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Hyperkinetic Movement Disorder Emergencies

  • Movement Disorders (SH Fox, Section Editor)
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Abstract

A movement disorder emergency has been defined by Fahn and Frucht as “any neurological disorder evolving acutely or subacutely, in which the clinical presentation is dominated by a primary movement disorder, and in which failure to accurately diagnose and manage the patient may result in significant morbidity or even mortality.” In this review, we discuss the most common situations in which hyperkinetic movement disorders, including chorea, ballism, dystonia, myoclonus, tics, as well as psychogenic disorders, can present as emergencies. Some acute hyperkinetic issues that can complicate Parkinson’s disease and parkinsonism, such as the rare dyskinesia-hyperpyrexia syndrome, will be also covered. The phenomenology and natural history of medication-induced dystonic reaction, a common form of acute secondary dystonia frequently leading to emergency department consultations, are discussed in detail. Despite the acute nature, most of these conditions can result in a good outcome. Rare but serious disorders such as status dystonicus or malignant Gilles de la Tourette syndrome may lead to substantial morbidity and mortality. Thus, we emphasize the need to develop means for more accurate and prompt recognition and treatment of these syndromes.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Munhoz RP, Scorr LM, Factor SA. Movement disorders emergencies. Curr Opin Neurol. 2015;28(4):406–12. A very detailed update on the clinical features and natural history of all movement disorders emergencies.

    Article  PubMed  Google Scholar 

  2. Munhoz RP, Moscovich M, Araujo PD, Teive HA. Movement disorders emergencies: a review. Arq Neuropsiquiatr. 2012;70:453–61.

    Article  PubMed  Google Scholar 

  3. • Robottom BJ, Factor SA, Weiner WJ. Movement disorders emergencies. Part 2: hyperkinetic disorders. Arch Neurol. 2011;68(6):719–24. A succinct but comprehensive review on this topic.

    Article  PubMed  Google Scholar 

  4. Barbeau A, Duvoisin RCJ, Gerstenbrandt F, et al. Classification of extrapyramidal disorders. Proposal for an international classification and glossary of terms. J Neurol Sci. 1981;51(2):311–27.

    Article  CAS  PubMed  Google Scholar 

  5. Berman SA. Chorea. In: Joseph AB, Young RR, editors. Movement disorders in neurology and neuropsychiatry. 2nd ed. Malden: Blackwell Science; 1999. p. 481–94.

    Google Scholar 

  6. Dewey Jr RB, Jankovic J. Hemiballism-hemichorea. Clinical and pharmacologic findings in 21 patients. Arch Neurol. 1989;46(8):862–7.

    Article  PubMed  Google Scholar 

  7. Fukui T, Hasegawa Y, Seriyama S, Takeuchi T, Sugita K, Tsukagoshi H. Hemiballism-hemichorea induced by subcortical ischemia. Can J Neurol Sci. 1993;20(4):324–8.

    Article  CAS  PubMed  Google Scholar 

  8. Sanchez-Ramos JR, Factor SA, Weiner WJ, Marquez J. Hemichorea-hemiballismus associated with acquired immune deficiency syndrome and cerebral toxoplasmosis. Mov Disord. 1989;4(3):266–73.

    Article  CAS  PubMed  Google Scholar 

  9. Vidaković A, Dragasević N, Kostić VS. Hemiballism: report of 25 cases. J Neurol Neurosurg Psychiatry. 1994;57(8):945–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cardoso F. Chorea: nongenetic causes. Curr Opin Neurol. 2004;17:433–6.

    Article  PubMed  Google Scholar 

  11. Zomorrodi A, Wald ER. Sydenham's chorea in western Pennsylvania. Pediatrics. 2006;117:e675–9.

    Article  PubMed  Google Scholar 

  12. Swedo SE. Sydenham's chorea. A model for childhood autoimmune neuropsychiatric disorders. JAMA. 1994;272(22):1788–91.

    Article  CAS  PubMed  Google Scholar 

  13. Beato R, Maia DP, Teixeira Jr AL, Cardoso F. Executive functioning in adult patients with Sydenham's chorea. Mov Disord. 2010;25(7):853–7.

    Article  PubMed  Google Scholar 

  14. Cardoso F. Movement disorders in childhood. Parkinsonism Relat Disord. 2014;20 Suppl 1:S13–6.

    Article  PubMed  Google Scholar 

  15. Red Book: 2009 Report of the committee on infectious diseases. 28th ed. American Academy of Pediatrics; 2009.

  16. Cardoso F, Vargas AP, Oliveira LD, et al. Persistent Sydenham's chorea. Mov Disord. 1999;14:805–7.

    Article  CAS  PubMed  Google Scholar 

  17. Korn-Lubetzki I, Brand A, Steiner I. Recurrence of Sydenham chorea: implications for pathogenesis. Arch Neurol. 2004;61:1261–4.

