Movement disorders are neurological conditions characterised by abnormalities in the planning, control, or execution of voluntary and involuntary movement, arising chiefly from dysfunction of the basal ganglia, cerebellum, and their connecting circuits. They are broadly divided into hypokinetic disorders, marked by …
Movement disorders are neurological conditions characterised by abnormalities in the planning, control, or execution of voluntary and involuntary movement, arising chiefly from dysfunction of the basal ganglia, cerebellum, and their connecting circuits. They are broadly divided into hypokinetic disorders, marked by poverty and slowing of movement as in Parkinson's disease and other parkinsonian syndromes, and hyperkinetic disorders, characterised by excess movement such as tremor, dystonia, chorea, myoclonus, tics, and ataxia. Causes are diverse and include neurodegeneration, genetic mutations, metabolic and electrolyte disturbances, vascular and structural lesions, autoimmune processes, and adverse drug effects. Diagnosis is largely clinical, based on the phenomenology of the abnormal movement, supported where needed by imaging, neurophysiology, and laboratory testing to identify reversible contributors. Management is tailored to the underlying disorder and may combine pharmacological therapy, as with dopaminergic and device-assisted continuous infusion strategies in advanced Parkinson's disease, with rehabilitation, and, in selected cases, surgical or neuromodulatory interventions. Distinguishing organic movement disorders from functional and paroxysmal phenomena, and recognising secondary causes such as cerebellar nystagmus provoked by metabolic derangement, is important for accurate treatment. Because these conditions often progress and affect daily function, care emphasises symptom control, preservation of mobility and independence, and attention to the broader physical and psychological impact on patients.
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