11 - Involuntary movements

Abstract

This chapter discusses the various types of involuntary movements. Essential tremor is the term used for the condition characterized by tremor and no or practically no other symptoms. This condition is inherited as an autosomal dominant trait. The onset is usually in childhood or adolescence, although in a few reported families, affected members noted the onset in their fifth or sixth decade. The patient complains of shaky unsteady finger movements. Tremor of the fingers and the hands is found on examination; it is present at rest and increases only slightly on voluntary movements. Nystagmus, head tremor, and other disturbances of movement or posture and neurological abnormalities are not found. The tremor may remain stationary throughout life or show a slow and mild progression. It is an annoying condition, which impairs the patient's ability to manage cutlery nimbly at the table and to write rapidly and neatly but otherwise has no influence on his ability to live a normal life. Choreoathetosis consists of slow writhing movements of the head, neck, and extremities and of large sudden jerks, usually of the arms and hands. It is found that because of these uncontrolled movements, all intentional activity is disturbed, and the patient may have great difficulty in keeping his balance when sitting or standing.