Movement Disorders

TRAPPED INSIDE YOUR OWN BODY?

Neurological conditions that affect the speed of movement, abnormal fluency, ease of movement, or may involve excessive or involuntary movement, or slowed or absent voluntary movement…

Movement Disorders

“I began experiencing serious fatigue and difficulties with my handwriting. These symptoms interfered with my ability to teach and participate actively in the classroom, and I sought medical attention.

I was started on a study medication as a last effort to quell the progression of my symptoms. Then the study was stopped, leaving me completely disabled, no longer able to walk or take care of normal household chores. Also, I lost all expression in my voice and face. I was 39 years old and unable to care for myself. I felt discouraged. This was not what I had expected my life to be…”

A movement disorder can be defined as any disease or injury that interferes with a person’s movement. By this definition, paralysis could be considered a movement disorder. However, movement disorders typically refer to conditions such as Parkinson’s disease, essential tremor or tremor due to problems with a part of the brain called the cerebellum. For example, some patients with multiple sclerosis, which harms nerve fibers in the brain, will have severe tremor.

Movement disorders are neurological conditions that affect the speed, fluency, quality, and ease of movement. Abnormal fluency or speed of movement (dyskinesia) may involve excessive or involuntary movement (hyperkinesia) or slowed and/or absent voluntary movement (hypokinesia).

Movement disorders include the following conditions:

1) Dystonia — A neurological disorder that causes repetitive, involuntary muscle contractions that can last from a few seconds to years. Various parts of the body can be affected, including the arms, legs, torso, neck, and eyelids. The movements can cause twisting, abnormal positions, pain, and disability. Dystonias usually do not impair the patient’s cognitive ability (i.e., reasoning, judgment, memory) or intelligence.

2) Huntington’s Disease — A fatal hereditary disease that destroys neurons in areas of the brain involved in the emotions, intellect, and movement. The course of Huntington’s is characterized by jerking uncontrollable movement of the limbs, trunk, and face (chorea); progressive loss of mental abilities; and the development of psychiatric problems. Huntington’s disease progresses without remission over 10 to 25 years and patients ultimately are unable to care for themselves. Huntington’s disease usually appears in middle age (30-50 years), but can develop in younger and older people.

3) Parkinson’s Disease — A chronic, progressive neurodegenerative movement disorder. Tremors, rigidity, slow movement (bradykinesia), poor balance, and difficulty walking (called parkinsonian gait) are characteristically the primary symptoms of Parkinson’s disease. Parkinson’s results from the degeneration of dopamine-producing nerve cells in the brain, specifically in the substantia nigra and the locus coeruleus. Dopamine is a neurotransmitter that stimulates motor neurons, those nerve cells that control the muscles. When dopamine production is depleted, the motor system nerves are unable to control movement and coordination. Parkinson’s disease patients have lost 80% or more of their dopamine-producing cells by the time symptoms appear.

4) Restless Leg Syndrome (RLS) (e.g., periodic limb movement disorder (PLMD) — A common condition which causes pain and discomfort and prevents healthy sleeping patterns in sufferers. If you often feel an urge to move your legs when sitting or lying still for a long time, experience a “funny,” uncomfortable, creepy or itchy sensation in your legs when at rest, or have ever woken yourself or your partner up during the night with jerking movements of your legs you may very well have Restless Leg Syndrome or RLS.

5) Tics — Involuntary muscle contractions which can create sudden, painless, non-rhythmic behaviors that are either motor (related to movement) or vocal and that appear out of context—for example, knee bends in science class. They are fairly common in childhood. In the vast majority of cases, they are temporary conditions that resolve on their own. In some children; however, the tics persist over time, becoming more complex and severe.

6) Tourette’s Syndrome — An inherited disorder characterized by multiple motor and vocal tics (repeated muscle contractions). Symptoms of Tourette’s usually develop during childhood or early adolescence. Patients with the disorder often develop behavioral problems such as hyperactivity, inattention, impulsivity, obsessions, and compulsions. In most cases, symptoms vary in frequency and in severity.

7) Tremor (e.g., essential tremor, resting tremor) — Involuntary trembling in a specific part of the body. Essential tremor is associated with purposeful movement (e.g., holding a glass to drink, shaving, writing, or buttoning a shirt). It occurs most often in the hands and head and also may affect the arms, voice box (larynx), trunk, and legs. Essential tremor is caused by abnormalities in areas of the brain that control movement and does not occur as the result of disease (e.g., Parkinson’s disease). It usually does not result in serious complications.

