-
Movement Disorders : Official Journal... May 2011The classification of movement disorders has evolved. Even the terminology has shifted, from an anatomical one of extrapyramidal disorders to a phenomenological one of... (Review)
Review
The classification of movement disorders has evolved. Even the terminology has shifted, from an anatomical one of extrapyramidal disorders to a phenomenological one of movement disorders. The history of how this shift came about is described. The history of both the definitions and the classifications of the various neurologic conditions is then reviewed. First is a review of movement disorders as a group; then, the evolving classifications for 3 of them--parkinsonism, dystonia, and tremor--are covered in detail.
Topics: History, 19th Century; History, 20th Century; Humans; Movement Disorders; Terminology as Topic
PubMed: 21626541
DOI: 10.1002/mds.23759 -
FP Essentials Dec 2022Most movement disorders in children are hyperkinetic. The most common type is tic disorders, which can involve motor and phonic tics and are classified as simple or...
Most movement disorders in children are hyperkinetic. The most common type is tic disorders, which can involve motor and phonic tics and are classified as simple or complex. Motor or phonic tics that persist for more than 1 year are defined as persistent (chronic) tic disorder. Tourette syndrome can be diagnosed if a child has multiple motor tics and at least one phonic tic for more than 1 year with onset before age 18 years. Children with Tourette syndrome may have symptoms of attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, depression, or behavioral disorders. Chorea can be seen as a symptom of rheumatic fever (Sydenham chorea), in children with a history of kernicterus, and in dyskinetic cerebral palsy. Chorea also may be part of an underlying metabolic or genetic condition. Dystonia is characterized by repetitive contortions and posturing of the limbs and body. It can be isolated or part of an underlying neurologic condition. Tremor can occur as a manifestation of essential tremor or can be an enhanced physiologic tremor exacerbated by drugs, illness, or stimulants. Ataxia most often is seen as a postinfectious or postvaccination acute cerebellar ataxia. Progressive ataxias are consistent with an underlying metabolic or genetic condition. Transient and developmental movement disorders include benign neonatal sleep myoclonus, jitteriness in neonates, shuddering, and stereotypies.
Topics: Child; Infant, Newborn; Humans; Adolescent; Tics; Chorea; Tourette Syndrome; Tremor; Movement Disorders
PubMed: 36459665
DOI: No ID Found -
Seminars in Nuclear Medicine Jan 2017Extrapyramidal movement disorders including Parkinson disease, multiple systems atrophy, progressive supranuclear palsy, and corticobasal degeneration are... (Review)
Review
Extrapyramidal movement disorders including Parkinson disease, multiple systems atrophy, progressive supranuclear palsy, and corticobasal degeneration are neurodegenerative syndromes with distinct neuropathological changes, indicating differing underlying etiologies. Clinical features that may distinguish among these conditions are often absent, particularly early after the onset of symptoms. Therapy is presently limited, and there are no established disease-modifying or neuroprotective interventions. Advances in therapeutics will depend on the early and accurate diagnostic classification of patients. Existing molecular imaging approaches demonstrate ability to separate several of these syndromes, but are clinically underutilized or are available only in research settings. The development of additional, specific imaging approaches targeting the misfolded protein deposits that characterize these neurodegenerative pathologies promises to advance not only the sensitive and specific endophenotyping of patients, but may also serve to measure directly potential therapeutic responses in the initial evaluations of new treatments.
