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! style="padding: 0 5px; font-size: 85%; background: #A8A8A8" align="center" |{{fontcolor|#2B3B44|Jerks/ twitches Resident Survival Guide Microchapters}}
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{{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo, M.D.]]
 
'''''Synonyms and Keywords:''' jerks, twitches, abnormal movements, movement disorders, movement disorders approach''<br />
==Overview==
'''[[Movement disorders]]''' are common [[conditions]]. The [[Clinical|clinical presentation]] of [[Movement disorder|movement disorders]] is complex and often has variation from person to [[person]]. Therefore, finding the correct [[diagnosis]] may be challenging. A focused [[physical examination]] and [[History and Physical examination|history]] are imperative, and many times the only required resource to establish the [[diagnosis]].  [[Movement disorder|Movement disorders]] may be divided into hyperkinetic and hypokinetic.  The most common hyperkinetic disorder is [[essential tremor]], while the most common hypokinetic disorder is [[Parkinson's disease]].
 
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
 
*[[Head trauma]]
*[[Toxins]]
*[[Metabolic]]
*[[Vascular]]
 
===Common Causes===
 
*[[Parkinson's disease]]
*[[Huntington chorea]]
*[[Lewy Body Dementia]]
*[[Tardive Dyskinesia]]
 
 
==Diagnosis==
Shown below is an [[algorithm]] summarizing the [[diagnosis]] of [[Movement disorders|Abnormal movements]] according thee American Academy of Neurology guidelines:<ref name="FlemmingJones2015">{{cite journal|last1=Flemming|first1=Kelly D|last2=Jones|first2=Lyell K|year=2015|doi=10.1093/med/9780190244927.001.0001}}</ref><ref name="Abdovan de Warrenburg2010">{{cite journal|last1=Abdo|first1=Wilson F.|last2=van de Warrenburg|first2=Bart P. C.|last3=Burn|first3=David J.|last4=Quinn|first4=Niall P.|last5=Bloem|first5=Bastiaan R.|title=The clinical approach to movement disorders|journal=Nature Reviews Neurology|volume=6|issue=1|year=2010|pages=29–37|issn=1759-4758|doi=10.1038/nrneurol.2009.196}}</ref><ref name="KojovicCordivari2011">{{cite journal|last1=Kojovic|first1=Maja|last2=Cordivari|first2=Carla|last3=Bhatia|first3=Kailash|title=Myoclonic disorders: a practical approach for diagnosis and treatment|journal=Therapeutic Advances in Neurological Disorders|volume=4|issue=1|year=2011|pages=47–62|issn=1756-2856|doi=10.1177/1756285610395653}}</ref><br><br> 
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | A01 | | | A01=Patient with [[movement disorders]]}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | |!| | | | |}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | A01 | | | | A01= Perform [[physical examination]]}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | |!| | | | |}}
{{Family tree | | | | | | | | | | | | | | | | | | | | | A01 | | | | A01= Perform finger or foot tapping}}
{{Family tree | | | | | | | | | | | |,|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|-|.| | }}
{{Family tree | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | A02 | | | | | A01=Increased alternating movements|A02=Progressive [[Fatigue (medical)|fatiguing]] and decrement
of repetitive alternating [[Movement disorder|movements]]}}
