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Clinical assessment 

Clinical assessment
Chapter:
Clinical assessment
Author(s):

Ivan Donaldson

, C. David Marsden

, Susanne A. Schneider

, and Kailash P. Bhatia

DOI:
10.1093/med/9780192619112.003.0137
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date: 22 November 2019

The field of movement disorders consists of a range of neurological conditions in which there is either a paucity of movement, usually associated with rigidity (the akinetic–rigid parkinsonian syndromes), or an excess of movement (the dyskinesias orhyperkinesias).

A general principle that is useful in assessing all movement disorders is to divide individual categories into primary versus secondary or symptomatic. Primary movement disorders, sometimes called idiopathic, are those in which there is no known cause, although many are inherited conditions. Primary movement disorders are those in which the abnormal movement is the major neurological abnormality, and it is not caused by other recognized neurological diseases. Symptomatic conditions are those in which the movement disorder is dominant, but it is due to a recognized neurological disease, or it is a feature of another neurological disease of which the abnormality of movement is a minor part. For example, a young person with parkinsonism due to Wilson’s disease would be defined as having symptomatic parkinsonism. Many symptomatic movement disorders are also of unknown cause, so should be called idiopathic. Symptomatic movement disorders have been classified here into hereditary and acquired.

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