Post-traumatic movement disorders can make simple activities, 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.
Causes of Post-Traumatic Movement Disorders
Post-traumatic movement disorders are the result of poor communication between the central nervous system (brain and spinal cord) and the muscles. When damage occurs to the brain or motor pathways that connect the brain to the body, individuals experience motor impairments.
Depending on the location of the brain damage, various movement disorders may occur. 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. In the following section, we’ll discuss various post-traumatic movement disorders that can occur after TBI.
Types of Post-Traumatic Movement Disorders
Depending on the severity and location of damage, individuals can experience a wide range of post-traumatic movement disorders after head injury.
Some of the most common types include:
Tremors are characterized by 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 tremor to develop after a head injury is cerebellar tremor, which is a type of action tremor and (as its name suggests) is caused by damage to the cerebellum. This type of tremor only occurs at the end of a purposeful movement.
2. 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 individuals to display odd, almost dancelike movements. Both of these conditions are caused by overactivity in the basal ganglia, usually due to too much dopamine in the brain.
Clonus is a hyperactive stretch reflex that many people mistake for a tremor.
This is understandable because the symptoms of clonus mimic tremor symptoms in many respects. Both cause rhythmic shaking, are painless, and 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.
There are a few different hypotheses about what exactly causes clonus. Generally speaking however, clonus occurs when the electrical signals sent by the brain to the muscles become interrupted. When the muscles don’t receive the proper stimulation from the brain, they don’t know whether to contract or relax. As a result, they end up doing both.
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.
5. Coordination Disorders
Damage to the cerebellum can cause a variety of coordination disorders. These prevent people from controlling their arms, legs, or trunk and may even inhibit them from using the muscles of their mouth correctly.
Some coordination disorders that may occur after a brain injury include:
- Ataxia. This coordination disorder can make everyday movements like reaching for an object or walking very difficult. Individuals with ataxia of the trunk are prone to falls, and therefore, when the person walks, they might take wide, staggering steps.
- Dysmetria. When patients cannot judge how far and how quickly their arms need to move to carry out a smooth purposeful movement. When trying to reach for an object, they will usually miss it.
- Apraxia of Speech. When individuals cannot control the muscles used for speech. As a result, they may make irregular mouth movements.
- Nystagmus. When it’s difficult to coordinate eye movements, which causes the eyes to look like they are bouncing around.
Dystonia refers to sustained, involuntary muscle contractions that force people into abnormal positions.
Neurologists separate dystonia into three types: focal dystonia, segmental dystonia, and general dystonia.
Focal dystonia only affects one part of the body. Some of these include:
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. In general dystonia, the whole body is affected by dystonia. Cervical dystonia occurs when spasms affect the neck, and would be classified as a type of focal dystonia.
Secondary Parkinsonism refers to symptoms similar to that of Parkinson’s disease, but caused by a different condition, such as head injury.
Symptoms of Parkinsonism include:
- Resting tremor
- Stiff muscles
- Slow movements
- Shuffling gait
- Difficulty with balance and walking
Secondary Parkinsonism is a rare secondary effect of brain injury and typically only occurs after repeated head trauma.
Treatment for Post-Traumatic Movement Disorders
Doctors often treat some of the more painful symptoms of post-traumatic movement disorders with medications like baclofen to 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 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.
Neuroplasticity refers to your brain’s ability to make adaptive changes and 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 repetitive exercise. Therefore, one of the best ways to manage post-traumatic movement disorders is to consistently stimulate the brain by using your affected muscles.
With time and practice, new neural pathways for those specific movements will be rewired and reinforced in healthy, undamaged regions of the brain, 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 an outpatient rehab clinic, but this will benefit you the most if you supplement with work at home. 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: Key Points
Post-traumatic movement disorders can cause serious and painful complications in brain injury patients.
Fortunately, the brain is capable of utilizing neuroplasticity to improve motor functions affected by movement disorders. The most effective way to promote neuroplasticity is through highly repetitive, task-specific practice.
We hope this article helped you understand the various movement disorders that can develop as a result of traumatic brain injury and how to manage them. Good luck!