DYSTONIA

Movement disorders

Hypokinetic
hyperkinetic  loss of voluntary and automatic
movements
 reduced amplitude of
movements
 slowness and rigidity
• Dystonia is a hyperkinetic movement disorder characterized by abnormal movement or
posture caused by excessive muscle contraction.
• https://www.youtube.com/shorts/0VrVAwWSnUo

• sustained or intermittent muscle contractions causing abnormal and often repetitive,

movements, postures,

• worsened by voluntary action and associated with over-overflow muscle activation.

 Classification-

time

body state’s impact

Hyperkinetic mvnt disorders

, space distribution
 REGULAR-
ESSENTIAL
RHYTHMIC TREMOR
Essential tremor (ET) is a
neurological disorder that causes
your hands, head, trunk, voice or
legs to shake rhythmically-
https://www.youtube.com/watch?
v=QM8KPWLzI7Q
DYSTONIA=-PD
RHYTMICITY
IRREGULAR-
CORTCAL
MYOCLONUS
Cortical myoclonus is a rare neurological disorder
characterized by sudden, involuntary muscle jerks or
twitches. -
https://www.youtube.com/shorts/Y_QYbj5S_bU
ARHYTHMIC
chorea, athetosis, ballism, tics, akathitic
movements).
• Chorea is a movement disorder that causes sudden, unintended, and
uncontrollable jerky movements of the arms, legs, and facial muscles.
Chorea is seen in many diseases and conditions and is caused by an
overactivity of the chemical dopamine in the areas of the brain that
control movement.

• https://www.youtube.com/watch?v=wTCnbga3sqg
• Athetosis is defined as slow, writhing, and continuous worm-like
movement of the limbs or trunk. The neck, face, and tongue can also
be affected. Athetosis usually occurs as a result of injury to the basal
ganglia.
ballism
• chorea that affects proximal joints such as shoulder or hip. This leads
to large-amplitude movements of the limbs, sometimes with a flinging
or flailing quality.

• https://www.youtube.com/shorts/zR7vL9yCddM
• Tics are fast, repetitive muscle movements that result in sudden and
difficult to control body jolts or sounds. -Tourette’s syndrome

• It is a neuropsychiatric syndrome that is associated with psychomotor

restlessness. The individual with akathisia will generally experience an
intense sensation of unease or an inner restlessness that usually
involves the lower extremities-this results in a compulsion to move. In
most cases the movement is repetitive.-akathetic movements
 Very fast-myoclonus,fast-
speed
tics,intermediate-chorea,slow-athetosis

time
Sustained,not sustained

Dystonia can have two Duration of Duration of Paroxysmal-sudden

contraction movement
components: the tonic reccurence,continual-cout
component, which leads to reccurence,continuous-
dystonic postures, and the without stopping
phasic component
• Focal: 1 body part is affected
• • Segmental: ≥2 contiguous body parts are affected
• • Multifocal: ≥2 non-contiguous body parts are affected
• • Hemidistonia: Ipsilateral arm and leg are involved
• • Generalized: ≥3 body parts are affected, including the trunk and ≥2
other sites; with or without leg involvemen
Muscular pattern
• Same group of muscles in a repetitive way-patterned

• amplitude
• large (e.g., ballism), medium (e.g., chorea), or small (e.g., tremor).
Body state
• 1)Action/rest-
During rest only-
paradoxical dystonia

During action Task specific Not Task

only specific

During rest
and action Mirror dystonia
Voluntary suppressibility , tics, akathitic movement
-nonsupressible- myoclonus
• Wakefulness- . Some movements appear during sleep only (e.g., REM
sleep behavior disorder, periodic movements in sleep), or persist
during sleep (e.g., spinal myoclonus, myokimia, moving toes) and
others are present only while awake. Except for severe dystonia that
can persists during sleep, generally, dystonia is only present while
awake, like most movement disorders.
etiology
• Nervous system pathology-degeneration,structural lesions
• Inherited-AD,AR,X-LINKED DOMINANT,X-LINKED
RECESSIVE,MITOCHONDRIAL
• Acquired-perinatal brain
injury,infection,drugs,toxic,vascular,neoplasms,injury,psychogenic,aut
oimmune-ms,metabolic,immune encephalopathy
• Idopathic-sporadic,familial