 DISORDER: Akathisia

 PRESENTATION: Restlessness and intense urge to move

 NOTES: Can be seen with neuroleptic use or in Parkinson disease.
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 DISORDER: Asterixis
 PRESENTATION: Extension of wrists causes “flapping” motion
 NOTES: Associated with hepatic encephalopathy, Wilson disease, and other
metabolic derangements.
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 DISORDER: Athetosis
 PRESENTATION: Slow, snake-like, writhing movements; especially seen in the
fingers
 CHARACTERISTIC LESION: Basal ganglia
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DISORDER: Chorea
PRESENTATION: Sudden, jerky, purposeless movements
CHARACTERISTIC LESION: Basal ganglia
NOTES: Chorea = dancing. Sydenham chorea seen in acute rheumatic fever.
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 DISORDER: Dystonia
 PRESENTATION: Sustained, involuntary muscle contractions
 NOTES: Writer’s cramp, blepharospasm, torticollis.
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 DISORDER: Essential tremor
 PRESENTATION: High-frequency tremor with sustained posture (eg,
outstretched arms), worsened with movement or when anxious.
 NOTES: Often familial. Patients often self- medicate with alcohol, which
decreases tremor amplitude. Treatment: nonselective β-blockers (eg,
propranolol), primidone.
 DISORDER: Hemiballismus
 PRESENTATION: Sudden, wild flailing of 1 arm +/− ipsilateral leg
 CHARACTERISTIC LESION: Contralateral Subthalamic nucleus (eg, lacunar
stroke).
 NOTES: Pronounce “Half-of-body ballistic.” Contralateral lesion.
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 DISORDER: Intention tremor
 PRESENTATION: Slow, zigzag motion when pointing/extending toward a
target.
 CHARACTERISTIC LESION: Cerebellar dysfunction
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 DISORDER: Myoclonus
 PRESENTATION: Sudden, brief, uncontrolled muscle contraction
 NOTES: Jerks; hiccups; common in metabolic abnormalities such as renal and
liver failure.
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 DISORDER: Resting tremor
 PRESENTATION: Uncontrolled movement of distal appendages (most
noticeable in hands); tremor alleviated by intentional movement
 CHARACTERISTIC LESION: Substantia nigra (Parkinson disease).
 NOTES: Occurs at rest; “pill-rolling tremor” of Parkinson disease. When
you park your car, it is at rest.