{{Family tree | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | |!| | | |}}
{{Family tree | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | A02 | | | | | A01=Hyperkinetic/non-rigid|A02=Rigid}}
{{Family tree | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | |,|-|-|-|+|-|-|-|.| | |}}
{{Family tree | | | | | A01 | | | | | | | | | | A02 | | | | | | | | A03 | | A04 | | A05 |A01=Jerky |A02=Non-jerky |A03=[[Akinesia|Akinetic]] |A04=[[Hypokinesia|Hypokinetic]] |A05=[[Bradykinesia|Bradykinetic]] }}
{{family tree | |,|-|-|-|+|-|-|-|.| | | | |,|-|-|^|-|-|.| | | | | | |!| | | |!| | | |!| |}}
{{Family tree | A01 | | A02 | | A03 | | | A04 | | | | A05 | | | | | |`|-|-| A06 |-|-|'| | |A01=Sudden, brief, shock-like involuntary [[Movement disorder|movements]]|A02=Randomly flowing movements, which are, individually, jerky in nature|A03= ‘Stereotyped’ character of the recurrent movements|A04=Involuntary, rhythmic and sinusoidal alternating movements of one or more body parts|A05=Involuntary abnormal co-contraction of [[Antagonist|antagonistic]] [[muscles]], which may cause sustained abnormal postures or twisting and repetitive movements |A06=Parkinsonism }}
{{Family tree | |!| | | |!| | | |!| | | | |!| | | | | |!| | | | | | | | | | |!| }}
{{Family tree | A01 | | A02 | | A03 | | | A04 | | | | A05 | | | | | | | | | A06 | | | | | |A01=[[Myoclonus]] |A02=[[Chorea]] |A03=[[Tics]] |A04=[[Tremor]] |A05=[[Dystonia]] |A06= • [[Parkinson's disease]]<br> • Juvenile parkinsonism<br> • [[Infectious]]<br> • [[Drugs]]<br> • [[Toxins]]<br> • [[Vascular]]<br> • [[Trauma]]<br> • [[Metabolic]]<br> • [[Corticobasal degeneration]] (CBD)<br> • [[Progressive Supranuclear Palsy]] (PSP)<br> • [[Multiple System Atrophy]] (MSA)<br> • Lewy-Body Dementia (LBD)}}
{{Family tree | |!| | | |!| | | |!| | | | |!| | | | | |!| | | | | | | | | | | }}
{{Family tree | A01 | | A02 | | A03 | | | A04 | | | | A05 | | | | | | | | | | | | | |A01=• [[Tardive dyskinesia]]<br> • Storage diseases<br> • Friedriech's ataxia<br> • Ataxia-telangectasia<br> • [[Prion diseases]]<br> • [[CNS]] [[infections]]<br> • [[Hashimoto's disease|Hashimoto]] [[Encephalopathy|encephalopathy]]<br> • [[Hyperthyroidism|Hyperthyroidism]]<br> • [[Electrolyte imbalance|Electrolyte imbalances]]<br> • [[Metabolic]] imbalances |A02=• [[Huntington's disease]]<br> • Familial benign chorea<br> • Familial inverse [[Choreoathetosis|choreoathetosis]]<br> • [[CNS]] [[infections]]<br> • [[Electrolyte imbalance|Electrolyte imbalances]]<br> • Metabolic imbalances |A03=• Transient [[tic]] disorder<br> • [[Tourette's disorder]]<br> • Chronic vocal or motor [[tic]] disorder<br> • [[Tic]] disorder not otherwise specified |A04=• [[Essential tremor]]<br> • Postural [[tremor]]<br> • Action [[tremor]]<br> • Resting [[tremor]]<br> • Pyschogenic tremor<br> • Physiologic tremor|A05=• [[Blepharospasm]]<br> • Tardive [[dystoni]]a<br> • Cervical [[dystonia]]<br> • Oromandibular [[dystonia]]<br> • Writer's Cramp (hand dystonia)<br> • Paroxismal dystonia}}
{{familytree/end}}<br><br>
==Treatment==
Management of [[movement disorders]] will vary depending on the underlying cause, among the [[treatment]] strategies, there is [[physical therapy]],  medical therapy, [[Botulinum toxin|botulin toxin]] [[Injections|injection]], and [[deep brain stimulation]].
 
