Hyperkinetic Movement Disorders: Chorea, Tic, and Dystonia

2021 ◽  
pp. 602-609
Author(s):  
Elizabeth A. Coon
Keyword(s):  
Movement Disorders ◽  
High Amplitude ◽  
Tic Disorders ◽  
Involuntary Movements ◽  
Muscle Groups

Hyperkinetic movement disorders are characterized by an excess of movement. This chapter outlines the classification, causes, and treatment of chorea, tic disorders, and dystonia. The term chorea refers to dancelike irregular, arrhythmic, rapid, involuntary movements that appear to flow between muscle groups. Athetosis, a slower and twisting dystonialike movement, may be superimposed with chorea, leading to choreoathetosis. Ballism is a form of high-amplitude and proximal chorea that has the appearance of flailing movement.

Movement Disorders in Childhood

1996 ◽  
Vol 17 (11) ◽  
pp. 388-394
Author(s):  
Michael R. Pranzatelli
Keyword(s):  
Movement Disorder ◽  
Movement Disorders ◽  
Correct Diagnosis ◽  
Tic Disorders ◽  
Clinical Aspects ◽  
Abnormal Involuntary Movements ◽  
Involuntary Movements ◽  
Throat Clearing ◽  
The Common ◽  
Nose And Throat

Clinical Aspects Dyskinesias are abnormal involuntary movements. The common dyskinesias include tics, chorea, tremor, dystonia, myoclonus, and hyperactivity (Table 1). Several other less common dyskinesias also are important to recognize. The diagnosis of the type of movement disorder is clinical. When the movements are episodic and not seen by the pediatrician, obtaining a home videotape is recommended. Most patients who have movement disorders, with the exception of tic disorders, should be referred to a neurologist, but it is important for the pediatrician to be able to identify them and to be informed on issues relevant to management. THE MOST COMMON DYSKINESIAS Tic disorders include motor (myoclonic and dystonic), vocal (phonic), and sensory tics. Tics may be simple or complex (Table 2). Myoclonic tics are jerks; dystonic tics are postures. Children who have vocal tics such as throat clearing, coughing, or sniffing may be referred to allergists or ear, nose, and throat specialists before the correct diagnosis is made. Sensory tics are peculiar sensations. Tics are increased by stress, decreased by activities that require concentration, exhibit a fluctuating pattern, and are less noticeable during sleep. The patient can suppress the movements or vocalizations voluntarily for minutes or hours, but then is unable to control the movements or the vocalizations.

Three Hysterical Movement Disorders

1988 ◽  
Vol 62 (3) ◽  
pp. 979-985 ◽  
Author(s):  
Arthur S. Walters ◽  
Doris Wright ◽  
James Boudwin ◽  
Karl Jones
Keyword(s):  
Movement Disorders ◽  
Hemifacial Spasm ◽  
Older Patients ◽  
Life Experiences ◽  
Spontaneous Resolution ◽  
Older Age ◽  
Supportive Psychotherapy ◽  
Involuntary Movements ◽  
Neurological Condition ◽  
The Third

Three hysterical movement disorders are reported: a case of hysterical bilateral blepharospasm which later presented as hysterical hemifacial spasm, a case of hysterical myoclonus, and a case of hysterical parkinsonism. Two patients presented with a relative indifference to preceding life experiences that would normally have evoked considerable emotion. Two of the cases first presented at an older age and one of these older patients was a man. Two of the patients agreed to hypnotherapy and supportive psychotherapy. In both cases the “involuntary” movements disappeared during hypnosis. In the third case, there was a complete spontaneous resolution of symptoms in a neurological condition where resolution would not be expected to occur.

