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Overview of management of infection-related movement disorders with focus on specific-infections
Vikram V Holla1, Pramod Kumar Pal1
1Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, Karnataka, India.
Abstract:
Infections are important treatable causes of secondary movement disorders (MD) that can have heterogeneous presentations. According to various studies, infection-related movement disorders (IRMD) account for around 10-20% of secondary MD. Certain infections have a predilection for causing various MD, and some MD phenomenologies, such as acute cerebellar ataxia and opsoclonus-myoclonus-ataxia syndromes (OMAS), suggest a strong possibility of an underlying infectious cause. The underlying pathophysiology is multifaceted, including direct neuronal damage due to neurotropism, granulomas, abscesses causing structural damage, and inflammatory and autoimmune responses triggered by infections. Understanding the prevalence, spectrum, and pattern of these IRMD and common infections that are responsible helps in early diagnosis, and instituting appropriate, timely treatment, thereby improving the overall prognosis and avoiding unnecessary investigations. In this review, we aim to provide a brief overview of common infections associated with MD, common clinical presentations of IRMD, their underlying pathophysiology, and overall approach to their treatment, with a focus on specific treatments of prevalent and treatable IRMD.
Insights
Infections can cause secondary movement disorders (MD), accounting for 10-20% of cases. Early diagnosis and treatment of infection-related movement disorders (IRMD) improve patient outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Movement Disorders
Background:
- Infections are significant, treatable causes of secondary movement disorders (MD).
- Infection-related movement disorders (IRMD) represent 10-20% of all secondary MD cases.
- Specific movement disorder presentations, like acute cerebellar ataxia and opsoclonus-myoclonus-ataxia syndromes (OMAS), strongly suggest an infectious etiology.
Purpose of the Study:
- To review common infections associated with MD.
- To outline the clinical presentations, pathophysiology, and treatment of IRMD.
- To emphasize timely diagnosis and management for improved prognosis.
Main Methods:
- Literature review of studies on infections and movement disorders.
- Analysis of pathophysiology, including neurotropism, inflammation, and autoimmune responses.
- Focus on prevalent and treatable IRMD.
Main Results:
- Infections trigger diverse MD through direct neuronal damage, structural lesions (granulomas, abscesses), and immune responses.
- Understanding IRMD patterns aids early diagnosis and targeted treatment.
- Specific infections show predilection for certain MD types.
Conclusions:
- IRMD are common and treatable, necessitating awareness for prompt intervention.
- Multifaceted pathophysiology requires a comprehensive diagnostic and therapeutic approach.
- Effective management of IRMD can significantly improve patient outcomes and reduce unnecessary investigations.
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