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La Revue de Medecine Interne Aug 2018Movement disorders (tremor, chorea, dystonia, tics, and myoclonus) are related to basal ganglia and/or interconnected brain areas dysfunction. Clinical examination is a... (Review)
Review
Movement disorders (tremor, chorea, dystonia, tics, and myoclonus) are related to basal ganglia and/or interconnected brain areas dysfunction. Clinical examination is a key point in order to characterize the abnormal movement and identify associated signs that can guide etiological approach. Iatrogenic diseases will be systematically ruled out before conducting additional investigations (brain MRI, electrophysiological studies). Wilson disease, but also other treatable metabolic and/or genetic diseases, and auto-immune diseases will be systematically considered. Therapeutic management is symptomatic and based on specific oral drugs appropriate to each movement disorders. In some cases, radiosurgery and deep brain stimulation should be helpful, especially for tremor and generalized dystonia.
Topics: Administration, Oral; Brain; Diagnosis, Differential; Electrophysiology; Humans; Magnetic Resonance Imaging; Movement Disorders
PubMed: 29050651
DOI: 10.1016/j.revmed.2017.09.001 -
Age and Ageing Dec 2019Movement disorders are a diverse and challenging group of neurological conditions. Geriatricians and allied health professionals play a key role in the care of patients...
Movement disorders are a diverse and challenging group of neurological conditions. Geriatricians and allied health professionals play a key role in the care of patients living with these disorders. Age and Ageing is making freely available online a collection of 15 papers that highlight the breadth and depth of this field. Perhaps unsurprisingly papers on Parkinson's disease predominate, but rarer movement disorders, including those seen following stroke and Huntington's disease, are also represented. Difficulties in diagnosis are explored, together with innovative approaches to management of both motor and non-motor symptoms. The collection includes qualitative work, longitudinal studies and clinical trials, and both the individual patient perspective and the international perspective are considered. There are papers for generalists, papers for specialists, papers for clinical commissioners and papers for researchers. Comprehensive review articles provide clarity, guidance and pragmatism. Finally, a New Horizons article encourages us to look to the future of movement disorders, which lies not only in developing novel therapies and trials but also in recognising the enormous value of palliative care and the multidisciplinary approach.
Topics: Humans; Movement Disorders; Parkinson Disease
PubMed: 31830237
DOI: 10.1093/ageing/afz147 -
Seminars in Neurology Feb 2023In this manuscript, we review the epidemiology of movement disorders including Parkinson's disease (PD), atypical parkinsonism, essential tremor, dystonia, functional... (Review)
Review
In this manuscript, we review the epidemiology of movement disorders including Parkinson's disease (PD), atypical parkinsonism, essential tremor, dystonia, functional movement disorders, tic disorders, chorea, and ataxias. We emphasize age-, sex-, and geography-based incidence and prevalence, as well as notable trends including the rising incidence and prevalence of PD. Given the growing global interest in refining clinical diagnostic skills in recognizing movement disorders, we highlight some key epidemiological findings that may be of interest to clinicians and health systems tasked with diagnosing and managing the health of patients with movement disorders.
Topics: Humans; Movement Disorders; Parkinson Disease; Parkinsonian Disorders; Essential Tremor; Chorea; Ataxia
PubMed: 36893797
DOI: 10.1055/s-0043-1764140 -
Current Opinion in Neurology Aug 2008
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Humans; Middle Aged; Movement Disorders
PubMed: 18607206
DOI: 10.1097/WCO.0b013e328308b657 -
Seminars in Neurology Apr 2020Movement disorders in childhood can be difficult to diagnose early. Disease processes present variably and can mimic each other. It is particularly important to remain... (Review)
Review
Movement disorders in childhood can be difficult to diagnose early. Disease processes present variably and can mimic each other. It is particularly important to remain vigilant for the subset of these movement disorders that are treatable. These disorders can be managed with (1) treatments specific to the disease that substantially reduce symptoms; (2) treatments that can prevent progression; (3) treatments that can hasten recovery; or (4) surveillance and management of the associated, sometimes life-threatening, comorbidities. Here, we present a practical and phenomenology-oriented framework for diagnosing and managing these treatable movement disorders of infancy and early childhood.
Topics: Child, Preschool; Humans; Infant; Movement Disorders
PubMed: 32079029
DOI: 10.1055/s-0040-1702938 -
Neurological Sciences : Official... Jun 2012Several movement disorders may occur during nocturnal rest disrupting sleep. A part of these complaints is characterized by relatively simple, non-purposeful and usually... (Review)
Review
Several movement disorders may occur during nocturnal rest disrupting sleep. A part of these complaints is characterized by relatively simple, non-purposeful and usually stereotyped movements. The last version of the International Classification of Sleep Disorders includes these clinical conditions (i.e. restless legs syndrome, periodic limb movement disorder, sleep-related leg cramps, sleep-related bruxism and sleep-related rhythmic movement disorder) under the category entitled sleep-related movement disorders. Moreover, apparently physiological movements (e.g. alternating leg muscle activation and excessive hypnic fragmentary myoclonus) can show a high frequency and severity impairing sleep quality. Clinical and, in specific cases, neurophysiological assessments are required to detect the presence of nocturnal movement complaints. Patients reporting poor sleep due to these abnormal movements should undergo non-pharmacological or pharmacological treatments.
