Movement Disorders

Early signs of a movement disorder may show differently in every patient. However, common early signs of a movement disorder include:

• Bradykinesia (unusually slow movement, difficulty initiating steps or getting out of a chair)
• Changes in your gait, or other issues walking
• Loss of facial expression
• Muscle stiffness
• Poor balance
• Tremors in the hands, arms, legs, face or voice

You should see a neurologist for tremors, muscle spasms or balance changes if they suddenly appear or worsen, begin to interfere with your everyday life or are accompanied by other neurological issues, such as changes in your movement, strength or memory.

While symptoms of Parkinson’s disease and essential tremor may overlap, they’re distinct conditions. Essential tremor is the most common movement disorder and is described as uncontrollable shaking or trembling in one or both hands and arms that becomes worse when you try to move. While the exact cause of essential tremor is unknown, it’s linked with abnormal signaling in the cerebellum.

Parkinson’s disease is a progressive disorder caused by the deterioration of nerve cells in the substantia nigra, a part of the brain responsible for movement. When these nerve cells are affected, they lose the ability to produce dopamine, which is a key chemical involved in movement. Symptoms of Parkinson’s disease include tremors, muscle stiffness, gradual loss of spontaneous movement, facial expression changes and balance issues.

To diagnose a movement disorder, doctors start with a physical exam alongside a neurological assessment to test your reflexes and fine motor skills. If your doctor believes further testing is needed, they may order:

• Blood tests
• Cerebrospinal fluid test
• Electrocardiogram (ECG)
• Electromyography (EMG)
• Muscle biopsy

Diagnostic imaging is usually used to confirm a movement disorder diagnosis through an MRI or PET scan.