Presentations – hyperkinetic
- Athetosis
- Ballism
- Chorea
- Dystonia
- Fasciculations
- Myoclonus
- Myokymia
- Myorhythmia
- Stereotypies
- Tics
- Tremor
Presentations – hypokinetic
- Bradykinesia
- Catatonia
- Freezing
- Parkinsonism
- Postural instability
- Rigidity
Conditions – psychological
- Conversion disorder
- Malingering
Conditions – specific hyperkinetic disorders
- Adult-onset focal dystonia
- Blepharospasm
- Cervical dystonia
- Episodic ataxia
- Facial dystonia
- Functional movement disorder
- Generalised dystonia
- Hemifacial spasm
- Huntington disease
- Myoclonus dystonia
- Tourette syndrome
- Tremors:
- drug-induced
- dystonic
- essential
- essential tremor plus
- functional
- palatal
- systemic / metabolic causes
- Wilson disease
- Writer’s cramp
Conditions – specific hypokinetic conditions
- Corticobasal syndromes
- Dementia with Lewy bodies
- Drug-induced Parkinsonism
- Functional neurological disorder
- Multiple system atrophy
- Normal pressure hydrocephalus
- Parkinson disease
- Progressive supranuclear palsy
- Stiff person syndrome
- Vascular parkinsonism
Conditions – other
- Functional neurological disorder
- Prion disease
- Stiff person syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Hereditary ataxia syndromes, including:
- Metabolic causes of movement disorders
- Paroxysmal dyskinesias:
- exercise-induced
- kinesogenic
- non-kinesogenic
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Acute, chronic, common, and rare diseases that cause disorders of movement
- Neuroanatomy, neuropharmacology, and neurophysiology of the motor pathways
Cerebrospinal fluid (CSF) procedures and investigations
- Lumbar puncture (LP) and interpretation of investigation results, such as:
- basic CSF analysis:
- cell count
- cytology
- cytometry
- immunological tests
- microbiological tests
- protein level
- sugar level
- opening pressure
- special tests:
- 14-3-3 protein
- real-time quaking induced conversion (RT-QuIC)
Neurogenetic investigations
- Genetic testing, including, but not limited to:
- chromosomal testing, such as:
- genomic testing, including whole exome or genome sequencing
- mitochondrial genome sequencing
- targeted panel testing
- Referral to a neurogeneticist
Neuroimaging investigations
- CT, including:
- CT angiography
- perfusion
- venography
- Dopamine uptake transporter (DAT)
- MRI, including:
- functional (fMRI)
- magnetic resonance:
- angiography (MRA)
- spectroscopy (MRS)
- venogram (MRV)
- with contrast
- Myelography
- PET
- Single photon emission computed tomography (SPECT)
- Vascular imaging:
- catheter angiography
- Doppler ultrasound
Neuroimmmunology investigations
- Autoantibody measurement:
- antinuclear antibodies (ANA)
- anti-amphiphysin, anti-GAD, and anti-glycine antibodies
- anti-phospholipid antibody testing
- double-stranded DNA (dsDNA)
- extractable nuclear antigens (ENA) antibody testing
- Referral to a neuroimmunologist
Neuropathology investigations
Neuropsychological investigations
- Cognitive screening:
- Mini-Mental State Examination
- Montreal Cognitive Assessment
- Referral to a neuropsychologist
Other investigations
- Other laboratory tests:
- acanthocytes
- B12 level
- copper
- fasting lipid profile
- iron studies
- serum angiotensin converting enzyme
- thrombophilia screen
- urinary porphyrins
- Polysomnography
- Overlap with other allied health and medical specialties, such as geriatrics, medical genetics, physiotherapy, and rehabilitation medicine, and when it is appropriate to refer
- Prognosis and implications of these disorders
