Movement disorders are group of neurological conditions in which there is either excessive voluntary or involuntary movement or reduced movement without any significant paralysis. Movement disorders can originate from dysfunction of brain, spinal cord, or nervous system throughout the body. All the three control almost all types of functions of body including involuntary as well as voluntary such as breathing, speech, walking, moving, swallowing etc.
There are hundreds of movement disorders, and most of them are caused due to genetics, injury, tumor in brain, infection in nervous system, external toxins, metabolic conditions etc.Movement disorder can be hyperkinetic (increased movement), hypokinetic (decreased movement), ataxia (jerky), dyskenesia (inability to perform voluntary movement) etc.
Patients suffering from movement disorders can experience several symptoms which include tremor, jerks, spasm, tics, dystonia, chorea etc. Treatment of movement disorder is aimed at correcting the underlying cause. The resultant effect will depend on the type of movement disorder and its underlying cause.
What Are The Causes Of Movement Disorders?
Movement disorder is a neurological condition. The disorder mainly affects the quality of movement, its speed and smoothness. The pathophysiology basically lies in the brain especially in the area called basal ganglia.This part of brain lies in the cerebrum which controls all the movement and posture. It is also therefore referred as extra pyramidal.
There are several causative factors that may lead to movement disorder:
- Genetic: A defect in certain genes can be inherited from parents. The best example is Huntington’s disease. In this condition patient has movement disorder due to defect in the 4th chromosome.
- Degenerative diseases of brain: The best example is Parkinson’s disease. In this condition, particular cells in basal ganglia are reduced. Their function is to produce dopamine which acts as a chemical messenger between the brain cells. Mostly the disease is genetically oriented. But sometimes exposure to pesticides and heavy minerals for a long time can produce this condition.
- Alcohol consumption can cause abnormal movement. It may cause loss of balance and coordination.
- Stress and anxiety is known to produce abnormal movement. It mainly produces tremors, change in voice etc.
- Certain drugs are known to cause movement disorder. In some people this may be a side effect of certain drugs such as phenothiazine, haloperidol or lithium. All the mentioned are antipsychotic medications that are meant to treat psychiatric illnesses. Sometimes anti vomiting medicines such as metoclopramide can also produce extra pyramidal symptoms.
- Infections: Viral infections such as encephalitis, Japanese B encephalitis, subacute sclerosing panencephalitis can cause movement troubles.
Most Common Type Of Movement Disorders
Movement disorder can manifest in several different types. They can be hyperkinetic, hypokinetic. Hyperkinetic movement includes tremor, chorea, athetosis, myoclonus, tics, dyskinesias. During sleep, movement disorder symptoms vanish.
- Tremor: It is most common movement disorder. It can be defined as involuntary, repetitive, regular, shaking of the body part about a fixed axis. Tremor can occur during rest as in case of Parkinson’s tremor. Postural tremors can occur when the body is against gravity. Anxiety, caffeine intake, too much fatigue can lead to such tremors. Patient often complains of difficulty in writing, pouring tea into the cup, holding an object etc.
- Tics: They are twitches occurring in group of muscles. They occur repeatedly. Tics usually occur in areas of head, eyes, neck, and upper extremities.
- Dystonia: Dystonia develops as a sustained contraction of muscle frequently leading to twisting and repetitive movement. It can affect single part of body such as eyelids, upper limb as writer’s cramp, face and mouth. It causes involuntary closing of eyelids and blinking.
- Dysphonia: In this type the muscles involved in voice production move abnormally. This may cause hoarse, quirky, and jerky voice.
- Atxia: In ataxia the regular movement such as walking and running is affected. There is loss of coordination and balance.
- Chorea: The word chorea is derived from Greek word meaning ‘dance’. In this type of movement disorder, there is irregular, unpredictable, jerky, movement pass on from one part of body to another.
- Athetosis: Slow and uncontrollable movement of limbs.
- Rigidity: In this type the muscles become extremely rigid, especially when the affected part of body usually any limb is pulled with force.
Treatment For Movement Disorders
There are many types of movement disorders. Each may need separate attention. However, most of the movement disorders have same medications.
- Medications used are: Anticonvulsants, beta blockers, tranquilizers, dopamine agonists.
- Patient may need medicines to alleviate depression and certain obsessive compulsive disorder.
- Most important is proper intake of nutrition and diet. In some cases where swallowing is difficult, food may be given in soft pureed form. Repeated suction from mouth will prevent increased amount of mucus.
- Speech therapy, physical therapy is beneficial.
- Acupressure and acupuncture is also beneficial.