*To view the specific [[treatment]]<nowiki/>of [[myoclonus]] [[Myoclonus medical therapy|click here]].
*To view the specific [[treatment]] of [[tics]] [[Tics|click here]].
*To view the specific [[treatment]] of [[Essential tremor|essential tremors]] [[Essential tremor|click here]].
*To view the specific [[treatment]] of [[Parkinson's disease]] [[Parkinson's disease medical therapy|click here]].
*To view the specific [[treatment]] of [[Progressive supranuclear palsy|progressive supranuclear palsy (PSP)]] [[Progressive supranuclear palsy|click here]].
*To view the specific [[treatment]]<nowiki/>of [[Multiple system atrophy|multiple system atrophy (MSA)]] [[Multiple system atrophy|click here]].
*To view the specific [[treatment]] of [[Dementia with Lewy bodies|Lewy body dementia (LBD)]] [[Dementia with Lewy bodies|click here]].
*To view the specific [[treatment]] of [[Tourette's disorder]] [[Tourette syndrome|click here]].
*To view the specific [[treatment]] of [[Huntington's disease]] [[Huntington's disease|click here]].
*To view the specific[[treatment]] of [[ataxia-telangiectasia]] [[Ataxia-telangiectasia|click here]].
*To view the specific [[treatment]] of [[tardive dyskinesia]] [[Tardive dyskinesia|click here]].
*To view the specific [[treatment]] of [[Friedreich's ataxia]] [[Friedreich's ataxia medical therapy|click here]].
 
==Do's==
 
*Perform a [[physical examination]] with finger or foot tapping.<ref name="FlemmingJones2015">{{cite journal|last1=Flemming|first1=Kelly D|last2=Jones|first2=Lyell K|year=2015|doi=10.1093/med/9780190244927.001.0001}}</ref>
*Always ask for exacerbating and relieving factors; for example, involuntary [[Movement disorders|movements]] that present in frequent, brief [[Attack rate|attacks]] that are induced by sudden [[Movement disorder|movements]] (such as rising from a chair) suggest the [[diagnosis]] of paroxysmal kinesigenic dyskinesia.<ref name="pmid26214782">{{cite journal |vauthors=Hao SS, Feng YH, Zhang GB, Wang AP, Wang F, Wang P |title=Neuropathophysiology of paroxysmal, systemic, and other related movement disorders |journal=Eur Rev Med Pharmacol Sci |volume=19 |issue=13 |pages=2452–60 |date=July 2015 |pmid=26214782 |doi= |url=}}</ref><ref name="pmid11346027">{{cite journal |vauthors=Bhatia KP |title=Familial (idiopathic) paroxysmal dyskinesias: an update |journal=Semin Neurol |volume=21 |issue=1 |pages=69–74 |date=2001 |pmid=11346027 |doi=10.1055/s-2001-13121 |url=}}</ref>
*Inquire about [[Ethnicity and health|ethnicity]] and family history of [[movement disorders]] as these aspects may guide into the [[diagnosis]].<ref name="Abdovan de Warrenburg2010">{{cite journal|last1=Abdo|first1=Wilson F.|last2=van de Warrenburg|first2=Bart P. C.|last3=Burn|first3=David J.|last4=Quinn|first4=Niall P.|last5=Bloem|first5=Bastiaan R.|title=The clinical approach to movement disorders|journal=Nature Reviews Neurology|volume=6|issue=1|year=2010|pages=29–37|issn=1759-4758|doi=10.1038/nrneurol.2009.196}}</ref>
*Ask the patient's partner for the nature, pattern, and description of the movement [[disorder]], since many times, these [[Movement disorders|movements]] are hampered by the fact that patients frequently try to mask their [[Movement disorder|abnormal movements]] by incorporating them into voluntary movements.<ref name="Abdovan de Warrenburg2010">{{cite journal|last1=Abdo|first1=Wilson F.|last2=van de Warrenburg|first2=Bart P. C.|last3=Burn|first3=David J.|last4=Quinn|first4=Niall P.|last5=Bloem|first5=Bastiaan R.|title=The clinical approach to movement disorders|journal=Nature Reviews Neurology|volume=6|issue=1|year=2010|pages=29–37|issn=1759-4758|doi=10.1038/nrneurol.2009.196}}</ref>
*Perform a systematic approach when encountering a patient with more than one type of [[Movement disorder|movement]] disorder (mixed).
*Perform a urine toxicology test to look for drug-induced [[movement disorders]] such as tardive [[dystonia]], [[Tremor|postural tremor]], [[parkinsonism]], etc.<ref name="ChoukseyPandey2020">{{cite journal|last1=Chouksey|first1=Anjali|last2=Pandey|first2=Sanjay|title=Clinical Spectrum of Drug-Induced Movement Disorders: A Study of 97 Patients|journal=Tremor and Other Hyperkinetic Movements|volume=10|issue=1|year=2020|issn=2160-8288|doi=10.5334/tohm.554}}</ref>
*Have in mind the possibility of adverse drug effects [[medication]] whenever patients present with a mixed [[Movement disorders|movement disorder]]; the most common are [[dopamine]] D2 receptor-blocking agents such as [[neuroleptics]].<ref name="Abdovan de Warrenburg2010">{{cite journal|last1=Abdo|first1=Wilson F.|last2=van de Warrenburg|first2=Bart P. C.|last3=Burn|first3=David J.|last4=Quinn|first4=Niall P.|last5=Bloem|first5=Bastiaan R.|title=The clinical approach to movement disorders|journal=Nature Reviews Neurology|volume=6|issue=1|year=2010|pages=29–37|issn=1759-4758|doi=10.1038/nrneurol.2009.196}}</ref>
*Perform [[genetic testing]] as the initial diagnostic step in possible [[genetic diseases]] that require confirmation, such as [[Huntington's disease]].<ref name="Abdovan de Warrenburg2010">{{cite journal|last1=Abdo|first1=Wilson F.|last2=van de Warrenburg|first2=Bart P. C.|last3=Burn|first3=David J.|last4=Quinn|first4=Niall P.|last5=Bloem|first5=Bastiaan R.|title=The clinical approach to movement disorders|journal=Nature Reviews Neurology|volume=6|issue=1|year=2010|pages=29–37|issn=1759-4758|doi=10.1038/nrneurol.2009.196}}</ref>
 
