Movement Disorders

Movement problems are conditions that affect how the nervous system controls movement. These problems can make a person move too much, or too little, or too slowly. The extra movements might be things the person consciously chooses to do (voluntary), or they could happen without the person wanting them (involuntary).

Many different types of movement disorders exist, each with its own set of symptoms. For example, dystonia causes muscles to tighten up and twist the body in unusual ways. A disorder called chorea involves short bursts of uncontrolled, repetitive, jerky movements. Parkinson's disease (a movement disorder) is characterized by slowness of movement, stiffness, trembling (shaking), and problems with balance.

Fortunately, there are often ways to manage the symptoms of these disorders. Treatment options vary greatly, depending on the specific type of movement problem. These can include medications, therapies (like physical or occupational therapy), or even surgery. In some cases, if the movement disorder is caused by another underlying condition, treating that condition can help improve the movement problems.

Different Movement Disorders and Their Symptoms

Movement disorders are conditions that affect how the body moves. These disorders can cause uncontrolled or unusual movements, postures, and sometimes even speech problems. The symptoms of these disorders vary greatly depending on the specific type. Here are some common movement disorders:

1. Ataxia: This disorder affects the part of the brain that coordinates movement. People with ataxia have trouble with smooth, coordinated movements. They might stumble or trip easily, have difficulty with tasks requiring precise movements like writing, and have problems with balance. Ataxia can also affect speech, making it slurred or difficult to understand. Ataxia can be caused by various factors, including genetic conditions, degenerative diseases, infections, or other treatable illnesses.

2. Chorea: Chorea involves sudden, brief, and uncontrolled movements that happen repeatedly. These movements often affect the face, mouth, torso, arms, and legs, appearing like excessive fidgeting or jerking. One common form of chorea is Huntington's disease. Huntington's disease is a genetic condition that gets progressively worse over time. It's passed down through families and can be diagnosed with genetic tests. Huntington's disease causes problems with movement, thinking, and mental health.

3. Dystonia: Dystonia is characterized by involuntary muscle contractions that lead to repetitive, twisting movements or unusual postures. These contractions can affect the entire body or just a specific part, like the neck. A frequent type of dystonia in adults is cervical dystonia. In cervical dystonia, the neck muscles involuntarily contract, causing the head to tilt, turn, or even shake (a tremor).

4. Functional Movement Disorder: In this case, the symptoms resemble other movement disorders, but they aren't caused by a problem in the nervous system (neurological disease). These disorders are treatable and often respond well to therapy and support.

5. Myoclonus: Myoclonus involves brief, sudden muscle jerks. These jerks can be subtle or quite noticeable.

6. Parkinson's Disease: This progressive neurological disorder causes a variety of symptoms, including tremors (shaking), muscle stiffness, slow movement (bradykinesia), and problems with balance. Parkinson's can also affect other functions beyond movement, such as the sense of smell, digestion (constipation), sleep (acting out dreams), and cognitive abilities.

7. Parkinsonism: This is a general term for a group of conditions that cause symptoms similar to Parkinson's disease, such as slow movement, stiffness, tremors, and balance problems. Parkinson's disease itself is a type of parkinsonism, but other conditions like multiple system atrophy and progressive supranuclear palsy can also cause parkinsonism. Certain medications that block dopamine, a brain chemical, can also lead to parkinsonism. Strokes and repeated head trauma can also be contributing factors.

8. Progressive Supranuclear Palsy: This rare neurological condition primarily affects the muscles controlling eye movement, balance, and walking. While it shares some symptoms with Parkinson's disease, it's a different disorder.

9. Restless Legs Syndrome: This disorder causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations like itching, tingling, or aching. These sensations usually happen when the person is resting or relaxing, and they are often relieved by movement.

10. Tardive Dyskinesia: This is a movement disorder that can develop from long-term use of certain medications, particularly those used to treat mental health conditions. It can also be triggered by a common gastrointestinal medicine. Tardive dyskinesia causes involuntary, repetitive movements, such as grimacing, blinking, and other unusual motions.

