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Overview of Movement Disorders

By Hector A. Gonzalez-Usigli, MD, Professor of Neurology; Movement Disorders Clinic, HE UMAE Centro Médico Nacional de Occidente; Neurology at IMSS ; Alberto Espay, MD, Associate Professor and Clinical Research Director of the James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati

Every body movement, from raising a hand to smiling, involves a complex interaction between the central nervous system (brain and spinal cord), nerves, and muscles. Damage to or malfunction of any of these components may result in a movement disorder.

Different types of movement disorders can develop, depending on the nature and location of the damage or malfunction, as in the following:

  • Damage to the parts of the brain that control voluntary (intended) movement or the connections between the brain and spinal cord: Weakness or paralysis of the muscles involved in voluntary movements and exaggerated reflexes

  • Damage to the basal ganglia (collections of nerve cells located at the base of the cerebrum, deep within the brain): Involuntary (unintended) or decreased movements, but not weakness or changes in reflexes

  • Damage to the cerebellum: Loss of coordination

The basal ganglia help smooth out muscle movements. The cerebellum coordinates the body’s movements, helps the limbs move smoothly and accurately, and helps maintain balance.

Some movement disorders, such as hiccups, are temporary, usually causing little inconvenience. Others, such as Parkinson disease, are serious and progressive, impairing the ability to speak, use the hands, walk, and maintain balance when standing.

Locating the Basal Ganglia

The basal ganglia are collections of nerve cells located deep within the brain. They include the following:

  • Caudate nucleus (a C-shaped structure that tapers to a thin tail)

  • Putamen

  • Globus pallidus (located within the putamen)

  • Subthalamic nucleus

  • Substantia nigra

The basal ganglia help smooth out muscle movements and coordinate changes in posture.

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