Do you also experience strange, uncontrollable movements in your body? Let's talk about Movement Disorders!

Do you sometimes feel like parts of your body are twitching, shaking, or moving uncontrollably? Maybe you have trouble controlling an arm, leg, or facial expression. It's okay if these things happen once or twice, but if you have these abnormal movements all the time, it could be a movement disorder. Let's talk about this in more detail today, shall we?

What are these movement disorders? Let's understand it very simply!

Simply put, movement disorders are conditions in which the body's movements become abnormal due to problems in our nervous system. There are two possible scenarios. One is that the body's movements increase unnecessarily (for example, jerking, shaking, twisting). The other is that the body's movements become less than necessary, or they happen very slowly.

Imagine, every movement we make, whether it's raising an arm, putting a leg forward, or opening our mouth to speak, happens in a very complex way. The Central Nervous System, which includes our brain and spinal cord , as well as the Motor Nerves and our Skeletal Muscles, all of these processes are connected together. So, if there is any damage to the parts of the brain that control these movements, or if there is any malfunction in their functioning, then these movement disorders occur.

The important thing is that these movement disorders are different. Some may affect only one part of the body, while others may affect the entire body. Sometimes they may interfere with simple tasks like writing, but in other cases, they can have a major impact on things like walking and moving around.

Sometimes conditions that completely eliminate movement, such as paralysis, or diseases that weaken muscles, such as muscular dystrophy, do not fall into this category of movement disorders, because movement disorders mainly involve the occurrence of unwanted, abnormal movements.

There are mainly two types of abnormal movements!

These unusual movements we are talking about can be divided into two main parts.

1. Hyperkinetic Movement: This means there are too many movements.

2. Hypokinetic Movement: This means that movements are few and slow.

In some movement disorders, both types may be seen, or only one may be present.

1. What is Hyperkinetic Movement?

"Hyper" means "excessive" and "kinetic" means "movement". This means an increase in unnecessary movements. These can be voluntary movements or involuntary movements.

Here are some types of hyperactive movements:

• Akathisia: This is a restlessness that makes it very difficult to sit still or stay still. This condition can be caused by some medications for mental illness, especially ``Antipsychotic'' or ``Neuroleptic'' drugs.
• Ataxia: This is a condition in which the body loses balance and coordination, causing unsteady, awkward movements. Sometimes, it can even appear as if the person is walking as if they are drunk. ``Ataxia`` can be a separate disease, or it can be a symptom of another disease.
• Chorea, Athetosis and Ballism:
• Chorea: This is an uncontrolled, unpredictable muscle movement. It can appear as if you are dancing or moving around restlessly. This is commonly seen in diseases such as Huntington's disease.
• (Athetosis): This is characterized by slow, twitching, worm-like movements of the arms and legs.
• (Ballism): This involves sudden, violent movements, such as a rapid throwing of an arm or leg.
• Dystonia: This is a condition in which muscles contract continuously or intermittently, causing abnormal, often repetitive movements or postures. This can be seen in cerebral palsy and some neurodegenerative conditions. Think of a neck that is pulled to one side, or an arm that is bent in an awkward way.
• Myoclonus: This is a sudden, uncontrollable muscle twitch or jerk. Sometimes we wake up suddenly while we are sleeping, that's how it is. But when it comes to a medical condition, it can happen more often.
• Spasticity: This is a condition in which the movement patterns of the muscles become disrupted, causing some muscles to suddenly tighten when we try to move or when we are just standing. This can interfere with movement and can affect speech and walking.
• Stereotypies: These are complex, patterned movements that often affect both sides of the body. They always occur in the same way or in a very similar way. For example, rocking, clapping, rocking, and stiffening. These can be seen in conditions such as autism spectrum disorder and Rett syndrome.
• Tics: These are also repetitive, rhythmic movements that occur in a pattern. Simple `(tics)` are small, limited to a few muscles, such as blinking, frowning, neck flexion, or throat clearing. Complex `(tics)` can be short-lived and involve more muscles. For example, jumping, saying certain words or phrases. These `(tics)` are a key feature of a condition called `(Tourette's syndrome)`.
• Tremor: This is an uncontrollable shaking of parts of the body. This tremor is caused by the repeated tightening and relaxing of muscles. This can occur in areas such as the hands, legs, head, and voice.

2. What is Hypokinetic Movement?

"Hypo" means "less." This means that movements are less frequent, very slow. This usually affects the movements we make consciously.

• Parkinsonism: This is the main type of hypoactive movement disorder. It refers to a number of brain conditions that cause slow movements, rigidity, tremors, or problems with balance.

Parkinsonism, a neurodegenerative disorder, is most commonly seen with Parkinson's disease . However, it can also occur with other conditions such as multiple system atrophy, corticobasal degeneration, progressive supranuclear palsy, and Lewy body dementia.

