Movement Disorders

Movement disorders are a group of neurological conditions that cause abnormal movements. They could be increased movement (like spasms, jerking or shaking) and/or decreased or slow movement. They can affect actions you choose to make (voluntary) or cause uncontrolled (involuntary) movements.

Every body movement you make, from lifting your leg to moving your jaw and tongue to talk, involves complex communication between your:

• Central nervous system (your brain and spinal cord).
• Motor nerves.
• Skeletal muscles.

Damage to or malfunction of the areas of your brain that control movement results in a movement disorder.

There are several different movement disorders, and they vary in severity. Some only affect one area of your body, while others can affect most of your body. Some may interfere with certain tasks, like writing, while others can lead to issues with walking and mobility.

Abnormal movements may be the only part of a condition, such as in essential tremor. Or they can be one of several symptoms or syndromes, like in Parkinson’s disease (PD). In addition, certain movement disorders can be both a condition by themselves and a symptom of other conditions, like myoclonus.

It’s important to note that conditions that result in a lack of movement (like paralysis) or weakened muscles (such as muscular dystrophy) aren’t considered movement disorders even though they affect mobility. Movement disorders cause abnormal, unwanted movements.

What are the types of abnormal movements?

There are two main types of abnormal movements:

• Hyperkinetic movement.
• Hypokinetic movement.

A movement disorder can have both of these or just one.

Hyperkinetic movement

Hyperkinetic movement disorders involve increased movement. “Hyper” means “over” or “beyond,” and “kinetic” means “motion.” It can affect voluntary movement (actions you choose to take) or cause involuntary movement (actions that are out of your control).

Types of hyperkinetic movement include:

• Akathisia: Akathisia makes it difficult to sit or remain still due to inner restlessness. Akathisia is associated with the use of certain types of medications, especially antipsychotic (neuroleptic) medications.
• Ataxia: Ataxia is when you have a problem with coordination, causing you to move in an uncertain, awkward or even clumsy way. Ataxia can be a condition or a symptom of another condition. It’s much more common as a symptom.
• Chorea, athetosis and ballism: Chorea is a movement disorder that causes involuntary, unpredictable muscle movements. The disorder can make you look like you’re dancing, restless or fidgety. It’s common in Huntington’s disease. Athetosis is a continuous stream of slow, twisting or squirming-like motions usually involving your hands and feet. Ballism usually involves more intense movements, such as forceful flinging of one arm or leg.
• Dystonia: Dystonia is sustained or intermittent muscle contractions causing abnormal, often repetitive movements or postures. Dystonia is a common symptom of cerebral palsy and several neurodegenerative conditions.
• Myoclonus: Myoclonus is brief, involuntary muscle twitching or jerking. People who experience myoclonic twitches or jerks have muscles that unexpectedly tighten (positive myoclonus) or relax (negative myoclonus).
• Spasticity: Spasticity is a disruption in muscle movement patterns that causes certain muscles to contract all at once when you try to move or even at rest. It interferes with movement and can also affect your speech and how you walk (gait).
• Stereotypies (stereotypic movements): Stereotypies are complex and usually bilateral (both sides of your body) movements. They’re patterned and look the same or very similar each time. Examples include rocking, hand flapping, pacing and body clenching. Stereotypies can be a feature of many conditions, including autism spectrum disorder and Rett syndrome.
• Tics: Tics are patterned, repetitive, nonrhythmic movements. Simple tics are brief and involve a small cluster of muscles. Examples include blinking, face scrunching, head jerking, throat clearing and grunting. Complex tics may last longer and involve more muscles. Examples include hopping and saying certain words or phrases. Tics are a part of Tourette’s syndrome but can be present in other conditions.
• Tremor: Tremor involves involuntary trembling or shaking movements. The movements may be in one or more parts of your body. Tremors happen when your muscles repeatedly contract and relax.

Hypokinetic movement

Hypokinetic movement disorders involve decreased or slow movement. “Hypo” means “below” or “beneath.” It generally affects voluntary movement.

Parkinsonism is the main type of hypokinetic movement. It’s an umbrella term that refers to brain conditions that cause slowed movements, rigidity (stiffness), tremor or balance trouble.

Neurodegenerative parkinsonism most commonly happens with Parkinson’s disease, but it can also be a feature of the following conditions:

• Multiple system atrophy.
• Corticobasal degeneration.
• Progressive supranuclear palsy.
• Lewy body dementia.

Parkinsonism can also develop due to repeated head injuries, toxic substances, use of psychiatric medications and a lack of blood flow to certain areas of your brain.

Bradykinesia is another hypokinetic movement. It involves slowness of movement and speed or progressive hesitations or halts as you continue movements. It’s one of the main signs of Parkinson’s disease.

What are the types of movement disorders?

There are several movement disorders. Some include:

• Essential tremor: Essential tremor causes parts of your body to shake uncontrollably. It usually affects your hands and arms but can also affect your head, voice and other body parts.
• Huntington’s disease: Huntington’s disease is a genetic condition that affects your brain, causing unsteady and uncontrollable movements (chorea) in your hands, feet and face. Symptoms get worse over time.
• Multiple system atrophy (MSA): MSA is a rare condition that causes certain brain areas to deteriorate. It may cause ataxia and parkinsonism.
• Parkinson’s disease: Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements and difficulty with balance and coordination. It also causes cognitive (mental) decline.
• Periodic limb movement disorder (PLMD): PLMD involves repetitive limb movements that occur during sleep and may cause sleep disruption. The limb movements usually involve your lower extremities, consisting of extension of your big toe and flexion of your ankle, knee and hip.
• Progressive supranuclear palsy (PSP): PSP is a rare neurodegenerative disorder that damages certain areas of your brain. It affects how you walk, think, swallow and move your eyes.
• Restless leg syndrome (RLS): RLS is a sleep disorder that causes an intense, often irresistible urge to move your legs (and even your arms or body). It occurs along with other sensations in your limbs like pulling, creeping, tugging, throbbing, itching, aching, burning or crawling.
• Rett syndrome: Rett syndrome is a rare genetic condition that affects speech, purposeful hand use and coordination.
• Tardive dyskinesia: Tardive dyskinesia can result from taking antipsychotic (neuroleptic) medications for many years. It can cause involuntary facial tics. It can also cause uncontrollable movements like lip-smacking.
• Tourette syndrome: Tourette syndrome is a neurological disorder that affects your brain and nerves. It causes you to make sudden movements or sounds (tics) and is accompanied by anxiety, ADHD and often obsessive-compulsive disorder.
• Wilson disease: Wilson disease is a rare genetic condition that happens when your body accumulates too much copper, especially in your liver and brain. It can cause stiff muscles, tremors and uncontrolled movements.