Show Summary Details
Page of

Approach to History Taking and Examination of the Movement Disorder Patient 

Approach to History Taking and Examination of the Movement Disorder Patient
Approach to History Taking and Examination of the Movement Disorder Patient

David J. Burn

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2021. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 19 September 2021

Movement disorders can be classified into akinetic–rigid and hyperkinetic categories. The value of a systematic approach to history taking and examination cannot be overstated. For example, taking a detailed family and drug history, or paying close attention to the saccadic eye movements, often produces important information. Cognitive and neuropsychiatric features commonly accompany movement disorders, are often not spontaneously volunteered, and therefore should always be screened for. Sadly, there appears to be an increasing over-reliance on ordering tests indiscriminately in the diagnostic quest, often at the expense of a thorough clinical evaluation. Such an approach is likely to have a low yield, to be potentially misleading, and also to be costly. The key to accurate diagnosis lies in identifying the phenomenology of the movement disorder, set in the context of the historical information obtained (e.g. rate of onset, progression, use of offending drugs), and whether there are additional physical signs to be elicited from the general medical or neurological examination that further narrow down the differential (e.g. organomegaly, eye movement disorder, reflex changes). For intermittent, situational, or task-specific movement disorders, asking the patient to make a video recording on their mobile phone or other device can be invaluable. Alternatively, bringing the relevant piece of equipment to the consulting room (such as a golf club, guitar, etc.) can be illuminating. The implications for other family members should always be borne in mind when undertaking genetic testing. Management should be incremental, engaging the patient in therapeutic decisions wherever possible.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.