运动障碍

概述

“运动障碍”是指一系列导致运动增加或者减少或减缓的神经系统医疗状况。这些运动可能是自主的，也可能是非自主的。

运动障碍的一些常见类型包括：

• 共济失调。此类运动障碍会影响大脑中控制协调运动的部分。共济失调可能导致平衡感、语言或肢体运动不协调或笨拙以及其他症状。共济失调可能由许多原因导致，其中包括遗传疾病和退行性疾病。共济失调还可能由感染或其他可治疗的医疗状况导致。
• 颈部肌张力障碍。颈部肌张力障碍患者的颈部肌肉会不自主收缩，导致头部向一侧或者向前或向后倾斜。可能出现抖动。
• 舞蹈症。舞蹈症的特征是重复、短暂、不规则、略快速的无意识动作。动作通常涉及面部、嘴部、躯干和四肢。舞蹈症看起来像是夸张的坐立不安。
• 肌张力障碍。此类医疗状况包括伴有扭转、重复动作的不自主肌肉反复收缩。肌张力障碍可能影响全身，也可能影响局部。
• 功能性运动障碍。此类医疗状况可能类似于任何运动障碍。功能性运动障碍并非由神经系统疾病引起，且可以治疗。
• 亨廷顿病。这是一种遗传性进行性疾病，可通过基因检测确认。亨廷顿病有三大特征：运动不受控、认知问题和精神状况。
• 多系统萎缩。此类不常见的神经障碍会累及多个脑部系统，并逐渐恶化。多系统萎缩会导致运动障碍，如共济失调或帕金森综合征。其还可能导致低血压、膀胱功能受损和梦游。
• 肌阵挛。此类医疗状况会导致肌肉极快速抽搐。
• 帕金森病。此类进展缓慢的疾病会导致震颤、肌肉僵硬、运动减慢或减少或者平衡问题。其还可能导致其他与运动无关的症状，包括嗅觉减退、便秘、梦游和认知能力下降。
• 帕金森综合征。帕金森综合征是运动减缓伴僵硬、震颤或失去平衡的统称。其可能由多种原因导致。最常见的原因是帕金森病和某些阻断多巴胺的药物。其他原因包括退行性疾病，如多系统萎缩和进行性核上性麻痹。卒中或反复头部创伤也可能导致帕金森综合征。
• 进行性核上性麻痹。这是一种罕见的神经障碍，会造成多种问题，例如行走、平衡和眼球运动困难。有时，这可能与帕金森病相似，然而是一种截然不同的医疗状况。
• 不宁腿综合征。这种运动障碍会在放松或躺下时引起腿部不适，往往在活动后得到缓解。
• 迟发性运动障碍。此类神经系统疾病由长期使用某些治疗精神疾病的药物（神经安定药物）所引起。迟发性运动障碍会导致重复和无意识的动作，如鬼脸、眨眼和其他动作。
• 图雷特综合征。这是一种始于儿童和青少年时期的神经系统疾病，与重复性运动和发声有关。
• 震颤。这类运动障碍会导致身体某些部位（如手、头部或身体其他部位）有节奏地抖动。最常见的类型是特发性震颤。
• 威尔逊氏症。这是一种罕见的遗传病，会导致铜在体内过量积累，从而导致神经系统问题、肌张力障碍、震颤、帕金森综合征或共济失调。

症状

Symptoms of movement disorders vary depending on the type of the disorder. Common types of movement disorders and their symptoms include:

• Ataxia. Ataxia affects the part of the brain that controls coordinated movement. Ataxia may cause clumsy movements of the arms and legs, and a loss of balance. Ataxia also can change a person's speech and cause other symptoms. There are many causes of ataxia, including genetic and degenerative conditions. Ataxia also may be caused by an infection or another treatable condition.

• Chorea. Chorea causes brief, irregular, somewhat rapid, involuntary movements that happen over and over. The movements typically involve the face, mouth, trunk, arm and leg. Chorea can look like exaggerated fidgeting.

  The most common genetic chorea is Huntington's disease. This disease is passed down from a parent and gets worse over time. It can be confirmed with genetic testing. Huntington's disease has three types of symptoms. They include movements that can't be controlled, trouble with thinking and mental health conditions.

