be associated with different types of movement disorders, such as hyperkinetic syndromes (hemichorea-hemiballism, unilateral asterixis, limb-shaking, dystonia, tremor, myoclonus) and hypokinetic syndromes (especially vascular parkinsonism). However, movement disorders are rare and transient in acute stroke and, as a permanent consequence, are more often delayed. While ischemic and hemorrhagic strokes can happen at any level of the frontal-subcortical motor system, they can be explained most of the time by a dysfunction in the basal ganglia motor circuit. However, only brain MRI allows the involved structure(s) to be precisely located, and each syndrome is specific to the type of lesion. Treatment is above all symptomatic. Only limb-shaking syndrome requires urgent surgical treatment because of the low-perfusion hemodynamic state. The functional prognosis depends on the type of movement disorder.
Topics: Chorea; Dyskinesias; Dystonia; Humans; Movement Disorders; Myoclonus; Parkinson Disease, Secondary; Prognosis; Stroke
PubMed: 27476417
DOI: 10.1016/j.neurol.2016.07.006 -
Handbook of Clinical Neurology 2020Movement disorders in women during pregnancy are uncommon. Therefore, high quality studies are limited, and guidelines are lacking for the treatment of movement... (Review)
Review
Movement disorders in women during pregnancy are uncommon. Therefore, high quality studies are limited, and guidelines are lacking for the treatment of movement disorders in pregnancy, thus posing a significant therapeutic challenge for the treating physicians. In this chapter, we discuss movement disorders that arise during pregnancy and the preexisting movement disorders during pregnancy. Common conditions encountered in pregnancy include but are not limited to restless legs syndrome, chorea gravidarum, Parkinson disease, essential tremor, and Huntington disease as well as more rare movement disorders (Wilson's disease, dystonia, etc.). This chapter summarizes the published literature on movement disorders and pharmacologic and surgical considerations for neurologists and physicians in other specialties caring for patients who are pregnant or considering pregnancy.
Topics: Dystonia; Essential Tremor; Female; Hepatolenticular Degeneration; Humans; Huntington Disease; Movement Disorders; Parkinson Disease; Pregnancy
PubMed: 32768090
DOI: 10.1016/B978-0-444-64240-0.00013-1 -
Revue Neurologique May 2020Functional movement disorders (FMD) represent a complex and disabling entity characterized by a broad range of clinical symptoms not explained by a classical... (Review)
Review
Functional movement disorders (FMD) represent a complex and disabling entity characterized by a broad range of clinical symptoms not explained by a classical neurological disease. In 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) added a clinical criterion based on incongruence and inconsistency, supported by recent literature highlighting the role of "positive clinical signs". These clinical signs allow a "rule-in" procedure in making a diagnosis of FMD so that the diagnosis is no longer a "rule-out" or "by default" diagnosis made after exclusion of other neurological conditions. This review summarizes current evidence on common clinical features and highlights bedside signs in FMD, such as tremor, dystonia, myoclonus and parkinsonism. Tics, chorea and hemiballism are also briefly discussed.
Topics: Diagnostic Techniques, Neurological; Diagnostic and Statistical Manual of Mental Disorders; History, 21st Century; Humans; Movement Disorders
PubMed: 31606137
DOI: 10.1016/j.neurol.2019.08.007 -
Neurology India 2018Pediatric movement disorders are commonly encountered clinical entities in the pediatric outpatient department. These disorders are a heterogenous group of disorders and... (Review)
Review
Pediatric movement disorders are commonly encountered clinical entities in the pediatric outpatient department. These disorders are a heterogenous group of disorders and may represent an underlying genetic disorder, a metabolic disorder or a hypoxic-ischemic insult during the perinatal period. Hyperkinetic movement disorders are more common as compared to hypokinetic disorders. This is unlike the situation in adult movement disorders where hypokinetic disorders are more often seen. A child's nervous system is more prone to hypoxic-ischemic insults due to its higher metabolic demands and the presence of an immature blood-brain barrier. The commonest movement disorders seen are tics, dystonia and chorea. Myoclonus is commonly associated with epilepsy syndromes. The aetiology of paediatric movement disorders depends on their course, their static or progressive nature, and whether an isolated symptom or an association with other neurological symptoms is present. The clue to the diagnosis is the proper recognition of the movement prevalent in the disorder.
Topics: Child; Disease Progression; Humans; Movement Disorders
PubMed: 29503328
DOI: 10.4103/0028-3886.226447 -
Current Opinion in Neurology Aug 2015Although movement disorders are traditionally viewed as chronic diseases that are followed electively, a growing number of these patients present with acute, severe... (Review)
Review
PURPOSE OF REVIEW
Although movement disorders are traditionally viewed as chronic diseases that are followed electively, a growing number of these patients present with acute, severe syndromes or complications of their underlying neurological problem. Identifying and managing movement disorders emergencies is challenging, even for the specialist. This review summarizes evidence outlining the clinical presentation of acute, life-threatening movement disorders.
RECENT FINDINGS
We review the most significant aspects in the most common movement disorders emergencies, including acute complications related to Parkinson's disease and parkinsonism, serotonergic, and neuroleptic malignant syndromes, chorea, ballismus, dystonia, myoclonus, and tics.
SUMMARY
The increasing amount of information delineating the descriptions of movement disorders emergencies provides means for more effective prevention, identification, and management for the nonspecialist. Although the commonest of these syndromes eventually have a good outcome, serious conditions such as neuroleptic malignant syndrome and status dystonicus may induce substantial rates of morbidity and mortality. This review re-emphasizes the need for their prompt identification and management.
