Movement disorder

Last updated
Movement disorder
Specialty Neurology
Psychiatry

Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity. [1] Movement disorders present with extrapyramidal symptoms and are caused by basal ganglia disease. [2] Movement disorders are conventionally divided into two major categories- hyperkinetic and hypokinetic .

Contents

Hyperkinetic movement disorders refer to dyskinesia, or excessive, often repetitive, involuntary movements that intrude upon the normal flow of motor activity.

Hypokinetic movement disorders fall into one of four subcategories: akinesia (lack of movement), hypokinesia (reduced amplitude of movements), bradykinesia (slow movement), and rigidity. In primary movement disorders, the abnormal movement is the primary manifestation of the disorder. In secondary movement disorders, the abnormal movement is a manifestation of another systemic or neurological disorder. [3] Treatment depends upon the underlying disorder. [4]

Classification

Movement Disorders [5] ICD-9-CMICD-10-CM
Hypokinetic Movement disorders
Poliomyelitis, [6] acute045A80
Amyotrophic lateral sclerosis, ALS [6] (Lou Gehrig's disease)335.20G12.21
Parkinson's disease (Primary or Idiopathic Parkinsonism)332G20
Secondary Parkinsonism G21
Parkinson plus syndromes
Pantothenate kinase-associated neurodegeneration G23.0
Progressive Supranuclear Ophthalmoplegia G23.1
Striatonigral degeneration G23.2
Multiple sclerosis [6] 340G35
Radiation-induced polyneuropathy (brachial and lumbar plexopathies)G62.82
Muscular dystrophy [6] 359.0G71.0
Cerebral palsy [6] 343G80
Rheumatoid arthritis [6] 714M05
Hyperkinetic Movement disorders
GLUT1 deficiency syndrome E74.810
Attention-deficit hyperactivity disorder (with hyperactivity)314.01F90
Tic disorders (involuntary, compulsive, repetitive, stereotyped)F95
Tourette's syndrome F95.2
Stereotypic movement disorder F98.5
Huntington's disease (Huntington's chorea)333.4G10
Dystonia G24
Drug induced dystonia G24.0
Idiopathic familial dystonia333.6G24.1
Idiopathic nonfamilial dystonia333.7G24.2
Spasmodic torticollis 333.83G24.3
Idiopathic orofacial dystonia G24.4
Blepharospasm 333.81G24.5
Other dystoniasG24.8
Other extrapyramidal movement disordersG25
Essential tremor 333.1G25.0
Drug induced tremorG25.1
Other specified form of tremorG25.2
Myoclonus 333.2G25.3
Chorea (rapid, involuntary movement)
Drug induced chorea G25.4
Drug-induced tics and tics of organic origin333.3G25.6
Paroxysmal nocturnal limb movementG25.80
Painful legs (or arms), moving toes (or fingers) syndromeG25.81
Sporadic restless leg syndrome G25.82
Familial restless leg syndromeG25.83
Stiff-person syndrome 333.91G25.84
Ballismus (violent involuntary rapid and irregular movements)G25.85
Hemiballismus (affecting only one side of the body)G25.85
Myokymia, facialG51.4
Neuromyotonia (Isaacs Syndrome)359.29G71.19
Opsoclonus 379.59H57
Rheumatic chorea (Sydenham's chorea)I02
Abnormal head movementsR25.0
Tremor unspecifiedR25.1
Cramp and spasmR25.2
Fasciculation R25.3
Athetosis (contorted torsion or twisting)333.71R25.8
Dyskinesia (abnormal, involuntary movement)
Tardive dyskinesia

Diagnosis

Step I : Decide the dominant type of movement disorder [7]

Step II : Make differential diagnosis of the particular disorder[ citation needed ]

Step II: Confirm the diagnosis by lab tests[ citation needed ]

History

Vesalius and Piccolomini in 16th century distinguished subcortical nuclei from cortex and white matter. However Willis' conceptualized the corpus striatum as the seat of motor power in the late 17th century. In mid-19th-century movement disorders were localized to striatum by Choreaby Broadbent and Jackson, and athetosis by Hammond. By the late 19th century, many movement disorders were described, but for most no pathologic correlate was known. [8]

References

  1. Fahn, Stanley; Jankovic, Joseph; Hallett, Mark (2011-08-09). Principles and Practice of Movement Disorders. Elsevier Health Sciences. ISBN   978-1437737707.
  2. Bradley, Walter George (2004-01-01). Neurology in Clinical Practice: Principles of diagnosis and management. Taylor & Francis. ISBN   9789997625885.
  3. Flemming, Kelly; Jones, Lyell (2015-06-15). Mayo Clinic Neurology Board Review: Clinical Neurology for Initial Certification and MOC. Oxford University Press. ISBN   9780190244934.
  4. "MedlinePlus: Movement Disorders".
  5. Singer, Harvey S.; Mink, Jonathan; Gilbert, Donald L.; Jankovic, Joseph (2015-10-27). Movement Disorders in Childhood. Academic Press. ISBN   9780124115804.
  6. 1 2 3 4 5 6 "Debilitating Diseases – 12 Diseases that change millions of lives". dodgepark.com. Dodge Park. 2 December 2013. Retrieved 14 March 2024.
  7. Poewe, Werner; Jankovic, Joseph (2014-02-20). Movement Disorders in Neurologic and Systemic Disease. Cambridge University Press. ISBN   9781107024618.
  8. Lanska, Douglas J. (2010-01-01). "Chapter 33 the history of movement disorders". History of Neurology. Handbook of Clinical Neurology. Vol. 95. pp. 501–546. doi:10.1016/S0072-9752(08)02133-7. ISBN   9780444520098. ISSN   0072-9752. PMID   19892136.