Odd and Unusual Movement Disorders

The hotch potch of miscellaneous and largely unclassified phenomena which comprise asignificant and fascinating part of movement disorders are a challenge for neurologists work-ing on the borderlands of psychiatry, sleep disorders, and epilepsy. Many of these conditions acquired exotic names like “Dubini’s electric chorea ” and “the variable chorea of Brissaud ” that are no longer acknowledged, and the historical conflict between neurological and psychiatric models continues to cause confusion. Where does a complex tic end and a compulsion begin? What about catalepsy and akinetic mutism? Are akathisia, habitual manipulations of the body (for example, trichotillomania), and stereotypies linked biologically? Progress has been made, nonetheless, and many of these odd movements are now recognised to be symptoms of neurological and systemic disorders: c oculomasticatory myorhythmia is virtually diagnostic of Whipple’s disease c bizarre nocturnal movements including dystonia, stereotypies, chorea, and even vocalisations are increasingly recognised as a presentation of medial frontal seizures; autosomal dominant fami-lies with mutations of the neuronal nicotinic acetylcholine receptor gene on chromosomes 20q and 15 respectively have been reported. c Ekbom’s syndrome has become de rigeur as a subject of consequence for neurologists following the demonstration that dopamine receptor agonists may be remarkably effective