Movement

Movement disorders are common problems in the Canadian population. Recognizing and identifying the type of movement disorder can provide a major clue toward solving the diagnostic puzzle.The first step in this process is to be able to identify the "phenomenology" (the type) of the movement disorder. Movement disorders can be divided into disorders of too much movement ("Hyperkinetic") and disorders of too little movement ("Hypokinetic"). The latter group is referred to as the rigid akinetic syndromes of which Parkinson's Disease would be the most typical example.

Tremor	Huntington's Disease
Dystonia	Other Choreas
Tics / Tourette's	Drug Induced Movement Disorders
Myoclonus	Restless Leg Syndrome
Hemi-Facial Spasm	Ataxias
Parkinson's Disease	Parkinson's "Plus"


HYPERKINETIC MOVEMENT DISORDERS Definitions TREMOR: A rhythmical sinusoidal oscillation of a body part DYSTONIA: An involuntary muscle contraction causing a sustained twisted or abnormal posture. ATHETOSIS: A writhing movement occurring at a slower speed than chorea but that is not sustained enough to be dystonia. This term is seldom used and when it is, it is usually described in conjunction with Chorea - "choreoathetosis". CHOREA: Random, purposeless, fleeting movements, that flow from one body part to another. HEMIBALISMUS: A high amplitude flailing of the limbs on one side of the body. MYOCLONUS: A lightening like jerk of a body part. STEREOTYPY : A recurrent or continuous often rythmic or patterned movement sometimes thought to be self stimulatory or compulsive. TIC: A stereotypic or patterned movement that is frequently preceeded by an urge to need to move, transient suppressibility, and post movement relief. Akathisia: An inability to tolerate inactivity resulting in a voluntary often stereotypic movement associated with this inner urge or restlessness. Synkinesia: An involuntary movement that occurs simultaneously with a voluntary movement. Hemifacial Spasm: An involuntary movement affecting muscles of facial expressioon on one side of the face. The movement may be myoclonic or more sustained hence the term "spasm". Startle Syndromes: Conditions associated with a excessive reaction (usually myoclonic) in response to a sudden unexpected noise, tactile or visual stimulus. Pseudoathetosis: A slow writhing movement occurring in a limb that has a marked impairment of sensory function (deafferented). Restless Leg Syndrome: A sydrome where an uncomfortable feeling occurs in the legs on lying still at night that creates an urge to move. This movement resolves the discomfort. Paroxysmal Dyskinesias: Involuntary movements that occur only intermintently. They can be triggered by mmovement (Kinesogenic) or be spontaneous (Nonkinesogenic). Painful Legs Moving Toes Syndrome: A writhing movement usually affecting the toes occurring secondary to any condition that causes chronic foot or leg pain. HYPOKINETIC MOVEMENT DISORDERS Rigid Akinetic Movement Disorders Parkinsonism - eg. Drug induced, Parkinson's Disease, Progressive Supranuclear Palsy, Multiple System Atrophy Stiff Man Syndrome Akinetic Mutism Psychomotor Retardation Catatonia: