Functional Neurology’s Role in Treating Movement Disorders
Functional Movement Disorders (FMD) is a set of debilitating diseases that are common and easy enough to diagnose but surprisingly have seen little success in terms of treatment and or mitigation of symptoms. Fortunately, there have been major collaborative breakthroughs in Functional Neurology and other fields of medicine that show great promise in dealing with movement disorders.
Previously considered a diagnostic of exclusion, movement disorder is now a rule-in diagnosis with current therapies. This is a significant step in destigmatizing the illness, which was formerly viewed with skepticism and believed untreatable. It’s firstly important to understand what the various types of movement disorders are and their impact on patients.
What are Movement Disorders and how do they affect everyday life?
Functional Movement Disorders are a variety of neurological problems that might impair a person’s ability to move quickly, fluidly, accurately, and easily. It is possible to have abnormal fluency or speed of movement (dyskinesia) that involves excessive or involuntary movement (hyperkinesia) or sluggish or absent voluntary movement (hypokinesia).
Unusual, involuntary body positions and motions are all signs of functional movement disorder. It is caused by a malfunction in the transmission of brain messages. Disorders of psychogenic movement and conversion are other names for functional movement disorders.
Examples of Movement Disorders are:
Ataxia – A loss or lack of coordination that results in jerky movements.
Blepharospasm – A condition where muscles of the eyelids contract abnormally.
Chorea – A form of dyskinesia or neurological illness characterized by abnormally high levels of the neurotransmitter dopamine in the brain’s sections responsible for movement control.
Dyspraxia – A typical disorder that affects the coordination of movements.
Dystonia – A condition that causes prolonged muscle contraction and involuntary movement
Huntington’s disease (also called chronic progressive chorea) – A rare, genetic disorder that leads to the gradual destruction of brain nerve cells. Huntington’s disease has a wide-ranging impact on a patient’s functioning abilities and typically causes issues in movement, cognitive skills, and mental stability.
Multiple system atrophies (e.g., Shy-Drager syndrome) – A rare disorder of the neurological system that gradually destroys brain nerve cells. This impacts balance, mobility, and the autonomic nerve system, which regulates a variety of fundamental activities including breathing, digestion, and bladder control.
Myoclonus – A condition characterized by rapid, brief, or irregular movements. It is considered more of a clinical symptom and is not an illness itself. The twitching cannot be prevented or controlled by the individual affected.
Parkinson’s disease – A brain disease that causes unwanted or uncontrollable movements, such as trembling, rigidity, and balance and coordination difficulties. Typically, symptoms manifest gradually and increase over time. As the condition advances, individuals may experience difficulty walking and communicating.
Periodic limb movement disorder (PLMD) – A condition where patients experience abnormal movements, which occur in a repeating or rhythmic pattern, approximately every 20 to 40 seconds. PLMD is also classified as a sleep disorder due to the fact that the movements frequently disturb sleep and create daytime tiredness. PLMD may coexist with several sleep disorders.
Progressive supranuclear palsy – A rare neurological illness that causes severe difficulties with walking, balance, and eye movements, as well as swallowing in later stages. The disorder is caused by the degeneration of brain cells in regions that regulate movement, coordination, cognition, and other vital functions.
Reflex sympathetic dystrophy (RSD) – A condition that produces persistent pain, typically in an arm or leg, and it manifests after an injury, stroke, or even a heart attack. Nevertheless, the intensity of discomfort is generally worse than the injury itself.
Restless legs syndrome (RLS) – Also known as Willis-Ekbom Disease, it is a condition characterized by unpleasant or uncomfortable feelings and an irrepressible urge to move the legs. Nighttime resting positions, such as sitting or lying in bed, are frequently accompanied by the most severe symptoms.
Tics (involuntary muscle contractions) – Rapid, repetitive muscular contractions that cause difficult-to-control body jerks or sounds such as blinking, clearing the throat, facial twitching grunting, shrugging the shoulders, and sighing. Very rarely, they might begin in maturity but they are frequent in children and often appear around the age of 5 years. Tics are typically not serious and improve over time but they often interrupt everyday activities.
