Movement Disorders

What are movement disorders?

Neurological movement disorders can affect your ability to walk, talk, and move. Living with a progressive movement disorder such as Parkinson’s disease can make everyday movements a struggle. You may also be worried about your future health as the disease progresses. At AHN Neuroscience Institute, we help you get symptom relief and manage the condition long term. Our team evaluates and manages patients who have movement disorders, functional movement disorders, and stereotypic movement disorder including:

• Dystonia
• Essential tremor
• Parkinson's disease
• Huntington's disease
• Tourette syndrome
• Ataxia 

AHN Movement Disorder Program

The AHN Movement Disorder Program is dedicated to treating the various movement disorders that affect our patients. Using specialized, comprehensive care that is focused on the unique needs that functional movement disorder, stereotypic movement disorders and the other health conditions associated with these conditions, we provide our patients the options they need to live full lives. We deliver truly multidisciplinary care, bringing together movement disorder neurologists, neurosurgeons, physical and occupational therapists, and other specialists who collaborate closely to address every aspect of your condition and improve your quality of life.

Why choose AHN for your movement disorders

Our movement disorder specialists are leaders in their fields. As fellowship-trained experts, we’ve helped hundreds of patients live more active lives after administering an innovative treatment called deep brain stimulation surgery. At AHN, we provide access to comprehensive evaluation services and novel treatment options to help you manage your care.

People with a range of movement disorders choose AHN because of our:

• Expertise: Our network includes several physicians who have received training in the diagnosis and treatment of complex and rare movement disorders. We are committed to helping patients live healthy, active lives.
• Specialized clinics: Our outpatient clinics for Parkinson’s disease and spasticity care bring together neurologists, neurosurgeons, physical therapists, and other medical professionals to address many aspects of your care during one visit. Read more about our comprehensive Parkinson’s care. 
• Novel treatment options: We offer a wide range of therapies, including new medications and innovative treatments and surgeries. Deep brain stimulation and other neurosurgical treatments have provided many benefits to patients with Parkinson’s disease, essential tremors, and dystonia. Certain types of physical, occupational, and speech therapy may improve symptoms of essential tremor and dystonia.
• Personalized care plans: At AHN, we use the latest technologies and therapies to diagnose and treat patients, tailoring care to your symptoms and circumstances. Our physicians coordinate all aspects of your care across our network of specialists and services.
• Long-term follow-up: Living with a movement disorder may mean your symptoms or challenges change over the coming years. We stay in regular contact with our patients, helping you reach goals that are meaningful for you while supporting you over the long term.

Quick guide to movement disorders

Movement disorders symptoms and signs

Movement disorders screening and diagnosis

Types and stages of movement disorders

Movement disorders treatment

Movement disorders FAQs

Contact us

Movement disorders symptoms and signs

Understanding the different types of movement disorder and their symptoms and signs can help lead to earlier diagnosis and treatment. There are different ways these neurological symptoms can show up in the body and impact everyday life. Recognizing the distinctions between conditions like a functional movement disorder and a stereotypic movement disorder can help in future conversations with your AHN care team.

Types of functional movement disorder (FMD) symptoms

Functional movement disorder symptoms are often highly variable, meaning they can change in their intensity, body location, or even disappear and reappear unpredictably. These symptoms are not caused by damage or disease in the brain itself, but rather by a how the brain sends and receives signals. These symptoms can include:

• Functional tremor: Often jerky, variable frequency, and distractible.
• Functional dystonia: Sustained muscle contractions causing twisting or repetitive movements and abnormal postures. Can be fixed (fixed dystonia) or paroxysmal.
• Functional gait disorder: Unusual or bizarre walking patterns (e.g., astasia-abasia, sudden knee buckling).
• Functional myoclonus: Sudden, brief, shock-like jerks.
• Functional weakness/paralysis: Inability to move a limb or part of the body.

Types of stereotypic movement disorder (SMDs) symptoms

Stereotypic movement disorder involves repetitive, often rhythmic, and seemingly purposeless movements like body rocking, head banging, or hand waving. These movements typically begin in childhood, can be suppressed temporarily with effort, and may increase with stress, excitement, or fatigue.

