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  • Updated 12.02.2016
  • Released 11.15.2004
  • Expires For CME 12.02.2019

Posttraumatic movement disorders

Introduction

This article includes discussion of posttraumatic movement disorders and peripherally-induced movement disorders. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

The concept of movement disorders following trauma to the central and peripheral nervous systems has been widely accepted. It has both medical and legal implications to clinicians and their patients. The authors of this clinical article review and provide 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 2 most common abnormal movements following nervous system injury.

• Pathophysiology of posttraumatic movement disorders is complex and may include but not be 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 pending litigation.

Historical note and terminology

Although direct causal link between neurologic injury and the development of movement disorders has not been elucidated, tremor, dystonia, and parkinsonism have been reported following trauma to both the central and peripheral nervous system (28). The cause and effect is 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 (97; 33), whereas others have argued that tremor, dystonia, and segmental myoclonus following peripheral trauma are widely accepted (40; 41; 90). Some authors suggest the term “posttraumatic syndrome” instead of “posttraumatic dystonia” in patients who have developed abnormal posturing of body parts following peripheral injury (55). Other movement disorders have been reported following trauma including chorea, hemiballism (49), ballism, paroxysmal dyskinesia, tics (17), progressive supranuclear palsy (50), painful legs and moving toes (83), cortical reflex myoclonus (31), palatal myoclonus (36), hemifacial spasm, hemimasticatory spasm, Meige syndrome (37), segmental myoclonus (42; 09), jumping postamputation stump, and other postamputation dyskinesia (41). In addition, trauma to both central and peripheral nervous systems may also trigger or accelerate the progression of preexisting movement disorders.

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