Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity. Movement disorders present with extrapyramidal symptoms and are caused by basal ganglia disease. Movement disorders are conventionally divided into two major categories- hyperkinetic and hypokinetic.
| Movement disorder | |
|---|---|
| Specialty | Neurology Psychiatry |
Hyperkinetic movement disorders refer to dyskinesia, or excessive, often repetitive, involuntary movements that intrude upon the normal flow of motor activity.
Hypokinetic movement disorders fall into one of four subcategories: akinesia (lack of movement), hypokinesia (reduced amplitude of movements), bradykinesia (slow movement), and rigidity. In primary movement disorders, the abnormal movement is the primary manifestation of the disorder. In secondary movement disorders, the abnormal movement is a manifestation of another systemic or neurological disorder. Treatment depends upon the underlying disorder.
Classification
| Movement Disorders | ICD-9-CM | ICD-10-CM |
|---|---|---|
| Hypokinetic Movement disorders | ||
| Poliomyelitis, acute | 045 | A80 |
| Amyotrophic lateral sclerosis, ALS (Lou Gehrig's disease) | 335.20 | G12.21 |
| Parkinson's disease (Primary or Idiopathic Parkinsonism) | 332 | G20 |
| Secondary Parkinsonism | G21 | |
| Parkinson plus syndromes | ||
| Pantothenate kinase-associated neurodegeneration | G23.0 | |
| Progressive Supranuclear Ophthalmoplegia | G23.1 | |
| Striatonigral degeneration | G23.2 | |
| Multiple sclerosis | 340 | G35 |
| Radiation-induced polyneuropathy (brachial and lumbar plexopathies) | G62.82 | |
| Muscular dystrophy | 359.0 | G71.0 |
| Cerebral palsy | 343 | G80 |
| Rheumatoid arthritis | 714 | M05 |
| Hyperkinetic Movement disorders | ||
| GLUT1 deficiency syndrome | E74.810 | |
| Attention-deficit hyperactivity disorder (with hyperactivity) | 314.01 | F90 |
| Tic disorders (involuntary, compulsive, repetitive, stereotyped) | F95 | |
| Tourette's syndrome | F95.2 | |
| Stereotypic movement disorder | F98.5 | |
| Huntington's disease (Huntington's chorea) | 333.4 | G10 |
| Dystonia | G24 | |
| Drug induced dystonia | G24.0 | |
| Idiopathic familial dystonia | 333.6 | G24.1 |
| Idiopathic nonfamilial dystonia | 333.7 | G24.2 |
| Spasmodic torticollis | 333.83 | G24.3 |
| Idiopathic orofacial dystonia | G24.4 | |
| Blepharospasm | 333.81 | G24.5 |
| Other dystonias | G24.8 | |
| Other extrapyramidal movement disorders | G25 | |
| Essential tremor | 333.1 | G25.0 |
| Drug induced tremor | G25.1 | |
| Other specified form of tremor | G25.2 | |
| Myoclonus | 333.2 | G25.3 |
| Chorea (rapid, involuntary movement) | ||
| Drug induced chorea | G25.4 | |
| Drug-induced tics and tics of organic origin | 333.3 | G25.6 |
| Paroxysmal nocturnal limb movement | G25.80 | |
| Painful legs (or arms), moving toes (or fingers) syndrome | G25.81 | |
| Sporadic restless leg syndrome | G25.82 | |
| Familial restless leg syndrome | G25.83 | |
| Stiff-person syndrome | 333.91 | G25.84 |
| Ballismus (violent involuntary rapid and irregular movements) | G25.85 | |
| Hemiballismus (affecting only one side of the body) | G25.85 | |
| Myokymia, facial | G51.4 | |
| Neuromyotonia (Isaacs Syndrome) | 359.29 | G71.19 |
| Opsoclonus | 379.59 | H57 |
| Rheumatic chorea (Sydenham's chorea) | I02 | |
| Abnormal head movements | R25.0 | |
| Tremor unspecified | R25.1 | |
| Cramp and spasm | R25.2 | |
| Fasciculation | R25.3 | |
| Athetosis (contorted torsion or twisting) | 333.71 | R25.8 |
| Dyskinesia (abnormal, involuntary movement) | ||
| Tardive dyskinesia | ||
Diagnosis
Step I : Decide the dominant type of movement disorder
Step II : Make differential diagnosis of the particular disorder[citation needed]
Step II: Confirm the diagnosis by lab tests[citation needed]
- Metabolic screening
- Microbiology
- Immunology
- CSF examination
- Genetics
- Imaging
- Neurophysiological tests
- Pharmacological tests
History
Vesalius and Piccolomini in 16th century distinguished subcortical nuclei from cortex and white matter. However Willis' conceptualized the corpus striatum as the seat of motor power in the late 17th century. In mid-19th-century movement disorders were localized to striatum by Choreaby Broadbent and Jackson, and athetosis by Hammond. By the late 19th century, many movement disorders were described, but for most no pathologic correlate was known.
