Movement Disorders

A group of nervous system (neurological) conditions that cause you to have abnormal voluntary or involuntary movements or slow, reduced movements is called movement disorders.

It can affect the speed, quality, ease and fluency of movement.

The signs and symptoms of movement disorders may vary depending on the type and severity of the condition, and this can be affected by the factors such as:

• stress,
• fatigue,
• anxiety,
• medication.

Abnormal movements may be:

• rhythmical such as essential tremor,
• or irregular, rapid and jerky like tics,
• or slowed and sustained such as Parkinson’s disease or dystonia.

Other movements cause:

• hyperkinesia which is the excessive spontaneous movement or abnormal involuntary movement,
• hypokinesia which is the absent or reduced ability to perform purposeful movement.

Irregular movements cannot be controlled or suppressed.

One of the causes of movement disorder is pathological changes in the brain especially in the area of the brain called basal ganglia. Basal ganglia is the part of the grey matter that lie deep within the brain.

There may be defects that can lead to difficulty in locomotion, maintenance of posture, walking and normal body balance.

Some of the people who have movement disorder are in their genes and some are widely prevalent.

If you are experiencing symptoms visit your doctor so he could run some tests to diagnose movement disorders. He may recommend you to a neurologist that specializes in managing disorders of the brain and nervous system.

Bring a family member or a close friend to support you and to help you remember information. Bring a notebook. Write down the symptoms that you are experiencing and when did it start. Write down the medications, supplements and vitamins that you are taking. You can also write down the major stresses in your life or previous changes in your life. You can ask your doctor these questions:

• What is likely causing my symptoms?
• Based on my symptoms, what kind of movement disorder do I have?
• Are there any treatments?
• What tests do I need?
• Is this a long term condition?
• What complications will occur?
• Is this hereditary?

Your doctor after doing a physical exam will likely ask you these questions:

• What symptoms are you experiencing?
• When did you start experiencing them?
• Are they severe?
• Is it occasional or consistent?

Your doctor will talk to you about your family history and do physical exams such as neurological examination and blood tests or imaging tests. In blood test, he will likely do a CBC or complete blood count, creatine kinase test and a DNA analysis. Sometimes they will give CSF or cerebrospinal fluid analysis that involves a spinal tap or lumbar puncture, about 2 tablespoons of CSF is drawn into a needle inserted between 2 lumbar vertebrae and then examined under a microscope.

He will also recommend imaging tests such as:

• computed tomography (CT scan),
• positron emission tomography (PET scan),
• magnetic resonance imaging (MRI scan)

to detect the structural abnormalities, damage in the basal ganglia or stroke.

He may also perform electromyogram (EMG) or electroencephalogram (EEG) to detect nerve and muscle disorders and to monitor electrical activity within the body.

In EMG, he will place electrodes on the skin (surface EMG) or into the muscle (intramuscular EMG) to record electrical activity of the muscles while in EEG, the electrodes are connected to a machine to record electrical impulses to the brain and are attached to the brain. He may also do a muscle biopsy that is performed under local anesthesia and making a small incision to remove a sample of the muscle for microscopic evaluation to distinguish between muscle and nerve disorders. About 1 week in this procedure, patients may experience pain and bruising.

There is no specific treatment for movement disorder, it depend on the underlying cause.

The treatment will relieve the symptoms that you are experiencing. It may include:

• medications like Antiepileptics such as carbamazepine (Tegretol), valproate (Depakote);
• Anti-seizure such as primidone (Mysoline), gabapentin (Neurontin);
• Beta-blockers such as propranolol (Inderal);
• Dopamine agonists such as bromocriptine (Parlodel), pergolide (Permax);
• Tranquilizers (benzodiazepines such as diazepam (Valium) and clonazepam (Klonopin),
• Botulinum toxin injection therapy (BOTOX therapy) may be recommended too, a potent neurotoxin is injected into a muscle to inhibit the release of neurotransmitters that cause muscle contraction.

When medications are ineffective, surgery may require for severe movement disorders. Surgery such as deep brain stimulation which uses a medical device (neurostimulator) to deliver electrical stimulation to the areas of the brain that controls movement; and abrasive surgery to locate and target then destroys the area of the brain that produces electrical impulses that cause abnormal movements. Other types of movement disorder uses speech therapy to improve the individual’s ability to communicate and swallow. You may also do physical therapy to improve mobility and restore function.

Movement disorders cannot be specifically prevented but you can follow these to prevent symptoms of movement disorders such as:

• have a healthy diet,
• drink supplements or vitamins to reduce symptoms associated with neurological disorders,
• avoid caffeine and alcohol,
• do not use drugs,
• avoid the use of drugs,
• look out for potential food allergies for it may contribute factor in neurological imbalance,
• avoid refined foods with high sugar content like soft drinks and candy for it may contribute to worsening the symptoms of neurological disorders,
• avoid foods that are hard to swallow as it may cause choking,
• exercise regularly to lessen and slow the progression of symptoms.

Homeopathic remedies used for movement disorder varies depending on what type of movement disorder you have, your symptoms and how severe are they.

For example in Parkinson’s disease, you can use Rhus-tox, Gelsemium, Cocculus or Lathyrus.

Consult first with your neurologist if you want to use alternative remedies.

Lifestyle modifications are necessary in order to cope with movement disorders.

Regular exercise and proper diet is important with people who have movement disorders.

If you are choking when you’re eating, swallowing therapy might be helpful. Maximize physical activity.

Physical therapy may help them in adaptive strategies.

If you have trouble balancing or walking, you can wear padding and sturdy shoes that fit well to protect you against injury from falls.

The risk factors of movement disorders are:

• age. the age of symptom onset is typically before the age of 18,
• sex, depending on what type of movements disorder you have,
• genetics, one or both parents can have the gene and pass it on to their children.

Some individuals may carry the gene but not exhibit symptoms of the neurological condition while some movement disorders are due to inheriting genes that carry the genetic condition.