• Tics: Tics are sudden, rapid, non-rhythmic, and often preceded by an urge. While suppressible, the urge builds up. Stereotypies are more rhythmic, longer in duration, and typically not preceded by an uncomfortable urge.
• Dystonia: Dystonia involves sustained or intermittent muscle contractions causing abnormal postures or repetitive movements. These are often involuntary and can be painful. Stereotypies are generally non-painful and less "involuntary" in the acute sense.
• Compulsions (OCD): While some stereotypes can resemble compulsions (e.g., checking behaviors), compulsions are typically goal-directed and performed to reduce anxiety associated with an obsession, whereas stereotypes are often for self-stimulation or sensory regulation.

Other symptoms with reduced or slowed movement

Movement disorder can also have other symptoms associated with it that include:

• Bradykinesia: Slowness of movement. This can make everyday tasks feel effortful and time-consuming.
• Akinesia: Difficulty initiating movement, or a complete absence of movement.
• Rigidity: Stiffness or inflexibility of limbs or the trunk, often felt as a resistance to passive movement.
• Postural instability: Difficulty maintaining balance, leading to increased risk of falls.
• Gait disturbances: Changes in walking patterns, such as shuffling, freezing, or an unsteady walk.

It's important to remember that many of these movement disorders symptoms can overlap, and experiencing one or more doesn't automatically mean you have a specific diagnosis. A healthcare professional can help properly evaluate and diagnose your specific situation.

Causes and risk factors

Movement disorders encompass a wide range of conditions characterized by either too much or too little movement. Their causes and risk factors are diverse and often fall into several key categories: 

Primary movement disorder causes

Primary movement disorders are neurological conditions where the movement problem is the main and defining feature, rather than being a symptom of another underlying condition. They are often caused by:

• Neurodegeneration: Progressive loss of specific brain cells, often in motor control areas (e.g., Parkinson's Disease).
• Genetics: Specific inherited gene mutations that directly cause the disorder (e.g., Huntington's Disease) or predispose an individual to it. 

Secondary (symptomatic) movement disorder causes

Secondary movement disorders are often caused by a symptom or complication from an underlying condition or medication. These can include:

• Medication side effects: Certain drugs, especially those affecting dopamine in the brain like some antipsychotics or even anti-nausea medications can cause movement disorders.
• Brain injury: Damage to specific areas of the brain that control movement, whether from a stroke (lack of blood flow), traumatic brain injury (like a severe concussion), or tumors pressing on brain tissue, can disrupt normal motor control and lead to abnormal movements.
• Infections or autoimmune conditions: With infections and autoimmune conditions, the body's immune system can mistakenly attack brain tissue and cause inflammation and damage that results in movement problems.
• Metabolic disorders: These are conditions where the body has problems with its chemical processes. Examples include Wilson's disease (where copper builds up in the body), certain vitamin deficiencies (like B12), or problems with kidney or liver function, all of which can disrupt brain activity and cause movement symptoms.
• Toxins: Exposure to certain harmful substances can damage the nervous system. For instance, heavy metals like mercury or lead, or certain pesticides, can accumulate in the body and lead to tremors, dystonia, or other involuntary movements.
• Functional: These are very real and involuntary movement symptoms, such as tremors, dystonia, or gait problems, that are not caused by structural damage to the brain or a clear neurological disease. Instead, they arise from complex, often reversible, alterations in how the brain functions and processes information, leading to abnormal motor output.
• Idiopathic: This term is used when movement disorder symptoms are present, but no identifiable cause can be found despite extensive medical investigation. While frustrating, it means that current diagnostic tools haven't pinpointed the underlying reason, even though the symptoms are real.

Key risk factors

There are certain risk factors associated with both primary and secondary movement disorders that can increase the risk of developing either disorder:

• Age: The most significant risk factor for many neurodegenerative movement disorders.
• Genetics/family history: Inherited genes or a family history of the disorder.
• Environmental exposures: Certain toxins (e.g., pesticides) or repetitive head trauma.
• Medication use: Particularly long-term use of certain drugs.
• Underlying medical conditions: Such as stroke, infection, or autoimmune diseases.
• Psychological factors: History of anxiety, depression, PTSD, chronic stress, or prior physical injury (especially for Functional Movement Disorders).

