Movement disorder

For the journal, see Movement Disorders (journal).

Medical condition

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.

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

[edit]

Movement Disorders[5] | ICD-9-CM  | ICD-10-CM

|
|

Hypokinetic Movement disorders
Poliomyelitis,[6] acute  | 045  | A80
Amyotrophic lateral sclerosis, ALS[6] (Lou Gehrig's disease)  | 335.20  | G12.21
Parkinson's disease (Primary or Idiopathic Parkinsonism)  | 332  | G20
Secondary Parkinsonism |  | G21
Parkinson plus syndromes |  |
Pantothenate kinase-associated neurodegeneration |  | G23.0
Progressive Supranuclear Ophthalmoplegia |  | G23.1
Striatonigral degeneration |  | G23.2
Multiple sclerosis[6] | 340  | G35
Radiation-induced polyneuropathy (brachial and lumbar plexopathies)  |  | G62.82
Muscular dystrophy[6] | 359.0  | G71.0
Cerebral palsy[6] | 343  | G80
Rheumatoid arthritis[6] | 714  | M05
Hyperkinetic Movement disorders
GLUT1 deficiency syndrome |  | E74.810
Attention-deficit hyperactivity disorder (with hyperactivity)  | 314.01  | F90
Tic disorders (involuntary, compulsive, repetitive, stereotyped)  |  | F95
Tourette's syndrome |  | F95.2
Stereotypic movement disorder |  | F98.5
Huntington's disease (Huntington's chorea)  | 333.4  | G10
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
Idiopathic 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
Myoclonus | 333.2  | G25.3
Chorea (rapid, involuntary movement)  |  |
Drug induced chorea |  | G25.4
Drug-induced tics and tics of organic origin  | 333.3  | G25.6
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
Ballismus (violent involuntary rapid and irregular movements)  |  | G25.85
Hemiballismus (affecting only one side of the body)  |  | G25.85
Myokymia, facial  |  | G51.4
Neuromyotonia (Isaacs Syndrome)  | 359.29  | G71.19
Opsoclonus | 379.59  | H57
Rheumatic chorea (Sydenham's chorea)  |  | I02
Abnormal head movements  |  | R25.0
Tremor unspecified  |  | R25.1
Cramp and spasm  |  | R25.2
Fasciculation |  | R25.3
Athetosis (contorted torsion or twisting)  | 333.71  | R25.8
Dyskinesia (abnormal, involuntary movement)  |  |
Tardive dyskinesia |  |

## Diagnosis

[edit]

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]

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

## History

[edit]

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

[edit]

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. ^ a b c d e f "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.

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* ICD-9-CM: 333.9, 781.0
* MeSH: D009069

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