Can Stress Cause Movement Disorders?
Yes, stress can cause or worsens the movement disorders. The exact mechanism of how stress cause movement disorders are unknown. Movement disorders caused by genetic predisposition, neurodegenerative conditions, and due to metabolic changes can be increased by stress and anxiety. There is also a separate entity called psychogenic movement disorders where involuntary movements in the limbs, trunk, face, and neck; muscle spasms, tremors, difficulty in walking, swallowing difficulties and difficulty in speaking can occur due to stress and other psychological conditions. Sometimes these movements are caused involuntarily, without consciousness and effort, sometimes these are done deliberately with an ulterior motive.
Tremors are rhythmic oscillatory movements due to muscle contractions. Psychogenic tremor is the commonest psychogenic movement disorder. It usually occurs during rest and with action, starts in the hands then can gradually spread to the limbs and trunks.1 Then the whole body can have a tremor at the same time. There can be changes in the direction the tremor moves, the way and distance it moves. The other key finding is this tremor is distractible. If the patient’s attention is focused on another activity then the tremor stops. The psychogenic tremor has an acute onset, remains only for a short period and spontaneously stops after sometime.
Dystonia is involuntary, continued or repetitive muscle spasms that occur in a pattern.2 Muscle contractions can occur in the form of twitching, squeezing, twisting and abnormal posture. Psychogenic dystonia can be divided into fixed or mobile dystonia. Fixed dystonia is at rest the affected body part is in an abnormal posture. Mobile dystonia is repetitive squeezing and twisting movements in the affected parts of the body. Fixed dystonia is more common and usually, an injury might have happened to that part of the body previously. One way to identify whether this is psychogenic is, patients don’t describe a way how to resolve the dystonia. The limbs are affected commonly than other parts of the body.
Myoclonus is a sudden involuntary jerky movement of a muscle or a group of muscles. Psychogenic myoclonus patients get startled excessively for sensory stimulations like loud noises. There can be a preceding injury at the site of the psychogenic myoclonus e.g. wound or minor surgery. It’s really difficult to identify organic myoclonus from psychogenic myoclonus and electromyography can help to differentiate.
Tics are repetitive patterned twitching of a muscle or muscle group.3 They can be stopped by the patients before it happens however, it brings a sense of relief after the tic occurs. Psychogenic tics can exist with other psychogenic movement disorders.
Psychogenic Paroxysmal Dyskinesia
Dyskinesia abnormal involuntary movements that cannot be controlled. Psychogenic dyskinesia occurs in episodes, the symptoms are only seen at times. A triggering factor is not found in many of the psychogenic dyskinesia patients and there were significant changes in the duration and the frequency of psychogenic dyskinesia.
Psychogenic Gait Disorders
Gait disorders are problems that occur while walking. Usually, psychogenic gait disorder is seen with other psychogenic movement disorders. The patients have a good balance but they tend to sway with a contortion of the body. Difficulty or slowness in walking, buckling of the knees are the common manifestations.
Psychogenic parkinsonism is very rare and it has the typical symptoms of parkinsonism such as tremors, rigidity, dyskinesia, imbalance, and slurring of speech. The symptoms tend to disappear with distraction especially, the tremors. Sometimes organic Parkinsonism and psychogenic Parkinsonism can co-exist together.
Yes, stress can cause or worsens the movement disorders. The exact mechanism of how stress cause movement disorders are unknown. Movement disorders caused by genetic predisposition, neurodegenerative conditions, and due to metabolic changes can be increased by stress and anxiety. There is also a separate entity called psychogenic movement disorders where involuntary movements in the limbs, trunk, face, and neck; muscle spasms, tremors, difficulty in walking, swallowing difficulties and difficulty in speaking can occur due to stress and other psychological conditions. This includes psychogenic tremors, dystonia, dyskinesia, myoclonus, tics, gait disorders, and Parkinsonism.
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