Distal Symmetric Polyneuropathy
Polyneuropathy that involves the distal aspects of the limbs (at least initially) in a symmetric pattern is a common neurologic presentation. Sometimes referred to as a “stocking-glove” distribution, the most…
Electromyography and Nerve Conduction Studies
Electrophysiologic study of the peripheral nervous system typically involves nerve conduction studies (NCS) and needle examination of the muscle (electromyography; EMG). NCS/EMG is useful to localize a lesion (root/plexus/nerve/neuromuscular junction/muscle)…
Treatment of Tics
A. Patients with simple motor tics can sometimes achieve acceptable symptom control with botulinum toxin injections, particularly if the areas injected involve the face (e.g., blinking tics, or tics involving…
Treatment of Dystonia
Dystonia is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned and twisting, and may be tremulous. Dystonia is…
Treatment of Parkinson’s Disease
A. Aerobic exercise may be neuroprotective, and should be recommended for all Parkinson disease (PD) patients. B. Cognitively intact patients under age 65 years can try a monoamine oxidase type…
Treatment of Essential Tremor
A. Certain patients with mild tremor may only need tremor control for short, specific periods of time (for example, while giving a speech or going to dinner with friends). In…
Abnormal Involuntary Movements
A. Paroxysmal kinesogenic dyskinesia (PKD) is characterized by sudden onset of abnormal hyperkinetic movements (dystonia, chorea, ballism, athetosis, or a combination of these) triggered by movement. Mutations in the PRRT2…
Parasomnias
Parasomnias are unwanted events or experiences that occur during sleep, during the transition from wake to sleep, or during arousals from sleep. Parasomnias may result from a mixed or unstable…
