scholarly journals Spontaneous dyskinesia in first-degree relatives of chronically ill, never-treated people with schizophrenia

2003 ◽  
Vol 183 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Robin G. McCreadie ◽  
Rangaswamy Thara ◽  
Tirupati N. Srinivasan ◽  
Ramachandra Padmavathi
Keyword(s):  
Movement Disorder ◽  
Movement Disorders ◽  
South India ◽  
Chronically Ill ◽  
Group Differences ◽  
Body Area ◽  
Abnormal Involuntary Movements ◽  
First Degree Relatives ◽  
Abnormal Movements ◽  
Area 5

BackgroundWe have suggested recently that there may be a subgroup of schizophrenia, namely schizophrenia with dyskinesia and striatal pathology Might movement disorders be more common in relatives of those with schizophrenia and dyskinesia than in relatives of those without dyskinesia?AimsTo determine the prevalence of abnormal movements in first-degree relatives of people with schizophrenia who themselves do or do not have abnormal movements.MethodChronically ill, never-treated people with schizophrenia in south India (n=70) and their first-degree relatives (n=181) were examined for dyskinesia using the Abnormal Involuntary Movements Scale (AIMS) and for parkinsonism by the Simpson and Angus scale.ResultsOf all relatives, 25 (14%) had dyskinetic movements in at least one body area and 6 (3%) had parkinsonism. Siblings of people with schizophrenia and dyskinesia, compared with siblings of people without dyskinesia, had a higher total AIMS score and more had mild dyskinetic movements in at least one area (5/15 v. 3/34, P=0.04). There were no between-group differences in parkinsonism.ConclusionsDyskinesia but not parkinsonism is more common in siblings of people with schizophrenia who have the corresponding movement disorder.

scholarly journals Diagnostic Challenges Revealed from a Neuropsychiatry Movement Disorders Clinic

2012 ◽  
Vol 39 (6) ◽  
pp. 782-788 ◽  
Author(s):  
Heather Rigby ◽  
Angela Roberts-South ◽  
Hrishikesh Kumar ◽  
Leonardo Cortese ◽  
Mandar Jog
Keyword(s):  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Drug Induced ◽  
Optimal Care ◽  
Rater Reliability ◽  
Abnormal Movements ◽  
Psychiatric Conditions ◽  
Referring Physicians ◽  
Made In

Background:Abnormal movements are frequently associated with psychiatric disorders. Optimized management and diagnosis of these movements depends on correct labeling. However, there is evidence of reduced accuracy in the labeling of these movements, which could result in sub-optimal care.Objective:To determine the consensus inter-rater reliability between a movement disorders neurologist and physicians referring from the community for phenomenology and diagnoses of individuals with co-existing psychiatric conditions and movement disorders.Method:Charts of all consecutive patients seen in a combined Movement Disorders and Neuropsychiatry Clinic between 2001-2009 were reviewed retrospectively. Consensus estimates and kappa values for inter-rater reliability were determined for phenomenology and diagnostic terms for the respective referring source and movement disorders neurologist for each patient.Results:A total of 106 charts were reviewed (62 men and 44 women). Agreement for phenomenology terms ranged from 0% (psychogenic) to 73% (tremor). Only 3 terms had kappa values that met or exceeded criteria for moderate inter-rater reliability. Agreement for diagnosis terms was highest for tardive dyskinesia (83%), drug induced tremor (33%), and drug induced parkinsonism (20%). In 18 of the 22 charts (82%), a diagnosis was made of drug induced movement disorder (DIMD) by the referring physician. In contrast, a diagnosis of DIMD was made in only 54 of 106 charts (51%) after the patients were assessed in the clinic.Conclusions:A movement disorders specialist frequently disagreed with referring physicians' identification of patient phenomenology and diagnosis. This suggests that clinicians would benefit from educational resources to assist in characterizing abnormal movements.

scholarly journals HEMIBALLISMUS AFTER HEMORRHAGIC STROKE

2015 ◽  
Vol 14 (1) ◽  
pp. 52-54
Author(s):  
Vlad Claudiu Stefanescu ◽  
◽  
Irene Davidescu ◽  
Ioan Buraga ◽  
Bogdan Ovidiu Popescu ◽  
...  
Keyword(s):  
Cerebral Cortex ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Large Amplitude ◽  
Hemorrhagic Stroke ◽  
Corpus Striatum ◽  
Post Stroke ◽  
Common Disorder ◽  
Abnormal Movements