In addition, Parkinsonism can also be caused by factors such as frequent head injuries, toxins, medications for certain mental illnesses, and decreased blood flow to certain parts of the brain.

• Bradykinesia: This is also a slow movement. Once a movement has started, it slows down or stops halfway. This is a major symptom of Parkinson's disease .

Several major types of movement disorders

There are many types of movement disorders. Let's look at a few of them:

• Essential tremor: This is when parts of the body, especially the hands and arms, shake uncontrollably. It can also affect areas such as the head and voice.
• Huntington's disease: This is a genetic disease. It affects the brain and causes uncontrolled movements (chorea) in the hands, feet, and face. Symptoms worsen over time.
• Multiple system atrophy (MSA): This is a rare disease. Some parts of the brain are gradually destroyed. This can cause conditions such as ``Ataxia`` and ``Parkinsonism``.
• Parkinson's disease: This is a brain disorder that causes uncontrolled movements, problems with balance and coordination. It can also cause cognitive decline.
• Periodic limb movement disorder (PLMD): This is a condition in which the limbs, especially the legs, move repeatedly while sleeping. This can disrupt sleep.
• Progressive supranuclear palsy (PSP): This is also a rare neurodegenerative disease. It damages certain parts of the brain. It affects walking, thinking, swallowing, and eye movement.
• Restless leg syndrome (RLS): This is a sleep disorder that causes an irresistible urge to move the legs (or sometimes the arms or the whole body). It is accompanied by strange sensations such as a pulling sensation, a feeling of something moving, numbness, or burning in the legs.
• Rett syndrome: This is a rare genetic condition that affects speech, manual dexterity, and coordination.
• Tardive dyskinesia: This can be caused by long-term use of certain antipsychotic medications. It can cause involuntary movements such as facial tics and lip smacking.
• Tourette syndrome: This is a disorder of the nervous system. It causes sudden, unusual movements or sounds (tics). It can also be associated with conditions such as anxiety, attention deficit hyperactivity disorder (ADHD), and sometimes obsessive-compulsive disorder (OCD).
• Wilson disease: This is also a rare genetic condition. It is caused by excess copper buildup in the body, especially in the liver and brain. Muscle stiffness, tremors, and uncontrolled movements can occur.

What are the most common movement disorders?

The two most common movement disorders are Parkinson's disease and essential tremor .

What are the symptoms of a movement disorder?

The symptoms of movement disorders vary greatly. All movement disorders involve abnormal movements. Some movement disorders may also be accompanied by other symptoms, such as changes in thinking and mood. These symptoms can range from mild to severe and can interfere with daily activities.

Some of the commonly seen symptoms are:

• Uncontrolled movements - such as jerking, twitching, shaking, and twisting.
• Problems with balance and coordination.
• Difficulty with certain motor functions, such as writing, swallowing, and speaking.
• Difficulty walking or changes in walking style.
• Rigidity in the limbs and trunk.

These abnormal movements can affect one or several parts of the body. For example:

• Limbs
• Hands and fingers
• Feet and toes
• Facial muscles
• Head and neck
• Trunk and posture
• Voice

How do I know if I have a movement disorder?

We all experience muscle twitches, sudden jerks during sleep (hypnic jerks), and involuntary movements like hiccups. However, if these symptoms persist, it could be a sign of a movement disorder. If you notice a persistent change in your or your child's movements, it is important to see a doctor immediately for a diagnosis and treatment.

What are the causes of movement disorders?

Movement disorders are usually caused by damage to or malfunction of certain parts of the brain that control our movements. These parts are:

• Primary motor cortex: This is a ribbon-like area in the frontal lobe of our brain. It helps us initiate movements that we consciously make. If it is damaged, it can cause spasticity, myoclonus, and problems with fine movements.
• Basal ganglia: These are the parts of our brain that are deep in our brain. They help us initiate and control voluntary muscle movements, control involuntary movements, and coordinate changes in posture. Damage to these can lead to conditions such as `(Chorea)`, `(Athetosis)`, `(Dystonia)`, and `(Parkinsonism)`.
• Cerebellum: This is the part of our brain at the back, at the bottom. It coordinates our movements, keeps our limbs moving smoothly and accurately, and helps us maintain balance. If it is damaged, coordination is lost.
• Thalamus: This is an egg-shaped structure. It is located deep in the brain, on both sides. It is like a center through which all movement and sensory information coming to our body passes through. If it is damaged, tremors and movement disorders can occur.

Here are some of the situations where these parts of the brain can be damaged:

• Genetic conditions and mutations.
• Traumatic brain injury.
• Infections.
• Toxins.
• Metabolic disorders that are present at birth or develop later.
• Stroke and blood vessel diseases.
• Side effects of some medications.

