Movement disorders: causes, symptoms and treatments

Movement disorders

The movement disorders are neurological conditions that affect a person's ability to control voluntary and involuntary movements. These disorders are caused by genetic factors, infections, medications or brain damage. There are different types of movement disorders, all with varying symptoms and severity. The following are descriptions of the main types of movement disorders:

Ataxia

The ataxia is a movement disorder characterised by the loss of coordination of voluntary muscle movements. People suffering from ataxia have difficulty walking, moving their hands and fingers, and maintaining balance. The causes of ataxia are diverse, including brain injury, genetic problems and infections.

Dystonia

The dystonia is a movement disorder that causes spasmodic contractions in the muscles, leading to abnormal postures and involuntary repetitive movements. The condition can affect any part of the body, including the neck, arms, legs or face. In some cases, dystonia may run in families or be caused by brain injury.

Huntington's disease

The Huntington's disease is an inherited, degenerative movement disorder that causes progressive loss of motor control, as well as cognitive and emotional problems. Symptoms of Huntington's disease usually appear in adulthood and worsen over time.

Parkinson's disease

The Parkinson's disease is a chronic, progressive movement disorder that affects the central nervous system. Symptoms of Parkinson's include tremors, muscle stiffness, slowness of movement and balance problems. The disease is caused by the breakdown of nerve cells in the brain that produce dopamine, a chemical that controls muscle movements.

Tourette Syndrome

The Tourette's syndrome is a movement disorder characterised by involuntary motor and vocal tics. The tics may be simple (such as winks or simple gestures) or complex (such as more elaborate movements or vocal sounds). Although the cause of Tourette syndrome is unknown, it is thought to be related to changes in the brain and may be inherited.

Tremor

The tremor is a movement disorder characterised by rhythmic involuntary movements. Tremor can occur in different parts of the body, including the hands, arms, head or legs, and can be triggered by certain emotions or stressful situations. Tremor can be a symptom of different diseases, such as Parkinson's disease or essential tremor.

Essential tremor

The essential tremor is a movement disorder in which a person experiences tremors affecting the hands, head and voice. These tremors are present during everyday activities and are not related to other diseases. The cause of essential tremor is unknown, although in some cases there is an inherited genetic determinant and it may be caused by changes in certain areas of the brain.

Causes of movement disorders

The exact cause of movement disorders can vary depending on the type of disorder present. Movement disorders can be inherited, caused by infection, medication or acquired brain damage. Some of the types of disorders are listed below.

Genetics

Some movement disorders, such as Huntington's disease, are caused by a genetic mutation inherited in a person. These mutations can be passed from parent to child.

Infections

Infections such as West Nile virus and Japanese encephalitis can also cause movement disorders. These infections can cause inflammation in the brain and damage nerve cells, resulting in movement problems.

Medicines

Some medications, such as antipsychotics and antivertiginants, can have the side effect of developing movement disorders. Prolonged use of these medicines can cause involuntary movements of the body.

Acquired brain damage

Movement disorders can also be caused by damage to the brain due to injuries such as head trauma and stroke. Brain damage can disrupt the brain's ability to send signals to the nervous system that control movement, resulting in movement disorders. 

Neurodegenerative diseases

In some cases, movement disorders are due to the progressive loss of certain neurons, diseases in which treatment is usually symptomatic, relieving symptoms and improving quality of life, but there is no curative treatment. 

Diagnosis of movement disorders

For diagnosing movement disordersa thorough medical evaluation is carried out. A neurologist or movement disorder specialist can evaluate the patient's medical history and perform a series of tests to establish an accurate diagnosis:

Neurological examinations

The specialist may perform a series of neurological tests to assess the patient's movement. These tests may include:

• Assessment of the speed of movement
• Assessment of movement coordination
• Balance assessment
• Reflex assessment

The specialist may also ask the patient about their medical and family history to determine if there is a genetic predisposition to certain movement disorders.

Medical tests

In addition to neurological examinations, specialised medical tests may be necessary to establish a diagnosis and rule out other conditions:

• Computed tomography (CT) or magnetic resonance imaging (MRI) scans to detect any structural abnormalities in the brain
  
  
• Electroencephalogram (EEG) to rule out an epileptic origin of the symptoms.
  
  
• Blood and urine tests to detect infections or alterations in hormone, metabolite and ion levels.
  
  
• Genetic testing for mutations in genes associated with certain movement disorders

Once an accurate diagnosis has been established, the specialist can recommend a treatment plan for the patient's movement disorders.

Treatment of movement disorders

The treatment of movement disorders may vary depending on the type and severity of the disorder. In some cases, it may be necessary to combine different types of treatments to achieve better results. In general, treatments can be divided into three categories: medication, deep brain stimulation and non-pharmacological therapies.

Medicines

Medications are a common treatment option for many movement disorders. These drugs can help reduce symptoms such as tremors, spasms and involuntary movements. Some of the most common medications to treat movement disorders include:

• Levodopa, which is used in the treatment of Parkinson's disease.
  
  
• Anticholinergics, which are used in the treatment of dystonia.
  
  
• Antipsychotics, which can help reduce the tics associated with Tourette's syndrome.
  
  
• Beta-blockers.

Deep brain stimulation

The deep brain stimulation is a treatment that has been used successfully to treat some movement disorders, such as Parkinson's disease and dystonia. The treatment involves implanting a device in the brain that sends electrical signals to help regulate the body's movements.

Surgery for device implantation is a major operation requiring general anaesthesia and a recovery period, but in many cases it can help to significantly reduce the symptoms associated with movement disorders.

Non-pharmacological therapies

In addition to medication and deep brain stimulation, there are a number of non-pharmacological therapies that can help alleviate the symptoms of movement disorders:

• Occupational therapy: focuses on the recovery of the ability to perform daily activities through training in adaptive techniques.
  
  
• Physiotherapy: helps to improve muscle strength, flexibility and balance, reducing the presence of many of the symptoms.
  
  
• Speech therapy: can help improve communication and speech ability in cases of speech disorders, such as those associated with Parkinson's disease and Tourette's syndrome.

It is important to find the right treatment for each individual patient. 

Awareness and care of movement disorders

The Awareness raising and medical care are essential to improve the quality of life of people with movement disorders. These disorders are neurological conditions that can severely affect a patient's daily life. It is important to raise awareness in society about these disorders and the importance of seeking medical help where necessary.

Non-pharmacological therapies

In addition to conventional pharmacological treatments, there are non-pharmacological therapies that can be effective in treating some movement disorders. Physiotherapy and occupational therapy can help patients improve their ability to perform daily activities, while speech and language therapy can improve the ability to speak and communicate. Yoga and tai chi may also be beneficial for some patients.