Hyperkinetic Movement Disorders

2015 ◽  
Author(s):  
Devin Mackay ◽  
Edison Miyawaki
Keyword(s):  
Computed Tomography ◽  
Clinical Features ◽  
Movement Disorders ◽  
Clinical Presentation ◽  
Genetic Correlations ◽  
Practical Approach ◽  
Involuntary Movements ◽  
Computed Tomography Scans ◽  
Paroxysmal Disorders ◽  
Laboratory Investigations

The hyperkinetic movement disorders include heterogeneous diseases and syndromes, all characterized by one or a variety of excessive, involuntary movements. The hyperkinetic movement disorders are heterogeneous in clinical presentation, but a rational and practical approach to diagnosis exists based on new genetic correlations and targeted laboratory investigations. Treatments informed by a still-developing picture of motor pathophysiology offer significant benefit for these disorders. This chapter discusses choreiform disorders, including patterns in choreiform diagnosis; tremor disorders; paroxysmal disorders, including tics and myoclonus; dystonias, including monogenic primary dystonias; and pathophysiology and treatment in the hyperkinetic movement disorders. Figures include clinical photos, computed tomography scans, and an algorithm representing cortical-subcortical circuitry. Tables delineate definitions, distinguishing clinical features, medications, genetics, protein products, and treatments associated with various disorders.  This review contains 6 figures, 12 tables, and 145 references.

Classification and Approach to Movement Disorders

2021 ◽  
pp. 571-575
Author(s):  
Paul E. Youssef ◽  
Kenneth J. Mack ◽  
Kelly D. Flemming
Keyword(s):  
Motor Activity ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Normal Flow ◽  
Slow Movement ◽  
Involuntary Movements ◽  
P Movement

Movement disorders are conventionally divided into 2 major categories. Hyperkinetic movement disorders (also called dyskinesias) are excessive, often repetitive, involuntary movements that intrude into the normal flow of motor activity. This category includes chorea, dystonia, myoclonus, stereotypies, tics, and tremor. Hypokinetic movement disorders are akinesia (lack of movement), hypokinesia (reduced amplitude of movement), bradykinesia (slow movement), and rigidity. Parkinsonism is the most common hypokinetic movement disorder. In childhood, hyperkinetic disorders are common, whereas hypokinetic movement disorders are relatively uncommon.

Movement Disorders

2009 ◽  
pp. 551-574
Author(s):  
John N. Caviness
Keyword(s):  
Botulinum Toxin ◽  
Movement Disorders ◽  
Surface Emg ◽  
Involuntary Movements ◽  
Botulinum Toxin Injections

Surface EMG, EEG, and elicited response results provide a simple and noninvasive means of studying movement disorders. These techniques are particularly helpful in classifying involuntary movements such as tremor and myoclonus. In addition, EMG can assist with designing and performing botulinum toxin injections.

scholarly journals How to Examine a Patient with Movement Disorders?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
H.W. Hoek ◽  
P.N. van Harten
Keyword(s):  
Clinical Practice ◽  
Physical Examination ◽  
Movement Disorders ◽  
Systematic Investigation ◽  
The Body ◽  
Sensitive Questions ◽  
Drug Induced ◽  
Hand Tremor ◽  
Involuntary Movements ◽  
Highly Sensitive

Patients with movement disorders do not always complain about their ‘troubles with muscles’ spontaneously, and sometimes, often out of shame, they try to hide their involuntary movements. E.g. a hand tremor can be temporarily suppressed by pushing the hand against the body or sitting on it. To reveal these movement disorders, a systematic investigation of the patient is required. This investigation consists of a (hetero) anamnesis and a physical examination. The anamnesis demands knowledge of sensitive questions such as: ‘Do you notice any movements that are not under your control? Do you feel restless: an inability to keep the legs still? Do you tremble, are you slower than usual?’ Next, a physical examination is required. The investigator lets the patient execute several movements such as stretching the arms, opening the mouth and walking.In this workshop you will learn and practice this highly sensitive examination. In clinical practice this investigation takes less than 5 minutes and will reveal all drug induced movement disorders.

scholarly journals Parkinsonism and AIDS: a clinical comparative study before and after HAART

2009 ◽  
Vol 67 (3b) ◽  
pp. 827-830 ◽  
Author(s):  
Ana Lucia Zuma de Rosso ◽  
James Pitágoras de Mattos ◽  
Rosalie Branco Correa ◽  
Denise Hack Nicaretta ◽  
Sérgio Augusto Pereira Novis
Keyword(s):  
Comparative Study ◽  
Movement Disorders ◽  
Clinical Results ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Involuntary Movements ◽  
Before And After

