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3 Things You Must Know About Movement Disorders

By Sasha de Beausset Aparicio, MSc

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Movement Disorders
Mood Disorder

Movement disorders usually refer to potential problems an individual might experience during his or her lifespan and manifests through the skeletal and muscular systems.

The muscular system is composed of smooth, skeletal, and cardiac muscles. It is directly involved in the body’s movement, while also maintaining posture as well as circulation of the blood throughout the organism. However, for vertebrates, the muscular system is controlled by the nervous system, despite the fact that some muscles like cardiac muscle, for example, are capable of being completely autonomous.

The skeletal system is another intricate part that can play a significant role when it comes to the development of a moving disorder. Humans are usually born with 270 bones, but some of them fuse into a longitudinal axis called the axial skeleton. 

Movement is possible because of the joints between the bones, among which some allow a more extensive movement range compared to others. So overall, muscle, joints, and bones are the ones that offer the principal movement mechanism, but they’re all coordinated by the nervous system.

Some problems may appear due to a poor diet, lack of exercise, or external and internal influences. Some may be of little importance like cramps, but some may lead to muscle malfunctioning or even paralysis. This is the reason why people have started taking nutritional supplementation to keep everything functioning at a high level. These are usually based on vitamins and minerals, but herbal extracts can sometimes help too.

4 Most Common Movement Disorders

1) Ataxia

Ataxia

Ataxia is a degenerative disorder attacking the spinal cord, brain stem, or the brain.[1][2] This can result in inaccuracy, clumsiness, instability, tremor, imbalance, or a lack of coordination while performing voluntary movements. Movements are not consistent and may appear jerky or disjointed. Patients may fall down frequently due to an unsteady gait. Ataxia also can affect the movement of the eyes and speech.[3][4]

If a metabolic disorder can be identified as the underlying cause, specific treatment may be available in select cases. Several recent clinical studies discovered a cornerstone therapy for ataxia of parkinsonism (or parkinsonism of any cause) is the use of L-DOPA (oral administration).[5][6][7]

Other medications used to treat ataxia associated with parkinsonism (or parkinsonism of any cause) include dopamine agonists, anticholinergics, amantadine, entacapone, and selegiline. However, the situation is different in children with ataxia.[8][9] In their case, generally, only anticholinergics are recommended.

2) Dystonia

Dystonia is another movement disorder (a neurological muscle disorder to be precise) defined by involuntary muscle spasms.[10] This movement disorder is the effect of abnormal functioning of a deep part of the brain (the basal ganglia), which helps control coordination of movement. Basal ganglia controls the fluidity and the speed of movement and prevents undesired movements. 

Individuals diagnosed with dystonia can experience abnormal postures and positions, uncontrollable twisting, or repetitive movements.[11][12] These can have a significant effect on any part of the body, including the vocal cords, arms, trunk, legs, and eyelids. Focal dystonias involve only one body location, most commonly eyelids (blepharospasm), the neck (spasmodic torticollis), hand (writer’s cramp or limb dystonia), or lower face (Meige syndrome).

On the other hand, general dystonias involve the entire body. Depending on what part of the body is affected, the condition can be very disabling.

There is a three-tiered approach to treating dystonia: surgery, medication, and botulinum toxin (commonly known as Botox) injections.[13][14] These may be used alone or in combination. Surgery is taken into consideration when other therapies have proven ineffective. 

The goal of surgery is to interrupt the pathways responsible for the abnormal movements at various levels of the nervous system. Some operations purposely damage small regions of the globus pallidus (pallidotomy), thalamus (thalamotomy), or other deep centers in the brain. Over the past few years, deep brain stimulation (DBS) has been tested with some success. 

Other surgeries include removing the nerves at the point they enter the contracting muscles (selective peripheral denervation) or cutting nerves leading to the nerve roots deep in the neck close to the spinal cord (anterior cervical rhizotomy).

Botulinum toxin injections help block the communication between the muscle and the nerve and may lessen abnormal movements and postures.