Movement disorders screening and diagnosis

Movement disorders are often misdiagnosed because their symptoms can mirror those of many other conditions. AHN’s specialists have a thorough understanding of many different movement disorders. We use a range of diagnostic tools to evaluate your symptoms and provide a precise diagnosis. No single test can diagnose a movement disorder. After evaluating your symptoms, your doctor may recommend testing be done to determine if you are experiencing a movement disorder.

Magnetic resonance imaging (MRI) or other imaging tests

An MRI is a powerful tool that uses strong magnets and radio waves to create detailed images of your brain and spinal cord. which can help physicians rule out conditions, such as a tumor, that might explain your symptoms. For example, an MRI can show if there's a tumor, a stroke, multiple sclerosis, or structural abnormalities in the brain that could be causing your symptoms. In many primary movement disorders (like Parkinson's disease or essential tremor), the brain MRI often appears normal, which helps your physician confirm that the issue isn't a structural problem, allowing them to focus on the functional aspects of the movement disorder.

Blood or urine tests

These laboratory tests analyze samples from your body to check for various biological markers. Blood and urine tests are used to screen for underlying conditions that can sometimes cause or worsen movement symptoms. They can tell us if there are unusual levels of hormones (like thyroid hormones, which can affect tremor), electrolytes, vitamins (e.g., B12 deficiency), or other substances that may be contributing to your symptoms. They can also detect toxins, certain infections, or metabolic imbalances (like liver or kidney problems) that can affect brain function and movement.

Neurological tests

During a neurological exam, your physician will carefully observe your movements, posture, balance, and gait. They will ask you to perform specific tasks to assess your coordination, fine motor skills, muscle strength, reflexes, and how your movements change with different activities or positions. This helps them characterize the specific type of abnormal movement you're experiencing (e.g., tremor, dystonia, bradykinesia) and determine if it fits the pattern of a known movement disorder. 

Types and stages of movement disorders

Movement disorders are incredibly diverse, with many different conditions falling under this umbrella. Understanding their types can help clarify what's involved, and while formal stages aren't always used, thinking about how symptoms can change over time is often helpful.

Functional movement disorders

In a functional movement disorder, patients experience very real and often debilitating involuntary movements or postures (such as tremors, dystonia, or gait problems) that are not caused by underlying neurological disease or damage to the nervous system. Instead, they are related to a problem in how the brain is processing movement, often influenced by stress, anxiety, or psychological factors. These are genuine and distressing symptoms, but they differ from other movement disorders in their underlying mechanism.

Stereotypic movement disorders

A stereotypic movement disorder is characterized by repetitive, seemingly driven, and nonfunctional motor behaviors. These can include actions like head banging, body rocking, hand flapping, or self-biting. These movements are typically not rhythmic or intentional. This disorder is most often seen in children, particularly those with developmental conditions such as autism spectrum disorder or intellectual disability and can sometimes interfere with daily activities.

Unlike some other neurological conditions (like cancer or certain types of dementia) that have very specific and universally recognized stages, most movement disorders do not follow a rigid staging system. Instead, their progression is often described in terms of severity and the impact on daily life. Generally the progression can be classified as:

• Early/Mild: Symptoms might be subtle, intermittent, or only affect one side of the body. They may not significantly interfere with daily activities. Diagnosis can sometimes be challenging at this stage.
• Moderate: Symptoms become more noticeable and consistent, potentially affecting both sides of the body or requiring adjustments to daily routines. Patients might experience some difficulty with tasks like writing, eating, or walking. Medication or other therapies are often introduced at this point.
• Advanced/Severe: Symptoms are prominent and significantly impact quality of life and independence. Many daily activities may become difficult or require assistance. More intensive treatments, including advanced therapies or surgical options, might be considered.

Movement disorders treatment

After a comprehensive evaluation, we develop a thoughtful care plan that addresses your symptoms and challenges. AHN’s movement disorders care team is led by a network of board-certified neurologists, neurosurgeons, and rehab physicians who have years of experience treating complex movement disorders. Your treatment plan may change as the condition progresses or as your preferences change.

