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Movement disorders are disorders related to the nervous system that cause involuntary - sometimes exaggerated - movements including jerking, shaking, tremors, spasms and so on. However, these conditions are not only responsible for increased movement; sometimes they result in the slowing down or reduction of movement as well.

According to a study published in The Lancet in 2005, movement disorders are among the most common neurological conditions, even though the prevalence of these conditions in specific populations isn't as well defined as other diseases and conditions. Parkinson's disease is the most common or well known movement disorder.

However, the study looking into a group of 706 men and women between the ages of 50 and 89 years found that the prevalence of movement disorders was about 28% in the group, and the likelihood of being diagnosed with such conditions increases with age. While the presence of certain neurological conditions as well as genetics have a role to play in the development of these disorders, one-fifth of the disorders diagnosed in the group were found to be the result of medication.

Movement disorders usually kick in due to a disruption in the basal ganglia, a group of nuclei that governs motor control in the brain. Any disturbance in the functioning of the basal ganglia gives rise to either a reduction or exaggeration in various movements of the body.

Read more: Spasmodic dysphonia

Even the smallest movement in the body, which may involve twitching of the nose, moving the fingers or the movement of the mouth requires an interaction between the muscles and the nervous system, and even a small malfunction in this channel can cause a movement disorder.

  1. Types of movement disorders
  2. Movement disorders symptoms
  3. Movement disorders causes
  4. Diagnosis of movement disorders
  5. Movement disorders treatment

Types of movement disorders

Movements disorders are divided into three broad categories: hyperkinetic (increased or exaggerated movement), hypokinetic (reduced or slow movement) and a third category dyskinesia, which results in abnormal involuntary movements.

Read more: Tardive dyskinesia

The following conditions come under movement disorders:

  • Ataxia: Marked by impaired coordination, ataxia is a degenerative neurological condition in which the part of the brain which controls balance and coordination is affected. This can happen due to damage to the cerebellum, the nerves or the muscles in the body. Some of the features of this condition include slurred speech, falling down frequently and a general lack of coordination. (Read more: Friedreich's ataxia)
  • Dystonia: Dystonia is a movement disorder that results in the patient's muscles contracting involuntarily. This causes the affected part of the body to twist abnormally, leading to unusual postures or repetitive movements that are often painful. It is a condition that can either affect a part of the body or the entire body. (Read more: Cervical dystonia)
  • Parkinson's disease: The most common of all movement disorders, Parkinson's disease is another degenerative neurological condition that causes tremors, slowing down of movement and difficulty walking.
  • Parkinsonism: This condition is a collection of disorders that have similar symptoms to the disease it borrows its name from.
  • Huntington's disease: Another degenerative condition, Huntington's disease is usually inherited or genetic. In this condition, the nerves in the brain gradually lose their function - this includes the nerves that control movement in the body. Huntington's usually leads to chorea (involuntary and abrupt movements), a reduction in cognitive ability and other neuropsychiatric conditions.
  • Tourette syndrome: Another widely known movement disorder, Tourette syndrome usually causes sudden twitching movements, tics or involuntary sounds. This condition usually appears early on in life, particularly before reaching adulthood.
  • Tremors: Another common movement disorder, tremors are usually characterised by twitching, shaking or other involuntary movements that commonly affect the hands, feet, face, head or even voice. (Read more: Hand tremors)
  • Multiple system atrophy: A rare movement disorder, multiple system atrophy can affect various bodily functions such as blood pressure, bladder function, motor movements as well as breathing.
  • Restless legs syndrome: One of the more common expressions of a movement disorder, restless legs syndrome presents as an uncontrollable urge to move the legs, especially when sitting or lying down. A study by neurologists in Lagos, Nigeria, found a prevalence of about 9,800 people per 100,000 population. A study in South India put the prevalence at about 2.1% among city dwellers.
  • Wilson's disease: A rare genetic condition, Wilson's disease is a neurological condition which occurs due to an abnormal build-up of copper in the body.
  • Myoclonus: An involuntary movement disorder, myoclonus is often characterised by sudden jerks or contractions in the muscles. Hiccups are considered to be a type of myoclonus. Current medical opinion is that myoclonus doesn't usually cause any problems and is not related to any underlying condition.(Read more: Muscle cramps)
  • Startle syndromes: An involuntary response to a sudden stimulus, a startle response could be vocal or physical. Startle syndromes encompass different conditions, including rare ones like hyperekplexia and Jumping Frenchmen of Maine. Some non-epileptic disorders are also categorised under this syndrome.

Movement disorders symptoms

Though sudden involuntary movements are the common factor, the symptoms of movement disorders can vary depending on the underlying condition:

  • Loss of coordination in the case of ataxia
  • Involuntary contraction of the muscles in the case of dystonia
  • The wasting away or degradation of nerve cells in Huntington's disease
  • Tremors that cause jerking, shaking or trembling in different parts of the body
  • Sudden twitches in movement or sounds, also known as tics
  • The slowing down of movement or difficulty in walking like in the case of Parkinson's disease

Movement disorders causes

The following may cause movement disorders:

  • Brain injury, spinal cord injury, damage to the peripheral nerves
  • Sudden brain condition such as stroke or vascular diseases (read more: Peripheral vascular disease)
  • Infections
  • Genetics: Some movement disorders are hereditary and passed on from either parent
  • Certain medications are also known to cause movement disorders. For example, anti-convulsants used in the treatment of epilepsy and some bronchodilators used in asthma can cause tremors
  • Metabolic disorders
  • Toxins

Diagnosis of movement disorders

Movement disorders are neurological conditions that can often be confused with another condition that has similar symptoms. To accurately diagnose the condition, other similar disorders must be ruled out.

The doctor will ask about the patient's medical history and symptoms. Next, he or she will perform a physical exam to assess the neurological functions. This exam may include checking the patient's reflexes and motor skills.

The doctor may also order some tests based on the symptoms and findings during the physical exam. These may include:

Movement disorders treatment

Many of the movement disorders mentioned above cannot be cured and thus treatment often includes clinical management to reduce the appearance of symptoms or any pain being caused by the underlying condition.

The treatment depends on the underlying condition.

Some conditions are degenerative and worsen with age and over time, and can result in the permanent impairment of movement or speech.

Early diagnosis can often help in slowing the progression of some types of movement disorders. Some disorders or their symptoms can be managed or slowed down with the help of medications, while physical therapy or occupational therapy can also help in maintaining the range of movement or restore function in the affected part of the body.

Muscle contractions are usually controlled through specific injections that can prevent the sudden onset of symptoms and the resulting pain.

In some cases, surgically inserting an implant to stimulate the part of the brain that manages movement in the body may help.

References

  1. American Association of Neurological Surgeons. [Internet] Rolling Meadows, IL, USA. Movement Disorders.
  2. International Parkinson and Movement Disorder Society. [Internet] Milwaukee, WI, USA. About Movement Disorders.
  3. Stanford Medicine [Internet]. Stanford, CA, USA. Involuntary Movements and Tremor Diagnosis.
  4. Lees AJ. Odd and Unusual Movement Disorders. Journal of Neurology, Neurosurgery and Psychiatry. 2002 Mar; 72: 17-21.
  5. Wenning GK et al. Prevalence of movement disorders in men and women aged 50–89 years (Bruneck Study cohort): a population-based study. The Lancet Neurology. 2005 Nov; 4(12): 815-820.
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