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Journal of Neural Transmission (Vienna,... Aug 2019Extrapyramidal movement disorders comprise hypokinetic-rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and... (Review)
Review
Extrapyramidal movement disorders comprise hypokinetic-rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and their information circuits that have been briefly reviewed in part 1 of the papers on neuropathology and pathogenesis of extrapyramidal movement disorders. The classification of hyperkinetic forms distinguishes the following: (1) chorea and related syndromes; (2) dystonias (dyskinesias); (3) tics and tourette disorders; (4) ballism; (5) myoclonic and startle disorders; and (6) tremor syndromes. Recent genetic and molecular classification distinguishes the following: (1) polyglutamine disorders (Huntington's disease and related disorders); (2) pantothenate kinase associated neurodegeneration; (3) Wilson's disease and related disorders; and (4) other hereditary neurodegenerations without hitherto detected genetic or specific markers. The diversity of phenotypes is related to the deposition of pathologic proteins in distinct cell populations, causing neurodegeneration due to genetic and environmental factors, but there is frequent overlap between various disorders. Their etiopathogenesis is still poorly understood but is suggested to result from an interaction between genetic and environmental factors, multiple etiologies, and noxious factors (protein mishandling, mitochondrial dysfunction, oxidative stress, excitotoxicity, energy failure, chronic neuroinflammation), being more likely than one single factor. Current clinical consensus criteria have increased the diagnostic accuracy of most neurodegenerative movement disorders, but for their definite diagnosis, histopathological confirmation is required. A timely overview of the neuropathology and pathogenesis of the major hyperkinetic movement disorders is presented.
Topics: Animals; Brain; Humans; Movement Disorders
PubMed: 31236685
DOI: 10.1007/s00702-019-02030-y -
Neurologic Clinics Aug 2009
Topics: Humans; Movement Disorders; Parkinson Disease
PubMed: 19555822
DOI: 10.1016/j.ncl.2009.04.012 -
Ugeskrift For Laeger Dec 2017Functional movement disorders include motor dysfunctions which are not explained by relevant neurological examination. The prevalence of the disorders is relatively high... (Review)
Review
Functional movement disorders include motor dysfunctions which are not explained by relevant neurological examination. The prevalence of the disorders is relatively high (10-15%) within an ordinary neurological patient group. Untreated, prognosis for the conditions is poor, and neurological imaging has not yet provided explanatory hypotheses. Treatment studies are sparse, but a heterogenous group of studies of intense, multidisciplinary treatment programmes all point toward good and promising treatment effects. This is not reflected in the actual treatment capacity in Denmark.
Topics: Ambulatory Care; Conversion Disorder; Denmark; Humans; Inpatients; Movement Disorders; Patient Care Team; Prognosis; Risk Factors
PubMed: 29260699
DOI: No ID Found -
Pediatric Annals Jul 1997
Review
Topics: Athetosis; Case Management; Child; Chorea; Diagnosis, Differential; Humans; Infant; Movement Disorders; Psychotropic Drugs; Seizures; Tourette Syndrome
PubMed: 9225355
DOI: 10.3928/0090-4481-19970701-04 -
Neurobiology of Disease Jul 2019Functional movement disorders (FMDs), known over time as "hysteria", "dissociative", "conversion", "somatoform", "non-organic" and "psychogenic" disorders, are... (Review)
Review
Functional movement disorders (FMDs), known over time as "hysteria", "dissociative", "conversion", "somatoform", "non-organic" and "psychogenic" disorders, are characterized by having a voluntary quality, being modifiable by attention and distraction but perceived by the patient as involuntary. Although a high prevalence of depression and anxiety is observed in these patients, a definitive role of psychiatric disorders in FMDs has not been proven, and many patients do not endorse such manifestations. Stressful events, social influences and minor trauma may precede the onset of FMDs, but their pathogenic mechanisms are unclear. Patients with FMDs have several abnormalities in their neurobiology including strengthened connectivity between the limbic and motor networks. Additionally, there is altered top-down regulation of motor activities and increased activation of areas implicated in self-awareness, self-monitoring, and active motor inhibition such as the cingulate and insular cortex. Decreased activation of the supplementary motor area (SMA) and pre-SMA, implicated in motor control and preparation, is another finding. The sense of agency defined as the feeling of controlling external events through one's own action also seems to be impaired in individuals with FMDs. Correlating with this is a loss of intentional binding, a subjective time compression between intentional action and its sensory consequences. Organic and functional dystonia may be difficult to differentiate since they share diverse neurophysiological features including decreased cortical inhibition, and similar local field potentials in the globus pallidus and thalamus; although increased cortical plasticity is observed only in patients with organic dystonia. Advances in the pathogenesis and pathophysiology of FMDs may be helpful to understand the nature of these disorders and plan further treatment strategies.