==Don'ts==
 
*Do not order [[imaging]] or [[laboratory]] tests to [[diagnose]] [[clinical]] [[disorders]], such as [[Parkinson's disease]] and [[essential tremor]].<ref name="pmid15099543">{{cite journal |vauthors=Piccini P, Whone A |title=Functional brain imaging in the differential diagnosis of Parkinson's disease |journal=Lancet Neurol |volume=3 |issue=5 |pages=284–90 |date=May 2004 |pmid=15099543 |doi=10.1016/S1474-4422(04)00736-7 |url=}}</ref><ref name="pmid16003111">{{cite journal |vauthors=Seppi K, Schocke MF |title=An update on conventional and advanced magnetic resonance imaging techniques in the differential diagnosis of neurodegenerative parkinsonism |journal=Curr Opin Neurol |volume=18 |issue=4 |pages=370–5 |date=August 2005 |pmid=16003111 |doi=10.1097/01.wco.0000173141.74137.63 |url=}}</ref>
*Do not apply [[deep brain stimulation]] therapy for [[Parkinson's disease]] if any of the following are present: [[cognitive]] disturbances (Mattis score ≥130), major [[comorbidities]], [[major depression]] (Beck depression score II <25), or other [[Psychiatric Disorders|psychiatric]] [[contraindications]], or [[neurosurgical]] [[contraindications]].<ref name="PaschenDeuschl2018">{{cite journal|last1=Paschen|first1=Steffen|last2=Deuschl|first2=Günther|title=Patient Evaluation and Selection for Movement Disorders Surgery: The Changing Spectrum of Indications|volume=33|year=2018|pages=80–93|issn=0079-6492|doi=10.1159/000480910}}</ref><ref name="DeuschlSchade-Brittinger2006">{{cite journal|last1=Deuschl|first1=Günther|last2=Schade-Brittinger|first2=Carmen|last3=Krack|first3=Paul|last4=Volkmann|first4=Jens|last5=Schäfer|first5=Helmut|last6=Bötzel|first6=Kai|last7=Daniels|first7=Christine|last8=Deutschländer|first8=Angela|last9=Dillmann|first9=Ulrich|last10=Eisner|first10=Wilhelm|last11=Gruber|first11=Doreen|last12=Hamel|first12=Wolfgang|last13=Herzog|first13=Jan|last14=Hilker|first14=Rüdiger|last15=Klebe|first15=Stephan|last16=Kloß|first16=Manja|last17=Koy|first17=Jan|last18=Krause|first18=Martin|last19=Kupsch|first19=Andreas|last20=Lorenz|first20=Delia|last21=Lorenzl|first21=Stefan|last22=Mehdorn|first22=H. Maximilian|last23=Moringlane|first23=Jean Richard|last24=Oertel|first24=Wolfgang|last25=Pinsker|first25=Marcus O.|last26=Reichmann|first26=Heinz|last27=Reuß|first27=Alexander|last28=Schneider|first28=Gerd Helge|last29=Schnitzler|first29=Alfons|last30=Steude|first30=Ulrich|last31=Sturm|first31=Volker|last32=Timmermann|first32=Lars|last33=Tronnier|first33=Volker|last34=Trottenberg|first34=Thomas|last35=Wojtecki|first35=Lars|last36=Wolf|first36=Elisabeth|last37=Poewe|first37=Werner|last38=Voges|first38=Jürgen|title=A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease|journal=New England Journal of Medicine|volume=355|issue=9|year=2006|pages=896–908|issn=0028-4793|doi=10.1056/NEJMoa060281}}</ref>
 
