Movement disorders are comprised of a variety of conditions resulting in abnormalities in the motor system. These include Parkinson's disease and other Parkinsonian syndromes, tremors, dystonia, tics and Tourette syndrome, and Huntington's disease. They can occur in all age groups from infancy to the elderly. In some cases, symptoms are restricted to problems in motor control while in others, cognitive and autonomic functions can be affected.
Parkinson’s disease is a progressive, chronic neurological condition that affects a person’s movement, gait and/or balance. Parkinson’s disease causes a gradual deterioration of a small area of cells in the midbrain known as the substantia nigra.
The deterioration of these cells causes a decrease in dopamine, a neurotransmitter used by your nerves to send signals from your brain to the rest of your body. The physical symptoms of Parkinson’s disease are caused by this decrease in dopamine.
There is no definitive blood test or X-ray to confirm a diagnosis of Parkinson’s disease. Rather, the diagnosis is based on a thorough neurological examination that includes your symptoms, medical history, and response to medications.
An MRI and blood tests can help rule out conditions that may produce similar symptoms, such as a stroke or normal pressure hydrocephalus. Once a probable diagnosis is established, your doctor will prescribe medications that will help confirm or disprove the diagnosis.
The classic signs of Parkinson’s disease include:
- Gait or balance problems (postural dysfunction)
- Generalized slowness of movement (bradykinesia)
- Resting tremor on one side of the body
- Stiffness of limbs (rigidity)
Other symptoms you may observe include:
- Decreased facial expression (hypomimia)
- Episodes of feeling “stuck in place” when initiating a step (freezing)
- Feelings of depression or anxiety
- Increase in dandruff or oily skin
- Lack of arm swing on the affected side
- Less frequent blinking and swallowing
- Lowered voice volume (dysarthria)
- Slight foot drag on the affected side
- Small cramped handwriting (micrographia)
Please note that few patients experience all of these symptoms, and some may experience other symptoms not listed here.
Dystonia is a condition characterized by involuntary muscle contractions that cause repetitive or twisting movements of an affected body part. Contractions can affect one muscle, groups of muscles, or muscles throughout the body. These uncontrollable movements are often accompanied by pain and can interfere with the ability to perform day-to-day tasks.
Dystonia can be classified by the parts of the body affected:
- Focal dystonia is localized to a specific part of the body (for example, the left arm).
- Segmentalized dystonia affects two or more adjacent parts of the body (for example, the left arm and left hand).
- Multifocal dystonia involves two or more unrelated body parts.
- Hemidystonia involves the arm and the leg on the same side of the body.
- Generalized dystonia affects most or all of the body.
Forms of focal dystonia include:
- Cervical dystonia affects the muscles in the neck that control the position of the head, causing the head to turn to one side or be pulled forward or backward.
- Blepharospasm affects muscles in the eyes, causing rapid blinking or spasms that force the eyelids to close completely.
- Craniofacial dystonia affects the muscles of the head, face, and neck.
- Task-specific dystonia occurs during a particular repetitive activity, such as handwriting or playing an instrument.
There is no single test that can definitively diagnose dystonia. Dr. Richardson will review your symptoms and medical history during a physical examination and may order any of the following tests:
- Blood tests
- Urine tests
- CT scan
- MRI scan
- Electromyography (EMG)
Involuntary muscle contractions are the primary symptom of dystonia. They can cause your body to assume twisting, repetitive, or painful postures. Symptoms may be progressive, and they may be aggravated by stress, anxiety, or fatigue.
Depending on the form of dystonia, symptoms may include:
- Foot cramps
- Tendency of one foot to turn or drag
- Rapid blinking
- Involuntary spasms that cause your eyelids to close
- Uncontrollable head movements
- Difficulties opening and closing your mouth
- Difficulty swallowing
- Strained, breathy, or slurred speech
- Cramps while doing a particular activity, such as handwriting or playing an instrument
Symptoms of dystonia vary depending on which muscles are affected and can signal a serious underlying condition.