3) Huntington’s Disease

Huntington’s Disease

Huntington’s disease is a progressive,[15][16] degenerative and fatal condition. Huntington’s disease is caused by the deterioration of specific nerve cells in the brain. Incidents most often occur between ages 35 and 50, with the condition advancing without remission over 10 to 25 years. This movement disorder affects an estimated one in every 10,000 Americans.[17] 

A juvenile form of the disease affects patients age 20 and younger, accounting for about 16 percent of all cases. Symptoms include the development of psychiatric problems, progressive loss of mental abilities, and uncontrollable movements of the limbs, trunk, and face. Huntington’s disease is hereditary – a child with one affected parent has a 50% chance of developing the condition.[18]

There is no known cure for Huntington’s disease, so treatment focuses on helping patients and family members cope with daily challenges, preventing complications, and alleviating symptoms. Depending on the situation, medical doctors will prescribe antidepressants, antipsychotics, tranquilizers, botox injections, or mood-stabilizers. 

The medication is usually prescribed in the lowest effective dosage, as all of these prescription drugs may have adverse effects. Huntington’s disease is an unforgiving condition that normally runs its full terminal course in 10 to 30 years. Researchers have noticed that the earlier in life the first symptoms occur, the quicker the disease often progresses.[19]

4) Parkinson’s Disease

Parkinson’s disease is a progressive disorder that is induced by degeneration of neurons in the part of the brain that controls movement. This part of the brain is commonly known as the substantia nigra. These nerve cells become impaired or die, losing the capability to produce a valuable chemical called dopamine. 

Parkinson’s disease produces numerous general symptoms,[20] including: 

  • Gradual loss of spontaneous movement, often leading to decreased reaction time or mental skill, decreased facial expression or voice changes;
  • Tremor;
  • Stiffness of the limbs or muscle rigidity; 
  • An unsteady walk or balance; 
  • Gradual loss of automatic movement, often leading to reduced frequency of swallowing, decreased Blinking, and drooling; 
  • A stooped, flexed posture, with bending at the knees, elbows, and hips; 
  • Dementia or depression.

According to the Parkinson’s Disease Foundation,[21] 60,000 new cases of Parkinson’s disease are diagnosed each year, adding to the seven to ten million people who have the disease worldwide. While the risk of Parkinson’s diagnosis increases with age, about 4% of patients afflicted with this condition are diagnosed before the age of 50.

Most Parkinson’s patients are treated with medications to relieve the symptoms of the disease. Some common medications used are anticholinergics, dopamine agonists, and dopamine precursors.[22][23][24] Thalamotomy can help stop tremor by placing a small lesion in a specific nucleus of the thalamus. Deep Brain Stimulation (DBS) of the subthalamic nucleus or globus pallidus can be useful in treating all of the primary motor features of Parkinson’s and sometimes allows for significant decreases in medication doses. Surgery is considered when medications have proven ineffective.

What Is the Treatment for Movement Disorders?

Treatment for Movement Disorders

Treatment for movement disorders varies from one case to another. In most circumstances, the goal of treatment is to alleviate symptoms. Treatment may include botulinum toxin injection therapy (BOTOX therapy), medication, and/or surgery.[25][26]

1) Medication

Medications that may be used include the following:

  • Antiseizure medications like Gabapentin (Neurontin) and Primidone (Mysoline). Antiseizure medications may cause dizziness, a lack of coordination and balance (ataxia), fatigue, and nausea.
  • Antiepileptics like Valproate (Depakote) and Carbamazepine (Tegretol). Side effects of antiepileptics include drowsiness, dizziness, vomiting, and nausea.
  • Dopamine agonists like Pergolide (Permax) and Bromocriptine (Parlodel). Dopamine agonists may cause headaches, nausea, fatigue, and dizziness.
  • Beta-blockers such as Propranolol (Inderal). Side effects caused by beta-blockers include depression, slowed heart rate (bradycardia), nausea, and lightheadedness.
  • Tranquilizers such as Clonazepam (Klonopin) and Benzodiazepines (Diazepam/Valium). Benzodiazepines may cause drowsiness, blood clots (thrombosis), and fatigue.

2) Speech therapy

Some movement disorders, such as Parkinson’s disease, can impair speech, altering the ability of the patient to express elaborate thoughts. For that reason, speech therapy may prove valuable, and it’s commonly recommended to improve the patient’s ability to communicate and swallow. It is crucial for caregivers to recognize that individuals with such movement disorders may not be communicating due to the disease and not due to lack of sociability.

