Environmental Triggers: Factors Contributing to Movement Disorders

19 Dec Environmental Triggers: Factors Contributing to Movement Disorders

Movement disorders are characterized by involuntary or abnormal movements. It affects the voluntary movements one tries to make by inhibiting it.

It is a broad term including a variety of conditions with a variety of causes. These disorders can affect a single part of the limb or multiple limbs. Sometimes, these movements can be triggered by certain medications or it can be sudden out of nowhere.

Is your child doing odd movements?

Do you think your child has been acting strange? Do you feel your child’s movements are “extra”? If these are some questions bothering you, visit the neuropsychiatrist in Patna, Dr. Vivek Pratap Singh. 

What are the Movement Disorders?

The movement disorders defined as jerky, abnormal muscle spasms (called tonic movements) can be because of abnormal electrical activity in the brain.

They can be increased movement like spasms, jerky, or shaking or slow movements. It can be voluntary or involuntary movement depending on the condition. The body movement is composed of complex connection between

• Central nervous system
• Motor nerves
• Skeletal muscles

Damage to any of these areas of the brain can lead to abnormal movement disorder. The list of movement disorder is

• Ataxia – it concerns the coordination leading to move the body in an uncontrolled, jerky way and involuntary hand movements in adults. This is more commonly a symptom of a condition rather than the condition itself. 
• Akathisia – this is a condition that makes one impossible to sit still due to the inner restlessness. It can be a side effect of certain antipsychotics. 

Some of the most common movement disorders can be 

• Chorea – chorea movement disorder involves fidgety, unpredictable clumsy movements causing the person to look fidgety and uncomfortable. This is a common symptom in Huntington’s disease. It even involves athetosis and ballism. Athetosis is a slow movement disorder that has turning and wriggling like motions. Ballism is a more fierce and vigorous movement disorder.
• Spasticity – a disruption in the connections of the brain leading to increased muscle movements that causes all muscles to contract even at rest. It manifests as unusual tightness, and stiffness of muscles even at rest. 
• Myoclonus – involuntary brief muscle movement disorder that is quick, and sudden uncontrollable by the child. They can be occasional or frequent jerks with a semi-rhythmic pattern having triggers like using the hands or legs in a certain position. 
• Dystonia – this causes the muscles to contract abnormally because of abnormal brain signals. The perfect synced movement occurs when the muscles contract in coordination. In this disorder, they act in an opposite fashion both pushing and pulling the muscles together resulting in awkward positioning of the body. 
• Tics – these are non-rhythmic, patterned, rhythmic movements that are involuntary in nature. It affects a group of muscles with symptoms like eye-blinking, nose scrunching, or head jerking. These are quite common in children involving any body part and varying in severity. 
• Tremor is shaking or trembling movement of the body that occurs with other symptoms such as weakness and difficulty in limb movement. This can be hereditary, that is running in the family or can have other causes. Essential tremor is uncontrollable shaking in hands that can start anytime out of nowhere. 

The movement disorder symptoms can vary widely depending on the condition.

The symptoms can cause abnormal movements along with other mental health symptoms such as anxiety and mood changes. The involuntary body movement examples are 

• Twitches, spasms, jerks are episodes of uncontrolled movement 
• Coordination and balance problems resulting from malfunction of cerebellum. They take uncontrolled wide steps while walking. 
• While doing tasks such as writing, speaking, or swallowing will cause involuntary jerky movements. 
• Trouble walking steadily and gait changes 
• Stiffness or rigidity in limbs and trunk or in some cases, there can be laxity.

These movement disorders result from disrupted brain chemistry that can lead to involuntary muscle contractions causing the body to take up awkward positions like twisting the limbs, trunk, or neck. 

These disorders can result from drug use or genetic mutations. At times, a tumor in some part of the brain compressing the nerves can cause movement disorders.

The involuntary movement disorders are known as movements that cannot be controlled and can cause a great amount of distress to people. 