Tourette’s syndrome – A condition with the neurological system that causes uncontrollable tics, which are abrupt movements or sounds. A person with Tourette’s may repeatedly blink or clear their throat, for instance. Some individuals may utter words unintentionally. The disease is frequently accompanied by behavioral issues such as hyperactivity, inattention, impulsivity, obsessions, and compulsions. Symptoms vary in frequency and severity in the majority of instances.
Torticollis (Wry neck) – A painfully twisted and slanted neck where the crown of the head often leans to one side, whereas the chin leans to the opposite side.
Wilson disease – A rare hereditary illness characterized by an accumulation of copper in the liver, the brain, and the corneas of the eyes. The disease is progressive and, if left untreated, can result in liver (hepatic) disease, dysfunction of the central nervous system, and death.
What are Common Symptoms of Movement Disorders?
Patients who are diagnosed with functional movement disorders could present with one or more of the following symptoms:
A tremor is an involuntary trembling of a limb that cannot be controlled by the person experiencing it. Tremors, no matter how slight or severe they are, can make it impossible to function normally. There are certain people who experience tremors every now and then.
It’s possible that you’ll have jerky or jerking motions, like twitching.
Both spasms and contractures can cause the limbs to become immobilized in a position that is unnatural or uncomfortable.
When you walk, you could experience a number of problems with your gait (sometimes called walking). For instance, having difficulty walking while maintaining a straight posture. It’s possible that you’re shaky on your feet, favoring one leg, or are paralyzed with fear of falling.
The signs and symptoms of functional mobility deficits are common, although they can frequently be reversed. According to the findings of the study, getting therapy significantly enhances the possibility that your symptoms will go away.
What is Functional Neurology?
Functional neurology is a field of rehabilitation that focuses on influencing the cells and connections of the nervous system through various therapeutic interventions.
The stimulation of the brain has an effect on multiple neurotransmitter systems, and it also supports the production of new neurons and blood vessels in the brain and spinal cord, in addition to the formation of new connections within the brain and spinal cord themselves.
What is the treatment process typically like for Movement Disorders?
A functional movement issue can be extremely aggravating and stressful. Many people with movement disorders have complex healthcare demands, thus a multidisciplinary team of medical professionals may be necessary. A team of functional neurologists, psychiatrists, psychologists, physical therapists, and other healthcare specialists can collaborate to design treatment regimens that are tailored to your specific symptoms and needs. Through counseling, exercise, and pharmaceuticals, the team’s mission is to improve your quality of life.
The goal of treatment is to reduce symptoms and enhance function by assisting the brain in overriding the mechanism producing the involuntary movements or postures. Physical and/or occupational therapy, cognitive behavior therapy, and/or oral drugs such as antidepressants may be required for treatment.
Physical and/or occupational therapy, cognitive behavior therapy, and/or oral drugs such as antidepressants may be required for treatment. Non-invasive brain or nerve stimulation treatments, acupuncture, hypnosis, and placebo therapies have been reported to help certain people. Patients with functional movement disorders who educate themselves on the diagnosis and actively participate in developing a treatment approach gain the most from treatment.
Your first evaluation will be with a functional neurologist, who will evaluate your medical history, examine you, and diagnose your illness. A diagnosis may necessitate additional testing. Your doctor will recommend therapies and refer you to additional specialists based on the diagnosis:
- Dialectical behavioral treatment or cognitive behavioral therapy
- Referral to the Neurobehavioral Clinic
Although there is no cure for many movement disorders, it is fully possible to live a life that is normal in all other respects despite having the condition. The reduction of symptoms and comfort associated with them should be achieved as a final objective of treatment. Some of them are severe and get worse over time, making it difficult to move and speak. The treatment for movement disorders can vary widely depending on the underlying reason of the patient’s issue; nonetheless, your physician may propose one or more of the following treatments for you:
- Medications to alleviate your symptoms
- Physical or occupational therapy might help you keep or regain control of your movements.
- Injections of botulinum toxin to assist prevent muscular contractions
- Deep brain stimulation is a surgical therapy option that involves implanting an electrode to stimulate the parts of your brain that control movement.
In some cases, treatment can dramatically reduce or eliminate symptoms. This is why it is important to seek proper treatment immediately. If you have been diagnosed with a movement disorder or suspect you may have one, get in touch with a functional neurologist immediately. Due to the progressive nature of many of these conditions, early treatment can help postpone disease progression.