Department of General Medicine, Burdwan Medical College & Hospital, Burdwan, West Bengal, India.
Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
Tremor Other Hyperkinet Mov (N Y). 2022 May 4;12:14. doi: 10.5334/tohm.671. eCollection 2022.
Multiple sclerosis (MS), a subset of chronic primary inflammatory demyelinating disorders of the central nervous system, is closely associated with various movement disorders. These disorders may be due to MS pathophysiology or be coincidental. This review describes the full spectrum of movement disorders in MS with their possible mechanistic pathways and therapeutic modalities.
The authors conducted a narrative literature review by searching for 'multiple sclerosis' and the specific movement disorder on PubMed until October 2021. Relevant articles were screened, selected, and included in the review according to groups of movement disorders.
The most prevalent movement disorders described in MS include restless leg syndrome, tremor, ataxia, parkinsonism, paroxysmal dyskinesias, chorea and ballism, facial myokymia, including hemifacial spasm and spastic paretic hemifacial contracture, tics, and tourettism. The anatomical basis of some of these disorders is poorly understood; however, the link between them and MS is supported by clinical and neuroimaging evidence. Treatment options are disorder-specific and often multidisciplinary, including pharmacological, surgical, and physical therapies.
Movements disorders in MS involve multiple pathophysiological processes and anatomical pathways. Since these disorders can be the presenting symptoms, they may aid in early diagnosis and managing the patient, including monitoring disease progression. Treatment of these disorders is a challenge. Further work needs to be done to understand the prevalence and the pathophysiological mechanisms responsible for movement disorders in MS.
多发性硬化症（MS）是中枢神经系统慢性原发性炎症性脱髓鞘疾病的一个子集，与多种运动障碍密切相关。这些障碍可能是由于 MS 的病理生理学引起的，也可能是偶然发生的。本文描述了 MS 中运动障碍的全貌，包括其可能的发病机制和治疗方式。
作者通过在 PubMed 上搜索“多发性硬化症”和特定的运动障碍，进行了叙述性文献综述，检索时间截至 2021 年 10 月。根据运动障碍的类型，筛选、选择并纳入了相关文章。
在 MS 中描述的最常见的运动障碍包括不安腿综合征、震颤、共济失调、帕金森病、阵发性运动障碍、舞蹈症和投掷症、面肌肌束颤动，包括半面痉挛和痉挛性半侧面肌萎缩、抽搐和妥瑞症。这些障碍中的一些的解剖学基础理解不足；然而，临床和神经影像学证据支持它们与 MS 之间的联系。治疗选择因障碍而异，通常包括药物、手术和物理治疗等多学科方法。
MS 中的运动障碍涉及多种病理生理过程和解剖学途径。由于这些障碍可能是首发症状，因此它们可以辅助早期诊断和管理患者，包括监测疾病进展。这些障碍的治疗是一个挑战。需要进一步研究来了解 MS 中运动障碍的患病率和负责的病理生理学机制。
