Movement disorders

Movement disorders are mostly neurogenic disorders of the postural and musculoskeletal system. Most often they are preceded by damage to the cerebellar nerve tissue, the basal ganglia, or the spinal cord. For the treatment of the disorder, combined medicinal, exercise therapeutic and in some cases even invasive surgical procedures of neurology and neurosurgery are used.

What are movement disorders?

Movement disorders in the narrower definition include all neurogenic disorders of the postural and musculoskeletal system that are caused by the central nervous system. In the extended definition, mental disorders of the postural and locomotor system also count as movement disorders, for example mentally induced lack of movement.

Neurogenic movement disorders are often characterized by incorrect or extra movements that severely impair the patient's everyday life. In many cases, these disorders are related to a change in muscle tone due to malfunctions in the central nervous system.

In other cases, neurogenic movement disorders manifest themselves in excessive movements and are then often due to a centrally disturbed deep sensitivity, without which movements in their extent can no longer be planned or controlled adequately.

The most well-known neurogenic movement disorders are ataxias, tremors and spasticity. The term movement disorders is also used particularly frequently in connection with degenerative diseases such as Parkinson's or Huntington's disease.

causes

According to the narrower definition, the cause of movement disorders lies in damage to the movement control authorities within the central nervous system. A movement disorder is often preceded by Parkinson's disease. Related degenerations of the central nervous system can also lead to decreased mobility.

Movement disorders such as tremors in the sense of tremor can be traced back to genetically hereditary factors or exist as intent tremors, for example in the context of cerebellar damage. Neurogenic movement disorders such as dystonia are usually hereditary and lead to an increased susceptibility to seizures due to a usually genetically increased muscle tone.

Neurological gait disorders and spastic paralysis are movement disorders and can be due to inflammatory, degenerative or traumatic damage to the central nervous system or, preferably, the spinal cord.

Ataxias occur as movement disorders, especially in cerebellar diseases such as Wilson’s disease and Gilles de la Tourette syndrome. Pathological processes in the basal ganglia are also often the cause of movement disorders. Above all, automatic movements and the precision of voluntary movements are disturbed.

People with movement disorders have different symptoms depending on the type of movement disorder and its cause. In some patients, deep motor perception is disturbed. Due to lesions on the spinal cord side, your central nervous system only receives less information about the position of joints and muscle tension.

So the movement planning is disturbed. Particularly in the dark, disturbances of the deep sensitivity lead to imprecise, sometimes excessive movements. In the case of movement disorders such as tremor, on the other hand, muscle groups that are antagonistic and strictly rhythmic contract involuntarily and in a strictly rhythmic manner, causing tremors.

In spastic movement disorders, there is an increased muscle tone, which makes it difficult for the patient to walk normally and the stretching and flexing movements of muscles involved in movement. For example, the result is a disturbed gait pattern with an unusual step frequency.

When movement disorders are caused by a decrease in muscle tone, however, the movements often appear diffuse and patients run the risk of falling over their own legs. Movement disorders are often also characterized by reflex defective muscle contractions that evade voluntariness and thus interfere with the execution of voluntary movements.

Diseases with this symptom

• alcoholism
• Wilson disease
• Dystonia
• AS
• Restless legs syndrome

• stroke
• Chorea huntington
• epilepsy
• Ataxia
• Circulatory disorders

• Multifocal motor neuropathy
• multiple sclerosis
• Spasticity
• Parkinson's
• Tourette syndrome

Diagnosis & course of disease

When diagnosing movement disorders, gait disorders and hand dysfunction are observed, their nature, origin and severity are assessed and associated with a higher-level disease. In addition to an apparatus-based reflex test, a line measurement in the central nervous system, for example, takes place as part of the diagnosis.

In addition, imaging such as MRI or examinations of attention and memory management are carried out. The prognosis of neurogenic movement disorders depends on the primary cause. Especially with degenerative diseases, the prognosis is not particularly favorable.

Complications

Movement disorders are mostly due to neurological interventions, and the cerebellar tissue is often damaged. Movement disorders are disorders of the postural and musculoskeletal system that are caused by the central nervous system. The patients are severely impaired in everyday life, movements can no longer be adequately planned and controlled.

The best-known movement disorders are ataxias, spasticity and tremors. Neurological gait disorders are not uncommon, inflammatory or traumatic damage to the central nervous system or the spinal cord are responsible for this. These people suffer from different symptoms, in some patients the deep motor perception is disturbed. The central nervous system only receives reduced information and can no longer assess the position of the joints and muscle tension.

Thus, the movement disorder is given, these disorders lead to very imprecise and sometimes excessive movements. The movements often appear diffuse and one always has the impression that the patient is falling over one's own feet. The diagnosis of gait disorders is associated with another disease, a line measurement in the central nervous system is used for diagnosis. Usually an MRI is done and attention and memory are checked.