Topics: Dystonic Disorders; Humans; Motor Cortex; Movement Disorders
PubMed: 30798005
DOI: 10.1016/j.nbd.2019.02.013 -
Progress in Neurological Surgery 2018Great progress has been made in expanding our understanding of the natural history of movement disorders, leading to impressive advancements in their medical and... (Review)
Review
Great progress has been made in expanding our understanding of the natural history of movement disorders, leading to impressive advancements in their medical and surgical management. Movement disorders are a diverse group of diseases, varying widely in clinical characteristics and evolution. Some are monosymptomatic while others have associated motor and nonmotor features. Some are static while others follow a progressive course. This chapter will review common primary and secondary movement disorders: Parkinson disease and other forms of Parkinsonism, essential tremor and its differential diagnoses, dystonia and tic disorders. Herein, we will provide an overview of the clinical presentation and prognosis of the primary and secondary movement disorders most relevant to discussions of surgical candidacy.
Topics: Dystonic Disorders; Essential Tremor; Humans; Parkinson Disease; Tic Disorders
PubMed: 29332071
DOI: 10.1159/000480719 -
Parkinsonism & Related Disorders Oct 2018
Topics: Disease Management; Humans; Movement Disorders
PubMed: 30396637
DOI: 10.1016/j.parkreldis.2018.09.024 -
Journal of Neural Transmission (Vienna,... Aug 2019Extrapyramidal movement disorders include hypokinetic rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and... (Review)
Review
Extrapyramidal movement disorders include hypokinetic rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and their information circuits. The functional anatomy of the BG, the cortico-BG-thalamocortical, and BG-cerebellar circuit connections are briefly reviewed. Pathophysiologic classification of extrapyramidal movement disorder mechanisms distinguish (1) parkinsonian syndromes, (2) chorea and related syndromes, (3) dystonias, (4) myoclonic syndromes, (5) ballism, (6) tics, and (7) tremor syndromes. Recent genetic and molecular-biologic classifications distinguish (1) synucleinopathies (Parkinson's disease, dementia with Lewy bodies, Parkinson's disease-dementia, and multiple system atrophy); (2) tauopathies (progressive supranuclear palsy, corticobasal degeneration, FTLD-17; Guamian Parkinson-dementia; Pick's disease, and others); (3) polyglutamine disorders (Huntington's disease and related disorders); (4) pantothenate kinase-associated neurodegeneration; (5) Wilson's disease; and (6) other hereditary neurodegenerations without hitherto detected genetic or specific markers. The diversity of phenotypes is related to the deposition of pathologic proteins in distinct cell populations, causing neurodegeneration due to genetic and environmental factors, but there is frequent overlap between various disorders. Their etiopathogenesis is still poorly understood, but is suggested to result from an interaction between genetic and environmental factors. Multiple etiologies and noxious factors (protein mishandling, mitochondrial dysfunction, oxidative stress, excitotoxicity, energy failure, and chronic neuroinflammation) are more likely than a single factor. Current clinical consensus criteria have increased the diagnostic accuracy of most neurodegenerative movement disorders, but for their definite diagnosis, histopathological confirmation is required. We present a timely overview of the neuropathology and pathogenesis of the major extrapyramidal movement disorders in two parts, the first one dedicated to hypokinetic-rigid forms and the second to hyperkinetic disorders.
Topics: Animals; Brain; Humans; Movement Disorders
PubMed: 31214855
DOI: 10.1007/s00702-019-02028-6 -
Current Opinion in Neurology Aug 2008Pediatric movement disorders the represent a broad range of disorders, the majority of which are intermittent and hyperkinetic. The goal of this review is to discuss... (Review)
Review
PURPOSE OF REVIEW
Pediatric movement disorders the represent a broad range of disorders, the majority of which are intermittent and hyperkinetic. The goal of this review is to discuss recent findings in several under-recognized conditions (motor stereotypy disorder, restless legs syndrome, and infantile masturbation) as well as the area of autoimmune movement disorders [Sydenham's chorea and PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection)].
RECENT FINDINGS
Advances to be discussed include clarification of symptoms, diagnostic clues, epidemiology, pathogenesis, and treatment.
SUMMARY
Significant progress has been made in the study of several paroxysmal movement disorders. Motor stereotypies can occur in typical children and persist over time. Infantile masturbation is often misdiagnosed for seizures or dystonia. Restless leg syndrome is a relatively common problem in children and established criteria are available. Advances have been made in the hallmark autoimmune disorder Sydenham's chorea, but PANDAS remains controversial.
Topics: Adolescent; Autoimmune Diseases; Child; Child, Preschool; Chorea; Humans; Infant; Infant, Newborn; Movement Disorders; Neurology; Pediatrics; Restless Legs Syndrome; Self Stimulation; Stereotyped Behavior; Streptococcal Infections
PubMed: 18607212
DOI: 10.1097/WCO.0b013e328307bf1c -
The Lancet. Neurology Jan 2013
Review
Topics: Comprehension; Early Diagnosis; Humans; Movement Disorders; Parkinson Disease; Tai Ji
PubMed: 23237891
DOI: 10.1016/S1474-4422(12)70302-2