Topics: Animals; Cognition; Dopamine; Glucose; Humans; Molecular Imaging; Movement Disorders; Synapses
PubMed: 27987553
DOI: 10.1053/j.semnuclmed.2016.09.007 -
Neurologic Clinics Nov 2004Movement disorders are not particularly common during pregnancy, with a few exceptions. RLS occurs most commonly followed by CG. Currently, with the incidence of... (Review)
Review
Movement disorders are not particularly common during pregnancy, with a few exceptions. RLS occurs most commonly followed by CG. Currently, with the incidence of rheumatic fever lower than previously, any woman who develops CG should be checked for illness other than rheumatic heart disease. The differential includes systemic lupus erythromatosis and antiphospholipid antibody syndrome. Regarding the use of dopaminergic agents, the dopamine agonist, pergolide, can be maintained during pregnancy for the treatment of PD, Segawa disease, and RLS. The use of levodopa and ropinirole should be limited during pregnancy because of the possible teratogenic effects. Amantadine is contraindicated during pregnancy. The data on selegiline are controversial; animal studies show possible serotonergic effects and teratogenic effects. If treatment is indicated in patients who have Tourette syndrome, the high potency neuroleptics drugs (haloperidol) are preferred to treat associated symptoms. Depression is a common comorbidity in patients who have PD, HD,Tourette syndrome, or other chronic neurologic diseases. Depression treatment during pregnancy is covered by Levy et al elsewhere in this issue. As discussed previously, most of the data on the use of drugs during pregnancy, especially the dopaminergic agents, are limited to animal studies and case reports. Therefore, it is in part left to the neurologist to decide on treatment based on the individual patient, clinical judgment, and inferences from animal studies and limited case reports.
Topics: Antipsychotic Agents; Dopamine Antagonists; Female; Humans; Movement Disorders; Pregnancy; Pregnancy Complications
PubMed: 15474767
DOI: 10.1016/j.ncl.2004.06.005 -
Neurosurgery Clinics of North America Jan 2014Surgical neuromodulation has emerged as the primary method to treat the medically refractory symptoms of essential tremor and Parkinson disease. With reversible... (Review)
Review
Surgical neuromodulation has emerged as the primary method to treat the medically refractory symptoms of essential tremor and Parkinson disease. With reversible manipulation of CNS neurons, neuromodulation can be used to intraoperatively localize and verify a stereotactic target, and to chronically treat movement disorders. This article discusses the historical advances in stereotactic surgery using various modalities of neuromodulation leading to contemporary treatment. Electrical neuromodulation, or deep brain stimulation, is emphasized as the major surgical intervention with a discussion of the technique, surgical targets, and clinical outcomes. A comparison of neuromodulation techniques is presented.
Topics: Cryotherapy; Deep Brain Stimulation; Essential Tremor; Humans; Movement Disorders; Parkinson Disease; Transcranial Magnetic Stimulation; Ultrasonics
PubMed: 24262899
DOI: 10.1016/j.nec.2013.08.002 -
The Lancet. Neurology Dec 2015Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or... (Review)
Review
Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or palate--are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient. Identification of the positive features of cranial functional movement disorders such as convergence and unilateral platysmal spasm might lend diagnostic weight to a suspected functional neurological disorder. Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management. Increased understanding of these disorders is also crucial to drive clinical trials and studies of individually tailored therapies.
Topics: Diagnosis, Differential; Humans; Movement Disorders; Neurologic Examination
PubMed: 26581970
DOI: 10.1016/S1474-4422(15)00226-4 -
Seminars in Neurology Apr 2009Movement disorders often occur in the context of medical illness, whether as the presenting sign of the illness, as a related feature of the underlying disease process,... (Review)
Review
Movement disorders often occur in the context of medical illness, whether as the presenting sign of the illness, as a related feature of the underlying disease process, or as a complication of treatment. Early recognition of an underlying medical cause for movement disorders is essential because the treatment and prognosis differ significantly depending on the underlying pathophysiology. Parkinsonism, nonparkinsonian tremor, dystonia, and chorea have a wide variety of etiologies, requiring a careful medical history in the evaluation of new-onset movement disorders. The spectrum of medical diseases associated with these four syndromes is reviewed in this article.
