Information on Common Movement Disorders

Parkinsonism

Parkinsonism characterizes a clinical picture of typical symptoms of Parkinson’s disease (see below), such as poorer or slower movements (hypokinesia, bradykinesia), muscle stiffness (rigor) or rhythmical, involuntary trembling (resting tremor). To clearly determine a causal disease, technical examinations are necessary in addition to detailed a clinical examination. So-called secondary Parkinsonism may arise as a result of, e.g., a severe vascular disease or taking certain psychotropic drugs. Atypical parkinsonism (see below) is a special group of diseases (e.g., multiple system atrophy), which lead to neurodegenerative changes of cell groups of the extrapyramidal system which are different from the classical Parkinson’s disease.

Parkinson's Disease - Idiopathic Parkinsonism

Parkinson’s disease is the most common form of parkinsonism, making up about 80% of patients with parkinsonism. First described by James Parkinson in 1817, Parkinson’s disease is a neurodegenerative disorder in which a group of brain cells (substantia nigra, a region of the midbrain) that produce dopamine die. The onset is insidious, developing gradually with time. At a critical point of damage onwards the patient will experience problems with controlling and coordinating movement such as retardation and trembling. In addition, we know that brain cells outside this (extrapyramidal) system are affected by the disease, partly explaining the broad spectrum of the symptoms. The average age of onset is between 58 and 62 years.

Atypical Parkinsonism

These rare causes of parkinsonism show deviations from the “typical” course of Parkinson’s disease (see above) and therefore require different treatments. Atypical parkinsonism includes the group disorders called “multiple system atrophy”. In order to avoid the danger of mixing it up with Parkinson’s disease, depression or Alzheimer’s disease and to make and early diagnosis, a thorough neurological and, if applicable, psychiatric assessment is required.

Tremor

In the broad sense, tremor means “trembling”. As soon as this involuntary symptom disturbs everyday life, it needs to be further examined by a neurologist. The causes of tremor can be several and only certain forms, particularly the so-called resting tremor, indicate parkinsonism.

Restless-Legs-Syndrom

This disorder is characterized by an unpleasant to painful urge to move one’s legs, mostly in the evening, when trying to fall asleep. The quality of sleep can be impaired considerably as a result. Diagnostics and treatment of this disorder can be carried out in our Outpatient Clinic for Movement Disorders.

Tardive dyskinesia

Tardive dyskinesia can be a long-term side effect of taking certain psychotropic drugs (particularly neuroleptics). Since it can first occur many years after withdrawing from medication, diagnosis can be very difficult and therefore should be done in an specialised clinic, such as ours.

Dystonia

This group of disorders is characterized by sustained or repetitive muscle contractions resulting in twisting or abnormal fixed postures, e.g., distortion of the head, hands and feet. Dystonia can occur in combination with tremor or parkinsonism.

Tic disorders and Tourette Syndrome

These disorders are also the anatomical responsibility of the extrapyramidal system. Tics are recurrent (single or multiple), sudden, stereotyped movements or verbal expressions, which can be very stressful for the patient. Tourette syndrome is when multiple motor tics and at least one phonic tic are present for more than a year.