When machines see more: Digital technologies, measurement, and meaning in hyperkinetic movement disorders

Hyperkinetic movement disorders force neurologists to ask: what movement are we seeing, and what does it mean? Developed from the Mark Hallett Plenary, this mini-review argues that digital technologies are best understood as tools for operationalised phenomenology: translating bedside descriptors into reproducible, clinically interpretable measures. From Charcot's visual documentation to Hallett's clinical neurophysiology, technology has long extended, rather than replaced, clinical observation. Wearables, smartphones, video/computer vision, EMG/EEG-EMG, and artificial intelligence now quantify selected features of tremor, chorea, dystonia, tics, myoclonus, dyskinesia, and functional hyperkinesia across clinic and real-world settings. We consider how these tools may clarify phenotype, capture fluctuation, guide treatment, support trials, and expose measurement pitfalls in mixed or context-dependent disorders. Their value depends on validation, interpretability, workflow integration, and patient relevance. Particular emphasis is placed on preserving clinical reasoning within the diagnostic funnel throughout care pathways. Machines may win at measurement; clinicians must ensure that measurement becomes meaning.