    Article  PubMed  Google Scholar 

  18. Garvey MA, Snider LA, Leitman SF, et al. Treatment of Sydenham's chorea with intravenous immunoglobulin, plasma exchange, or prednisone. J Child Neurol. 2005;20:424–9.

    Article  PubMed  Google Scholar 

  19. Daoud AS, Zaki M, Shakir R, et al. Effectiveness of sodium valproate in the treatment of Sydenham's chorea. Neurology. 1990;40:1140–1.

    Article  CAS  PubMed  Google Scholar 

  20. Ronchezel MV, Hilario MO, Forleo LH, et al. The use of haloperidol and valproate in children with Sydenham chorea. Indian Pediatr. 1998;35:1215–8.

    CAS  PubMed  Google Scholar 

  21. Miyasaki JM, Aldakheel A. Movement disorders in pregnancy. Continuum. 2014;20:148–61.

    PubMed  Google Scholar 

  22. Khamashta MA, Bertolaccini ML, Hughes GR. Antiphospholipid syndrome. Autoimmunity. 2004;37:309–12.

    Article  CAS  PubMed  Google Scholar 

  23. Khamashta MA, Gil A, Anciones B, et al. Chorea in systemic lupus erythematosus: association with antiphospholipid antibodies. Ann Rheum Dis. 1988;47:681–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Panzer J, Dalmau J. Movement disorders in paraneoplastic and autoimmune disease. Curr Opin Neurol. 2011;24:346–53.

    Article  PubMed  PubMed Central  Google Scholar 

  25. • Dalmau J, Lancaster E, Martinez-Hernandez E, et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol. 2011;10:63–74. A very comprehensive update on the diagnosis and natural history of autoimmune encephalitis.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Johnson N, Henry C, Fessler AJ, et al. Anti-NMDA receptor encephalitis causing prolonged nonconvulsive status epilepticus. Neurology. 2010;75:1480–2.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Iizuka T, Sakai F, Ide T, et al. Anti-NMDA receptor encephalitis in Japan: long-term outcome without tumor removal. Neurology. 2008;70:504–11.

    Article  CAS  PubMed  Google Scholar 

  28. Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008;7:1091–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kleinig TJ, Thompson PD, Matar W, et al. The distinctive movement disorder of ovarian teratoma- associated encephalitis. Mov Disord. 2008;23:1256–61.

    Article  PubMed  Google Scholar 

  30. Irani SR, Bera K, Waters P, et al. N-methyl-D-aspartate antibody encephalitis: temporal progression of clinical and paraclinical observations in a predominantly nonparaneoplastic disorder of both sexes. Brain. 2010;133:1655–67.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Tonomura Y, Kataoka H, Hara Y, et al. Clinical analysis of paraneoplastic encephalitis associated with ovarian teratoma. J Neuro-Oncol. 2007;84:287–92.

    Article  Google Scholar 

  32. Koide R, Shimizu T, Koike K, et al. EFA6A-like antibodies in paraneoplastic encephalitis associated with immature ovarian teratoma: a case report. J Neuro-Oncol. 2007;81:71–4.

    Article  CAS  Google Scholar 

  33. Bayreuther C, Bourg V, Dellamonica J, et al. Complex partial status epilepticus revealing anti- NMDA receptor encephalitis. Epileptic Disord. 2009;11:261–5.

    PubMed  Google Scholar 

  34. Ishiura H, Matsuda S, Higashihara M, et al. Response of anti-NMDA receptor encephalitis without tumor to immunotherapy including rituximab. Neurology. 2008;71:1921–3.

    Article  CAS  PubMed  Google Scholar 

  35. Wong-Kisiel LC, Ji T, Renaud DL, et al. Response to immunotherapy in a 20-month-old boy with anti-NMDA receptor encephalitis. Neurology. 2010;74:1550–1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Bansil S, Prakash N, Kaje J et al. Movement disorders after stroke in adults: a review. Tremor Other Hyperkinet Mov. 2012;2. doi:10.7916/D86W98TB.

