Movement disorder emergencies

Movement Disorder Emergencies: Diagnosis and Treatment provides a fresh and unique approach to what is already a high-profile subspecialty area in clinical neurology. The disorders covered in this volume are standard fare in the field but emphasize the urgencies and emergencies that can occur. One of the very attractive features of the field of movement disorders is that diagnosis is often based on unique visible and sometimes audible phenomenological symptoms and signs. Therefore, in this era of highly sophisticated laboratory and radiological diagnostic tools, the diagnosis of many movement disorders is still largely made in the clinic where pattern recognition is key. Crucial to astute clinical diagnosis is broad clinical experience. In short, you have to have seen one to recognize one! Patients with movement disorders nearly always present as outpatients but, as aptly recognized by Drs. Frucht and Fahn, this may include acute manifestations leading to emergency presentations, often in an emergency room setting, where they are very likely to be unrecognized and therefore poorly managed. The authors define an “emergency” movement disorder as one in which failure to promptly diagnose and treat may result in significant morbidity or mortality. However, they also stress the importance of certain “can’t miss” diagnoses such as Wilson’s disease, dopa-responsive dystonia, and Whipple’s disease in which delayed diagnosis in less emergent situations can lead to slowly evolving and often irreversible neurological damage with tragic consequences.