Topics: Animals; Autoimmune Diseases; Communicable Diseases; Humans; Metabolic Diseases; Movement Disorders
PubMed: 19370491
DOI: 10.1055/s-0029-1213731 -
European Journal of Paediatric... Mar 2018Immune mediated movement disorders include movement disorders in the context of autoimmune encephalitis such as anti-NMDAR encephalitis, post-infectious autoimmune... (Review)
Review
Immune mediated movement disorders include movement disorders in the context of autoimmune encephalitis such as anti-NMDAR encephalitis, post-infectious autoimmune movement disorders such as Sydenham chorea, paraneoplastic autoimmune movement disorders such as opsoclonus myoclonus ataxia syndrome, and infection triggered conditions such as paediatric acute neuropsychiatric syndrome. This review focuses on the approach to treatment of immune mediated movement disorders, which requires an understanding of the immunopathogenesis, whether the disease is destructive or 'altering', and the natural history of disease. Factors that can influence outcome include the severity of disease, the delay before starting therapy, use of multimodal therapy and whether the course is monophasic or relapsing. Although the four main conditions listed above have different pathophysiological processes, there are general themes that broadly apply including: early diagnosis and treatment is better, minimise the severity of disease, escalate treatment if the patient is not responding to initial treatments, and minimise relapse.
Topics: Child; Humans; Immune System Diseases; Movement Disorders
PubMed: 29289523
DOI: 10.1016/j.ejpn.2017.11.010 -
Revue Neurologique 2016Hypnosis might represent an interesting complementary therapeutic approach to movement disorders, as it takes into account not only symptoms, but also well-being, and... (Review)
Review
INTRODUCTION
Hypnosis might represent an interesting complementary therapeutic approach to movement disorders, as it takes into account not only symptoms, but also well-being, and empowers patients to take a more active role in their treatment.
METHODS
Our review of the literature on the use of hypnosis to treat movement disorders was done by systematically searching the PubMed database for reports published between 1984 and November 2015. The following variables were extracted from each selected paper: study design; sample size; type of movement disorder; hypnotic procedure; treatment duration; and efficacy.
RESULTS
Thirteen papers were selected for detailed analysis. Most concerned tremor in Parkinson's disease and tics in Gilles de la Tourette syndrome. Although promising, the data were insufficient to allow conclusions to be drawn on the efficacy of hypnosis in movement disorders or to recommend its use in this setting.
CONCLUSION
Well-designed studies taking into account some specific methodological challenges are needed to determine the possible therapeutic utility of hypnosis in movement disorders. In addition to the potential benefits for such patients, hypnosis might also be useful for studying the neuroanatomical and functional underpinnings of normal and abnormal movements.
Topics: Humans; Hypnosis; Movement Disorders; Parkinson Disease; Tourette Syndrome; Treatment Outcome
PubMed: 27503098
DOI: 10.1016/j.neurol.2016.07.008 -
Parkinsonism & Related Disorders Apr 2024Genetic testing has become a valuable diagnostic tool for movement disorders due to substantial advancements in understanding their genetic basis. However, the... (Review)
Review
Genetic testing has become a valuable diagnostic tool for movement disorders due to substantial advancements in understanding their genetic basis. However, the heterogeneity of movement disorders poses a significant challenge, with many genes implicated in different subtypes. This paper aims to provide a neurologist's perspective on approaching patients with hereditary hyperkinetic disorders with a focus on select forms of dystonia, paroxysmal dyskinesia, chorea, and ataxia. Age at onset, initial symptoms, and their severity, as well as the presence of any concurrent neurological and non-neurological features, contribute to the individual clinical profiles of hereditary non-parkinsonian movement disorders, aiding in the selection of appropriate genetic testing strategies. There are also more specific diagnostic clues that may facilitate the decision-making process and may be highly specific for certain conditions, such as diurnal fluctuations and l-dopa response in dopa-responsive dystonia, and triggering factors, duration and frequency of attacks in paroxysmal dyskinesia. While the genetic and mutational spectrum across non-parkinsonian movement disorders is broad, certain groups of diseases tend to be associated with specific types of pathogenic variants, such as repeat expansions in many of the ataxias. Some of these pathogenic variants cannot be detected by standard methods, such as panel or exome sequencing, but require the investigation of intronic regions for repeat expansions, such as Friedreich's or FGF14-linked ataxia. With our advancing knowledge of the genetic underpinnings of movement disorders, the incorporation of precise and personalized diagnostic strategies can enhance patient care, prognosis, and the application and development of targeted therapeutic interventions.
Topics: Humans; Chorea; Movement Disorders; Movement; Genetic Testing; Cerebellar Ataxia
PubMed: 38429185
DOI: 10.1016/j.parkreldis.2024.106033