  37. Dewey RB, Hemiballism-hemichorea JJ. Clinical and pharmacologic findings in 21 patients. Arch Neurol. 1989;46:862–7.

    Article  PubMed  Google Scholar 

  38. Postuma RB, Lang AE. Hemiballism: revisiting a classic disorder. Lancet Neurol. 2003;2:661–8.

    Article  PubMed  Google Scholar 

  39. Pelletier J, Cabanot C, Lévrier O, et al. Angiodysplasia of moya-moya type disclosed by choreic unvoluntary abnormal movements during oral contraception. Apropos of 2 cases]. Rev Neurol (Paris). 1997;153(6–7):393–7.

    CAS  Google Scholar 

  40. Midi I, Dib H, Köseoglu M, et al. Hemichorea associated with polycythaemia vera. Neurol Sci. 2006;27(6):439–41.

    Article  CAS  PubMed  Google Scholar 

  41. Mestre TA, Ferreira JJ, Pimentel J. Putaminal petechial haemorrhage as the cause of nonketotic hyperglycaemic chorea: a neuropathological case correlated with MRI findings. J Neurol Neurosurg Psychiatry. 2007;78:549–50.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Gil-Navarro S, Grandas F. Another Parkinson’s disease emergency. Mov Disord. 2010;25:2691–2.

    Article  PubMed  Google Scholar 

  43. Onofrj M, Bonani L, Cossu G, et al. Emergencies in parkinsonism: akinetic crisis, life-threatening dyskinesias, and polyneuropathy during L-dopa gel treatment. Parkinsonism Relat Disord. 2009;15 Suppl 3:S233–6.

    Article  PubMed  Google Scholar 

  44. Jankovic J, Penn AS. Severe dystonia and myoglobinuria. Neurology. 1982;32(10):1195–7.

    Article  CAS  PubMed  Google Scholar 

  45. Kipps CM, Fung V, Grattan-Smith P, et al. Movement disorders emergencies. Mov Disord. 2005;20:322–34.

    Article  PubMed  Google Scholar 

  46. Abdo WF, van de Warrenburg BP, Burn DJ, et al. The clinical approach to movement disorders. Nat Rev Neurol. 2010;6:29–37.

    Article  PubMed  Google Scholar 

  47. Marsden CD, Jenner P. The pathophysiology of extrapyramidal side-effects of neuroleptic drugs. Psychol Med. 1980;10(1):55–72.

    Article  CAS  PubMed  Google Scholar 

  48. Pierre JM. Extrapyramidal symptoms with atypical antipsychotics: incidence, prevention and management. Drug Saf. 2005;28(3):191–208.

    Article  CAS  PubMed  Google Scholar 

  49. van Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ. 1999;319(7210):623–6.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Bansal S, Gill M, Bhasin C. Carbamazepine-induced dystonia in an adolescent. Indian J Pharm. 2016;48(3):329–30.

    Article  Google Scholar 

  51. Tekin U, Soyata AZ, Oflaz S. Acute focal dystonic reaction after acute methylphenidate treatment in an adolescent patient. J Clin Psychopharmacol. 2015;35(2):209–11.

    Article  PubMed  Google Scholar 

  52. Hawthorne JM, Caley CF. Extrapyramidal reactions associated with serotonergic antidepressants. Ann Pharmacother. 2015;49(10):1136–52.

    Article  CAS  PubMed  Google Scholar 

  53. Derinoz O, Caglar AA. Drug-induced movement disorders in children at paediatric emergency department: 'dystonia'. Emerg Med J. 2013. doi:10.1136/emermed-2011-200691.

  54. Digby G, Jalini S, Taylor S. Medication-induced acute dystonic reaction: the challenge of diagnosing movement disorders in the intensive care unit. BMJ Case Rep. 2015. doi:10.1136/bcr-2014-207215.

  55. Casey DE. Neuroleptic-induced acute dystonia. In: Lang AE, editor. Drug-induced movement disorders. Mount Kisco: Futura Publishing Co; 1992. p. 21–41.1.

    Google Scholar 

  56. Christodoulou C, Kalaitzi C. Antipsychotic drug-induced acute laryngeal dystonia: two case reports and a mini review. J Psychopharmacol. 2005;19:307–11.

    Article  PubMed  Google Scholar 

  57. Poston KL, Frucht SJ. Movement disorders emergencies. J Neurol. 2008;255:S2–S13.

    Article  Google Scholar 

  58. Graus F, Dalmau J. Paraneoplastic neurological syndromes. Curr Opin Neurol. 2012;25(6):795–801.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Barreira R, Magaldi RB. Acute dystonia after use of bromopride in pediatric patients. Rev Paul Pediatr. 2009;27:110–4.

