Overview of movement disorders
Movement disorders are clinical syndromes with excessive movement or insufficient voluntary and involuntary movement, not related to weakness or spasticity. Movement disorders are synonymous with basal tumours or extrapyramidal diseases. Movement disorders are conventionally divided into two main categories – hyperkinetic and hypokinetic.
- Hyperkinetic movement disorders refer to dyskinesia, or excessive, often repetitive, involuntary movements that interfere with the normal flow of motor activity.
- Hypokinetic movement disorders mention to akinesia (lack of movement), hypokinesia (reduced range of movements), bradykinesia (slow movement), and rigidity. In primary movement disorders, abnormal movement is the main manifestation of the disorder. In minor movement disorders, abnormal movement is a manifestation of another systemic or neurological disorder.
Types of movement disorders
The types of movement disorders include:
- This movement disorder affects the part of the brain that controls coordinated movement (cerebellum). Ataxia may cause uncoordinated or clumsy balance, speech or limb movements, and other symptoms.
- Cervical dystonia. This condition causes long-lasting contractions (spasms) or intermittent contractions of the neck muscles, causing the neck to turn in different ways.
- Chorea is characterized by repetitive, brief, irregular, somewhat rapid, involuntary movements that typically involve the face, mouth, trunk and limbs.
- This condition involves sustained involuntary muscle contractions with twisting, repetitive movements. Dystonia may affect the entire body (generalized dystonia) or one part of the body (focal dystonia).
- This condition causes lightning-quick jerks of a muscle or a group of muscles.
- Parkinson’s disease. This slowly progressive, neurodegenerative disorder causes tremor, stiffness (rigidity), slow decreased movement (bradykinesia) or imbalance. It may also cause other nonmovement symptoms.
Symptoms of movement disorders
We all experience uncontrollable movements at times, the jitters from too much coffee, trembling from nervousness or fear, or even a case of hiccups. However, unusual or persistent symptoms may indicate a movement disorder.
If you knowledge any unusual symptoms, see your primary care physician for an evaluation. The first symptoms may include:
- Muscle spasms
- Changes in gait when walking, clumsiness.
- Muscular weakness
Many diseases are careful a movement disorder, and the causes, symptoms, and progression vary greatly. Some are not significantly debilitating or life-threatening and can be managed well, while others are seriously debilitating and progressive throughout life. A general list of common symptoms also includes:
- Stiffness or rigidity of limbs and trunk (spasticity)
- Slow movement (bradykinesia)
- Inability to move (akinesia)
- Tightening or contraction of muscles (dystonia)
- Swallowing and speaking difficulties
- Cognitive and behavioural problems
Causes of movement disorders
Movement disorders can result from many types of brain injuries, such as head trauma, infection, inflammation, metabolic disturbances, toxins, or unwanted side effects from medications. They can also be a symptom of other fundamental diseases or conditions, including genetic disorders.
Your doctor will take your medical history and perform a physical exam with a neurological evaluation. This will include checking your motor skills and reflexes. You may need to walk a short distance so your doctor can detect any problems with your gait.
Your doctor may order more tests, including:
- Blood test
- Lumbar puncture to analyze cerebrospinal fluid.
- Electromyography to measure electrical impulses along nerves, nerve roots, and muscle tissue.
- Electroencephalogram (EEG) to check the electrical activity of the brain.
- Electrocardiogram (ECG or EKG) to check the electrical activity of the heart and determine if heart problems are causing your disorder.
- Muscle biopsy to differentiate between nerve and muscle disorders.
Physicians often use imaging tests to help diagnose drive disorders. Images alone may not be sufficient for a definitive diagnosis, but they are often helpful in clarifying clinical findings. These tests can include:
- Magnetic Resonance Imaging (MRI) – Head: MRI can sometimes discovery problems in the brain that may be connected to or cause a movement disorder, such as atrophy in certain parts of the brain.
- Positron Emission Tomography (PET): Functional and neurochemical PET images of the brain help provide information about the brain’s metabolism and chemistry.
Movement disorders treatment
Watchful waiting may be best for some cases. Other cases may require more aggressive treatment. Your doctor may prescribe injections or medications such as:
- Beta-blockers to reduce shaking and other physical symptoms.
- Anti-seizure medications to reduce tremors, especially in the hands.
- Anticholinergic agents to treat dystonia by reducing the effects of a brain chemical called acetylcholine. This may decrease tremors or muscle stiffness.
- Anti-anxiety medications to work on the central nervous system and relax the muscles to supply short-term relief from spasms.
- Botulinum toxin to block certain chemicals in the brain (neurotransmitters) that can cause muscle spasms.
If you have a movement disorder, deep brain stimulation (DBS) can reduce your involuntary movements. A two-part procedure first grafts a small electrode in the brain using general anaesthesia. The second surgery connects a lead from the electrode to a small battery that sends electrical impulses by pressing a button. Once the electrode is in place, you can adjust the device on your own. You will work with a neurologist to control the combination of locations that best control your symptoms.
Doctors are studying MRI-guided focused ultrasound (MRgFUS) as a treatment for some movement disorders. The procedure uses focused beams of sound energy to heat and destroys a small volume of brain tissue without damaging the surrounding tissue.