Movement Disorders Caused by Medical Disease

Abstract

Movement disorders often occur in the context of medical illness, whether as the presenting sign of the illness, as a related feature of the underlying disease process, or as a complication of treatment. Early recognition of an underlying medical cause for movement disorders is essential because the treatment and prognosis differ significantly depending on the underlying pathophysiology. Parkinsonism, nonparkinsonian tremor, dystonia, and chorea have a wide variety of etiologies, requiring a careful medical history in the evaluation of new-onset movement disorders. The spectrum of medical diseases associated with these four syndromes is reviewed in this article.

Uremic Encephalopathy: MR Imaging Findings and Clinical Correlation

“…UE diagnoses in patients were clinical and supported by laboratory findings showing deterioration of renal function and typical neurologic complications. Other possible causative conditions, such as cerebral stroke, drug-induced movement disorder, neurodegenerative disease, or other metabolic disorders 7,8 were excluded by chart review. The medical records of the 10 patients were reviewed for the history and duration of diabetes mellitus (DM); hypertension; the cause of renal failure and categorization into acute renal failure (ARF) or chronic renal failure; presenting symptoms; laboratory findings (serum blood urea, nitrogen, and creatinine levels; metabolic acidosis on arterial blood gas); treatment; and recurrence.…”

Movement Disorders in Systemic Diseases

“…36 Tremor was less frequently observed than bradykinesia and rigidity. 37 Patients may develop rapidly progressive apathy and bilateral bradykinesia. 38 Parkinsonism, probably triggered by thromboocclusive vasculopathy and white matter changes, also can be seen in patients with APS.…”

“…In these patients, response to dopamine replacement therapy is generally poor. 37 The diagnosis of movement disorders as a result of SLE is challenging. The presence of serologic markers typical for SLE or APS and exclusion of other causes, such as vascular chorea and Huntington disease, points toward an autoimmune process.…”

Monoballism associated with newly onset ketotic Hyperglycemia

“…The random blood glucose concentration was 309 mg/dL with (++) urine ketones and glycosuria. She had normal arterial blood gas analysis of pH, P CO2 and HCO 3 − concentrations on room air and temperature. Blood count and liver function tests were normal.…”

“…Focal epilepsy, transient chorea or ballism provoked by an episode of nonketotic hyperglycemia (NKH) in adults with type 2 diabetes [1][2][3][4][5][6][7][8], and ketotic hyperglycemia in children with type I diabetes mellitus have been reported [9]. Nonketotic hyperglycemia occurs more often in women [1,3,6] and usually is associated with very high blood glucose [3]. In these cases, the seizures [7] as well as the choreiform movements have resolved within days to a few weeks after normalization of blood glucose and hence, reversible metabolic derangements within the basal ganglia have often been assumed [1-4, 8, 9].…”