Ischemic or hemorrhagic stroke may be accompanied by movement disorders (1), either hyperkinetic or hypokinetic. Hyperkinetic movement disorders after stroke comprise dystonia (2-4), chorea with or without hemiballismus (5), tremor (6), parkinsonism (7), segmental or focal myoclonus, athetosis, pseudathetosis, and asterixis (8). Hemiballismus is a movement disorder characterized by involuntary, arrythmic, and large amplitude excursion of a limb, usually from a proximal joint, witn an element of rotation (9). Ballismus is explainable with lesions in the subthalamic nuclei, cerebral cortex, corpus striatum, thalamus and brainstem. (10) The frequency of post-stroke abnormal movements is unclear, the prevalence in a swiss registry being 1% with an incidence of 0.08% per year (8). Of them, hemichorea-hemiballismus is the most common, while dystonia is the next most common disorder (11).

Autoimmune Movement Disorders: A Video-Based Case Series of 11 Patients

2021 ◽  
pp. 1-5
Author(s):  
Anjali Chouksey ◽  
Sanjay Pandey
Keyword(s):  
Movement Disorder ◽  
Movement Disorders ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Case Series ◽  
Autoimmune Encephalitis ◽  
Intravenous Immunoglobulins ◽  
Thyroid Peroxidase ◽  
Tertiary Care Centre ◽  
Abnormal Movements

Autoimmune encephalitis (AIE) constitutes an important treatable cause of movement disorders. We aimed to highlight the spectrum of movement disorder and other salient features of AIE patients diagnosed at our tertiary care centre and describe their clinical symptoms, diagnostic approach, treatment, and outcome. We evaluated 11 patients who presented with movement disorder in association with AIE at our centre. Various abnormal movements observed were tremor, dyskinesias, stereotypy, dystonia, ataxia, asterixis, myoclonus, and parkinsonism. Antibodies were detected against NMDAR (n = 3), LGI-1 (n = 2), GAD-65 (n = 1), CASPR-2 (n = 1), Sox-1 (n = 1), Yo (n = 1), and thyroid peroxidase (n = 1). One patient was diagnosed with opsoclonus myoclonus syndrome associated with the suspected neuroblastic tumour. Six patients responded well to first-line immunotherapy (intravenous immunoglobulins or steroid or both). Three patients with anti-NMDAR antibodies received second-line therapy consisting of rituximab. Movement disorder is one of the most consistent features of AIE. Understanding of the ever-expanding spectrum of antibodies associated with movement disorders helps in the early diagnosis and better management of patients of autoimmune movement disorder.

Movement Disorder in Never and Minimally Treated Nigerian Schizophrenic Patients

1994 ◽  
Vol 164 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Robin G. McCreadie ◽  
Jude U. Ohaeri
Keyword(s):  
Movement Disorder ◽  
Antipsychotic Medication ◽  
Mental State ◽  
Movement Disorders ◽  
Negative Symptoms ◽  
Abnormal Involuntary Movements ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Negative Syndrome ◽  
Barnes Akathisia Scale

Two hundred and forty-two Nigerian schizophrenic patients (63% male, 37% female), whose mean age was 42 years and length of illness 12 years, were examined for movement disorders using the Abnormal Involuntary Movements Scale, the Simpson and Angus Parkinsonism Scale and the Barnes Akathisia Scale. Twelve patients had never received antipsychotic medication; and none of these had dyskinesia. Dyskinesia was found in 5 of 49 patients (10%) who had taken medication throughout the course of their illness for a total of up to 3 months, 13 of 74 (18%) who had taken medication for 4–12 months, 14 of 41 (34%) for 1–5 years, and 29 of 66 (45%) who had taken medication for more than 5 years. Of 77 patients who were receiving antipsychotic medication at the time of examination, 9 (12%) had Parkinsonism and 12 (15%) akathisia. Examination of the patients' mental state by the Positive and Negative Syndrome Scale showed an association between dyskinesia and positive, but not negative, schizophrenic symptoms. Nigerian patients showed a low level of negative symptoms.

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.