==References==
{{Reflist|2}}
 
[[Category:Up-To-Date]]

Latest revision as of 13:52, 4 March 2021

Jerks/ twitches Resident Survival Guide Microchapters
Overview
Causes
Diagnosis
Treatment
Do's
Don'ts

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.

Synonyms and Keywords: jerks, twitches, abnormal movements, movement disorders, movement disorders approach

Overview

Movement disorders are common conditions. The clinical presentation of movement disorders is complex and often has variation from person to person. Therefore, finding the correct diagnosis may be challenging. A focused physical examination and history are imperative, and many times the only required resource to establish the diagnosis. Movement disorders may be divided into hyperkinetic and hypokinetic. The most common hyperkinetic disorder is essential tremor, while the most common hypokinetic disorder is Parkinson's disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes


Diagnosis

Shown below is an algorithm summarizing the diagnosis of Abnormal movements according thee American Academy of Neurology guidelines:[1][2][3]

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Patient with movement disorders
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Perform physical examination
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Perform finger or foot tapping
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Increased alternating movements
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Progressive fatiguing and decrement of repetitive alternating movements
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hyperkinetic/non-rigid
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Rigid
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Jerky
 
 
 
 
 
 
 
 
 
Non-jerky
 
 
 
 
 
 
 
Akinetic
 
Hypokinetic
 
Bradykinetic
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sudden, brief, shock-like involuntary movements
 
Randomly flowing movements, which are, individually, jerky in nature
 
‘Stereotyped’ character of the recurrent movements
 
 
Involuntary, rhythmic and sinusoidal alternating movements of one or more body parts
 
 
 
Involuntary abnormal co-contraction of antagonistic muscles, which may cause sustained abnormal postures or twisting and repetitive movements
 
 
 
 
 
 
 
 
 
Parkinsonism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Myoclonus
 
Chorea
 
Tics
 
 
Tremor
 
 
 
Dystonia
 
 
 
 
 
 
 
 
Parkinson's disease
• Juvenile parkinsonism
Infectious
Drugs
Toxins
Vascular
Trauma
Metabolic
Corticobasal degeneration (CBD)
Progressive Supranuclear Palsy (PSP)
Multiple System Atrophy (MSA)
• Lewy-Body Dementia (LBD)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Tardive dyskinesia
• Storage diseases
• Friedriech's ataxia
• Ataxia-telangectasia
Prion diseases
CNS infections
Hashimoto encephalopathy
Hyperthyroidism
Electrolyte imbalances
Metabolic imbalances
 
Huntington's disease
• Familial benign chorea
• Familial inverse choreoathetosis
CNS infections
Electrolyte imbalances
• Metabolic imbalances
 
• Transient tic disorder
Tourette's disorder
• Chronic vocal or motor tic disorder
Tic disorder not otherwise specified
 
 
Essential tremor
• Postural tremor
• Action tremor
• Resting tremor
• Pyschogenic tremor
• Physiologic tremor
 
 
 
Blepharospasm
• Tardive dystonia
• Cervical dystonia
• Oromandibular dystonia
• Writer's Cramp (hand dystonia)
• Paroxismal dystonia
 
 
 
 
 
 
 
 
 
 
 
 
 



Treatment

Management of movement disorders will vary depending on the underlying cause, among the treatment strategies, there is physical therapy, medical therapy, botulin toxin injection, and deep brain stimulation.