References
- Fahn, Stanley; Jankovic, Joseph; Hallett, Mark (2011-08-09). Principles and Practice of Movement Disorders. Elsevier Health Sciences. ISBN 978-1437737707.
- Bradley, Walter George (2004-01-01). Neurology in Clinical Practice: Principles of diagnosis and management. Taylor & Francis. ISBN 9789997625885.
- Flemming, Kelly; Jones, Lyell (2015-06-15). Mayo Clinic Neurology Board Review: Clinical Neurology for Initial Certification and MOC. Oxford University Press. ISBN 9780190244934.
- "MedlinePlus: Movement Disorders".
- Singer, Harvey S.; Mink, Jonathan; Gilbert, Donald L.; Jankovic, Joseph (2015-10-27). Movement Disorders in Childhood. Academic Press. ISBN 9780124115804.
- "Debilitating Diseases – 12 Diseases that change millions of lives". dodgepark.com. Dodge Park. 2 December 2013. Retrieved 14 March 2024.
- Poewe, Werner; Jankovic, Joseph (2014-02-20). Movement Disorders in Neurologic and Systemic Disease. Cambridge University Press. ISBN 9781107024618.
- Lanska, Douglas J. (2010-01-01). "Chapter 33 the history of movement disorders". History of Neurology. Handbook of Clinical Neurology. Vol. 95. pp. 501–546. doi:10.1016/S0072-9752(08)02133-7. ISBN 9780444520098. ISSN 0072-9752. PMID 19892136.
External links
Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements unrelated to weakness or spasticity Movement disorders present with extrapyramidal symptoms and are caused by basal ganglia disease Movement disorders are conventionally divided into two major categories hyperkinetic and hypokinetic Movement disorderSpecialtyNeurology Psychiatry Hyperkinetic movement disorders refer to dyskinesia or excessive often repetitive involuntary movements that intrude upon the normal flow of motor activity Hypokinetic movement disorders fall into one of four subcategories akinesia lack of movement hypokinesia reduced amplitude of movements bradykinesia slow movement and rigidity In primary movement disorders the abnormal movement is the primary manifestation of the disorder In secondary movement disorders the abnormal movement is a manifestation of another systemic or neurological disorder Treatment depends upon the underlying disorder ClassificationMovement Disorders ICD 9 CM ICD 10 CMHypokinetic Movement disordersPoliomyelitis acute 045 A80Amyotrophic lateral sclerosis ALS Lou Gehrig s disease 335 20 G12 21Parkinson s disease Primary or Idiopathic Parkinsonism 332 G20Secondary Parkinsonism G21Parkinson plus syndromesPantothenate kinase associated neurodegeneration G23 0Progressive Supranuclear Ophthalmoplegia G23 1Striatonigral degeneration G23 2Multiple sclerosis 340 G35Radiation induced polyneuropathy brachial and lumbar plexopathies G62 82Muscular dystrophy 359 0 G71 0Cerebral palsy 343 G80Rheumatoid arthritis 714 M05Hyperkinetic Movement disordersGLUT1 deficiency syndrome E74 810Attention deficit hyperactivity disorder with hyperactivity 314 01 F90Tic disorders involuntary compulsive repetitive stereotyped F95Tourette s syndrome F95 2Stereotypic movement disorder F98 5Huntington s disease Huntington s chorea 333 4 