Common Movement Disorders Pitfalls:

The many powerful lessons in this case-based book convey clinical pearls on diagnostic or therapeutic issues in movement disorders.

Alberto J. Espay is Associate Professor of Neurology and Director of Clinical Research at the James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati Neuroscience Institute, Cincinnati, Ohio, USA. Anthony E. Lang is Professor of Neurology, Director, Division of Neurology and the Jack Clark Chair in Parkinson's Disease Research, University of Toronto, and also Director, Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.

Acknowledgements	p. ix
Preface	p. xi
Diseases discussed in this book	p. xiii
Missing the diagnosis altogether	p. 1
Bizarre ataxia of rapid onset	p. 1
Staggering progression of gait impairment, urinary incontinence, and dementia	p. 3
Excessive rigidity… and other features	p. 6
Jerky hemifacial spasms	p. 7
Paroxysmal finger posturing	p. 8
Psychogenic tremor until proven otherwise	p. 10
Attributing findings to a known or suspected disorder	p. 13
Mild spasticity in the stiff-person syndrome	p. 13
Unsteadiness when standing	p. 14
Supranuclear gaze palsy and parkinsonism: why not PSP?	p. 16
Chronic hemifacial pain and tightness	p. 17
Anxiety in Parkinson's disease: dopaminergic wearing off?	p. 18
Ataxia and a "gray zone" genetic test	p. 19
Clinical findings that are subtle	p. 23
Orofacial dystonia in presumed PD	p. 23
Intermittent "risus sardonicus" in a young man	p. 25
Resting and postural tremor: PD or ET?	p. 27
Restlessness of some sort	p. 28
Mild orofacial dyskinesias in parkinsonism	p. 30
Speech arrests in Parkinson's disease	p. 31
When movement disorders are difficult to characterize	p. 34
An unusual tremor for PD	p. 34
Another unusual tremor for PD	p. 35
A "dirty essential tremor"	p. 37
Is it a mixed movement disorder or a "twitch"?	p. 38
"Tipsy"	p. 39
Slow but not bradykinetic?	p. 42
Over-reliance on negative test results	p. 45
Normal cognitive screen in PD	p. 45
Comatose movements and undetermined pleocytosis	p. 46
Feeding dystonia with a negative diagnostic test	p. 47
B₁₂-deficiency ataxia with normal B₁₂ levels?	p. 49
Failure of pattern recognition	p. 53
Facial and neck dystonia in PD	p. 53
When familial alcohol-responsive tremor is not ET	p. 54
Rhythmic facial movements	p. 56
Dyskinesias with a "restless leg" pattern	p. 58
Feet twisting after walking	p. 60
Anxiety and shortness of breath in PD	p. 61
Unusual tics in "Tourette syndrome"	p. 62
Testing pitfalls of commission or omission	p. 65
Low HVA and BH4 in "DRD"	p. 65
Potential for over-testing in ataxia	p. 67
"Variant of unknown significance" in genetic testing of PD	p. 69
Multiple positive results in chorea: perils of the shot-gun approach	p. 71
Multiple negative results in tremor: perils of the exclusionary approach	p. 73
Missing radiographic clues	p. 76
An MRI finding only seen when suspected in "PD"	p. 76
An MRI finding only seen when suspected in "ET"	p. 78
The MRI pattern of only four parkinsonisms	p. 79
Not-very-normal pressure "NPH"	p. 82
The helpful T1-weighted MRI clue	p. 84
The helpful T2* and SWI MRI clues	p. 85
Management misadventures	p. 89
"Rapidly progressing" PD	p. 89
From orofacial dyskinesias to worse	p. 91
Shunt-unresponsive "NPH"	p. 92
Replacing one deficit with another	p. 96
"This is not my husband"	p. 97
"This is definitely not my husband"	p. 98
When rigidity follows pain	p. 100
Poor response to L-dopa, poor response to DBS	p. 102
Appendix: Video Legends	p. 106
Index	p. 114
Table of Contents provided by Ingram. All Rights Reserved.

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Common Movement Disorders Pitfalls: Case-Based Learning

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Table of Contents

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