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Chapter 16 - Movement disorders following non-metal intoxications

from Section III - Iatrogenic and toxic movement disorders

Published online by Cambridge University Press:  05 April 2014

By
Kinley Roberts  and
Timothy Lynch
Edited by
Werner Poewe  and
Joseph Jankovic
Kinley Roberts
Affiliation:
Dublin Neurological Institute, Mater Hospital, Dublin, Ireland
Timothy Lynch
Affiliation:
Dublin Neurological Institute, Mater Hospital, Dublin, Ireland
Werner Poewe
Affiliation:
Medical University Innsbruck
Joseph Jankovic
Affiliation:
Baylor College of Medicine, Texas
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Summary

Movement disorders may be classified etiologically as either genetic or secondary. Secondary causes include metabolic, vascular, infectious, nutritional, toxicological, and endocrine abnormalities.

Certain classes of prescription drugs, including antipsychotics, selective serotonin reuptake inhibitors, and anti-epileptics, may result in dyskinesis, dystonia, myoclonus, or parkinsonism. This subject is comprehensively discussed in Chapter 14.

Movement disorders may also occur following exposure to chronic heavy metal poisoning as discussed in Chapter 15. The nervous system is particularly susceptible to toxic insults despite the existence of specific mechanisms to prevent the entry of toxins, such as the “blood-brain barrier” and the “blood-nerve barrier.”

Here we review movement disorders that may occur following non-metal intoxications. Therefore, we will discuss those movement disorders that occur secondary to illicit drugs, alcohol, other solvents, small molecules, and natural toxins.

Illicit drugs

Recreational drug abuse can result in psychological dependence, physical dependence, or both. Psychological dependence or addiction describes a pattern of compulsive drug use characterized by a continued craving.

Physical dependence is an adaptive state in which abrupt cessation of drug use results in physical symptoms and signs (Brust 2004). Here we describe a number of movement disorders encountered in recreational drug abusers, some associated with toxicity, some with withdrawal, and some with a more indirect pathogenesis.

Type
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Information
Movement Disorders in Neurologic and Systemic Disease , pp. 234 - 246
Publisher: Cambridge University Press
Print publication year: 2014

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