Gamma knife radiosurgery as a lesioning technique in movement disorder surgery

1997 ◽  
Vol 2 (3) ◽  
pp. E13 ◽  
Author(s):  
Ronald F. Young ◽  
Anne Shumway-Cook ◽  
Sandra S. Vermeulen ◽  
Peter Grimm ◽  
John Blasko ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Gamma Knife ◽  
Movement Disorders ◽  
Rating Scale ◽  
Gamma Knife Radiosurgery ◽  
Magnetic Resonance Images ◽  
Maximum Deviation

Fifty-five patients underwent radiosurgical placement of lesions either in the thalamus (27 patients) or globus pallidus (28 patients) for treatment of movement disorders. Patients were evaluated pre- and postoperatively by a team of observers skilled in the assessment of gait and movement disorders who were blinded to the procedure performed. They were not associated with the surgical team and concomitantly and blindly also assessed a group of 11 control patients with Parkinson's disease who did not undergo any surgical procedures. All stereotactic lesions were made with the Leksell gamma unit using the 4-mm secondary collimator helmet and a single isocenter with dose maximums from 120 to 160 Gy. Clinical follow-up evaluation indicated that 88% of patients who underwent thalamotomy became tremor free or nearly tremor free. Statistically significant improvements in performance were noted in the independent assessments of Unified Parkinson's Disease Rating Scale (UPDRS) scores in the patients undergoing thalamotomy. Eighty-five and seven-tenths percent of patients undergoing pallidotomy who had exhibited levodopa-induced dyskinesias had total or near-total relief of that symptom. Clinical assessment indicated improvement of bradykinesia and rigidity in 64.3% of patients who underwent pallidotomy. Independent blinded assessments did not reveal statistically significant improvements in Hoehn and Yahr scores or UPDRS scores. On the other hand, 64.7% of patients showed improvements in subscores of the UPDRS, including activities of daily living (58%), total contralateral score (58%), and contralateral motor scores (47%). Ipsilateral total UPDRS and ipsilateral motor scores were both improved in 59% of patients. One (1.8%) of 55 patients experienced a homonymous hemianopsia 9 months after pallidotomy due to an unexpectedly large lesion. No other complications of any kind were seen. Follow-up neuroimaging confirmed correct lesion location in all patients, with a mean maximum deviation from the planned target of 1 mm in the vertical axis. Measurements of lesions at regular interals on postoperative magnetic resonance images demonstrated considerable variability in lesion volumes. The safety and efficacy of functional lesions made with the gamma knife appear to be similar to those made with the assistance of electrophysiological guidance with open functional stereotactic procedures. Functional lesions may be made safely and accurately using gamma knife radiosurgical techniques. The efficacy is equivalent to that reported for open techniques that use radiofrequency lesioning methods with electrophysiological guidance. Complications are very infrequent with the radiosurgical method. The use of functional radiosurgical lesioning to treat movement disorders is particularly attractive in older patients and those with major systemic diseases or coagulopathies; its use in the general movement disorder population seems reasonable as well.

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.

Sleep-Related Movement Disorders

2020 ◽  
pp. 193-214
Author(s):  
Ravi Gupta
Keyword(s):  
Movement Disorder ◽  
Psychiatric Disorders ◽  
Iron Metabolism ◽  
Restless Legs Syndrome ◽  
Movement Disorders ◽  
Genetic Factors ◽  
Psychotropic Medications ◽  
Predisposing Factors ◽  
Treatable Condition

Sleep-related movement disorders include disorders that manifest as simple and mostly stereotyped movements occurring at sleep–wake interface or during sleep. Restless legs syndrome (RLS), the most common sleep-related movement disorder. RLS is a treatable condition that psychiatrists must be familiar with due to its common comorbidity with a broad range of psychiatric disorders. In addition, commonly used psychotropic medications are known to induce or worsen RLS symptoms in predisposed individuals, and these symptoms may be mistaken for akathisia or sleep-initiation insomnia and lead to mismanagement. This chapter discusses, among other RLS-related topics, the diagnosis, epidemiology, predisposing factors, genetic factors, and the role of iron metabolism.

Hypokinetic Movement Disorders: Parkinson Disease

2021 ◽  
pp. 576-582
Author(s):  
Sarah M. Tisel ◽  
Bryan T. Klassen
Keyword(s):  
Cell Death ◽  
Substantia Nigra ◽  
Parkinson Disease ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Dopaminergic Neurons ◽  
Microscopic Level ◽  
Rest Tremor ◽  
Macroscopic Level ◽  
Progressive Degeneration

Parkinson disease (PD) is the classic hypokinetic movement disorder and one of the most common and widely recognized neurodegenerative conditions. PD is distinct from parkinsonism, a term that refers to a syndrome of rest tremor, bradykinesia, rigidity, and postural instability. The mechanism behind the progressive degeneration and cell death that result in PD is not precisely understood. Substantia nigra depigmentation occurs on a macroscopic level and loss of dopaminergic neurons and gliosis on a microscopic level.

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