3) Lifestyle and nutrition changes

Exercise and proper diet are crucial for patients with movement disorders. Huntington’s disease, for instance, may cause individuals to choke.[27] Caregivers who help patients eat should provide plenty of time for meals. Food can be softened, cut into small pieces, or pureed to prevent choking and ease swallowing. While some foods may need to be thinned, other foods may require the addition of thickeners. Dairy products, in particular, tend to increase the secretion of mucus, which in turn increases the risk of choking.

4) Caregiver support

Caregiver support

While it may be emotionally challenging, it is crucial for caregivers and patients to make carefully considered, informed decisions regarding the future while the patient is capable of making his or her contribution to a planned course of action. Movement disorders confront individuals and their caregivers with many difficult problems that must be dealt with for the life of the patient.

5) Social activity

Unless and until the disease’s progression hinders it, people with movement disorders should pursue hobbies and interests, socialize, and participate in outside activities. These activities also give caregivers and family members valuable time for themselves.

6) Physical therapy

According to the American Physical Therapy Association, the goal of physiotherapy or physical therapy is to restore function, improve mobility, prevent further injury, and reduce pain by using a variety of methods, including stretches, exercises, electrical stimulation, traction, and massage. Physical therapy has been reported useful in treating many neurological disorders.

5 Amazing Ingredients That May Help

1) 5-HTP

5-HTP is the precursor for serotonin, a brain chemical associated with nervousness, mood, sleep, feeding, and movement. In clinical trials, 5-HTP has been observed to produce benefits in some individuals who have difficulty walking or standing due to cerebellar ataxia.[28][29] However, additional research is needed before a clear conclusion can be drawn.

Avoid taking 5-HTP if you have been diagnosed with mitochondrial encephalomyopathy, eosinophilia syndromes, or Down syndrome. 5-HTP is not recommended to individuals who are hypersensitive or allergic to it. Signs of allergy to 5-HTP may include shortness of breath, itching, or rash. Use with caution if taking antidepressant medications, 5-HTP receptor agonists, phenobarbital, carbidopa, pindolol, tramadol, reserpine, or zolpidem.[30]

2) Arginine

Arginine, (also known as L-arginine), is considered a semi-essential amino acid because supplementation is sometimes required, although it is usually produced in sufficient amounts by the body. As a method of treatment for movement disorders, injections with L-arginine have been recommended to help manage adrenoleukodystrophy (ALD).[31][32] However, many clinical study results are inconclusive, and additional research is required to evaluate the use of arginine in ALD and other neurological conditions.

L-arginine is not recommended to those with a history of stroke or kidney or liver disease. L-arginine is not recommended to pregnant or nursing women. Blood potassium levels should be monitored. L-arginine may worsen symptoms of sickle cell disease. Use cautiously if taking blood pressure drugs, antidiabetic drugs, blood-thinners, or dietary supplements or herbal supplements with similar effects.

3) Ashwagandha

Ashwagandha

Ashwagandha (Withania somnifera) is extensively cultivated in the Middle East and India for its medicinal properties, and it is also found in parts of Africa. Today, Ashwagandha is being used to treat a wide range of health concerns, including for several types of movement disorders. Ashwagandha may be prescribed as a treatment for Parkinson’s disease, but additional research is needed to determine whether Ashwagandha is effective or not.

4) Choline

Data regarding the effectiveness of choline in the treatment of movement disorders is inconclusive and conflicting at this time.[33] Avoid if hypersensitive/allergic to phosphatidylcholine, lecithin, or choline. Use cautiously with liver or kidney disorders or trimethylaminuria. Use carefully with a history of depression. If pregnant or breastfeeding it generally seems safe to consume choline within the recommended adequate intake (AI) parameters.

5) L-Carnitine

Although used traditionally for support of neurological conditions, one poorly designed preliminary clinical study reported that L-acetyl-carnitine (L-carnitine or carnitine) possesses neither efficacy nor toxicity towards the patients with movement disorders. Further trials are required to determine if L-carnitine is beneficial in individuals with neurological disorders.

Early research on the use of carnitine for Rett’s syndrome has produced promising results. However, additional research is needed before a firm conclusion can be made.

Reference Sources