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Post-Traumatic Movement Disorders: Causes, Types, and Recovery

therapist helping man with post-traumatic movement disorder

Post-traumatic movement disorders can make simple motions, such as eating, more difficult. In some cases, they can cause severe pain.

Fortunately, with the right approach, it is possible to overcome these disorders and regain normal movement, or as close to normal movement as possible.

To help with this, you’re about to learn the causes, types, and treatment for post-traumatic movement disorders.

Let’s get started.

Causes of Post-Traumatic Movement Disorders

All post-traumatic movement disorders are a result of poor communication between the central nervous system (brain and spinal cord) and the muscles.

The location of the brain damage will determine which type of movement disorder occurs. For example:

  • Damage to the primary motor cortex or other parts of the brain that control voluntary movements can cause muscle weakness or paralysis.
  • Damaging the basal ganglia can cause involuntary spasms or tremors.
  • Damage to the cerebellum can lead to a loss of coordination and balance.

Some movement disorders are only temporary, but others can cause more lasting problems.

Types of Post-Traumatic Movement Disorders

Here are the most common types of post-traumatic movement disorders that can appear after a head injury:

Tremors

man squeezing hand to stop his tremors, a common post-traumatic movement disorder

Tremors are an uncontrollable, rhythmic shaking of parts of the body, usually the hands.

There are three primary classifications of tremors that a person can develop after TBI:

  • Postural tremors. These occur when the person holds a position against gravity, such as keeping their arms outstretched.
  • Resting tremors. These tremors occur when the muscles relax, such as when the hands are in the person’s lap.
  • Action tremors. These happen only at the end of certain actions, such as reaching for a cup.

The most frequent type of tremors to develop after a head injury are cerebellar tremors.
With these tremors, the shaking only occurs at the end of a purposeful movement.

As the name suggests, damage to the cerebellum or its neural pathways will cause cerebellar tremors.

Chorea and Athetosis

Athetosis and chorea are conditions that cause strange, involuntary movements.

Chorea refers to brief, repetitive movements that start in one body part and move abruptly to another part.

Athetosis is a stream of slow, flowing, writhing movements that occur in the hands, feet, and torso.

Chorea and athetosis often occur together, which causes the person to display odd, almost dancelike movements. Too much dopamine in the brain, which overstimulates the basal ganglia, will cause both conditions.

A secondary type of chorea, called hemiballismus, involves swinging one arm wildly. 

Clonus

woman holding arm with clonus, a post-traumatic movement disorder

Clonus is a hyperactive stretch reflex that many people mistake for a tremor.

This is understandable. The symptoms of clonus mimic tremor symptoms in many respects. Both cause rhythmic shaking, both are painless, and both mainly affect a person’s arms and legs.

With clonus, however, stretching the affected limb will trigger or increase the shaking, which is not the case with tremors.

Clonus occurs when the electrical signals sent by the brain to the muscles become interrupted. 

When the muscles don’t receive enough stimulation from the brain, they don’t know whether to contract or relax. As a result, they end up doing both.

Myoclonus

Despite the name, myoclonus is not related to clonus. It does not cause rhythmic shaking, and it does not change in response to stretching movements.

Instead, myoclonus refers to sudden muscle spasms. They can happen at rest or during movement.

Most people experience myoclonus throughout their life. For example, when you jerk awake after just falling asleep.

However, myoclonus after a head injury is more severe and frequent.

Coordination Disorders

patient practicing walking movements to overcome post-traumatic movement disorders

Damage to the cerebellum can cause a variety of coordination disorders. These prevent people from controlling their arms and legs or using the muscles of their mouth correctly.

Some coordination disorders after brain injury include:

  • Ataxia. Moving more than one muscle at a time is difficult. For example, when the person walks, they might take wide, staggering steps.
  • Dysmetria. Patients cannot judge how far their arms move. When trying to reach for an object, they will usually miss it.
  • Apraxia of Speech. The person cannot control their speech muscles. This causes them to make strange mouth movements.
  • Nystagmus. Coordinated eye movement is difficult, which causes the eyes to look like they are bouncing around.

Dystonia

Dystonia refers to sustained, involuntary muscle contractions that force people into abnormal positions.

Neurologists separate dystonia into two types: focal dystonia and segmental dystonia.

Focal dystonia only affects one part of the body. Some of these include:

  • Eyes
  • Jaw
  • Mouth
  • Neck
  • Arms/legs

Sometimes dystonia can also cause the torso to bend or writhe, but that is less common.

Segmental dystonia, on the other hand, strikes at two or more adjacent muscle groups at once. So, instead of just your neck acting up, both your neck and jaw would display symptoms.

With both segmental and focal dystonia, the spasms occur on the side of your body opposite the brain-injured side. Cervical dystonia occurs when spasms affect the neck.

Parkinsonism

close-up of doctor holding parkinson's patient's hand

Parkinsonism, also known as secondary Parkinsonism, refers to symptoms of Parkinson’s disease caused by a different condition, such as head injury.

The symptoms of Parkinson’s include:

  • Resting tremor
  • Stiff muscles
  • Slow movements
  • Difficulty with balance and walking

Parkinsonism is a rare side effect of brain injury and typically only occurs after repeated head trauma.

Treating Post-Traumatic Movement Disorders

Doctors often treat some of the more painful symptoms of post-traumatic movement disorders with baclofen and other meds. These relax the muscles and prevent spasms.

However, they are only temporary solutions, because they do not address the root cause of motor disorders: the poor connection between the central nervous system and the muscles.

Therefore, to treat post-traumatic movement disorders, patients will need to somehow improve communication between the brain and the rest of the body.

Fortunately, you can accomplish this by activating your brain’s natural repair mechanism, neuroplasticity.

How Neuroplasticity Treats Movement Disorders

illustration of neuroplasticity for post-traumatic movement disorders

Neuroplasticity refers to your brain’s ability to create new neural pathways. This allows the brain to change its structure so that undamaged areas of the brain take control of muscle movement.

The brain forms new neural pathways in response to massed practice exercise. This means one of the best ways to treat post-traumatic movement disorders is to work out with your affected muscles.

After enough time and practice, you will reinforce those new pathways and the connection to your muscles will return.  

It’s crucial that you practice your PT exercises as often as you can. One hour, three times a week is about the most you can get from a rehab clinic, but this is simply not enough to make real progress.

That’s why home therapy devices such as FitMi or MusicGlove are so helpful. They motivate patients to perform hundreds of exercises at home, all in a fun and engaging way.

Movement Disorders After Brain Injury

Post-traumatic movement disorders can cause serious, painful side effects in brain injury patients.
Different movement disorders can develop depending on where the most brain damage occurred.

The good news is you can reverse most of the side effects of these motor disorders by engaging neuroplasticity. You can do this by exercising your affected muscles.

With enough practice, you can help your brain rewire itself, until eventually, you regain full control of your body again.

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