Movement disorders: Information & movement disorder specialists

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Doctors summarize disorders of movement coordination under the collective term ataxia. The term is derived from the Greek 'ataxia' for 'disorder'. Ataxia is usually caused by impaired communication between the movement centers, i.e. between the cerebellum, the spinal cord and the connections between them. In any case, the interplay of movement sequences in ataxia is disturbed temporarily, permanently or recurrently. Here you will find further information as well as selected specialists and centers for movement disorders.

ICD codes for this diseases: F44.4, F98.4, G25, R25

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Article overview

What are the symptoms of movement disorders?

The symptoms of a movement disorder vary depending on which part of the body is affected by the ataxia. Doctors therefore differentiate between the following clinical pictures:

  • Gait ataxia
  • trunk ataxia
  • Limb ataxia
  • Dysarthria
  • Optic ataxia
  • Dystonia

With gait ataxia, those affected suffer from an unsteady gait that is often very small-stepped or wide-legged.

Trunk ataxia primarily affects sitting and standing upright. Without support, this is not or hardly possible.

If fine movements in particular - such as writing - are impaired, this is limb ataxia.

Problems with speaking are also considered a movement disorder. In this case, the doctor speaks of dysarthria, which is usually accompanied by slow, choppy and/or slurred speech.

Another form of movement disorder is visual ataxia. In this case, those affected are unable to perform targeted hand movements under eye control.

Dystonia, also known as dystonic movement disorder, is caused by prolonged muscle tension that cannot be consciously controlled.

Doctors distinguish between different forms of dystonia:

  • idiopathic,
  • symptomatic and
  • genetic.

While no specific trigger can be found for idiopathic dystonia, symptomatic dystonia occurs as a symptom of another disease. Genetic dystonia is the result of a hereditary predisposition.

Depending on the type and severity of the movement disorder, accompanying symptoms may occur, for example

Causes and risk factors

The cause of a movement disorder usually lies in the cerebellum. The following triggers are possible:

Zitternde Hand
Parkinson's disease causes limb ataxia © Alessandro Grandini | AdobeStock

    Intoxication can also be associated with movement disorders. For example, years of intensive alcohol consumption in combination with malnutrition can lead to alcoholic cerebellar degeneration, or ACD for short. Ataxia as a result of poisoning with lead or pesticides or a lack of vitamin E or B12 is rare but possible.

    Movement disorders also occur as a side effect of some medications. The main ones are atiepileptics and benzodiazepines, but also certain antibiotics.

    Movement disorders are very often a symptom of a genetic disorder.

    It is an autosomal recessive hereditary form of movement disorder if

    • the ataxia occurs before the age of 25,
    • the siblings are also affected,
    • the parents are not affected.

    In this case, more than 30 diseases may be the cause of the ataxia.

    If the mother and/or father also suffer from movement disorders, an autosomal dominant form of the disease is likely. For example, episodic ataxia (EA) or spinocerebellar ataxia (SCA).

    There are also some hereditary diseases in which the genetic changes affect the X chromosome. These diseases therefore occur primarily in men.

    Movement disorders: When to see a doctor?

    Those affected should always take movement disorders seriously and consult a doctor if symptoms persist. The family doctor can be the first point of contact - however, a neurologist is generally the specialist for diseases associated with movement disorders.

    A visit to the doctor is highly recommended for the following symptoms:

    • feelings of instability when walking, standing or sitting
    • an unsteady gait
    • if the execution of alternating movements causes problems
    • motor disorders, for example when writing
    • speech disorders
    • movement disorders of the eyes
    • if the hands tremble when moving

    Important: If the symptoms occur suddenly, almost out of the blue, it is an emergency! A stroke or poisoning may have occurred. In this case, you should call an emergency doctor immediately.

    Schlaganfall
    A stroke caused by a lack of blood flow in the brain causes sudden movement disorders © Alex Mit | AdobeStock

    Examinations and diagnostic procedures

    The examination begins with a doctor-patient consultation (anamnesis). Among other things, the doctor asks the patient

    • what symptoms have existed since when,
    • whether there are any pre-existing conditions and
    • what medication is taken regularly.

    This is followed by a physical examination:

    • Listening to the heart and lungs,
    • blood pressure measurement,
    • palpation of the abdomen

    and a blood test. The latter provides information on whether an infection or vitamin deficiency is present.

    Neurological tests are particularly important for movement disorders. For example, the specialist checks the reflexes and the reaction of the pupils to changing light conditions. This can provide important information about the cause of the ataxia.

    Other examinations that are frequently carried out for movement disorders are

    • Magnetic resonance imaging(MRI) of the head
    • Electroneurography (ENG)
    • Examination of cerebrospinal fluid
    • Genetic testing

    How are movement disorders treated?

    Physiotherapeutic measures play an important role in the treatment of movement disorders. The patient learns coordination-enhancing exercises under the guidance of a physiotherapist. They should then carry these out independently at home, if possible on a daily basis.

    Further therapy depends on the cause. If alcoholic cerebellar degeneration (ACD) has been diagnosed, the patient must strictly abstain from alcohol. They must also change their diet to a special diet in order to supply the body with all the important vitamins.

    Good results have been achieved with medication for certain forms of ataxia. This is the case with episodic ataxia with the active ingredients carbamazepine or acetazolamide. However, the mode of action and effectiveness of these drugs have not yet been fully researched.

    If the patient also suffers from accompanying symptoms, these are also treated in a targeted manner as part of the therapy.

    As people with ataxia often tend to withdraw and avoid social contact, it is particularly important to communicate with other sufferers. Self-help groups are an example of this.

    Conclusion

    Patients should never take movement disorders lightly. Instead, it is advisable to have the cause medically clarified as quickly as possible in order to rule out serious illnesses.

    A specialist in neurology is the right person to contact if movement disorders occur repeatedly. They are very familiar with the complex processes in the human brain and nervous system. They will not only make a reliable diagnosis, but will also initiate appropriate treatment to alleviate the symptoms as quickly as possible.

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