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Movement Disorders

Movement disorder is defined as abnormal movements seen during voluntary or involuntary movements. Although they are grouped under different groups with the affected area and characteristic features, movement disorders are rarely limited to one species, often several species coexist.

Transient And Developmental Movement Disorders Headnodding Sleep myoclonus Jitteriness Shuddering Paroxysmal tonic upgaze of infancy Spasmusnutans Benignparoxysmaltorticollis Benignidiopathic dystonia of infant Sandifer's syndrome Paroxysmal Movement Disorders Tic and tourettesmal tonic upgaze of infancy Spasmusnutans Non-objective dystonicity of infants It is defined as sudden onset, involuntary movements (motor tic) or sounds (vocal tic) that involve one or more muscle groups.

It is the inappropriate emergence of some of the normal motor movements and sounds in inappropriate environments. They differ from other movement disorders in that they are quite stereotypical and can be suppressed voluntarily even for a short time. Contrary to other movement disorders, tics can be seen, although their severity and frequency decrease during sleep. It is common enough to be seen in 5% of school-age children.

With age, tics tend to plateau and disappear. It can be seen in three types. Transient tics: Transient tics are the most common bait tics in childhood and involve a single muscle group. It most commonly manifests as blinking, throat clearing, head bowing or facial movements. It increases with stress and disappears during sleep. It can be voluntarily suppressed for a while. It disappears within weeks or months. No treatment is required. Chronic motor tics: These are tics that last longer than a year and involve 1-3 muscle groups. It can continue for life. Tourette's syndrome is a familial/genetic disorder in which various verbal and motor tics are seen together. The disease begins between the ages of 2-15. The four major symptoms of the disease are motor tics, vocal tics, obsessive-compulsive disorder, attention deficit, and hyperactivity. Some of the symptoms go away with age. Motor or vocal tics: If they affect the child's social and academic relationships, drug treatment is required. In the first step, the concerns of the family and the child should be eliminated and psychological support should be given.


It is described as an involuntary, fluent-continuous, variable speed and direction hyperkinetic movement disorder. Although it can be seen in all parts of the body, there are areas where it is characteristically affected in certain diseases and disorders. Choreic movements worsen during voluntary actions. If the amplitude of this involuntary movement is large and involves the proximal limb, it is called ballism. Choreic and ballistic movements sometimes coexist or may follow each other during the course of an illness. If one half of the body is affected, it is called hemiballism. Sometimes the person makes a semi-voluntary movement (such as touching one's own face) to mask the involuntary choreic movement, this is called parakinesia.


Dystonia is a movement disorder characterized by simultaneous contractions of involuntary, opposing muscles, leading to repetitive involuntary movements or temporary or permanent abnormal postures. While dystonic movements increase with fatigue and stress, they decrease and disappear during sleep. It has three important components. A certain pattern, muscle group involvement Movement-body specific Touching certain parts of the body can end dystonic spasm A disease that starts in childhood and shows significant improvement with L-dopa, typically gait disturbance due to dystonia in the feet, signs become more pronounced over time, better in the morning, in the afternoon progressive deterioration is observed.


Ataxia is the condition in which voluntary movements cannot be performed properly and in a balanced way. It may be caused by involvement of the cerebellum and its connections, spinal cord lesions, peripheral sensory loss, and disorders involving the major input system coming from the frontal lobes to the cerebellum, or pathologies in combination of these systems. Cerebellar ataxia is also an unstable, unstable broad-based gait. As they seem to fall at any moment, they walk without lifting their feet from the ground. The imbalance becomes more evident in sudden stops and turns. The patient has difficulty standing with his feet together. Whether the eyes are closed or open, the character of the gait does not change.

In cerebellarvermis lesions, the patient walks by staggering from right to left. In lesions in the hemispheres, the extremity on the lesion side is hypotonic and the patient may fall on the lesion side. Sensorial ataxia is a gait that occurs because the position sense in the lower extremities is impaired in the peripheral nerves, posterior roots, posterior column of the medulla spinalis and medial lemnicus and parietal lobe lesions in deep senses. It becomes evident when the eyes are closed. The gait has a wide base and the patient is bent forward. In the evaluation of ataxia; It would be appropriate to evaluate it in acute ataxia, subacute ataxia, intermittent ataxia, congenital nonprogressive ataxia and chronic progressive ataxia groups. The definition of acute ataxia is used when ataxia occurred a few days ago. Acute cerebellar ataxia is the most common cause of infection-related ataxia in children. It develops within 1-3 weeks after viral and other infections (chickenpox, mumps, parvovirus, epstein-barr virus) and is usually seen in children aged 1-4 years. It starts suddenly and at the very beginning ataxia is at the maximal level. It can be mild or severe. Consciousness is clear even if it is heavy.


Tremor is an involuntary, rhythmic oscillating movement resulting from alternating or synchronous contraction of agonist and antagonist muscles that move a body part.

It may occur or increase at rest or during movement. Rest tremor: When the limb is fully supported against gravity Action tremor: Occurs during various types of movement, Postural tremor: When the limb is held in a certain position, Kinetic tremor: During voluntary movement towards a specific target, Intentional/terminal tremor: During movement of the limb towards the target, Isometric Tremor: Occurs only with the contraction of muscles without moving. rhythmic tremor. Indicates brain stem pathology. Trembling: Jaw tremor.


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