However, if the cerebellum is damaged, physiotherapeutic treatment is recommended; the movement disorders in other brain regions can be balanced out through regular and targeted training. However, if the movement disorders do not improve, patients must learn how to deal with the movement disorder and what aids are available.

When should you go to the doctor?

Movement disorders have a variety of causes. Most of them are neurological, but there are also emotional reasons for movement disorders, for example Munchausen syndrome. Shivering is the most common symptom in neurology and can appear at rest and when moving.

A well-known restriction of movement is the essential tremor, also known as "restless legs". It occurs as a result of Parkinson's disease, which must be treated by a specialist. Many movement disorders are the result of accidents. They also need treatment. Neurological movement disorders are caused by a whole range of diseases, so it is imperative to clarify precisely.

In addition to Parkinson's disease and tremors (tremor), dementia, diseases of the autonomic nervous system, stroke, epilepsy and spastic paralysis can also trigger movement disorders. A wide variety of brain area disorders, but also injuries to the spinal cord, cause movement disorders in various forms. Neurological gait disorders severely restrict the patient and can significantly increase the risk of falling. That is why a visit to the doctor is extremely important.

Only a specialist clinic can find out the cause of a movement disorder. It has the diagnostic capabilities, for example, it can carry out performance measurements on the central nervous system. Investigations of attention and memory performance are also possible here. In addition, special neurological clinics often have tremor laboratories that can measure informative movement and muscle currents. Only the combination of individual facets gives a meaningful overall picture and leads to a clear diagnosis.

Doctors & therapists in your area

Treatment & Therapy

Patients with movement disorders are usually cared for by an interdisciplinary team of nurses, neurologists, physiotherapists and speech therapists who specialize in the treatment of movement disorders. The disorder is treated based on its primary cause. For some diseases, for example, drug therapies are available.

The tremor of Parkinson's patients can be suppressed at least temporarily in the initial stage with drugs such as L-Dopa. Botulinum toxin therapy has also established itself as a drug therapy for various movement disorders. A rather new treatment method is deep brain stimulation, which is mainly used for Parkinson's disease, spastic movement disorders, dystonia and tremor diseases.

Stimulation electrodes are placed in the patient's nervous system as part of a neurosurgical procedure, where they use high-frequency signals to inhibit over-excited activity. For some time now, intrathecal baclofen has been used to treat severe dystonia and spasticity. Physiotherapeutic treatment is one of the most important treatment options, especially for movement disorders following cerebellar damage caused by strokes.

The patients can shift the functions of defective brain areas through regular and targeted training under professional supervision to healthy brain areas and thus bring about an improvement in the movement disorder. If the movement disorders do not improve, the patients learn to deal with the disorder in occupational therapy and to find their way around better in everyday life using aids.

Outlook & forecast

Movement disorders cannot only arise in old age. Movement disorders occur again and again at a young age. The causes can be different. Studies repeatedly show that the younger generation is less active. Too little movement or the wrong movement can be causes of movement disorders. For example, strength athletes often have to struggle with movement disorders. The reasons for this are usually over and under training.

The chances of a cure for movement disorders are very good. If the injured patient has exercised too much, he should approach the training more gently. This is the only way for the overloaded muscles to recover. The muscles then regenerate by themselves.

Undertraining, i.e. too little exercise, can also have consequences. Sitting for too long in front of the computer, television etc. can result in movement disorders. An exact prognosis can be made with a doctor. It is important to determine how severe this disorder is so that the correct treatment can be chosen.

prevention

Neurogenic movement disorders can only be prevented to the extent that diseases of the central nervous system can be prevented. There are currently no promising preventive measures for autoimmune diseases such as multiple sclerosis and degenerative diseases such as Parkinson's.

You can do that yourself

In the apartment and in the home environment, all routine activities of everyday life should be simplified. This applies to dressing, eating, personal hygiene and even going to the toilet. Barrier-free living is not always possible. However, carpet edges and door sills are sources of danger that should not be underestimated. This can be remedied by small ramps and removing the carpets.

A chair in the bathroom and hallway, additional handles to hold on to, a comfortable coat rack that is easy to put on and take off, or shoes with Velcro fasteners are real helpers. The bedroom and the bed must meet the requirements of restricted mobility.Adapted entry height so that you can get in and out comfortably, brackets for walking aids and easily accessible light switches also make it easier to get up at night. Utensils such as glasses, water glasses, medication and dentures are conveniently quick and easy to grasp on a small next table.

A home emergency call system proves useful, which various institutions such as the Johanniter, DRK or the Malteser-Hilfsdienst offer. In an emergency, be it a fall or you can't get out of the bathtub, fast and reliable help is available. A phone that is easy to use, has large buttons and a bright display makes it easier to make calls. A mobile phone is useful when staying outside the home.