Movement Disorders in Metabolic Disorders


Purpose of Review

We provide a review of the movement disorders that complicate selected metabolic disorders, including the abnormal movements that may appear during or after their treatment.

Recent Findings

Movement disorders may be underrecognized when arising in the context of a broad range of metabolic disorders.


Abnormal movements may occur as the initial manifestation of a systemic disease, at any time during its course, or as a result of the medical interventions required for its management. Ascertaining movement phenomenology in acute and subacute presentations may assist in the determination of the specific underlying metabolic disorder. The management of movement disorders associated with metabolic disorders depends on the underlying pathophysiology.

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Corresponding author

Correspondence to Alberto J. Espay.

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Conflict of Interest

Orlando Barsottini and José Luiz Pedroso each declare no potential conflicts of interest. Alberto Espay has received grant support from the NIH, Great Lakes Neurotechnologies, and the Michael J Fox Foundation; personal compensation as a consultant/scientific advisory board member for Abbvie, TEVA, Impax, Acadia, Acorda, Cynapsus/Sunovion, Lundbeck, and USWorldMeds; publishing royalties from Lippincott Williams & Wilkins, Cambridge University Press, and Springer; and honoraria from Abbvie, UCB, USWorldMeds, Lundbeck, Acadia, the American Academy of Neurology, and the Movement Disorders Society.

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Supplementary Video 1

We illustrate with 6 patients selected movement disorders associated with metabolic disorders. Segment 1: chorea in the setting of primary hypoparathyroidism with basal ganglia calcification (Courtesy of Dr. Thiago Cardoso Vale, from the Department of Neurology, Federal University of Juiz de For a, MG, Brazil). Segment 2: Trousseau sign in hypomagnesemia. Segment 3: hemichorea-hemiballism due to non-ketotic hyperglycemia. Segment 4: asterixis in hepatic failure (Courtesy of Dr. Guilherme Felga, from the Albert Einstein Hospital, SP, Brazil). Segment 5: tremor and myoclonus in uremic encephalopathy/renal failure. Segment 6: myoclonus in post-cardiac arrest anoxic encephalopathy. Segment 7: post-pump chorea after cardiac valve replacement surgery. (HTML 268 kb)

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Pedroso, J.L., Barsottini, O.G. & Espay, A.J. Movement Disorders in Metabolic Disorders. Curr Neurol Neurosci Rep 19, 7 (2019).

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  • Movement disorders
  • Abnormal movements
  • Metabolic disorders
  • Electrolytes
  • Internal medicine