8) Multiple Sclerosis — Common disease that tends to begin in young adulthood. Multiple sclerosis can affect any part of the central nervous system. When it affects the cerebellum or the cerebellum’s connections to other parts of the brain, severe tremors can result.

Signs & Symptoms of Movement Disorders:

Dystonia

Early Symptoms:

Begin in a single region, such as your foot or hand;
Occur with a specific action. For example, you may experience involuntary contractions in one leg — when walking forward, but not when running forward or walking backward;
Worsen with stress, fatigue or anxiety;
Plateau within a few years;

Progressed Symptoms:

Eyelids – Rapid blinking or squinting (blepharospasm) can be so severe as to make a person functionally blind;
Neck – Cervical dystonia may cause the head to twist and turn painfully to one side, or to pull forward or backwards;
Jaw and tongue – Oromandibular dystonia may cause slurred speech or difficulty eating or swallowing;
Hand and forearm – Writer’s cramp or musician’s cramp causes pain during a single repetitive motion, such as writing or playing an instrument;

Huntington’s Disease

Early Symptoms:

Depression;
Mood swings;
Forgetfulness;
Clumsiness;
Involuntary twitching;
Lack of coordination;

 

Progressed Symptoms:

Concentration and short-term memory diminish;
Involuntary movements of the head, trunk and limbs increase;
Walking, speaking and swallowing abilities deteriorate;
Unable to care for him or herself;

Parkinson’s Disease

Early Symptoms:

Tremor, or trembling in hands, arms, legs, jaw, and face;
Rigidity, or stiffness of the limbs and trunk;
Bradykinesia, or slowness of movement;
Postural instability, or impaired balance and coordination;

Progressed Symptoms:

Depression and other emotional changes;
Difficulty in swallowing, chewing, and speaking;
Urinary problems or constipation;
Skin problems;
Sleep disruptions;

Restless Legs Syndrome

An irritating sensation in legs – Sensations can be painful or just uncomfortable. Feelings are described as creeping, crawling, tingling, and pulling. While people usually feel the sensations in the calf area, some feel them in the upper leg, the feet, the arms, or the hands;
An overwhelming urge to move – Getting up and moving around can relieve the discomfort;
Sensations that vary depending on position and time of day – Discomfort tends to increase when sitting or lying down and during the evening or night. These sensations can vary in intensity; some describe the sensations as merely bothersome or annoying, while others describe them as quite painful and feel them deep in the leg;
Visible movements in toes or feet – others may notice your feet or toes moving slightly or jerking when you are sitting still or resting;

Tics

Blinking;
Clearing the throat;
Facial twitching;
Grunting;
Shrugging the shoulders;
Sighing;

Tourette’s Syndrome

Early Symptoms:

Begins with simple muscle tics, such as grimacing, head jerking, and blinking;
Simple tics may be only a nervous habit and may disappear with time;
Such tics do not necessarily lead to Tourette’s Syndrome, which involves more than a simple tic;
For example, people with Tourette’s Syndrome may repeatedly move their head from side to side, blink their eyes, open their mouth, and stretch their neck;

Progressed Symptoms:

The disorder may progress to bursts of complex tics, including vocal tics, hitting, kicking, and sudden, irregular, jerky breathing;
Vocal tics may start as grunting, snorting, humming, or barking noises and progress to compulsive, involuntary bouts of cursing;
For no apparent reason and often in the midst of conversation, some people with Tourette’s Syndrome may call out obscenities or words related to feces (called coprolalia);
Often have difficulty functioning and experience considerable anxiety in social situations;
Impulsive, aggressive, and self-destructive behaviors develop in many people, and obsessive-compulsive behavior develops in about half;
Children with Tourette’s Syndrome often have difficulty learning;
Many also have attention-deficit/hyperactivity disorder;

Tremor

Intention tremors are slower types of tremors, so the movements look broader and coarse. Intention tremors can occur at rest, but usually increase with activity;
Essential tremors, however, are fairly quick, small movements. These most commonly affect the head and hands, but they may also affect other muscles. However, unless the tremor is very severe, the hands and arms usually do not shake when they are at rest;
Can be embarrassing because they can affect the person’s ability to write and eat;
Usually worsen when the person is stressed, tired, anxious, or affected by caffeine or other stimulants;
May cause the voice to shake if they affect the vocal cords;

Multiple Sclerosis

Tingling, numbness or painful sensations;
Slurred speech;
Blurred or double vision;
Muscle weakness;
Poor balance or coordination;
Muscle tightness or spasticity;
Tremors;
Paralysis which may be temporary or permanent;
Problems with bladder, bowel, or sexual function;
Fatigue;
Forgetfulness or difficulty concentrating;
Mood swings;
More susceptible to depression;