Jerks/ twitches resident survival guide: Difference between revisions
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==Treatment== | ==Treatment== | ||
Management of movement disorders will vary depending on the underlying cause, among the treatment strategies, there is physical therapy, medical therapy, botulin toxin injection, and deep brain stimulation. | |||
*To view the specific treatment of myoclonus click here. | |||
*To view the specific treatment of tics click here. | |||
*To view the specific treatment of essential tremors click here. | |||
*To view the specific treatment of Parkinson's disease click here. | |||
*To view the specific treatment of progressive supranuclear palsy (PSP) click here. | |||
*To view the specific treatment of multiple system atrophy (MSA) click here. | |||
*To view the specific treatment of Lewy body dementia (LBD) click here. | |||
*To view the specific treatment of Tourette's disorder click here. | |||
*To view the specific treatment of Huntington's disease click here. | |||
*To view the specific treatment of ataxia-telangiectasia click here. | |||
*To view the specific treatment of tardive dyskinesia click here. | |||
*To view the specific treatment of Friedreich's ataxia click here. | |||
==Do's== | ==Do's== | ||
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==Don'ts== | ==Don'ts== | ||
*Do not order imaging tests to diagnose clinical disorders, such as Parkinson's disease and essential tremor. | *Do not order imaging or laboratory tests to diagnose clinical disorders, such as Parkinson's disease and essential tremor. | ||
==References== | ==References== | ||
{{Reflist|2}} {{WikiDoc Help Menu}} {{WikiDoc Sources}} | {{Reflist|2}} {{WikiDoc Help Menu}} {{WikiDoc Sources}} | ||
Revision as of 18:56, 25 November 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.
Synonyms and Keywords: jerks, twitches, abnormal movements, movement disorders, movement disorders approach
Overview
Movement disorders are common conditions. The clinical presentation of movement disorders is complex and often has variation from person to person. Therefore, finding the correct diagnosis may be challenging. A focused physical examination and history are imperative, and many times the only required resource to establish the diagnosis. Movement disorders may be divided into hyperkinetic and hypokinetic, and this can be evaluated by performing a finger or foot tapping. Among the hyperkinetic disorders, you may classify them as jerky and non-jerky, while hypokinetic may vary in velocity, but in the end, are classified as a whole. The most common hyperkinetic disorder is essential tremor, while the most common hypokinetic one is Parkinson's disease.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Diagnosis
Shown below is an algorithm summarizing the diagnosis of Abnormal movements according thee American Academy of Neurology guidelines:[1][2][3]
| Patient with movement disorders | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Perform physical examination | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Perform finger or foot tapping | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Increased alternating movements | Progressive fatiguing and decrement of repetitive alternating movements | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Hyperkinetic/non-rigid | Rigid | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Jerky | Non-jerky | Akinetic | Hypokinetic | Bradykinetic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Sudden, brief, shock-like involuntary movements | Randomly flowing movements, which are, individually, jerky in nature | ‘Stereotyped’ character of the recurrent movements | Involuntary, rhythmic and sinusoidal alternating movements of one or more body parts | Involuntary abnormal co-contraction of antagonistic muscles, which may cause sustained abnormal postures or twisting and repetitive movements | Parkinsonism | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Myoclonus | Chorea | Tics | Tremor | Dystonia | • Parkinson's disease • Juvenile parkinsonism • Infectious • Drugs • Toxins • Vascular • Trauma • Metabolic • Corticobasal degeneration (CBD) • Progressive Supranuclear Palsy (PSP) • Multiple System Atrophy (MSA) • Lewy Body Dementia (LBD) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| • tardive dyskinesia • Storage diseases • Friedriech's ataxia • Ataxia-telangectasia • Prion diseases • CNS infections • Hashimoto encephalopaty • Hypertiroidism • Electrolyte imbalances • Metabolic imbalances | • Huntington's disease • Familial benign chorea • Familial inverse choreoatetosis • CNS infections • Electrolyte imbalances • Metabolic imbalances | • Transient tic disorder • Torette's disorder • Chronic vocal or motor tic disorder • Tic disorder not otherwise specified | • Essential tremor • Postural tremor • Action tremor • Resting tremor • Pyschogenic tremor • Physiologic tremor | • Blepharospasm • Tardive dystonia • Cervical dystonia • Oromandibular dystonia • Writer's Cramp (hand dystonia) • Paroxismal dystonia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Management of movement disorders will vary depending on the underlying cause, among the treatment strategies, there is physical therapy, medical therapy, botulin toxin injection, and deep brain stimulation.
- To view the specific treatment of myoclonus click here.
- To view the specific treatment of tics click here.
- To view the specific treatment of essential tremors click here.
- To view the specific treatment of Parkinson's disease click here.
- To view the specific treatment of progressive supranuclear palsy (PSP) click here.
- To view the specific treatment of multiple system atrophy (MSA) click here.
- To view the specific treatment of Lewy body dementia (LBD) click here.
- To view the specific treatment of Tourette's disorder click here.
- To view the specific treatment of Huntington's disease click here.
- To view the specific treatment of ataxia-telangiectasia click here.
- To view the specific treatment of tardive dyskinesia click here.
- To view the specific treatment of Friedreich's ataxia click here.
Do's
- Perform a physical examination with finger or foot tapping.[1]
- Perform a urine toxicology test to look for drug-induced movement disorders such as tardive dystonia, postural tremor, parkinsonism, etc.[4]
Don'ts
- Do not order imaging or laboratory tests to diagnose clinical disorders, such as Parkinson's disease and essential tremor.
References
- ↑ 1.0 1.1 Flemming, Kelly D; Jones, Lyell K (2015). doi:10.1093/med/9780190244927.001.0001. Missing or empty
|title=(help) - ↑ Abdo, Wilson F.; van de Warrenburg, Bart P. C.; Burn, David J.; Quinn, Niall P.; Bloem, Bastiaan R. (2010). "The clinical approach to movement disorders". Nature Reviews Neurology. 6 (1): 29–37. doi:10.1038/nrneurol.2009.196. ISSN 1759-4758.
- ↑ Kojovic, Maja; Cordivari, Carla; Bhatia, Kailash (2011). "Myoclonic disorders: a practical approach for diagnosis and treatment". Therapeutic Advances in Neurological Disorders. 4 (1): 47–62. doi:10.1177/1756285610395653. ISSN 1756-2856.
- ↑ Chouksey, Anjali; Pandey, Sanjay (2020). "Clinical Spectrum of Drug-Induced Movement Disorders: A Study of 97 Patients". Tremor and Other Hyperkinetic Movements. 10 (1). doi:10.5334/tohm.554. ISSN 2160-8288.