    Article  Google Scholar 

  60. Frucht SJ. Hyperkinetic movement disorders emergencies. American Academy of Neurology. Minneapolis: Sillabus; 2002.

    Google Scholar 

  61. Miyasaki JM, Lang AE. Treatment of drug-induced movement disorders. In: Kurlan R, editor. Treatment of movement disorders. Philadelphia: Lippincott; 1995. p. 429–74.

    Google Scholar 

  62. Kipps CM, Fung VSC, Grattan-Smith P, de Moore GM, Morris JGL. Movement disorder emergencies. Mov Disord. 2005;20:322–34.

    Article  PubMed  Google Scholar 

  63. • Ekbom K, Lindholm H, Ljungberg L. New dystonic syndrome associated with butyrophenone therapy. Z Neurol. 1972;202:94–103. The first historical description of Pisa syndrome.

    CAS  PubMed  Google Scholar 

  64. Guy N, Raps A, Assael M. The Pisa syndrome during maintenance antipsycotic therapy. Am J Psychiatry. 1986;143(11):1492.

    CAS  PubMed  Google Scholar 

  65. Tariot PN, Pendlebur W, Hamill R. Pisa syndrome with neuroleptic exposure in a patient with dementia of Alzheimer type: a follow-up report [abstract]. J Geriatr Psychiatry Neurol. 1997;10:130.

    Article  CAS  PubMed  Google Scholar 

  66. Kwan YT, Han IW, Baik J, et al. Relation between cholinesterase inhibitor and Pisa syndrome. Lancet. 2000;355(9222):2222.

    Article  Google Scholar 

  67. Miyaoka T, Seno H, Yamamori C, Inagaki T, et al. Pisa syndrome due to anticholinesterase inhibitor (donepezil): a case report. J Clin Psychiatry. 2001;62(7):573–4.

    Article  CAS  PubMed  Google Scholar 

  68. Cossu G, Melis M, Melis G, et al. Reversible Pisa syndrome (pleurothotonus) due to the cholinesterase inhibitor galantamine: Case report. Mov Disord. 2004;19:1243–4.

    Article  PubMed  Google Scholar 

  69. Colosimo C. Pisa syndrome in a patient with multiple system. Mov Disord. 1998;13:607–9.

    Article  CAS  PubMed  Google Scholar 

  70. Tassorelli C, Furnari A, Buscone S, et al. Pisa syndrome in Parkinson’s disease: clinical, electromyographic, and radiological characterization. Mov Disord. 2012;27:227–35.

    Article  PubMed  Google Scholar 

  71. Tinazzi M, Fasano A, Geroin C, et al. Pisa syndrome in Parkinson disease: an observational multicenter Italian study. Neurology. 2015;85(20):1769–79.

    Article  CAS  PubMed  Google Scholar 

  72. Vaamonde J, Narbona, Weiser R, et al. Dystonic storms: a practical management problem. Clin Neuropharmacol. 1994;17(4):344–7.

    Article  CAS  PubMed  Google Scholar 

  73. Teive HA, Munhoz RP, Souza MM, et al. Status dystonicus: study of five cases. Arq Neuropsiquiatr. 2005;63:26–9.

    Article  PubMed  Google Scholar 

  74. Fasano A, Ricciardi L, Bentivoglio AR, et al. Status dystonicus: predictors of outcome and progression patterns of underlying disease. Mov Disord. 2012;27:783–8.

    Article  PubMed  Google Scholar 

  75. Yoshida K, Moriwaka F, Matsuura T, et al. Myoclonus and seizures in a patient with parkinsonism: induction by levodopa and its confirmation on SEPs. Jpn J Psychiatry Neurol. 1993;47:621–5.

    CAS  PubMed  Google Scholar 

  76. Neufeld MY. Periodic triphasic waves in levodopa‐induced encephalopathy. Neurology. 1992;42(2):444–6.

    Article  CAS  PubMed  Google Scholar 

  77. Manca D, Cossu G, Murgia D, et al. Reversible encephalopathy and axonal neuropathy in Parkinson's disease during duodopa therapy. Mov Disord. 2009;24(15):2293–4.

    Article  PubMed  Google Scholar 

  78. • Sandroni C, Cariou A, Cavallaro F, et al. Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40:1816–31. This review shows the evidence on predictors of poor outcome in comatose patients after cardiac arrest, highlighting the often poor outcome of MSE.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Ferlazzo E, Gasparini S, Cianci V, et al. Serial MRI findings in brain anoxia leading to Lance-Adams syndrome: a case report. Neurol Sci. 2013;34:2047–50.

