Movement Disorders Caused by Medical Disease

Brandon Barton; S. Elizabeth Zauber; Christopher G. Goetz


Semin Neurol. 2009;29(2):97-110. 

In This Article

Abstract and Introduction


Movement disorders often occur in the context of medical illness, whether as the presenting sign of the illness, as a related feature of the underlying disease process, or as a complication of treatment. Early recognition of an underlying medical cause for movement disorders is essential because the treatment and prognosis differ significantly depending on the underlying pathophysiology. Parkinsonism, nonparkinsonian tremor, dystonia, and chorea have a wide variety of etiologies, requiring a careful medical history in the evaluation of new-onset movement disorders. The spectrum of medical diseases associated with these four syndromes is reviewed in this article.


Movement disorders occur in a variety of medical illnesses and can be a complication of medications used to treat medical illnesses. In some cases, the movement disorder can be the presenting sign of a general medical condition, and accurate recognition of the movements is helpful in establishing the medical diagnosis. In other cases, the general medical diagnosis will suggest the risk for either a single type of disorder or a mixed form of several movement disorders, so that the clinician can be vigilant to look for their appearance. Drug-related movement disorders are especially important to recognize because often the disorder will clear completely with medication adjustment. Of the many movement disorders, the four prototypic conditions are parkinsonism, nonparkinsonian tremor, dystonia, and chorea. An understanding of the common systemic diseases associated with these disorders and the common drugs used in internal medicine that can precipitate these four syndromes will facilitate rapid diagnosis and intervention strategies.