Today we have the final installment in this series discussing the above article on assessing and describing movement disorders. This episode is on taking in what we’ve seen and assigning a name or diagnosis to what we see. Now, this is a physicians roll to officially give a diagnostic name to these things, but it is good for other medical professionals to see and understand the process. And sometimes you may have had a previous experience that may prove useful to the physician in their diagnostic process.
Here’s a visual decision making tree from the article.
Step 1: Which types of movement disorder are present?
— Describe the movement you’re looking at. This part anyone with eyeballs that work and has some idea of what the previous 6 posts have been about can do. (That’s you!)
— If you weren’t able to get on the Facebook Live with the Neurocollaborative last Monday night, this step is the topic that was covered, so take a look at that video and blog. I’m not going to re-invent their wheel, because their wheel is great, so click over there for more details on that step.
Step 2: What is the dominant movement disorder type?
— Many syndromes will show a combination of movement types, but there’s usually one that is more prominent.
— This answer will steer the differential.
— This is most easily done in the early stages of any disease, but could also be performed with a thorough medical history and also being informed of what the differing syndromes on differential list look like throughout their stages.
Step 3: What are the associated features?
— Associated features are additional signs and symptoms that have come on with the movement disorder.
— Could be neurological like an apraxia or non-neurological like recurrent venous thrombosis.
— Good questions to ask the patient in this step is if there are factors that exacerbate or relieve the movement disorder, if there is a family history of movement disorders and what ethnicity they put themselves in.
Step 4: What is the differential diagnosis?
–Sometimes that is enough to get the diagnosis.
— Other times that gets you a list of several things that could be the culprit and you’ll need to put on your detective gear and either search the books or run diagnostic tests to rule in or out your hypothesis.
Thanks for “tuning in” to this special series on the analysis and description of movement disorders! I hope you’ve enjoyed it and learned as much as I have! I’ll be doing some lighter material for a few posts to shake us all off this super intense series. Thanks for hanging in there!