World Movement Disorders Day

Do you know what is “Movement Disorders”?  Or Do you know what are the disorders treated by an “Movement Disorders Specialists”?.  Some of us have heard about the name “Parkinson’s Disease”, but do you know who named this disorder as “Parkinson’s Disease”?  To answer these questions and create awareness about Movement Disorders, the “International Parkinson’s and Movement Disorders Society” has initiated November 29th  as “World Movement Disorders Day”.  This year (2022) would be first world Movement Disorder’s Day and would be a platform to create awareness about Movement Disorders Globally. 

Movement Disorders are a group of brain disorders, which leads to either abnormally excess or slowness of body movements and not related to any other body system involvement.  For example unable to move leg due to a ‘Fracture’ is NOT an Movement Disorders, however, unable to easily move the same leg due to dysfunction in brain (more specifically basal ganglia) leading to “Parkinson’s Disease” is an “Movement Disorder”.   The movement disorders are specific set of diseases which occur due to dysfunction in certain deep brain structures, called as Basal Ganglia and its various connections.  The common symptoms of dysfunction of this part of brain causes – generalized slowness (Parkinsonism), shaking of body parts (tremors), imbalance sensation (ataxia /drunkard walking), tendency to fall, abnormal posturing of body parts (dystonia), unwanted excessive movements of different body parts (chorea, ballism,)  etc.  These symptoms can occur individually or can occur in various combinations, based upon which different disease names are suggested like, Parkinson’s Disease, Huntington’s Disease, Progressive Supranuclear Palsy (PSP), Wilson’s disease, Spinocerebellar ataxia etc.  These disorders can occur due to various underlying causes varying from infections of brain, body metabolic changes (like high or low blood sugars), medication related side effects, allergic disease of brain (autoimmune diseases), tumors of the brain, stroke like events, genetic abnormalities and due to normal ageing process.  The underlying cause decides the treatment and outcome of these treatment.  For example, a person developing symptoms of Parkinsonism (Slowness, stiffness, tremors, walking changes) due to metabolic / acute drug related reaction can be completely cured with treating the metabolic changes or stopping the offending medication.  However, development of Parkinsonism secondary to ageing / genetic process – Parkinson’s disease can be well managed with treatment similar to blood pressure and diabetes.  Given that these disorders are due to changes in the brain, these disorders are managed by Neurologist who is further specialized in this field, and they are called as “Movement Disorders Specialists”. 

Jean-Martin Charcot

The International Parkinson and Movement Disorders Society has chosen 29th November to be as World Movement Disorders Day to commemorate with birth anniversary of Prof. Jean-Martin Charcot (1825 – 1893).  Prof. Jean-Martin Charcot was French Neurologist, born on 29th November 1825 in Paris.   He has been referred as the ‘Father of French Neurology and one of the World’s Pioneers of Neurology’.  He established Neurology clinic at the famous Salpetriere hospital in Paris, which was first of its kind then.  His contributions are tremendous across the field of Medicine but much more to Neurology.  His interests included hysteria and hypnotism.   Dr. Charcot has various diseases / conditions / anatomical parts named after him (e.g: Charcot’s Artery, Charcot’s Joint, Charcot -Marie-Tooth Disease, Charcot’s Triad of Multiple Sclerosis etc).  James Parkinson’s essay – “The Shaking Palsy”, which was written in 1817, was well recognized during the tenure of Charcot and was being known by the name of “Paralysis agitans”.  Charcot lauded James Parkinson’s extensive descriptions and suggested that the disorder be named after him – “Parkinson’ Disease”.  Hence, the term “Parkinson’s disease” came to existence in in later part of 19th century, due to Charcot’s recognition (la maladie de Parkinson).  His extra ordinary contributions to field of Neurology and Movement disorders, has made International Parkinson and Movement Disorders Society to initiate World Movement Disorders Day to create awareness for all the movement disorders, albeit some of the major movement disorders have their own awareness days (e.g: April 11th – World Parkinson’s Disease Awareness day).  

Speciality Clinic based movement disorders epidemiology, published in Annals of Indian Academy of Neurology

The Field of Movement disorders has been growing in India since the 2000’s and India has now its own movement disorders specialist’s society called as ‘Movement Disorders Society of India’, started in 2014.  The number of movement disorders cases are on steady increase in India and the World Health Organization, has predicted a tremendous increase in Parkinson’s disease and other ageing disorders across India over the next decades.  There is clear lack of systematic epidemiological studies to understand the prevalence of various movement disorders in India.  Dr. Prashanth LK, Consultant Parkinson’s disease and Movement Disorders Specialist from Bangalore has worked with two other specialty Movement Disorders Clinic located in Mumbai and Kolkata to discuss the burden of movement disorders in India.  In these specialized private movement disorders clinics, it has been noted that Parkinsonism disorders contributed to almost 2/3rd of the various diseases seen, which is followed by dystonic disorders (15%), and tremors (8%). The group also comment that among the Parkinsonian disorders, a trend of increase in atypical parkinsonism disorders are being on the raise and contributed to about 22% of the cohort.  Given the variability of these disorders, and India needs to have its own research which can address these concerns.  Some of the movement disorders are almost exclusive to India like the Spinocerebellar ataxia type-12 (also known as Aggarwal disease, as it is predominantly limited to this community) or some of the diseases are predominantly more here (like the Wilson’s disease, much more common in southern India due to increased consanguinity).  To address these things awareness and support for research is required from all the stake holders.  The Movement Disorders Specialists of India have formed consortium to address these specific issues and are trying to collaborate with other basic sciences fields to get in-house answers for problems which are exclusive for Indian community – Parkinson Research Alliance of India.   In this context major pan India collaborative studies are going on diseases like Young Onset Parkinson’s Disease, Progressive Supranuclear Palsy with collaboration from Indian and International working groups.   On the occasion of this first World Movement Disorders Awareness Day, lets spread the awareness of various movement disorders in India and need to encourage co-operative works with clinicians, scientists, philanthropists and patients to find answers to many of these rare and well known disorders.      

Table :  List of Few Common Movement Disorders and there understanding in simple English:

Disease / Symptom name Simple English interpretation
Parkinson’s DiseaseSomeone who is have a combination of slowness of body movement, stiffness of body, shaking/ tremors of hands and walking changes
DystoniaExcess abnormal involuntary muscle contraction leading to posturing of the affected body parts (like neck = cervical dystonia, writing = writers cramp, jaw = jaw dystonia)
TremorsAbnormal rhythmic shaking of a body part (hand = hand tremors, head = head tremors etc)
Huntington’s DiseaseSomeone have abnormally excessive, body movements, which are variable in intensity and duration.  These people may also have behavioral / memory issues.
BlepharospasmExcessive eye blinking and sometimes leading to closure of eyes
Hemifacial spasmAbnormal intermittent facial contractions
AtaxiaImbalance while walking (drunkard type walking)
Restless Leg SyndromeAbnormal sensation of legs, especially during late evening / night, which improves/ reduced by walking around.
TicAbnormal repetitive body movements, which are due to satisfy once urge to do it (e.g, shoulder shrugging, jerking movements of head while speaking etc)
Progressive supranuclear palsySomeone who is having symptoms of Parkinson’s disease, but also has significant balance issue leading to fall (especially backwards)