A movement disorder is one of the many diseases or conditions of the brain (epilepsy excluded) that adversely affects the production or control of bodily movements. The effect might be of the quantity or quality of voluntary movements or the occurrence of involuntary movements, depending on the disorder. The characteristic signs and symptoms often define a disorder. A list and the meanings of the more common signs and symptoms are as follows.
Akathisia – A feeling of inner restlessness and the inability to sit or stand still. A person with it may fidget, rock back and forth, cross and uncrossed the legs, etc. while sitting. It standing the person with it might involuntarily march in place. Sometimes the person will make purposeless noises such as moaning.
Asynergia (Asynergy) – The absence of coordination among muscle groups that usually work together during the performance of complex movements such that there is a loss of skill and speed. It occurs with disease or injury to the cerebellum.
Ataxic gait – A manner of walking that is unsteady and swaying or staggering, usually with the feet widely apart. It is indicative of disease or injury of the cerebellum.
Blepharospasm – A form of focal dystonia of the muscles surrounding the eyes resulting in rapid blinking or even sustained, sometimes forceful, eyelid closure.
Chorea –Rapid, involuntary, repetitive, brief and irregular movements that start in one part of the body and move abruptly and unpredictably to another part. It typically involves the face, mouth, trunk and limbs.
Dysmetria – A form of ataxia in which there is the tendency for a patient to overshoot or undershoot the finger target when performing a back and forth pointing test maneuver in which the targets are the patient’s nose and the examiners finger. It is a sign of a disorder of the cerebellum.
Dystonia –Involuntary painful, muscle contractions (cramps) that result in usually sustained and repetitive abnormal, often twisting, movements and postures. It can affect one part of the body such as a limb(s), the neck, face, or vocal cords and often spreads to other parts. At the onset the abnormal movements usually occur only with voluntary activity of the affected body part. But as it worsens the dystonic movements can occur in the affected body part even when it is at rest. The condition can be a manifestation of Parkinson disease or other basal ganglia disorders. It also often occurs without a known cause.
Freezing – A brief period of not being able to move, which most commonly occurs with Parkinson’s disease. It may affect walking or other activities such as dressing, writing, eating, etc. When it affects walking it is as if the person’s feet are suddenly stuck in glue.
Hemiballismus – A form of chorea usually involving violent involuntary flinging of one arm and/or leg. The movements are wider and more intense than regular chorea though.
Hemifacial spasm – Brief, rapid, repetitive spasms sometimes mixed with periods of sustained or absent spasms involving one side of the face. Voluntary facial movements such as smiling often trigger it. Sometimes the cause is pressure on the facial nerve from a nearby blood vessel.
Rigidity – Sustained increase in muscle tone in a part of the body, causing it to be stiff and resistant to movement. There are basically two types of rigidity. They are lead-pipe and cogwheel rigidity.
Cogwheel rigidity – there is alternating compliance and resistance causing the affected limb to give way in little jerks during passive movement. As a result limb movement with this type of rigidity is ratchety (ratchet-like), jerky, or irregular.
Cogwheeling – is a sign of the rigidity of Parkinson’s disease that a doctor detects on a physical examination. It is not a symptom that a patient notices. It is most detectable during passive rotary movements of the hand or foot at the wrist or ankle joint respectively.
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Spasmodic dysphonia – Is a form of dystonia involving the muscles that control the vocal cords which results in speech difficulties. As those muscles go into spasm or contract the vocal cords become too close or too far apart during speaking. This may cause the voice to be jerky, quivery, broken or interrupted, hoarse, raspy, strained, or strangled. There might even be periods of no sound at all as well as periods when the voice quality is near normal.
Tardive dyskinesia – Is a syndrome of repetitive, involuntary, purposeless body movements caused by certain medications. Some of the more common such movements are tongue protruding, lip smacking and grimacing. The medications that can cause it include:
- Some of the older psychiatric drugs for treatment of psychosis
- Metoclopramide for treatment of decreased peristalsis of the stomach and gastroesophageal sphincter dysfunction
- Some drugs for treatment of depression
- Levodopa for treatment of Parkinson disease
- Phenobarbital and Dilantin for treatment of some seizures
Tic – It is a repetitive movement or vocal sound with an irresistible urge to produce it. Although it is habitual and a person might be able to suppress it at times, it is involuntary and difficult to control. Examples of tics are the following:
- eye blinking
- nose twitching
- throat clearing
- profane uttering
Torticollis (Wryneck) – Is a form of focal dystonia involving spasm of neck muscles resulting in fixed or changing head and neck positions. Those positions can be lateral flexion (tilted to the side), rotation (twisted to the right or left), and or flexion (bent forward).