    Article  PubMed  Google Scholar 

  80. Obeso JA, Artieda J, Rothwell JC, et al. The treatment of severe action myoclonus. Brain. 1989;112:765–77.

    Article  PubMed  Google Scholar 

  81. Cohen SC, Leckman JF, Bloch MH. Clinical assessment of Tourette syndrome and tic disorders. Neurosci Biobehav Rev. 2013;37:997–1007.

    Article  PubMed  Google Scholar 

  82. Martino D, Madhusudan N, Zis P, Cavanna AE. An introduction to the clinical phenomenology of Tourette syndrome. Int Rev Neurobiol. 2013;112:1–33.

    Article  CAS  PubMed  Google Scholar 

  83. Cheung MC, Shahed J, Jankovic J. Malignant Tourette syndrome. Mov Disord. 2007;22:1743–50.

    Article  PubMed  Google Scholar 

  84. Cavanna AE, Servo S, Monaco F, Robertson MM. The behavioural spectrum of Gilles de la Tourette syndrome. J Neuropsychiatr Clin Neurosci. 2009;21:13–23.

    Article  Google Scholar 

  85. Vandewalle V, van der Linden C, Groenewegen HJ, et al. Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus. Lancet. 1999;353(9154):724.

    Article  CAS  PubMed  Google Scholar 

  86. Servello D, Sassi M, Brambilla A, et al. Long-term, post-deep brain stimulation management of a series of 36 patients affected with refractory Gilles de la Tourette syndrome. Neuromodulation. 2010;13(3):187–94.

    Article  PubMed  Google Scholar 

  87. Baldermann JC, Schüller T, Huys D, et al. Deep brain stimulation for Tourette-Syndrome: a systematic review and meta-Analysis. Brain Stimul. 2016;9(2):296–304.

    Article  PubMed  Google Scholar 

  88. Kranick S, Ekanayake V, Martinez V, et al. Psychopathology and psychogenic movement disorders. Mov Disord. 2011;26(10):1844–50.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Edwards MJ, Stone J, Lang AE. From psychogenic movement disorder to functional movement disorder: it’s time to change the name. Mov Disord. 2014;29(7):849–52.

    Article  PubMed  Google Scholar 

  90. Stone J, Carson A, Duncan R, et al. Symptoms ‘unexplained by organic disease’ in 1144 new neurology out-patients: how often does the diagnosis change at follow-up? Brain. 2009;132:2878–88.

    Article  PubMed  Google Scholar 

  91. • Fahn S, Jankovic J. Principles and practice of movement disorders. Philadelphia: Churchill Livingstone; 2007. p. 597–611. A classical and comprehensive textbook on movement disorders.

    Google Scholar 

  92. Bramstedt KA, Ford PJ. Protecting human subjects in neurosurgical trials: the challenge of psychogenic dystonia. Contemp Clin Trials. 2006;27:161–4.

    Article  PubMed  Google Scholar 

  93. Hallett M, Fahn S, Jankovic J, et al., editors. Psychogenic movement disorders: neurology and neuropsychiatry. Philadelphia: Lippincott Williams and Wilkins; 2006.

    Google Scholar 

  94. Feinstein A, Stergiopoulos V, Fine J, et al. Psychiatric out-come in patients with a psychogenic movement disorder: a prospective study. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14:169–76.

    CAS  PubMed  Google Scholar 

  95. Crimlisk HL, Bhatia K, Cope H, et al. Slater revisited: 6-year follow-up study of patients with medically unexplained motor symptoms. BMJ. 1998;316:582–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Morgante F, Edwards MJ, Espay AJ, et al. Diagnostic agreement in patients with psychogenic movement disorders. Mov Disord. 2012;27(4):548–52.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Fahn S, Williams DT. Psychogenic dystonia. Adv Neurol. 1988;50:431–55.

    CAS  PubMed  Google Scholar 

  98. Shill H, Gerber P. Evaluation of clinical diagnostic criteria for psychogenic movement disorders. Mov Disord. 2006;21:1163–8.

    Article  PubMed  Google Scholar 

  99. Gupta A, Lang AE. Psychogenic movement disorders. Curr Opin Neurol. 2009;22:430–6.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Movement Disorders Unit, Department of Neurology, Brotzu General Hospital, Cagliari, Italy

    Giovanni Cossu

  2. Department of Neurology, Santa Maria University Hospital, Via Tristano di Joannuccio 1, 05100, Terni, Italy

    Carlo Colosimo

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  1. Giovanni Cossu
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  2. Carlo Colosimo
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Cossu, G., Colosimo, C. Hyperkinetic Movement Disorder Emergencies. Curr Neurol Neurosci Rep 17, 6 (2017). https://doi.org/10.1007/s11910-017-0712-7

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