Moving forward in childhood-onset movement disorders: a multidisciplinary approach to diagnosis and care

Abstract

Eggink focused her research on movement disorders in children and young-adults, especially dystonia. Neurological movement disorders cause a disruption in the execution of movements or present with involuntary movements. The thesis is divided in three parts. The first parts describes that the recognition of movement disorders in young patient can be challenging. This is caused by the frequent mixed presentation with multiple symptoms, which makes it difficult for the individual doctor. A multidisciplinary approach involving a team of doctors and the facilitation of discussions among doctors may improve the recognition, leading to more diagnoses and targeted management of movement disorders. Part two investigates the impact of movement disorders, especially dystonia, upon quality of life. THe quality of life is severely impaired, but not only affected by the severity of motor symptoms. Non-motor symptoms, including mood, anxiety, cognition and pain are important influencers of the quality of life too. The last part describes the measurement of effectiveness of therapies, such as deep brain stimulation. The effect is primarily measured in terms of motor response, despite the fact that motor symptoms only partly explain the quality of life. Measuring the effect of deep brain stimulation with pre-operative set priorities by the patients may show different effect with motor non-responders still reporting meaning improvements on their priorities. Movement disorders in children and young-adults require a broad, multidisciplinary approach to facilitate the recognition and management as far as possible.