Movement Disorders - An Overview

What Are Movement Disorders?

Movement disorders are a group of neurological conditions that cause abnormal movements. This can increase movements like jerking, spasm, and shaking. These actions can affect the movements immensely; they can cause both voluntary and involuntary movements. Body movements, from lifting the leg to moving the jaw and tongue to talk, involve complex communication; this includes:

• Motor nerves.

• Skeletal muscles.

• Central nervous system.

Damage or malfunction in the areas of the brain that control movements can result in movement disorders. It is essential to note that conditions resulting from a lack of movement or weakened muscles are not considered movement disorders, even when they affect mobility. These movement disorders cause abnormal and unwanted movements. There are mainly two types of abnormal movements. They are:

• Hyperkinetic movement (it is an abnormal involuntary movement that can be rhythmic and regular)

• Hypokinetic movement (movement in which there is an abnormally reduced amount of intentional motor activity).

Movement disorders can have both of these conditions or just one type of condition.

What Are the Different Types of Movement Disorders?

Movement disorders are conditions that can cause increased or reduced slow movements. This can be both voluntary and involuntary movements.

The different types of movement disorders are:

• Akathisia - Akathisia makes it difficult for an individual to sit and remain still due to inner restlessness. This condition is associated with the use of certain types of medications, like antipsychotic medications.

• Cervical Dystonia - In this condition, the neck muscles contract involuntarily and cause a head pull to one side or a tilt forward or backward. There may be shaking due to this condition.

• Chorea - Chorea is characterized by irregular, brief, and repetitive involuntary movements. These movements can typically involve the trunk, mouth, face, and limbs. This condition can look like excessive fidgeting.

• Ataxia - This type of movement disorder affects the part of the brain that controls coordinated movement. Ataxia can cause uncoordinated, clumsy balance, limb, and speech movements. They can be caused by ataxia and genetic and degenerative disorders. This condition may be caused by an infection or a treatable condition.

• Dystonia - The condition involves sustained involuntary muscle contractions with twisting and repetitive movements. This condition may affect the entire body or a part of it.

• Spasticity - This is a disruption in muscle movement patterns that causes certain muscles to contract anymore or even at rest. This interferes with movement and can also affect gait, walking, and speech.

• Huntington's Disease - It is a progressive inherited disease that can be confirmed by genetic testing. This condition has three components: cognitive issues, uncontrolled movements, and psychiatric conditions.

• Functional Movement Disorders - This condition can resemble any other type of movement disorder. Functional movement disorders are not due to neurological disease and are treatable.

• Myoclonus - Myoclonus is a diseased condition that could cause lightning-quick jerks of the muscles.

• Parkinson’s Disease - This is a slowly progressive disease that causes muscle stiffness, tremor, slow or decreased movement, and imbalance. This can also cause other symptoms that are not related to movements, like a decreased sense of constipation, smell and acting out dreams and a decline in cognition.

• Multiple System Atrophy - It is an uncommon neurological disorder that affects the brain and worsens progressively. Multiple system atrophy causes movement disorders like ataxia (a condition that affects coordination, balance, and speech) and parkinsonism (a motor syndrome that manifests as tremors, rigidity, and bradykinesia). This can cause low blood pressure, impaired bladder function, and acting out dreams.

• Parkinsonism - This condition is a general term for the slowness of movement along with tremors, stiffness, and loss of balance. There are many different reasons why certain dopamine-blocking medications are common causes. Other reasons for degenerative disorders include multiple system atrophy and progressive supranuclear palsy. Repeated head trauma and stroke are also caused by Parkinsonism.

• Restless Leg Syndrome - This is a movement problem that creates an unpleasant sensation in the legs while lying down and relaxing, which is often cured by movement.

• Progressive Supranuclear Palsy - It is a rare neurological disorder that causes problems with balance, walking, and eye movement. This condition sometimes resembles Parkinson’s disease but is a distinct condition.

• Tardive Dyskinesia - Neurological condition that is caused by long-term use of certain drugs like a psychiatric condition called neuroleptic drugs. Tardive dyskinesia causes involuntary and repetitive movements such as eye blinking, grimacing, and other movements.

• Tremor - It is a movement disorder that causes rhythmic shaking of body parts like the head, hands, and other body parts. The most common type is essential tremor.

• Wilson’s Disease - This is an inherited rare condition that causes excessive amounts of copper, which builds up in the body and causes neurological problems like tremors, dystonia, parkinsonism, or ataxia.

• Tourette Syndrome - It is a neurologic condition that starts between the teenage years and childhood and is mostly associated with repetitive movements and vocal sounds.

What Are the Symptoms of Movement Disorders?

The symptoms of movement disorders can vary widely. This disorder can cause symptoms like thinking and mood changes. Symptoms can range in severity from barely noticeable to disruptive. These symptoms involve:

• Episodes of uncontrolled movements like spasms, tremors, jerks, twisting, shaking, and twisting.

• The trouble with movements like swallowing, writing, and speaking.

• Issues with balance and coordination.

• Stiffness and rigidity of trunk and limbs.

• Changes in gait and walking difficulties.

These movements mostly affect several parts of the body:

• Feet and toes.

• Facial muscles.

• Limbs.

• Hands and fingers.

• Trunk and posture.

• Head and neck.

• Voice.

How Are Movement Disorders Diagnosed?

Based on the symptoms, movement disorders are diagnosed by tests like:

• Electromyography - This test is done to check the health of the muscles and the nerves that control them.

• Lumbar Puncture - This test is done to analyze the cerebrospinal fluid.

• Electroencephalogram - A test is done to check the electrical activity of the brain.

• Blood Test - This helps in the diagnosis of certain movement conditions.

• Biopsy: Muscle biopsy to distinguish between nerve and muscle conditions.

• Nerve Conduction: A nerve conduction study can also be done in some cases.

• Imaging Test: Other tests like a computed tomography scan and magnetic resonance imaging tests are done to look for any abnormalities.

What Treatment Is Provided for Movement Disorders?

The treatment of movement disorders is based on the types of movement disorders. Some movement disorders, like medication-induced parkinsonism, are often treatable. The treatments include:

• Medication - Anti-anxiety medications and dopaminergic medications can help with restless leg syndrome.

• Occupational Therapy - This therapy helps improve the ability to perform tasks.

• Physical Therapy - This helps improve physical movements. This helps in managing symptoms like stiffness, pain, and discomfort and makes it hard to move.

• Mobility Aids - Aids like walkers, canes, and wheelchairs can help people move more safely and increase independence.

• Speech Therapy - This helps improve speech, language, and swallowing skills.

• Botulinum Toxin (BOTOX) - This can help relax the muscles if they have dystonia and spasticity.

• Deep Brain Stimulation - Brain surgery for individuals with advanced Parkinson’s disease, tremors, and dystonia. This reduces involuntary movements.

• Psychotherapy - Psychotherapy is a treatment technique that aims to help identify and change unhealthy thoughts, emotions, and behaviors. These disorders can often help in conditions like anxiety and depression. Psychotherapy can help in such conditions.

Conclusion

The diagnosis of movement disorders can be overwhelming. The healthcare team can help find a treatment plan that is unique according to the needs of an individual. It is necessary to make sure that getting support and care at the right time is important, and one needs to stay attentive to their health.