• Parkinsonism is caused by brain injury or certain toxins. It has  tremors when the muscles relax, along with stiff muscles and rigidity. It is characterized by slow movements and difficulty maintaining balance. 
• Huntington’s disease, a hereditary disorder with occasionally involuntary jerking or spasms that can progress to more pronounced involuntary movements like athetosis and chorea. Muscles contract rapidly leading to jerky movements several times consecutively. People with this disorder will have odd movements such as blinking, grimacing, or flick the limbs. 
• Multiple system atrophy like its name affects multiple systems such as blood pressure, limb movement disorder and other systems. It includes symptoms like freezing slowed movements, rigidity, instability, loss of balance. Because it causes low blood pressure leading to orthostatic hypotension. The other symptoms involve blurred vision, urine difficulties, speech and swallowing issues.
• Progressive supranuclear palsy is a slow loss of certain brain cells that cause slowed movements and reduced coordination leading to loss of balance, swallowing, and eye movement problems. This disease is predominant in people aged 40-60 years and can attain its full potential in 10 years. There’s no specific cause as of yet, but researchers suggest it is due to accumulation of tau proteins or genetic inheritance. 
• Rett syndrome, a childhood disorder with progressive neurological symptoms like reduced muscle tone, autistic behavior, repetitive and rhythmic limb movement disorder. They have decreased expressive function, with developmental delays in terms of brain growth, and gait abnormalities. This is a genetic mutation disorder occurring in children from 6-18 months of age. The disorder is debilitating leaving children with functional disability and dependency. 

Diagnosis

The movement disorders are diagnosed clinically with the presence of abnormal movement and motor disorder.

Along with this, the physician’s order some lab and imaging tests to confirm the causes. Depending on the type of movement that is hyperkinetic or hypokinetic, slow or increased, it can be known which part of the brain is affected and if it is of genetic inheritance or a secondary disorder.

The following tests can be ordered like

• Blood count to rule out infections and toxins as the causes. 
• Electromyography is to check the electrical activity in the brain. 
• Lumbar puncture analysis of the cerebrospinal fluid and their abnormalities which can tell us about infection or any other condition.
• Nerve conduction study to measure the electrical current flow through the nerve cell to know what parameters are affected. 

Treatment 

The movement disorder treatment depends on the child’s condition and its severity. Depending upon the type of movement disorder, the treatment regime can be established. 

• Medications to relax the muscle stiffness, ease the tremors and spasms.
• Botox injections are available to help with dystonia and related disorders like tic disease, and myoclonus. If this doesn’t help with the spasticity symptoms, baclofen pump has been introduced to better help with the symptoms. 
• Levodopa for parkinson’s disorder
• For dystonia that doesn’t respond to the above treatment, might benefit from deep brain stimulation. 
• Physical therapy for children with movement disorder can make a great difference. It involves stretching and working the limbs and muscles. It improves balance, posture, strength, and coordination. The exercises can help people walk independently without assistance. 
• Occupational therapy has been shown to improve limitations from abnormal movements. The recommended devices can help with activities like eating, and swallowing. 

Moral support from family and friends for children with movement disorder is vital.

They are already suffering because of the involuntary movement of arms and legs, during this time they need assurance and assistance.

At the same time, it is hard on the parents too. So, psychotherapy for the family for how to deal with the situation and their condition is vital.

Parents should know everything about the disorder so they can be prepared to face any situation concerning their child. Their child can throw a fit or tantrum and it gets difficult to handle them along with the abnormal movements. 

Neuropsychiatric testing for disorders can rule out the cause of the condition and the doctors can treat the children with the specific medication and therapies that are needed for the disorder. 

Eliminating the cause might reverse the movement disorder. For example, if alcohol is the cause, stopping it can help the individual.

Sometimes, because of high doses of certain medications the movement disorder can develop. If that’s the case the physician might taper the dose or give something for the tremor. 

Movement disorders can be exhausting for the child or the individual who is experiencing it. It is important to not ignore the subtle signs of abnormal movement.

To know more about these disorders and their treatment check the neuropsychiatric illness treatment in Patna, Dr. Vivek Pratap Singh.