Topics: Diagnosis, Differential; Humans; Movement Disorders; Sleep Wake Disorders
PubMed: 22203333
DOI: 10.1007/s10072-011-0905-9 -
European Journal of Pediatrics Apr 2019This short communication provides an update on childhood psychogenic movement disorders (PMD), focusing on descriptive studies and case reports from 2008 to 2018. Known... (Review)
Review
This short communication provides an update on childhood psychogenic movement disorders (PMD), focusing on descriptive studies and case reports from 2008 to 2018. Known also as functional movement/motor disorders, PMD diagnoses are relatively common in adults but less so in children. In group studies over the past decade, sample prevalence of childhood PMD ranged from 2.8 to 23.1%, with a higher percentage of girls in most studies (consistent with adult PMD literature). Common types of PMD included tremor (32.4%), dystonia (29.5%), and myoclonus (24.3%). Precipitating events for PMD onset included H1N1 influenza vaccinations, family/child stressors, anxiety/depression in the child or parent, panic attacks, behavior disorders, injury or accident, sexual abuse of the child or family member, death of a close relative, parental discord, domestic violence, school-related problems, medical illness/surgery, sleep disturbance, and participation in competitive sport or dance. The most frequently mentioned treatments were cognitive behavioral therapy, psychotherapy, relaxation techniques, and physiotherapy.Conclusion: Although additional cases of childhood PMD have been published over the past decade, little new information has appeared. There is still no "diagnostic gold standard," making an accurate estimate of prevalence virtually impossible and contributing to confusion among pediatricians when trying to identify children with PMD. What is Known: • Psychogenic movement disorders (PMD) occur in children as well as adults. • The most common types of childhood PMD are tremor, dystonia, and myoclonus. What is New: • The most common childhood PMD treatments were cognitive behavioral therapy, psychotherapy, physiotherapy, and relaxation techniques (2008-2018). • Due to lack of a standardized definition for PMD, confusion exists as to which movement disorders to include. With the inability to reliably diagnose PMD and the ambiguity as to which movement disorders it comprises, it is difficult to determine the most effective treatments.
Topics: Adolescent; Child; Female; Humans; Male; Movement Disorders
PubMed: 30635706
DOI: 10.1007/s00431-019-03317-8 -
Current Opinion in Neurology Aug 2017The review highlights the clinical presentation of functional movement disorders (FMDs) and presents current evidence on bedside signs and paraclinical tests to... (Review)
Review
PURPOSE OF REVIEW
The review highlights the clinical presentation of functional movement disorders (FMDs) and presents current evidence on bedside signs and paraclinical tests to differentiate them from other neurological disorders.
RECENT FINDINGS
FMDs are diagnosed by the presence of positive clinical signs as emphasized in the new Diagnostic and Statistical Manual of Mental Disorders-5 classification criteria. Bedside signs are numerous, and a subset of them has been validated in controlled studies. This review summarizes evidence from the literature on specificity and sensibility of positive clinical signs for FMDs. The value of rule-in paraclinical tests to confirm the diagnosis is also presented. Recent developments in neuroscience with pathophysiological mechanisms and current treatment strategies are also discussed.
SUMMARY
FMDs represent a field of neurology that is currently rapidly growing in terms of research. Clinicians should be aware that highly reliable signs exist for the diagnosis and that early multidisciplinary treatment should be offered.
Topics: Humans; Movement Disorders; Treatment Outcome
PubMed: 28590986
DOI: 10.1097/WCO.0000000000000464 -
Continuum (Minneapolis, Minn.) Aug 2016This article provides an overview of movement disorders that present in childhood. Key clinical features are discussed, and a brief guide to management strategies is... (Review)
Review
PURPOSE OF REVIEW
This article provides an overview of movement disorders that present in childhood. Key clinical features are discussed, and a brief guide to management strategies is provided. Recent advances in the field of pediatric movement disorders are also a focus of the article.
RECENT FINDINGS
Advances in genetic technologies and cell biology have contributed greatly to the elucidation of underlying disease mechanisms in childhood movement disorders. This article discusses the expanding spectrum of both genetic and acquired movement disorders that present in childhood, including benign, acquired, genetic, and psychogenic movement disorders.
SUMMARY
Movement disorders in childhood comprise a wide spectrum of both genetic and acquired diseases, ranging from benign self-limiting conditions to more progressive phenotypes associated with significant morbidity and mortality. Elucidation of the underlying cause is achieved through accurate history, detailed clinical examination, review of video footage (including home videos), and, where appropriate, neuroimaging and laboratory investigations. Early accurate diagnosis will facilitate the instigation of appropriate management strategies.
Topics: Child; Diagnosis, Differential; Humans; Movement Disorders; Pediatrics
PubMed: 27495203
DOI: 10.1212/CON.0000000000000367 -
Neurologic Clinics Feb 2015Movement disorders, classically involving dysfunction of the basal ganglia commonly occur in neurodegenerative and structural brain disorders. At times, however,... (Review)
Review
Movement disorders, classically involving dysfunction of the basal ganglia commonly occur in neurodegenerative and structural brain disorders. At times, however, movement disorders can be the initial manifestation of a systemic disease. In this article we discuss the most common movement disorders which may present in infectious, autoimmune, paraneoplastic, metabolic and endocrine diseases. Management often has to be multidisciplinary involving primary care physicians, neurologists, allied health professionals including nurses, occupational therapists and less frequently neurosurgeons. Recognizing and treating the underlying systemic disease is important in order to improve the neurological symptoms.
Topics: Autoimmune Diseases; Communicable Diseases; Endocrine System Diseases; Humans; Metabolic Diseases; Movement Disorders
PubMed: 25432733
DOI: 10.1016/j.ncl.2014.09.015