Topics: Acute Disease; Disease Management; Emergencies; Humans; Movement Disorders
PubMed: 26110802
DOI: 10.1097/WCO.0000000000000212 -
Parkinsonism & Related Disorders Jan 2019Cerebrotendinous xanthomatosis (CTX) is an inborn error of cholesterol and bile acid metabolism, leading to neuropsychiatric and systemic manifestations. Movement... (Review)
Review
Cerebrotendinous xanthomatosis (CTX) is an inborn error of cholesterol and bile acid metabolism, leading to neuropsychiatric and systemic manifestations. Movement disorders have rarely been reported in CTX, while a detailed appreciation of the full phenotypic spectrum is required in order to prevent underdiagnosis of this disease. This review focuses on the frequency of more unusual, non-ataxia and non-spasticity movement disorders reported in CTX. In total, 39 articles were reviewed, describing 55 CTX patients with a movement disorder. Additionally, we report on seven patients with parkinsonism out of our Dutch cohort of 79 (77 genetically proven) CTX patients. Mean age at onset of the movement disorder was 40 ± 12 years (median 40, range 13-62 years). Movement disorders can be considered a late disease manifestation. Parkinsonism was the most frequently reported movement disorder, followed by dystonia, myoclonus and postural tremor. Movement disorders were found to be mixed in 23% of patients and were usually part of a complex clinical picture, rather than a prominent symptom. Still, in 18% of the cases, a movement disorder was the presenting symptom. Unusual movement disorders represent a rare clinical feature in CTX, but CTX should be considered in the differential diagnosis of these movement disorders, particularly in case of early onset, and when associated with other neurological features (especially cognitive impairment, pyramidal and cerebellar signs) and/or with systemic features (such as diarrhoea, cataract and tendon xanthomas). CTX is a treatable disorder, stressing the importance of considering CTX as a potential cause of movement disorders.
Topics: Adolescent; Adult; Cohort Studies; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Movement Disorders; Netherlands; Parkinsonian Disorders; Xanthomatosis, Cerebrotendinous; Young Adult
PubMed: 30054180
DOI: 10.1016/j.parkreldis.2018.07.006 -
Current Neurology and Neuroscience... Nov 2019There is emerging evidence that music therapy and other methods using music and rhythm may meaningfully improve a broad range of symptoms in neurological and... (Review)
Review
PURPOSE OF REVIEW
There is emerging evidence that music therapy and other methods using music and rhythm may meaningfully improve a broad range of symptoms in neurological and non-neurological disorders. This review highlights the findings of recent studies utilizing music and rhythm-based interventions for gait impairment, other motor symptoms, and non-motor symptoms in Parkinson disease (PD) and other movement disorders. Limitations of current studies as well as future research directions are discussed.
RECENT FINDINGS
Multiple studies have demonstrated short-term benefits of rhythmic auditory stimulation on gait parameters including gait freezing in PD, with recent studies indicating that it may reduce falls. Demonstration of benefits for gait in both dopaminergic "on" and "off" states suggests that this intervention can be a valuable addition to the current armamentarium of PD therapies. There is also emerging evidence of motor and non-motor benefits from group dancing, singing, and instrumental music performance in PD. Preliminary evidence for music therapy and music-based interventions in movement disorders other than PD (such as Huntington disease, Tourette syndrome, and progressive supranuclear palsy) is limited but promising. Music therapy and other music and rhythm-based interventions may offer a range of symptomatic benefits to patients with PD and other movement disorders. Studies investigating the potential mechanisms of music's effects and well-controlled multicenter trials of these interventions are urgently needed.
Topics: Humans; Movement Disorders; Music Therapy; Parkinson Disease
PubMed: 31720865
DOI: 10.1007/s11910-019-1005-0 -
Neurologic Clinics Feb 2015Psychogenic movement disorders (PMDs) can present with varied phenomenology that may resemble organic movement disorders. The diagnosis is based on clinical evaluation... (Review)
Review
Psychogenic movement disorders (PMDs) can present with varied phenomenology that may resemble organic movement disorders. The diagnosis is based on clinical evaluation with a supporting history and classic features on neurologic examination. Ancillary testing, such as imaging and neurophysiologic studies, can provide supplementary information but is not necessary for diagnosis. There is no standard protocol for the treatment of PMDs, but a multidisciplinary approach has been recommended. This review discusses the clinical characteristics of various PMDs as well as ancillary testing, treatment, and research in the pathophysiology of this complex group of disorders.
Topics: Humans; Movement Disorders; Psychophysiologic Disorders; Somatoform Disorders
PubMed: 25432730
DOI: 10.1016/j.ncl.2014.09.013 -
The Medical Clinics of North America Mar 2009Abnormal involuntary movements are major features of a large group of neurologic disorders, some of which are neurodegenerative and pose a significant diagnostic and... (Review)
Review
Abnormal involuntary movements are major features of a large group of neurologic disorders, some of which are neurodegenerative and pose a significant diagnostic and treatment challenge to treating physicians. This article presents a concise review of clinical features, pathogenesis, epidemiology, and management of seven of the most common movement disorders encountered in a primary care clinic routinely. The disorders discussed are Parkinson disease, essential tremor, restless legs syndrome, Huntington disease, drug-induced movement disorder, Wilson disease, and Tourette syndrome.
Topics: Age Distribution; Genetic Predisposition to Disease; Humans; Movement Disorders; Neurologic Examination; Risk Factors
PubMed: 19272514
DOI: 10.1016/j.mcna.2008.09.002