Mouvements anormaux secondaires (dystonies, myoclonies, tremblements, dyskinésies)

Secondary movement disorders (SMDs) such as dystonia, myoclonus, tremor, and dyskinesias may be considered a heterogeneous corpus. That is true when considering either the variability of their clinical aspects or the large body of their etiological factors, even if they share, as a more or less common rule, some dysfunctions within the basal ganglia motor circuits. The general diagnostic approach of a SMD is mainly based upon the clinical observation, further enriched with video recordings. It is followed by the etiological inquiry that has to be exhaustive in order to identify the underlying pathology (hypoxia-ischemia, multiple sclerosis, infections, auto-immunity, metabolic disorders, toxins and drugs). The therapeutic management of SMDs is based on the assessment of their functional consequences on daily living using dedicated semi-quantitative clinical scales and video and neurophysiological data. There are many therapeutic tools; to date, the classic or more recent medications are usually associated with botulinum toxin, functional neurosurgery and readaptative procedures.