A Comprehensive Guide to Neurological Movement Disorders

Parkinson's disease

Parkinson's disease is a neurodegenerative disease – a condition that causes nerve cells in the brain or nervous system to lose function over time and eventually die – that can affect any part of the body controlled by nerves.

"There is a group of diseases under the umbrella term, 'Parkinsonism,' which is any motor disorder that manifests as rigidity, tremors, and slowing of the muscles," says Dr. Elahi. "Parkinson's disease comprises about 80% of cases of Parkinsonism and is the disorder I deal with the most when speaking with patients."

Parkinson's primarily affects the dopamine-producing part of the brain known as substantia nigra, an area of the brain that plays a critical role in modulating motor movement and reward functions. Dopamine affects many parts of the central nervous system, including movement control and emotional control.

There is no cure for Parkinson's disease, but medication or surgery can drastically improve the quality of life for patients.

Symptoms

Generally, symptoms develop slowly over years. The progression of symptoms can be different from person to person due to the different ways Parkinson's can affect the body. Early stage symptoms may go mild and unnoticed, such as your face showing little expression.

Other symptoms include:

• Tremors
• Slowed movement
• Rigid muscles
• Impaired posture and balance
• Loss of automatic movements
• Speech changes
• Writing changes

Causes

The cause of Parkinson's disease is not known, but some factors seem to play a bigger role than others.

• Genetics. There are specific genetic changes that have been shown to trigger Parkinson's. However, these are fairly uncommon, unless a family member is also affected.
• Environmental triggers. Although the risk is small, certain toxins or environmental factors can increase the risk of the disease.

Huntington's disease

Similar to Parkinson's, Huntington's disease is a neurodegenerative condition that causes the eventual death of nerve cells in the brain. This can result in movement, cognitive and psychiatric diseases over time, having a significant impact on the patient's ability to function.

Unfortunately, there is no cure for Huntington's nor can any treatment prevent the eventual physical, mental and behavioral decline in patients. However, medication is available to manage the symptoms.

Symptoms

Like Parkinson's, Huntington's disease can appear as many symptoms, some of which will vary greatly from person to person. The symptoms can even change throughout the course of the disease, having a greater effect when first appearing and diminishing over time or vice versa.

In general, there are different symptoms for movement, cognitive and psychiatric diseases caused by the disease.

Movement disorders

• Involuntary jerking or writhing movements
• Muscle problems, such as rigidity or muscle contracture
• Slow or unusual eye movements
• Impaired gait, posture and balance
• Difficulty with speech or swallowing

Unfortunately, many of these impairments are involuntary movements, which can have a greater impact on a patient's ability to work, perform daily activities, and remain independent.

Cognitive disorders

• Difficulty organizing, prioritizing or focusing on tasks
• Lack of flexibility or the tendency to get stuck on a thought, behavior or action
• Lack of impulse control
• Lack of awareness of one's own behaviors and abilities
• Slowness in processing thoughts
• Difficulty in learning new information

Psychiatric disorders

• Feelings of irritability, sadness or apathy
• Social withdrawal
• Insomnia
• Fatigue and loss of energy
• Frequent thoughts of death, dying or suicide

Other psychiatric conditions can also occur, such as obsessive-compulsive disorder (OCD), mania and bipolar disorder.

Causes

The main difference between Parkinson's and Huntington's is the cause. While researchers aren't certain what causes the former, and the connection to genetics is complicated, Huntington's disease is caused by a difference in a single inherited gene.

Someone only needs to inherit one copy of the different gene to develop the disease. Because the gene is dominant, each child born to a parent with the gene has a 50-50 chance of inheriting the gene themselves.

Dystonia

Dystonia is a muscle disease that causes involuntary contraction, including repetitive or twisting motions. It can affect one, two or more, or all parts of your body, and the spasms can be mild or severe. Some of the spasms are painless while others can be fairly painful.

This disease can affect the body by itself or be a symptom of other conditions, such as Huntington's or Parkinson's. Similar to those diseases, dystonia has no cure, but medications, therapy and surgery can improve symptoms.

Symptoms

Like other neurological movement diseases, symptoms of dystonia can appear differently in different people. Generally, consistent muscle spasms in one or more areas of your body could indicate you have the condition.

Causes

The exact cause of dystonia is not known. Scientists believe it has to do with how the nerve cells in different parts of the brain communicate with each other. Dystonia can also be passed down in families. You're more likely to suffer from dystonia if you suffer or have suffered from these conditions:

• Parkinson's disease
• Huntington's disease
• Wilson's disease
• Traumatic brain injury
• Birth injury
• Stroke
• Brain tumor
• Oxygen deprivation or carbon monoxide poisoning
• Infections, such as tuberculosis or encephalitis
• Reactions to certain medications or heavy metal poisoning

Restless legs syndrome

If you've ever felt the compulsive need to shake or bounce your leg, you may suffer from restless legs syndrome (RLS). As the name suggests, this disorder is characterized by a strong urge to move the legs. It usually occurs during the evening while sitting or lying down.

RLS can begin at any age and can worsen as you get older. Self-care steps, lifestyle changes, and medications can help people who suffer from RLS.

Symptoms

The main symptom for RLS is an urge to move your legs. Alongside this urge, you may feel:

• Sensations that begin while resting
• Relief with movement
• Worsening of symptoms in the evening
• Nighttime leg twitching

Some patients describe the urges as pulling, throbbing, aching, itching, and electric. Most people usually don't describe the sensation as a muscle cramp or numbness. However, the common sensation is a desire to move the leg(s).

RLS may be associated with another, more common condition called periodic limb movement of sleep (PLMS), which causes the legs to twitch and kick, possibly throughout the night, while you sleep.

Causes

Many times, RLS has no cause. Some research suggests that RLS may be caused by an imbalance of dopamine in the brain. This neurochemical is used to send messages to control muscle movement. But no exact cause has been determined. Many times, perfectly healthy patients will suffer from RLS.

Sometimes, RLS can run in families, especially if the patient started experiencing the condition before turning 40. Pregnant women also sometimes experience RLS signs and symptoms, although they usually go away after delivery.