Movement Disorders include conditions either an increase of movements (hyperkinetic) referring to dyskinesia or a lack of voluntary and involuntary movements (hypokinetic) referring to akinesia (lack of movement), hypokinesia (reduced amplitude of movements), bradykinesia (slow movement) and rigidity, unrelated to weakness or spasticity. Nearly 40 million people in the U.S. suffer movement disorder of some type.

Cause

Pathological changes in the basal ganglia, an area of grey matter at the base of the forebrain, heredity reasons and environment factors may play a role.

Classification

Hyperkinetic movement disorders

• Ataxia - causing uncoordinated or clumsy balance, speech or limb movements.
• Chorea and Huntington’s disease - repetitive, brief, irregular, somewhat rapid, involuntary movements that typically involve the face, mouth, trunk and limbs.
• Dystonia - involving sustained involuntary muscle contractions with twisting, repetitive movements.
• Myoclonus - causes lightning-quick jerks of a muscle or a group of muscles.
• Restless legs syndrome - unpleasant, abnormal feelings in the legs while relaxing or lying down, often relieved by movement.
• Tourette syndrome - repetitive movements (motor tics) and vocal sounds (vocal tics).
• Tremor - involuntary rhythmic shaking of parts of the body.

Hypokinetic movement disorders

Cervical dystonia - This condition causes long-lasting contractions (spasms) or intermittent contractions of the neck muscles, causing the neck to turn in different ways. Multiple system atrophy. Parkinson’s disease. Parkinsonism.

Functional movement disorder

This condition may resemble any of the movement disorders but is not due to neurological disease.

Diagnosis

Diagnosis starts by taking an extensive medical history addressing your symptoms, the trigger factors, the duration and the frequency, work environment, social habits, toxic exposure, risk of infectious diseases and family history of neurological disease. Check of vital signs such as blood pressure and pulse, followed by a proper physical examination with focus on movement disturbances, balance, muscle stiffness and speech should give a first differential diagnosis. Additional tests such as laboratory tests, Electromyography (EMG), Nerve Conduction Studies (NCS) and imaging of brain are sometimes recommended investigations for ruling out symptomatic reasons.

Treatments

Treatments include medications, botulinum toxin injections, occupational and physical therapy, and surgical procedures such as deep brain stimulation.