Movement disorders

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 are synonymous with basal ganglia or extrapyramidal diseases.[2] Movement disorders are conventionally divided into two major categories- hyperkinetic and hypokinetic.

For the journal, see Movement Disorders (journal).
Movement disorder
SpecialtyNeurology
Psychiatry

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

Hypokinetic movement disorders refer to 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]

Classification
Movement Disorders[4] ICD-9-CM ICD-10-CM
Hypokinetic Movement disorders
Parkinson's disease (Primary or Idiopathic Parkinsonism) 332 G20
Secondary Parkinsonism G21
Parkinson plus syndromes
Hallevorden-Spatz Disease G23.0
Progressive Supranuclear Ophthalmoplegia G23.1
Striatonigral deneneration G23.2
Hyperkinetic Movement disorders
Dystonia G24
Drug induced dystonia G24.0
Idiopathic familial dystonia 333.6 G24.1
Idiopathic nonfamilial dystonia 333.7 G24.2
Spasmodic torticollis 333.83 G24.3
Ideopathic orofacial dystonia G24.4
Blepharospasm 333.81 G24.5
Other dystonias G24.8
Other extrapyramidal movement disorders G25
Essential tremor 333.1 G25.0
Drug induced tremor G25.1
Other specified form of tremor G25.2
Tremor unspecified R25.1
Myoclonus 333.2 G25.3
Opsoclonus 379.59 H57
Chorea (rapid, involuntary movement)
Drug induced chorea G25.4
Rheumatic chorea (Sydenham's chorea) I02
Huntington's Chorea 333.4 G10
Ballismus (violent involuntary rapid and irregular movements) G25.85
Hemiballismus (affecting only one side of the body) G25.85
Athetosis (contorted torsion or twisting) 333.71 R25.8
Dyskinesia (abnormal, involuntary movement)
Tardive dyskinesia
Tic disorders (involuntary, compulsive, repetitive, stereotyped) F95
Tourette's syndrome F95.2
Drug-induced tics and tics of organic origin 333.3 G25.6
Stereotypic movement disorder F98.5
Paroxysmal nocturnal limb movement G25.80
Painful legs (or arms), moving toes (or fingers) syndrome G25.81
Sporadic restless leg syndrome G25.82
Familial restless leg syndrome G25.83
Stiff-person syndrome 333.91 G25.84
Abnormal head movements R25.0
Cramp and spasm R25.2
Fasciculation R25.3

Diagnosis

Step I : Decide the dominant type of movement disorder[5]

Step II : Make differential diagnosis of the particular disorder

Step II: Confirm the diagnosis by lab tests

  • Metabolic screening
  • Microbiology
  • Immunology
  • CSF examination
  • Genetics
  • Imaging
  • Neurophysiological tests
  • Pharmacological tests

Treatment

Treatment depends upon the underlying disorder.[6] Movement disorders have been known to be associated with a variety of autoimmune diseases.[7]

See also: Parkinson's disease

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 1437737706.
  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. Singer, Harvey S.; Mink, Jonathan; Gilbert, Donald L.; Jankovic, Joseph (2015-10-27). Movement Disorders in Childhood. Academic Press. ISBN 9780124115804.
  5. Poewe, Werner; Jankovic, Joseph (2014-02-20). Movement Disorders in Neurologic and Systemic Disease. Cambridge University Press. ISBN 9781107024618.
  6. "MedlinePlus: Movement Disorders".
  7. Baizabal-Carvallo, JF; Jankovic J. (2012-07-18). "Movement disorders in autoimmune diseases". Movement Disorders. 27 (8): 935–46. doi:10.1002/mds.25011. PMID 22555904.
  8. Lanska, Douglas J. (2010-01-01). "Chapter 33: the history of movement disorders". Handbook of Clinical Neurology. 95: 501–546. doi:10.1016/S0072-9752(08)02133-7. ISSN 0072-9752. PMID 19892136.
Classification
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