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Concept
Movement disorder
Summary
Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity. Movement disorders are synonymous with basal ganglia or extrapyramidal diseases. 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 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.
Step I : Decide the dominant type of movement disorder
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
Parkinson's disease
Treatment depends upon the underlying disorder. Movement disorders have been known to be associated with a variety of autoimmune diseases.
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.
Official source
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