Movement Disorders

Pathophysiology:
Movement disorders are a group of diseases and syndromes affecting the ability to produce and control movement. Though it seems simple and effortless, normal movement in fact requires an astonishingly complex system of control. Movement is produced and coordinated by several interacting brain centers, including the motor cortex, the cerebellum, and a group of structures in the inner portions of the brain called the basal ganglia.

Statistics:
Out of 1,579 screened children, 104 met criteria for tic disorders, giving a lifetime prevalence of 9.9% (95% CI 7.1–12.6%) and a point prevalence of 6.7% (4.3–9.1%). Lifetime prevalence of ICD-10 tic disorders was 2.6% (95% CI 1.2–4.1%) for transient tic disorder (TTD); 3.7% (1.9–5.4%) for chronic tic disorder (CTD); 0.6% (0.2–0.9%) for Tourette disorder (TD); and 2.9% (1.2–4.6%) for non-specific tic disorder.

Treatment:
Benzodiazepines, such as diazepam (Valium), clonazepam (Klonopin, Rivotril), and lorazepam (Ativan) act on the central nervous system to improve passive range of motion, reduce muscle overactivity and painful spasms, and provide overall relaxation. These medications are often taken at night because they cause drowsiness, but they also can relieve muscle spasms that interrupt sleep.

Major Research:
Tendon transfer surgery is another technique to treat contractures. During this procedure, the tendon attached to a spastic muscle is cut and transferred to a different site, preventing the muscle from being pulled into an abnormal position. The disadvantages of these orthopedic procedures are that they are irreversible and they may need to be repeated.