| Movement Disorders |
| Type | Comments |
| Tremor | Essential tremor presentationmost commonly affects the hands or armstypically bilateralcan cause functional impairmentthe tremor worsens with stress and improves withalcoholβ-blockersoften familial with anautosomal dominant inheritance patterntreatmentβ-blockers (e.g., propranolol) primidonePhysiologic tremorpresentationaffects all people but may become visible withcaffeinebeta-agonistshypoglycemiaanxietyexcitementalcohol and opioid withdrawalthyrotoxicosistreatmentdependent on etiologye.g., decrease caffeine intakeIntention tremor presentationappendicular ataxiawhen using their extremity towards a target there isirregular and oscillating moevmentassociated with cerebellar disordersResting tremor presentationtremor that occurs when the limbs are relaxedcan be best observed when distracting the patienttremor improves when the patient moves their limbscan be described as “pill rolling”this is an important of Parkinson’s disease |
| Dystonia | Presentationsustained or slowed abnormal positions of the limb, trunk, or faceexamples of dystonia includetorticollisblepharospasmspasmodic dysphoniawriter’s crampBelieved to be due to dysfunction of thebasal ganglia Treatmentmany cases have a good response tobotulinum toxin injection |
| Myoclonus | Presentationrapid muscular jerk that can be due to multiple causesseizuree.g., juvenile myoclonic epilepsyanoxi brain injuryencephalitistoxic or metabolic encephalopathyparaneoplastic syndromesCreutzfeldt-Jakob disease |
| Chorea | Presentationdance-like involuntary movement An important cause of chorea isHuntingon’s disease |
| Athetosis | Presentationwrithing and twisting movementof the limbs, face, and trunkthat can merge with chorea to formchoreoathetosis |
| Ballismus | Presentationrotatory or flinging movement of the proximal limb musclesThe most common type of ballismus ishemiballismuscontralateral extremity flinging movement secondary toa lesion (e.g., lacunar stroke) to the subthalamic nucleus |
| Tics | Presentationa sudden and brief movement that is preceded byan urge that is then relieved afterthe movement is performedThe types of tics includemotor ticsvocal ticse.g., barking-like noises and coprolaliaAn important syndrome to know isTourette’s syndrome |
