Вы находитесь на странице: 1из 12

Movement disorder tutorial

Surat Tanprawate, MD, FRCPT! Division of Neurology, Chaing Mai University

Step approach
3 question should be asked!

1.Is it hypokinetic or hyperkinetic

movement disorder?!

2.What is the pattern of movement


3.What is the classication of such

movement disorder?

Movement disorder
Hyperkinetic rigid syndrome Hypokinetic rigid syndrome

Pattern of movement disorder
Classify by anatomy, distribution, cause, age

Hyperkinetic movement disorder

Rhythmic, sustained, intermittent,
speed, suppressibility, complex movement! myoclonus, ballism, tic

Tremor, Chorea, athetosis, dystonia,

Chorea = dance
irregular, nonrhythmic, unsustained involuntary movement that ows from one part of the body to another motor impersistence

Dancing lady

syndrome of sustained muscle contractions, frequently causing twisting, repetitive movements, or abnormal postures
sustained contractions, consistent directional or patterned character (predictable), and exacerbation during voluntary movements! sensory trick

sudden, brief, jerky, and shock-like involuntary movements involving face, trunk, and extremities

positive myoclonus! negative myoclonus

a rhythmic oscillation of a body part produced by alternating or synchronous contraction of opposing muscles

other movement clinical symptoms can be act like tremor: dystonic tremor, myoclonic tremor

repetitive, stereotyped, involuntary, sudden, inopportune, non-propositional, and irresistible movement
unpleasant feeling! not absolutely clear as patients can exert some control on the movement! can be simple or complex

involuntary, inging motions of the extremities, the movement are often violent and have wide amplitude of motion, continuous and random, can involve proximal or distal

Athetosis = without xed position

involuntary, convoluted, writhing, slow movements of the arms, ngers and legs