11. Tourette Syndrome: This neurological condition is characterized by repetitive, involuntary movements and vocalizations called tics. Although the person may feel an urge to make these movements, they are involuntary. Tourette syndrome usually begins during childhood or adolescence.

12. Tremor: Tremor is a movement disorder where a part of the body, like the hands, head, or other body parts, shakes rhythmically. Essential tremor is the most common type.

Movement disorders can have many different causes. These problems with movement can stem from a variety of factors:

1. Inherited Conditions: Sometimes, a person's genes play a role. A change (mutation) in a gene can be passed down from a parent to a child. This is called an inherited condition. Examples of movement disorders that can run in families include Huntington's disease and Wilson's disease. These genetic changes affect how the body functions, leading to the movement problems.

2. Medication Side Effects: Certain medicines, like those used to treat seizures or mental health conditions, can sometimes cause movement disorders as a side effect. These medications can interfere with the normal functioning of the brain and nervous system, leading to unusual movements.

3. Substance Abuse: Using illegal drugs, such as cocaine, can lead to movement problems. Large amounts of alcohol can also cause issues with coordination and movement, like chorea (involuntary jerky movements) or ataxia (problems with balance and coordination).

4. Vitamin Deficiencies: Not getting enough of certain vitamins can impact the nervous system and lead to movement disorders. A lack of vitamin B-1, vitamin B-12, or vitamin E can result in ataxia, causing problems with balance and coordination. A healthy diet that includes a variety of foods is important for getting all the necessary nutrients.

5. Underlying Medical Conditions: Many other health issues can be connected to movement problems. Conditions like thyroid problems, multiple sclerosis, stroke, viral infections affecting the brain (encephalitis), and brain tumors can all cause movement disorders. These conditions disrupt the normal functioning of the brain and nervous system, leading to the symptoms.

6. Head Injuries: A blow to the head, or traumatic brain injury, can also cause movement disorders. The impact can damage the brain, affecting its ability to control movement.

Finding a Cause: For many people with movement disorders, doctors can't pinpoint a specific cause. When no clear reason is found, this is called an "idiopathic" movement disorder. This means the cause is unknown. Doctors work to understand the specific movement disorder and develop appropriate treatment plans, even when the exact cause remains unclear.

Some movement problems, like shaking (essential tremor), Huntington's disease, Wilson's disease, and Tourette syndrome, can run in families. If a parent has one of these conditions, their children may have a higher chance of developing it. This means there's a family link, and a genetic predisposition, that might make someone more susceptible.

Beyond family history, other things can raise your risk of movement disorders. For example, certain medical conditions, like thyroid problems, can sometimes lead to movement issues. Taking specific medications can also be a factor. Additionally, lifestyle choices play a role. Heavy alcohol use, drug use (like cocaine), and nutritional deficiencies—not getting enough essential vitamins—can all increase your risk of developing a movement disorder.

Finding the cause of movement problems starts with a visit to your doctor. They'll ask about your symptoms and medical history, and then do a physical exam.

Sometimes, more tests are needed to figure out what's causing the movement problems, or to rule out other possibilities. These tests might include:

• Blood tests: These can check for things like vitamin deficiencies, problems with your thyroid, or other medical conditions that could be affecting your movements.

• Genetic tests: If there's a possibility that a genetic condition is involved, your doctor might recommend genetic testing. This can look for specific genes that are linked to movement disorders.

• Imaging tests: These tests create pictures of the inside of your body. Common types include MRI (magnetic resonance imaging), CT (computed tomography), and PET (positron emission tomography) scans. These scans can help see if there are any physical problems in your brain or other parts of your body that might be causing the movement issues. Sometimes, a test called electromyography (EMG) is needed. EMG measures the electrical activity in your muscles.

• Other specialized tests: In some cases, a dopamine transporter (DAT) scan might be ordered. This scan is particularly helpful in diagnosing conditions that are similar to Parkinson's disease (called parkinsonism).

Essentially, your doctor uses a combination of a thorough evaluation and various tests to pinpoint the exact cause of your movement problems.