Some movement disorders can be traced to a single specific cause. However, most of the time, these conditions are caused by a combination of factors. The exact cause of some movement disorders is still unknown.

How to diagnose movement disorders?

Because movement disorders are complex and can often mimic other conditions, your medical team will often perform a series of tests to make a diagnosis. The first step is to ask you a detailed question, perform a physical exam, and perform a neurological exam.

Depending on your symptoms, these tests may be done:

• Blood tests: To identify some movement disorders, or to check for other causes.
• Electromyography (EMG): Check the health of muscles and the nerves that control them.
• Electroencephalogram (EEG): View the electrical activity of the brain.
• Lumbar puncture: Examine the cerebrospinal fluid.
• Muscle biopsy: To differentiate between nerve and muscle problems.
• Nerve conduction study: Measures the speed at which an electrical current travels through a nerve before reaching a muscle.

Doctors also use imaging tests to diagnose movement disorders. These can look at the brain, spinal cord, or nerves. Examples:

• CT scan (CT scan - Computed tomography)
• MRI scan (Magnetic resonance imaging)

What are the treatments for movement disorders?

Treatment for movement disorders varies depending on the disorder. Many movement disorders cannot be completely cured. Therefore, the main goal of treatment is to control the symptoms. However, some movement disorders, such as those caused by medications (Parkinsonism), can be cured.

Here are some treatment options:

• Medication: There are several types of medications that can help control the symptoms of movement disorders. For example, muscle relaxants can help with spasticity. Dopaminergic medications can help with Parkinson's disease and restless leg syndrome. Antianxiety medications can help with dystonia. There are also medications that are specific to each condition.
• Physical therapy: This helps improve the way the body moves. Physical therapists help manage symptoms that make it difficult to move, such as pain, stiffness, and discomfort.
• Occupational therapy: This helps improve the ability to perform daily tasks. An occupational therapist helps you stand, sit, move around safely, and use various equipment to do your job.
• Mobility aids: You can use things like canes, walkers, and wheelchairs to move around more safely and increase your independence.
• Speech therapy: This helps improve speaking, language skills, and swallowing.
• Psychotherapy: This involves identifying and helping to change unhealthy feelings, thoughts, and behaviors. Movement disorders can often cause mental health problems like depression and anxiety. Psychotherapy can help with this.
• Botulinum toxin (Botox®) injections: If you have either `(Dystonia)` or `(Spasticity),` these injections can help relax the muscles.
• Deep brain stimulation: This is a brain surgery performed on people with severe Parkinson's disease, dystonia, and other tremors. It can reduce involuntary movements.
• Clinical trials: This is a type of research that studies new tests and treatments for specific medical conditions. There may be a clinical trial you can take part in.

What kind of experiences does someone with a movement disorder have to face?

Not everyone with a movement disorder is affected the same way. The best thing to do is to talk to the specialists who research and treat your condition.

You may need the help of a team of doctors. These may include:

• Neurologists
• Neurosurgeons
• Physiotherapists
• Occupational therapists
• Speech therapists
• Psychologists

People like that can be included.

How can I take care of myself and my child?

If you or your child has a movement disorder, it is important to seek the best medical care possible to maximize your quality of life.

It may also be helpful for you and your family to join a support group where you can meet people who have had similar experiences.

When should I see a doctor?

If you notice any changes in the way you normally move, or if you have a problem that affects your daily activities, see a doctor right away. The sooner your doctor identifies a movement disorder, the sooner you can start treatment.

If you already have a movement disorder, seek medical advice even in these cases:

• When your medical team has scheduled an appointment for you: Going to these appointments helps your medical team monitor your condition and make any necessary changes to your treatment.
• If you notice a change in your symptoms: These changes can be very important information for the medical team monitoring your condition and treating you.
• If you notice side effects from your treatment or changes in the effectiveness of your treatment: It may take a while to find the right treatment for you, or the effectiveness of your medication may decrease over time. If your treatment isn't working, or you have bothersome side effects, tell your healthcare team.

Your medical team can tell you about the symptoms you should be more aware of, as well as when you should seek medical advice immediately.

Finally, things to remember (Take-Home Message)

Being diagnosed with a movement disorder can be overwhelming. That's normal. But remember, you're not alone. Your healthcare team can help you find a treatment plan that's right for you. It's important to make sure you get the support you need, and to stay focused on your health. And don't forget that your healthcare team is always there to support you. With proper treatment and management, you can live a good life with these conditions. Don't be afraid, be courageous!

` Movement disorders, Parkinson's disease, essential tremor, neurological diseases, brain disorders, abnormal movements, muscle problems