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Chapter 10 - Movement disorders in endocrinological diseases

from Section II - Movement disorders in systemic disease

Published online by Cambridge University Press:  05 April 2014

By
Renato Puppi Munhoz  and
Hélio A. G. Teive
Edited by
Werner Poewe  and
Joseph Jankovic
Renato Puppi Munhoz
Affiliation:
Neurology Service, Hospital Cajuru, Pontificial Catholic University; Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil
Hélio A. G. Teive
Affiliation:
Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil
Werner Poewe
Affiliation:
Medical University Innsbruck
Joseph Jankovic
Affiliation:
Baylor College of Medicine, Texas
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Summary

Introduction

Several endocrine disorders can affect any part of the central and peripheral nervous systems. Neurological complications of endocrine disorders such as neuropathy and coma in diabetes mellitus, for instance, are well recognized; however, the occurrence of secondary movement disorders (MDs) has only recently been properly appreciated in the medical literature. MDs can develop in different settings, ranging from chronic and relatively well controlled to acute, decompensated endocrine diseases.

In this chapter, we concisely describe the phenomenology and other clinical aspects of MDs most consistently found in association with several endocrinopathies. Here, we include clinical scenarios that involve the occurrence of MDs as complications of endocrinopathies, syndromes that encompass MDs and endocrinopathies, and specific situations in which independent MDs and endocrinopathies co-occur and interfere negatively with each other (see Table 10.1).

Diabetes mellitus

Hemichorea-hemiballism in non-ketotic hyperglycemia

MD can occur in both hypo- and hyperglycemia. The most widely recognized clinical scenario is that of hemichorea-hemiballism (HCHB) during non-ketotic hyperglycemia (NKH), in situations that range from pure hyperglycemia to non-ketotic hyperosmolar state (Lin and Chang 1994). The typical presentation is that of an acute, lateralized hyperkinetic syndrome in older adults with type 2 diabetes mellitus. Occasionally, more insidious onset and more generalized movements have been described. Additional features include hypotonia, weakness, pyramidal tract signs, asterixis, seizures, and altered level of consciousness. Although MDs in these cases are self-limited, the rate and degree of improvement range from days with no need for symptomatic interventions, except for correction of blood glucose level, to a persistent state lasting for months, requiring specific treatment (Oh et al. 2002; Zétola et al. 2010).

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Movement Disorders in Neurologic and Systemic Disease , pp. 131 - 143
Publisher: Cambridge University Press
Print publication year: 2014

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  • Movement disorders in endocrinological diseases
    • By Renato Puppi Munhoz, Neurology Service, Hospital Cajuru, Pontificial Catholic University; Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil, Hélio A. G. Teive, Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil
  • Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
  • Book: Movement Disorders in Neurologic and Systemic Disease
  • Online publication: 05 April 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139175845.011
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  • Movement disorders in endocrinological diseases
    • By Renato Puppi Munhoz, Neurology Service, Hospital Cajuru, Pontificial Catholic University; Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil, Hélio A. G. Teive, Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil
  • Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
  • Book: Movement Disorders in Neurologic and Systemic Disease
  • Online publication: 05 April 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139175845.011
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Movement disorders in endocrinological diseases
    • By Renato Puppi Munhoz, Neurology Service, Hospital Cajuru, Pontificial Catholic University; Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil, Hélio A. G. Teive, Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paraná, Curitiba, PR, Brazil
  • Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
  • Book: Movement Disorders in Neurologic and Systemic Disease
  • Online publication: 05 April 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139175845.011
Available formats
×