In 2002, after analyzing 28 HIV-positive patients with movement disorders we emphasized the decreasing not only of Parkinsonism but also of other involuntary movements in HIV patients in the last few years. The objective of this study is to compare the clinical results between HIV-positive patients with Parkinsonism before and after HAART. In 14 years (1986-1999) 2,460 HIV-positive patients were seen in our Hospital 14 (0.6%) of which presented with Parkinsonism. Eight years after (2000-2007) 970 HIV positive patients were seen and only two (0.2%) had Parkinsonism. We conclude that after the introduction of HAART there was an evident decrease in AIDS-related Parkinsonism.

Involuntary Movements

2020 ◽  
Author(s):  
Hiroshi Shibasaki ◽  
Mark Hallett ◽  
Kailash P Bhatia ◽  
Stephen G. Reich ◽  
Bettina Balint
Keyword(s):  
Clinical Features ◽  
Movement Disorders ◽  
Involuntary Movement ◽  
Current Treatment ◽  
Video Cases ◽  
Visual Appearance ◽  
Involuntary Movements ◽  
Published Paper

This book is aimed at describing clinical features of various kinds of involuntary movements by demonstrating a number of cases on video. Most of the video cases presented in this book were directly observed and studied by at least one of the five authors, and a few cases were from the published paper with permission. The authors also discuss the current consensus about the classification, pathophysiology, and current treatment of each involuntary movement. This book adopts a unique way of looking at movement disorders by considering two aspects of the diagnosis: Axis 1, the phenomenology, and Axis 2, the etiology and/or pathophysiology. The visual appearance of the disorder, as seen on video, is a big part of Axis 1 diagnosis.

scholarly journals Tetrabenazine in treatment of hyperkinetic movement disorders: an observational study

2016 ◽  
Vol 10 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Rita Miguel ◽  
Marcelo D. Mendonça ◽  
Raquel Barbosa ◽  
Filipa Ladeira ◽  
Tânia Lampreia ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Exposure Time ◽  
Movement Disorders ◽  
Tic Disorders ◽  
The Other ◽  
Tolerability Profile ◽  
Discontinuation Rate ◽  
Meaningful Improvement ◽  
Minimal Dose ◽  
Time Required

Background: Tetrabenazine (TBZ) is commonly used in hyperkinetic movement disorders. In this retrospective study, we aimed to assess the TBZ effectiveness and adverse events (AEs) in Huntington disease (HD), vascular chorea, tics, dystonia, tardive oromandibular (OM) dyskinesia and other tardive syndromes (TS). Methods: Qualitative analysis of clinical response was used to estimate TBZ effectiveness. TBZ-associated AE frequency and subsequent discontinuation rate were used to estimate tolerability; the tolerability profile was measured through the TBZ minimal dose and exposure time required to elicit AEs. Results: Of 108 included patients, 87% had a clinically meaningful improvement sustained over a period of 40 months. TBZ-responder rate ranged from 100% in HD to 62.5% and 77.1% in tic disorders and OM dyskinesia, respectively ( p < 0.001). TBZ-associated AE frequency ranged from 40.9% in other TS and 41.7% in vascular chorea and HD, to 60% in OM dyskinesia ( p < 0.001). The most common AEs were Parkinsonism (51.8%) and psychiatric disorders (25%). The ‘other AEs’ category (mainly somnolence) presented the shortest minimal exposure time (3 months). AE-eliciting dose differed from 18.8 mg and 25 mg in tics and tardive disorders, to 75 mg in HD ( p = 0.003). Patients with AEs were tendentiously older at TBZ initiation ( p = 0.022). Conclusions: TBZ proved an effective and relatively well tolerated treatment in hyperkinetic disorders, with excellent results in HD. AEs were more common in OM dyskinesia, which may be related to higher age at TBZ initiation. TBZ-associated somnolence and Parkinsonism were more frequent during the titration and maintenance periods, respectively.

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