Treatment options include:

• Medication: Your physician helps determine which medications and dosage would most benefit you, based on your symptoms and specific challenges.
• Physical therapy: Certain exercises or activities may improve your symptoms. Regular activity can also benefit your health in many ways. Our knowledgeable, caring physical therapists work with you on a customized physical therapy plan.
• Speech or occupational therapy: Our specially trained speech and occupational therapists can help you relearn how to complete daily activities that have become difficult.
• Surgery: Neurosurgical procedures, such as deep brain stimulation, may be an option for you. Our specialists have performed hundreds of these innovative procedures, which involve surgically implanting electrodes into the brain to regulate impulses. 

Movement disorders FAQs

Having the right information about movement disorders can help you feel more confident in your care and treatment plan. AHN is here to help. Patients often find these frequently asked questions to be helpful in guiding future conversations with their AHN care team.

What are the first signs of movement disorder?

The first signs of a movement disorder can vary greatly depending on the specific condition. Generally, people might first notice subtle, involuntary movements or a change in how they move that they can't control. This could include a slight tremor in a hand or limb, a feeling of stiffness, difficulty with coordination, changes in walking, or an urge to move their legs when at rest. Sometimes, family or friends are the first to notice these changes. Since movement disorders symptoms can be subtle at first and often worsen gradually, they might initially be dismissed as signs of aging or fatigue. For example, the earliest movement disorders symptoms might look like mild clumsiness, or an unusual repetitive action. If you notice persistent or unusual changes in your movement, it's a good idea to consult with a doctor.

Are movement disorders serious?

The seriousness of a movement disorder depends entirely on the specific condition and how it affects an individual. Some movement disorders, like essential tremor, are generally not life-threatening but can significantly impact daily activities and quality of life over time. Others, such as Huntington's disease, are progressive and can be very serious, leading to severe disability.

Even conditions like functional movement disorder, while not caused by structural brain damage, can present with severe and debilitating movement disorders symptoms that significantly affect a person's life. Similarly, a stereotypic movement disorder can interfere with a child's learning and social interactions. Many movement disorders are chronic, meaning they are long-lasting conditions, but they are often manageable with various treatments and therapies. While some can be serious, many people with movement disorders lead fulfilling lives, especially with early diagnosis and appropriate management.

How do I know if I have a movement disorder?

The only way to know for certain if you have a movement disorder is to be evaluated by a healthcare professional, ideally an AHN neurologist specializing in movement disorders. They will conduct a thorough physical and neurological examination, ask detailed questions about your medical history and movement disorders symptoms, and may order various tests. These tests can include imaging scans like an MRI, blood and urine tests, or specialized neurological assessments. This comprehensive evaluation helps them to identify the specific type of movement disorder, if present (distinguishing, for example, between a tremor from Parkinson's and one from functional movement disorder), or rule out other conditions that might be causing your symptoms.

Do movement disorders show in MRI?

For many common movement disorders like Parkinson's disease or essential tremor, a standard MRI of the brain often appears normal. This is because these conditions are often related to changes in brain chemistry or the function of brain cells, rather than large structural abnormalities that an MRI is designed to detect. The same is true for functional movement disorder, where the MRI typically shows no structural problems that would explain the movement disorders symptoms. However, an MRI is still a very important tool. It helps your doctor rule out other conditions that could cause movement disorders symptoms, such as a brain tumor, stroke, or multiple sclerosis, which would show up on an MRI.

Do movement disorders go away?

Generally, most movement disorders are considered chronic conditions, meaning they are long-lasting and often do not go away completely. However, this doesn't mean they can't be effectively managed or that movement disorders symptoms can't improve significantly. Many movement disorders are progressive, meaning symptoms may worsen over time, but the rate of progression varies widely. For some, symptoms might remain stable for many years.

Even in conditions like functional movement disorder, while the underlying cause is not structural, the symptoms are very real and often require treatment, though they can sometimes resolve with appropriate therapies. For a stereotypic movement disorder, interventions often focus on behavioral strategies rather than a cure.

Contact us

To schedule an appointment or learn more about AHN neuroscience services, call 412-359-8850 in Pittsburgh or 814-452-7575 in Erie.

If you’re an existing patient, you can also call (412) DOCTORS 412-362-8677 in Pittsburgh or request an appointment with AHN neuroscience services.