Movement disorders

    
      Re: Movement disorders
    


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Posted by CCF Neuro MD on June 10, 1997 at 10:16:55:

In Reply to: Movement disorders posted by Lisa Fuller on May 31, 1997 at 10:40:34:

: HI, I'm a OT working in a state development center ,
  with a client population, who are M/R, and
  also have PDD.Many have been on typical anti-psycotics
  for 15-30 years or more. How can I tell tics,
   steriotypical movements,and hyperactivity
  associated, with PDD and TS, from the dsykenesia and
  akathesias, associated with long term use of
   thorazine and Melaril. I would like to convince our
  doctors to try to use meds that are safer,
   and more appropriate, for the clients dx.
                   Thank YOU.
================================================================================================
Hello Lisa,
Your question is a good one.  The differentiation of tics, akathesias, dyskinesias, and other movement disorders can be quite challenging.  It often requires consultation with a Movement disorder specialist to help differentiate these various types of abnormal extra movements.
I will briefly describe to you the various types of extra movement you listed in your question.  Tics are habitual movements that are stereotyped and irresistible.  Patients often say that they feel a need to perform these movements to relieve some perceived tension.  These movements can be suppressed voluntarily for a short period of time.  
Akathesia is used in patients who have an inner feeling of restlessness and so have an extremely difficult time sitting still.  They are constantly shifting positions while they are seated and often will pace about the room instead of sitting still. This condition is seen in patients who have received a class of medications called neuroleptics as well as in patients with Parkinson