Management of movement disorders in primary care

Abstract

Movement disorders (MDs), are a spectrum of neurological diseases consisting of motor and non-motor symptoms regarding the dysfunctional motor control circuitry and some parts of the nervous system including the basal ganglia, thalamus, cortex, cerebellum besides peripheral autonomic nervous system. Usually, movement disorders are a clinical syndrome which is a specific movement disorder with some other disorders besides neurological and non-neurological abnormalities. The clinical manifestations that should be considered as MDs are complex and heterogeneous. These conditions include symptoms of motor functions like tremor, myoclonus or dystonia, so-called hyperkinetic movements, problems with cognitive functioning like attention problems, prediction error, and sometimes emotion hyper-responsiveness. It is estimated that more than 500,000 individuals in Europe were affected by rare neurological diseases according to the European Reference Network for Rare Neurological Diseases - ERN-RND. Parkinson's Disease is the most common disease in the large spectrum of neurodegenerative disorders characterized by movement disorder and this affected more than 1 million persons over 55 years old in the United States. In response to the COVID-19 pandemic, movement disorders followed up by all forms of telemedicine usage increased across almost all of the countries in the world. In most countries, the patient's first contact is the primary care physician and it is important to disseminate the knowledge of primary care among movement disorders. It is important to be aware of and be an expert in neurological symptoms for diagnosing rare movement disorders. Due to technological improvements, it is feasible to implement continuing medical education and on-the-job training programs among MDs to exchange information, training, and skill.