The Canadian Movement Disorder Group
Movement Disorder Definitions

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 also referred to as the rigid akinetic syndromes of which Parkinson's Disease would be the most typical example.

Hyperkinetic Disorders

Hypokinetic / Akinetic Rigid Syndromes / Parkinsonisms

Tremor

Parkinsonism

Dystonia

Parkinson's Disease

Myoclonus

Parkinson's "Plus"

Hemi-Facial Spasm

Stiff Person Syndrome

Hyperekplexia and other Startle Syndromes

Catatonia

Tics / Stereotypy

Psychomotor Retardation

Tourette's Syndrome

Akinetic Mutism

Chorea / Huntington's Disease

Others

Athetosis

Drug Induced Movement Disorders

Pseudo-athetosis

Restless Leg Syndrome

Hemiballismus

Periodic Leg Movements of Sleep

Dyskinesia

Akathisia

Synkinesia

Functional Movement Disorders

Mirror Movements

Ataxia

Painful Legs Moving Toes Syndrome

Paroxysmal Dyskinesias

 

Hereditary Spastic Paraparesis / Overlap Neuromuscular disorders

 

HYPERKINETIC MOVEMENT DISORDERS

Definitions

    TREMOR :  a rhythmic, oscillation of a body part

    DYSTONIA : an involuntary muscle contraction causing a sustained twisted or abnormal posture.

    MYOCLONUS: a lightening like jerk of a body part.

    HEMIFACIAL SPASM: an involuntary movement affecting muscles of facial expression on one side. The movement may be myoclonic or more sustained hence the term "spasm".

    STARTLE SYNDROMES: conditions associated with a excessive motor reaction (usually myoclonic) in response to a sudden unexpected noise, tactile or visual stimulus, additional term - Hyperekplexia.

    TIC: A stereotypic or patterned movement or utterance, that is frequently preceded by an urge to need to move, transient suppressibility, and post movement relief.

    TOURETTE'S SYNDROME: a familial, multi focal, motor and vocal tic disorder lasting longer than 12 months 

    STEREOTYPY: a recurrent or continuous, often rhythmic or patterned movement sometimes thought to be self stimulatory or compulsive.

    HUNTINGTON'S DISEASE: a familial, autosomal dominant (chromosome 4), progressive, neurodegenerative disorder characterized by disordered movement, mood and memory.

    CHOREA: Random, purposeless, fleeting movements, that flow from one body part to another.

    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".

    PSEUDO-ATHETOSIS: A slow writhing movement occurring in a limb that has a marked impairment of sensory function (deafferented). More evident with eyes closed.

    HEMIBALLISMUS: A high amplitude flailing (like throwing a ball) of the limbs on one side of the body.

    SYNKINESIA: An involuntary movement that occurs simultaneously with a voluntary movement.

    DYSKINESIA: "trouble moving". A general non specific term encompassing an abnormality of voluntary movement, typically due to a superimposed, hyperkinetic pattern of involuntary movement of varying types.

    MIRROR MOVEMENTS: a pattern whereby a voluntary movement on one side triggers a similar but involuntary movement on the other side. This can be seen in cases of Parkinson's disease and schizencephaly.

    PAINFUL TOES MOVING LEG SYNDROME: A writhing movement usually affecting the toes  occurring secondary to any condition that causes chronic foot or leg pain.

OTHERS:

    RESTLESS LEG SYNDROME : A syndrome where an uncomfortable feeling occurs in the legs during periods of relaxation - eg - lying still at night,  that creates an urge to move. This movement resolves the discomfort.

    PERIODIC LEG MOVMENTS OF SLEEP: A jerking, twisting, typically dystonic movement occurring typically every 20-30 seconds during sleep often associated with restless leg syndrome, which results in a disruption of sleep quality and results in daytime fatigue.

    AKATHISIA: a movement or utterance associated with an urge to move due to a subjective feeling of restlessness often relieved by lying down. Also described as an inability to tolerate inactivity resulting in a voluntary often stereotypic movement associated with this inner urge or restlessness.

    ATAXIA: a problem with balance causing an unsteadiness of gait and poor coordination of movement due to cerebellar dysfunction.

    PAROXYSMAL DYSKINESIAS: Involuntary movements that occur only intermittently. They can be triggered by movement (Kinesogenic) or be spontaneous (Nonkinesogenic).

HYPOKINETIC (Rigid Akinetic) MOVEMENT DISORDERS

    PARKINSON'S DISEASE: A neurodegenerative disease associated with slow movement (bradykinesia), muscle stiffness (rigidity) and tremor (typically at rest) along with non motor features (constipation, fatigue, loss of sense of smell, sleep disorders) thought in part to be predisposed to genetically and triggered by a variety of environmental influences.

    PARKINSON"S "PLUS" / PARKINSONISMS: Disorders characterized by Parkinsonian features but secondary to conditions in addition to Parkinson's disease and having different diagnostic criteria. eg. Drug induced, Parkinson's Disease, Progressive Supranuclear Palsy, Multiple System Atrophy, Cortical basal syndromes, Dementia with Lewy Bodies

    STIFF PERSON SYNDROME: An uncommon autoimmune disorder of spinal inhibitory interneuron function associated with anti-GAD antibodies, associated with an inability to relax affected muscles,  muscle stiffness, and intermittent spasms of varying severity.

    CATATONIA: A motor behavior, triggered by psychiatric or neurologic illness, which in its most typical form is associated with rigidity and a marked slowing of willed movement. Maintenance of abnormally positioned limbs for prolonged periods is characteristic. Less commonly it may be manifest by agitated undirected purposeless movements

    PSYCHOMOTOR RETARDATION: a slowing down of both motor function and thinking speed secondary to a diffuse physiologic abnormality including psychiatric (depression) and/or metabolic (hypothyroidism) causes, not typically describing a condition caused by a focal brain injury (see akinetic mutism).

    AKINETIC MUTISM: a syndrome of apparent severe apathy, secondary to widespread damage or dysfunction of the frontal lobes associated with a paucity of movement or speech in association with retention of consciousness and awareness.

     

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