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.

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 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]

Classification

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Movement Disorders[4] ICD-9-CM ICD-10-CM
Hypokinetic Movement disorders
Poliomyelitis,[5] acute 045 A80
Amyotrophic lateral sclerosis, ALS[5] (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[5] 340 G35
Radiation-induced polyneuropathy (brachial and lumbar plexopathies) G62.82
Muscular dystrophy[5] 359.0 G71.0
Cerebral palsy[5] 343 G80
Rheumatoid arthritis[5] 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

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Step I : Decide the dominant type of movement disorder[6]

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

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

Treatment

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Treatment depends upon the underlying disorder.[7] Movement disorders have been known to be associated with a variety of autoimmune diseases.[8]

History

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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.[9]

References

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  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. ^ Singer, Harvey S.; Mink, Jonathan; Gilbert, Donald L.; Jankovic, Joseph (2015-10-27). Movement Disorders in Childhood. Academic Press. ISBN 9780124115804.
  5. ^ 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.
  6. ^ Poewe, Werner; Jankovic, Joseph (2014-02-20). Movement Disorders in Neurologic and Systemic Disease. Cambridge University Press. ISBN 9781107024618.
  7. ^ "MedlinePlus: Movement Disorders".
  8. ^ 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. S2CID 25191890.
  9. ^ 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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