eMedicine Specialties > Neurology > Movement and Neurodegenerative Diseases

Movement Disorders in Individuals with Developmental Disabilities: Follow-up

Author: Norberto Alvarez, MD, Assistant Professor, Department of Neurology, Harvard Medical School; Consulting Staff, Department of Neurology, Boston Children's Hospital
Contributor Information and Disclosures

Updated: May 6, 2009

Follow-up

Further Inpatient Care

  • Patients generally do not need to be admitted except for surgery.

Further Outpatient Care

  • The outpatient setting is preferred for treatment.

Prognosis

  • The prognosis varies depending on the specific diagnosis.
    • When the movement disorder is a consequence of a drug reaction, discontinuing or decreasing the dose of the offending drug generally improves the condition.
    • Tardive dyskinesia might improve when psychotropic medications are discontinued.
    • The movement disorder in cerebral palsy (CP) does not improve spontaneously.
    • Prevention of contractures may improve the prognosis.
  • With good comprehensive services, most children with CP children reach adulthood.
    • A recent life-expectancy study of persons with CP indicated that 85% reach the age of 39 years.
    • The survival rate was lower among people with profound mental retardation than among others.

Miscellaneous

Medicolegal Pitfalls

  • Obtain informed consent from the patient (if possible) or a legal guardian. Patients aged 22 years or older are independent unless the parents are granted legal guardianship.
  • Tardive dyskinesia (TD) might be a cause for medicolegal action.
    • Document the patient's condition before beginning any psychotropic medication. Movement disorders might be preexistent.
    • Perform an AIMS or equivalent evaluation.
    • If abnormal movements are observed, videotape the patient, if possible.
 


More on Movement Disorders in Individuals with Developmental Disabilities

Overview: Movement Disorders in Individuals with Developmental Disabilities
Differential Diagnoses & Workup: Movement Disorders in Individuals with Developmental Disabilities
Treatment & Medication: Movement Disorders in Individuals with Developmental Disabilities
Follow-up: Movement Disorders in Individuals with Developmental Disabilities
References
Further Reading
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Further Reading

Clinical guidelines

Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Ashwal S, Russman BS, Blasco PA, Miller G, Sandler A, Shevell M, Stevenson R. Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2004 Mar 23;62(6):851-63. [77 references] PubMed

Practice parameter: evaluation of the child with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society. Shevell M, Ashwal S, Donley D, Flint J, Gingold M, Hirtz D, Majnemer A, Noetzel M, Sheth RD. Practice parameter: evaluation of the child with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2003 Feb 11;60(3):367-80. [123 references] PubMed

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Keywords

mental retardation, MR, cerebral palsy, CP, Down syndrome, delayed-onset movement disorder, mild neuromotor disabilities, tardive dyskinesia, TD, bruxism, stereotypies, autism, drug-induced movement disorder, Smith-Magenis syndrome, Lesch-Nyhan syndrome, Prader-Willi syndrome, obsessive-compulsive disorder, Rett syndrome, pyramidal cerebral palsy, extrapyramidal cerebral palsy, developmental disability, movement disability, limited intellectual capacity, limited intellect, biomedical mental retardation, social mental retardation, behavioral mental retardation, educational mental retardation, self-injurious behavior, SIB

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Contributor Information and Disclosures

Author

Norberto Alvarez, MD, Assistant Professor, Department of Neurology, Harvard Medical School; Consulting Staff, Department of Neurology, Boston Children's Hospital
Norberto Alvarez, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, and Child Neurology Society
Disclosure: Nothing to disclose.

Medical Editor

Rodrigo O Kuljis, MD, Esther Lichtenstein Professor of Psychiatry and Neurology, Director, Division of Cognitive and Behavioral Neurology, Department of Neurology, University of Miami School of Medicine
Rodrigo O Kuljis, MD is a member of the following medical societies: American Academy of Neurology and Society for Neuroscience
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Nestor Galvez-Jimenez, MD, MSc, MHA, Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida
Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society
Disclosure: Nothing to disclose.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

 
 
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