Definition & Overview
A healthy person seldom or rarely thinks about his or her ability to move the body. Walking, running, eating, brushing teeth, writing, typing, and breathing all seem to be automated. However, the body is prone to a number of conditions that can result in movement issues. When this occurs, simple tasks can be much more difficult or even seemingly impossible to perform.
Movement relies on different muscles located practically everywhere in the body. Controlling the muscles is possible because of the network of nerves that make up the nervous system, which originates from the brain and runs down the spinal cord where it branches out to every portion of the body.
Movement issues or disorders are likely caused by a problem with the nervous system and could be related to a disease or it may be functional, meaning that it’s not caused by damage to the nervous system due to disease or injury.
Functional movement disorders are usually described as tremors, twitches, spasms, or gait (walk) problems. Tremors usually occur in the extremities and are uncontrollable while twitches are a response to outside factors, such as loud noise. Spasms result in an abnormal posture of a limb, such as a clenched fist or twisted foot while gait problems are characterized by difficulty in walking, such as the dragging of a foot or weakness in a leg.
Non-functional movement disorders are a result of a disease or injury that affects the nervous system.
Cause of Condition
Quite a number of diseases result in movement disorders. Some of the most common are ataxia, dystonia, essential tremor, Huntington’s disease, multiple system atrophy (MSA), myoclonus, Parkinson’s disease, progressive supranuclear palsy (PSP), Rett syndrome, secondary parkinsonism, spasticity, tardive dyskinesia (TD), Tourette syndrome, and Wilson’s disease.
- Ataxia is a degenerative disorder of the spinal cord, brainstem, or brain that results in general clumsiness, instability, and difficulties in performing voluntary movements.
- Dystonia is a neurological muscle disorder caused by a problem with the basal ganglia, a deep part of the brain that enables muscle control.
- Essential tremor is quite a common condition and affects over 5 million people in the US alone. The condition is characterized by sudden tremors in the hands or feet while attempting to perform a basic movement.
- Huntington’s disease is a fatal degenerative disease that affects certain nerve cells in the brain causing uncontrollable movements of the limbs.
- Multiple system atrophy (MSA) is a neurodegenerative disease that results in abnormal blood pressure, problems with body functions, and a variety of movement issues.
- Myoclonus is described as the twitching or spasms of muscles or a group of muscles caused by diseases, such as Rett syndrome, Huntington’s disease, Celiac disease, and Angelman syndrome, to name a few.
- Parkinson’s disease affects the part of the brain that controls movement, called the substantia nigra.
- Progressive supranuclear palsy (PSP) is not as common as the other diseases but results in serious neurological problems that are often permanent. People with this condition display slow movement and difficulty in balancing, swallowing, and speaking.
- Rett syndrome is a neurodegenerative disorder that results in a variety of movement issues, such as irregular breathing, walking problems, seizures, and repetitive hand movements. People with this condition also usually display autistic-like behaviour and have a significantly reduced muscle tone.
- Secondary parkinsonism is similar to Parkinson’s disease but is usually a result of medication side effects.
- Spasticity is characterized by muscle contractions that make it difficult to walk, speak, or move the limbs.
- Tardive dyskinesia is a muscle disorder caused by prolonged use of certain medications. People with this condition usually display repetitive or involuntary movements of the hands, lips, facial muscles, or legs.
- Tourette syndrome is a hereditary neurological disorder that results in involuntary movements and difficulty in controlling vocal sounds.
- Wilson’s disease is a genetic disorder that not only results in a variety of movement problems, but also in abdominal and behavioural problems.
Every disease mentioned above has its corresponding symptoms, but the most common are involuntary movements of the arms, legs, hands, or feet. Some of the diseases can result in behavioural problems, such as aggression or suicidal tendencies. If the disease affects the brain, there is a high possibility that the person’s mental skills will be reduced.
Who to See and Types of Treatment Available
Although the majority of movement issues cannot be treated, consulting a doctor as soon as possible is crucial as available treatment can slow down the progression of the disease and allow for a certain degree of control of the muscles, making it possible to live an almost normal life.
Meanwhile, less serious movement issues that are not caused by a disease or injury to the brain, brainstem, or spinal cord, are typically temporary and in most cases, they resolve on their own without any medical treatment.
For other conditions, treatment will depend on the disease and the part of the nervous system it has affected. Most treatments will involve a variety of medications, but some will also require a surgical procedure. For example, people with dystonia will be treated using botulinum toxin (Botox) injections. Botox affects the communication between the nerves and the muscles, preventing sudden involuntary movements. If all else fails, surgery will be the last resort. Surgery would involve cutting the nerves or intentionally damaging certain portions of the brain to correct or manage the symptoms. Deep brain stimulation (DBS) has also been effective in some cases.
Family doctors can diagnose and provide treatment for a wide variety of movement issues. However, if the cause of the condition is a disease, the patient will be referred to a specialist.
Jankovic J, Lang AE. Movement disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 21.
Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 410.