2.05.11 - Literature review on peripheral trauma and movement disorders: A systematic review of reported cases
Two researchers from TREND independently searched electronic medical databases. They collected data regarding patient characteristics, type of movement disorder (MD) and type of injury, as well as information on spread of the MD, predisposing factors, psychological characteristics, presence of nerve lesions and treatment.
The researchers identified 133 publications presenting findings on 713 patients with peripherally induced movement disorders (PIMDs). The results show that MDs were more frequent in women. The most commonly reported PIMD was fixed dystonia, which was often associated with pain and sensory abnormalities of the affected body part. In one quarter of the patients a nerve injury was identified.
More than a third of the patients had Complex Regional Pain Syndrome. These patients were younger, had a shorter interval before developing MDs and more often showed spread of the MD to other body parts. Nearly 15% was diagnosed with a psychogenic movement disorder. In general, response to various treatments, including botulinum toxin administrations, was disappointing.
While there is overlap in clinical characteristics between PIMDs and psychogenic movement disorders, the current review shows that there are many well-documented organic cases of PIMDs. This suggests that MDs, such as dystonia, tremor, myoclonus, and tics, may under certain circumstances (like nerve lesions or genetic predisposition), be triggered by peripheral trauma. The researchers address potential mechanisms that may explain the underlying pathophysiology.
Authors: Van Rooijen DE, Geraedts EJ, Marinus J, Jankovic J, Van Hilten JJ.
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