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  • Updated 05.14.2024
  • Released 11.15.2004
  • Expires For CME 05.14.2027

Posttraumatic movement disorders



The concept that movement disorders may develop following trauma to the central and peripheral nervous systems has been widely accepted. It has both medical and legal implications for clinicians and their patients. The author of this clinical article review and provides updates on the pathogenesis, diagnosis, and management of posttraumatic movement disorders.

Key points

• Movement disorders can occur following central and peripheral nervous system trauma.

• Tremors and dystonia are the two most common abnormal movements following nervous system injury.

• The pathophysiology of posttraumatic movement disorders is complex and may include but is not limited to functional reorganization and alteration of neurotransmitters.

• Treatments for posttraumatic movement disorders are similar to those of nontraumatic movement disorders; however, the response is variable.

• A multidisciplinary approach is recommended in patients with comorbid psychological conditions and when there is pending litigation.

Historical note and terminology

Tremor, dystonia, and parkinsonism are the movement disorders that have been most often reported following trauma to both the central and peripheral nervous systems (34). Other movement disorders have been reported following trauma including chorea, hemiballism (57), ballism, paroxysmal dyskinesia, tics (22), progressive supranuclear palsy (59), painful legs and moving toes (99), cortical reflex myoclonus (37), palatal myoclonus (44), hemifacial spasm, hemimasticatory spasm, Meige syndrome (45), segmental myoclonus (50; 10), jumping postamputation stump, and other postamputation dyskinesia (49).

Although a direct causal link between a neurologic injury and the subsequent development of a movement disorder is not always clear with CNS trauma, a causal linkage is often even less apparent in cases of movement disorders following trauma to the peripheral nervous system. Some authors argue against the existence of “peripherally induced” movement disorders (113; 40), whereas others have argued that tremor, dystonia, and segmental myoclonus do occur following peripheral trauma (48; 49; 107).

Some authors suggest the term “posttraumatic syndrome” instead of “posttraumatic dystonia” in patients who have developed abnormal posturing of body parts following peripheral injury (64).

In addition, anecdotal reports suggest that trauma to both central and peripheral nervous systems may trigger or accelerate the progression of preexisting movement disorders.

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