Prototypical Variability Meets Phenomenology in Movement Disorders : A Bench to Bed Approach in Clinical Parkinsonism
Abstract
Massod Vadiee BS, MD. PhD
The movement disorders are chronic neurodegenerative group of diseases such as; Parkinson’s disease, Huntington’s disease, tremor, and dystonia which are increasingly becoming more prevalent. The establishing of their classification, accurate diagnosis and clinical management can be a difficult and lengthy process in part due to their complex natural history and heterogeneous presentations. Unfortunately, the under recognition and under diagnosed movement disorders are also common partly as a result of the clinicians inadequate understanding of disease phenomenology and prototypical variability and challenges related inability to differentiate functional and secondary movement disorders from organic movement disorders. In addition to challenges of clinicians knowledge and attitudes and the lack of coordination and obstacles in the dynamics of care pathways that link the primary care services with the higher specialists care can significant have adverse impacts on of quality of the chronic neurological care delivery needed among the vulnerable patient population. A unique group of conditions that are commonly encountered by the community healthcare providers are the secondary movement disorders or the mimickers of movement disorders that include the drug-induced and the systemic or metabolically-induced movement disorders which present both as a diagnostic and management challenge and opportunity for the general practitioners and community neurologist alike.