G10Dystonia G24Drug induced dystonia G24 0Idiopathic familial dystonia 333 6 G24 1Idiopathic nonfamilial dystonia 333 7 G24 2Spasmodic torticollis 333 83 G24 3Idiopathic orofacial dystonia G24 4Blepharospasm 333 81 G24 5Other dystonias G24 8Other extrapyramidal movement disorders G25Essential tremor 333 1 G25 0Drug induced tremor G25 1Other specified form of tremor G25 2Myoclonus 333 2 G25 3Chorea rapid involuntary movement Drug induced chorea G25 4Drug induced tics and tics of organic origin 333 3 G25 6Paroxysmal nocturnal limb movement G25 80Painful legs or arms moving toes or fingers syndrome G25 81Sporadic restless leg syndrome G25 82Familial restless leg syndrome G25 83Stiff person syndrome 333 91 G25 84Ballismus violent involuntary rapid and irregular movements G25 85Hemiballismus affecting only one side of the body G25 85Myokymia facial G51 4Neuromyotonia Isaacs Syndrome 359 29 G71 19Opsoclonus 379 59 H57Rheumatic chorea Sydenham s chorea I02Abnormal head movements R25 0Tremor unspecified R25 1Cramp and spasm R25 2Fasciculation R25 3Athetosis contorted torsion or twisting 333 71 R25 8Dyskinesia abnormal involuntary movement Tardive dyskinesiaDiagnosisStep I Decide the dominant type of movement disorder Step II Make differential diagnosis of the particular disorder citation needed Step II Confirm the diagnosis by lab tests citation needed Metabolic screening Microbiology Immunology CSF examination Genetics Imaging Neurophysiological tests Pharmacological testsHistoryVesalius and Piccolomini in 16th century distinguished subcortical nuclei from cortex and white matter However Willis conceptualized the corpus striatum as the seat of motor power in the late 17th century In mid 19th century movement disorders were localized to striatum by Choreaby Broadbent and Jackson and athetosis by Hammond By the late 19th century many movement disorders were described but for most no pathologic correlate was known ReferencesFahn Stanley Jankovic Joseph Hallett Mark 2011 08 09 Principles and Practice of Movement Disorders Elsevier Health Sciences ISBN 978 1437737707 Bradley Walter George 2004 01 01 Neurology in Clinical Practice Principles of diagnosis and management Taylor amp Francis ISBN 9789997625885 Flemming Kelly Jones Lyell 2015 06 15 Mayo Clinic Neurology Board Review Clinical Neurology for Initial Certification and MOC Oxford University Press ISBN 9780190244934 MedlinePlus Movement Disorders Singer Harvey S Mink Jonathan Gilbert Donald L Jankovic Joseph 2015 10 27 Movement Disorders in Childhood Academic Press ISBN 9780124115804 Debilitating Diseases 12 Diseases that change millions of lives dodgepark com Dodge Park 2 December 2013 Retrieved 14 March 2024 Poewe Werner Jankovic Joseph 2014 02 20 Movement Disorders in Neurologic and Systemic Disease Cambridge University Press ISBN 9781107024618 Lanska Douglas J 2010 01 01 Chapter 33 the history of movement disorders History of Neurology Handbook of Clinical Neurology Vol 95 pp 501 546 doi 10 1016 S0072 9752 08 02133 7 ISBN 9780444520098 ISSN 0072 9752 PMID 19892136 External links
