A Blinded Study of the Suppressibility of Involuntary Movements in Huntingtonʼs Chorea, Tardive Dyskinesia, and L-DOPA-Induced Chorea

Walters, Arthur S.; McHale, Denise M.; Sage, Jacob I.; Hening, Wayne A.; Bergen, Michael T.

doi:10.1097/00002826-199006000-00006

Cited by 17 publications

(5 citation statements)

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“…Tardive stereotypies typically disappear during sleep and can be temporarily suppressed volitionally: conversely, they can be exaggerated by stress. 53 Despite their distressing appearance, up to 67% of patients might not even be aware of the involuntary movements. 54 Apart from tardive stereotypy, various other subtypes of tardive dyskinesia resulting from the use of DRBDs have been described, including tardive chorea, tardive dystonia, tardive akathisia, tardive tics (both motor and phonic), tardive myoclonus, tardive tremor and tardive sensory syndromes, such as persistent burning and pain sensations.…”

Section: Chronic/tardive Dimdsmentioning

confidence: 99%

Drug Insight: from disturbed motility to disordered movement—a review of the clinical benefits and medicolegal risks of metoclopramide

Pasricha

Pehlivanov

Sugumar

et al. 2006

Nat Rev Gastroenterol Hepatol

149

115

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Metoclopramide, the only drug approved by the FDA for treatment of diabetic gastroparesis, but used off-label for a variety of other gastrointestinal indications, has many potentially troublesome adverse neurologic effects, particularly movement disorders. In this article, we comprehensively review the indications and side effects of metoclopramide, and describe some common pitfalls and strategies to minimize the medicolegal risks to the prescribing physician. Metoclopramide accounts for nearly a third of all drug-induced movement disorders, a common reason for a malpractice suit. The entire spectrum of drug-induced movement disorders, ranging from subtle to life-threatening, can ensue from its use; akathisia and dystonia are generally seen early in the course of metoclopramide-induced movement disorders, whereas tardive dyskinesia and parkinsonism seem to be more prevalent in chronic users. Female sex, age and diabetes are the major risk factors for metoclopramide-induced movement disorders. It is therefore incumbent on gastroenterologists and other prescribing physicians to become familiar with the adverse neurologic effects associated with the use of metoclopramide, and to take appropriate preventive and defensive measures.

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Section: Chronic/tardive Dimdsmentioning

confidence: 99%

Drug Insight: from disturbed motility to disordered movement—a review of the clinical benefits and medicolegal risks of metoclopramide

Pasricha

Pehlivanov

Sugumar

et al. 2006

Nat Rev Gastroenterol Hepatol

149

115

View full text Add to dashboard Cite

show abstract

“…• Suppression of movements by voluntary activities: Amelioration of abnormal movements by action, partial volitional suppressibility and lack of subjective distress are important characteristics in patients with TD that help to differentiate them from HD. 4 Voluntary activities like speaking and eating reduces the movements in patients with TD but not in HD.…”

Section: Discussionmentioning

confidence: 99%

“…As in oro-buccolingual movements, limb movements are partially suppressible and result in limited or no functional impairment in TD. 4 • Semi-purposiveness of abnormal movements: Incorporation of involuntary limb movements into some voluntary activities (semi-purposiveness) is frequently seen in patients with HD but is rare in TD. [1][2][3] Semi-purposeful movement has been included in the definition of chorea in classical literature.…”

Section: Discussionmentioning

confidence: 99%

Missing Huntington's Disease for Tardive Dyskinesia: A Preventable Error

Kumar

Jog²

2011

Can. J. Neurol. Sci.

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“…Patients may suppress chorea during examination, only to release it when they think they are not observed. 126 Ask the patient to sit quietly in a chair for 30-60 seconds, and if chorea is not clearly manifested, ask him or her to count backward with eyes closed. Attention and cognitive load Distraction and cognitive stress typically worsen chorea.…”

Section: Volitional Suppressionmentioning

confidence: 99%

Variability of Movement Disorders: The Influence of Sensation, Action, Cognition, and Emotions

et al. 2020

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A BS TRACT: Patients with movement disorders experience fluctuations unrelated to disease progression or treatment. Extrinsic factors that contribute to the variable expression of movement disorders are environment related. They influence the expression of movement disorders through sensory-motor interactions and include somatosensory, visual, and auditory stimuli. Examples of somatosensory effects are stimulus sensitivity of myoclonus on touch and sensory amelioration in dystonia but also some less-appreciated effects on parkinsonian tremor and gait. Changes in visual input may affect practically all types of movement disorders, either by loss of its compensatory role or by disease-related alterations in the pathways subserving visuomotor integration. The interaction between auditory input and motor function is reflected in simple protective reflexes and in complex behaviors such as singing or dancing. Various expressions range from the effect of music on parkinsonian bradykinesia to tics. Changes in body position affect muscle tone and may result in marked fluctuations of rigidity or may affect dystonic manifestations. Factors intrinsic to the patient are related to their voluntary activity and cognitive, motivational, and emotional states. Depending on the situation or disease, they may improve or worsen movement disorders. We discuss various factors that can influence the phenotypic variability of movement disorders, highlighting the potential mechanisms underlying these manifestations. We also describe how motor fluctuations can be provoked during the clinical assessment to help reach the diagnosis and appreciated to understand complaints that seem discrepant with objective findings. We summarize advice and interventions based on the variability of movement disorders that may improve patients' functioning in everyday life.

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A Blinded Study of the Suppressibility of Involuntary Movements in Huntingtonʼs Chorea, Tardive Dyskinesia, and L-DOPA-Induced Chorea

Cited by 17 publications

References 0 publications

Drug Insight: from disturbed motility to disordered movement—a review of the clinical benefits and medicolegal risks of metoclopramide

Drug Insight: from disturbed motility to disordered movement—a review of the clinical benefits and medicolegal risks of metoclopramide

Missing Huntington's Disease for Tardive Dyskinesia: A Preventable Error

Variability of Movement Disorders: The Influence of Sensation, Action, Cognition, and Emotions

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