Do's

Don'ts

References

  1. 1.0 1.1 Flemming, Kelly D; Jones, Lyell K (2015). doi:10.1093/med/9780190244927.001.0001. Missing or empty |title= (help)
  2. 2.0 2.1 2.2 2.3 2.4 Abdo, Wilson F.; van de Warrenburg, Bart P. C.; Burn, David J.; Quinn, Niall P.; Bloem, Bastiaan R. (2010). "The clinical approach to movement disorders". Nature Reviews Neurology. 6 (1): 29–37. doi:10.1038/nrneurol.2009.196. ISSN 1759-4758.
  3. Kojovic, Maja; Cordivari, Carla; Bhatia, Kailash (2011). "Myoclonic disorders: a practical approach for diagnosis and treatment". Therapeutic Advances in Neurological Disorders. 4 (1): 47–62. doi:10.1177/1756285610395653. ISSN 1756-2856.
  4. Hao SS, Feng YH, Zhang GB, Wang AP, Wang F, Wang P (July 2015). "Neuropathophysiology of paroxysmal, systemic, and other related movement disorders". Eur Rev Med Pharmacol Sci. 19 (13): 2452–60. PMID 26214782.
  5. Bhatia KP (2001). "Familial (idiopathic) paroxysmal dyskinesias: an update". Semin Neurol. 21 (1): 69–74. doi:10.1055/s-2001-13121. PMID 11346027.
  6. Chouksey, Anjali; Pandey, Sanjay (2020). "Clinical Spectrum of Drug-Induced Movement Disorders: A Study of 97 Patients". Tremor and Other Hyperkinetic Movements. 10 (1). doi:10.5334/tohm.554. ISSN 2160-8288.
  7. Piccini P, Whone A (May 2004). "Functional brain imaging in the differential diagnosis of Parkinson's disease". Lancet Neurol. 3 (5): 284–90. doi:10.1016/S1474-4422(04)00736-7. PMID 15099543.
  8. Seppi K, Schocke MF (August 2005). "An update on conventional and advanced magnetic resonance imaging techniques in the differential diagnosis of neurodegenerative parkinsonism". Curr Opin Neurol. 18 (4): 370–5. doi:10.1097/01.wco.0000173141.74137.63. PMID 16003111.
  9. Paschen, Steffen; Deuschl, Günther (2018). "Patient Evaluation and Selection for Movement Disorders Surgery: The Changing Spectrum of Indications". 33: 80–93. doi:10.1159/000480910. ISSN 0079-6492.
  10. Deuschl, Günther; Schade-Brittinger, Carmen; Krack, Paul; Volkmann, Jens; Schäfer, Helmut; Bötzel, Kai; Daniels, Christine; Deutschländer, Angela; Dillmann, Ulrich; Eisner, Wilhelm; Gruber, Doreen; Hamel, Wolfgang; Herzog, Jan; Hilker, Rüdiger; Klebe, Stephan; Kloß, Manja; Koy, Jan; Krause, Martin; Kupsch, Andreas; Lorenz, Delia; Lorenzl, Stefan; Mehdorn, H. Maximilian; Moringlane, Jean Richard; Oertel, Wolfgang; Pinsker, Marcus O.; Reichmann, Heinz; Reuß, Alexander; Schneider, Gerd Helge; Schnitzler, Alfons; Steude, Ulrich; Sturm, Volker; Timmermann, Lars; Tronnier, Volker; Trottenberg, Thomas; Wojtecki, Lars; Wolf, Elisabeth; Poewe, Werner; Voges, Jürgen (2006). "A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease". New England Journal of Medicine. 355 (9): 896–908. doi:10.1056/NEJMoa060281. ISSN 0028-4793.