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Movement Disorder Emergencies and Movement Disorders in the ICU 

Movement Disorder Emergencies and Movement Disorders in the ICU
Movement Disorder Emergencies and Movement Disorders in the ICU

Mihai C. Sandulescu

, and Edward A. Burton

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date: 05 April 2020

Movement disorders include syndromes characterized by either slowness and paucity of voluntary movement (hypokinetic disorders) or involuntary movements (hyperkinetic disorders). Both types of movement disorder can present as a clinical emergency, where prompt diagnosis and treatment are necessary to avoid morbidity or mortality. This chapter reviews the most common hypokinetic and hyperkinetic movement disorder emergencies encountered in the hospital and intensive care unit, emphasizing diagnostic workup and practical management. Hypokinetic emergencies include neuroleptic malignant syndrome, parkinsonism-hyperpyrexia syndrome, acute parkinsonism, and psychosis in Parkinson’s disease. Hyperkinetic emergencies include hemiballismus-hemichorea, autoimmune orobuccolingual dyskinesia, serotonin syndrome, posthypoxic and other types of myoclonus, and acute dystonia. Diagnosis of these disorders is nearly always based on clinical evaluation; rapid recognition often results in effective treatment and a good prognosis for recovery. Consequently, familiarity with diagnosis and management of movement disorder emergencies is both important and useful.

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