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Patterned or Repetitive Movements and/or Abnormal Posturing

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Disorders of Movement

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Abstract

Patterned or repetitive movements and/or abnormal posturing are clinical features that can be encountered in a group of disorders of movement either originating from the central nervous system (e.g. dystonia, complex tics or stereotypies) or from the peripheral nervous system (e.g. neuromuscular diseases causing contractures and spasms [neuromyotonia] or difficulty in muscle relaxation [myotonic disorders]). Syndromes characterized by moving toes/moving fingers might also fall in the category of patterned repetitive movements, caused by a central or a peripheral mechanism. Once the disorder of movement is classified, the differential diagnosis includes a large list of genetic, acquired, idiopathic and functional (psychogenic) disorders. This category of involuntary movements often involves several muscle groups and might produce complex motor schemes; on the other hand, some of the related conditions, such as dystonia or peripheral muscle spasms, might appear to be an abnormality of posture. When approaching such movements, the following features should be searched for during clinical examination: effect of voluntary action in the affected body segment, change with distraction, occurrence in sleep, effect of increased attention, presence of premonitory urge, presence of geste antagoniste, occurrence of tremor, occurrence of abnormal posturing and paroxysmal course. Table 6.1 illustrates the main motor behaviours and clinical examination findings that should be recognized in this category. Conditions sharing some of these phenomenological features are dystonia, pseudodystonias, functional (or psychogenic) hyperkinesia, complex tics, alien limb syndrome, stereotypies, painful legs and moving toes syndrome, neuromyotonia, myotonic disorders, muscle spasms and periodic limb movements in sleep.

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Authors and Affiliations

  1. Neurology Department, King’s College Hospital NHS Foundation Trust, London, UK

    Davide Martino MD, PhD (Consultant Neurologist and Honorary Senior Lecturer)

  2. James J. and Joan A. Gardner Center for Parkinson’s Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA

    Alberto J. Espay MD, MSc (Associate Professor of Neurology)

  3. Division of Neurology, University of Toronto Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson’s Disease Toronto Western Hospital, UHN, Toronto, Ontario, Canada

    Alfonso Fasano MD, PhD (Associate Professor of Medicine)

  4. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Francesca Morgante MD, PhD (Assistant Professor Neurology)

Authors
  1. Davide Martino MD, PhD
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  2. Alberto J. Espay MD, MSc
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  3. Alfonso Fasano MD, PhD
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  4. Francesca Morgante MD, PhD
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© 2016 Springer-Verlag Berlin Heidelberg

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Martino, D., Espay, A.J., Fasano, A., Morgante, F. (2016). Patterned or Repetitive Movements and/or Abnormal Posturing. In: Disorders of Movement. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48468-5_6

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  • DOI: https://doi.org/10.1007/978-3-662-48468-5_6

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