• Dystonia. This condition involves involuntary muscle contractions that cause twisting, irregular postures, or movements that occur again and again. Dystonia may affect the entire body or one part of the body.

  The most common type of dystonia in adults is cervical dystonia. In cervical dystonia, the neck muscles contract involuntarily. This causes the head to pull to one side or to tilt forward or backward. The head also may shake, known as a tremor.

• Functional movement disorder. This condition may look like any of the movement disorders. But it's not caused by a disease of the nervous system, also known as a neurological disease. Functional movement disorders are treatable.
• Multiple system atrophy. This rare condition affects many brain systems and gets worse over time. Multiple system atrophy causes a movement disorder, such as ataxia or parkinsonism. It also can cause low blood pressure, bladder symptoms and acting out dreams.
• Myoclonus. Myoclonus are very quick jerks of a muscle.
• Parkinson's disease. Parkinson's disease causes tremors, muscle stiffness, slow or decreased movement, or loss of balance. It also can cause symptoms not related to movement. These symptoms include a reduced sense of smell, constipation, acting out dreams and a decline in thinking skills. Parkinson's disease slowly gets worse over time.
• Parkinsonism. Parkinsonism is a general term for slowness of movement along with stiffness, tremors or loss of balance. There are many different causes. Parkinson's disease and certain dopamine blocking medicines are the most common causes. Other causes include degenerative disorders such as multiple system atrophy and progressive supranuclear palsy. Stroke or repeated head trauma also can cause parkinsonism.
• Progressive supranuclear palsy. This is a rare nervous system condition that causes problems with walking, balance and eye movements. It may resemble Parkinson's disease but is a distinct condition.
• Restless legs syndrome. This movement disorder causes aching, itching, or creeping feelings in the legs while relaxing or lying down. The feeling often goes away with movement.
• Tardive dyskinesia. This neurological condition is caused by long-term use of certain medicines used to treat mental health conditions, called neuroleptic medicines. It also can be caused by a common gastrointestinal medicine called metoclopramide (Reglan, Gimoti). Tardive dyskinesia causes involuntary movements that occur over and over. Symptoms include grimacing, eye blinking and other movements.
• Tourette syndrome. This is a neurological condition associated with repetitive movements and vocal sounds called tics. Tics are voluntary movements, but they're caused by an involuntary urge to make the movements. Tourette syndrome starts between childhood and teenage years.
• Tremor. This movement disorder causes rhythmic shaking of parts of the body, such as the hands, head or other body parts. The most common type is essential tremor.

病因

A wide variety of factors can cause movement disorders, including:

• Genetics. Some types of movement disorders can be caused by an altered gene. The altered gene is passed down from a parent to a child. This is called an inherited condition. Huntington's disease and Wilson's disease are two movement disorders that can be inherited.
• Medicines. Medicines such as anti-seizure and anti-psychotic medicines can lead to movement disorders.
• Illegal drugs or large amounts of alcohol. Illegal drugs such as cocaine can cause movement disorders such as chorea. Drinking large amounts of alcohol can cause chorea or ataxia.
• Not getting enough of certain vitamins. Having low levels of certain vitamins in the body, known as a vitamin deficiency, can cause movement disorders. A deficiency in vitamin B-1, vitamin B-12 or vitamin E can lead to ataxia.
• Medical conditions. Thyroid conditions, multiple sclerosis, stroke, viral encephalitis and several others can cause movement disorders. Brain tumors also can lead to movement disorders.
• Head injury. Head trauma from an injury can lead to movement disorders.

For most people with a movement disorders, there is no known cause. When healthcare professionals haven't found the exact cause, it's called idiopathic.

风险因素

Your risk of some movement disorders is higher if you have a parent with the condition. Movement disorders that can be passed down through families include essential tremor, Huntington's disease, Wilson's disease and Tourette syndrome.

Other factors that may increase the risk of having a movement disorder include having certain medical conditions or taking certain medicines. Drinking large amount of alcohol, doing illegal drugs such as cocaine or not having enough of certain vitamins in the body also can increase risk.