The impetus for this monograph comes directly from the success of “Movement Disorders for the Clinical Practitioner,” a continuing medical education course that has been held in Aspen, Colorado, each summer since 1990. The trio of Fahn, Marsden, and Jankovic originated and lectured in the course until Marsden's untimely death. C. David Marsden, DSc, MB, FRCP was professor and head of the Department of Clinical Neurology at the Institute of Neurology in Queen Square, London. Dividing the lectures equally, the three covered the entire field of movement disorders in four half-day sessions that included a large sampling of videos to demonstrate the variety of movement disorders that a neurologist in practice may encounter.
As the course continued to grow in popularity, the three decided to produce a textbook of movement disorders, using as a starting point the annually updated course syllabus. They determined that the book would be not a collection of overlapping chapters by different authors but an integrated work in which the tasks of writing and editing were shared among the three as co-authors. The project began, but it came to a halt on September 29, 1998, with the untimely death of Professor Marsden.
To continue the Aspen course, Fahn and Jankovic invited Mark Hallett, MD, chief of the Human Motor Control Section at the National Institute of Neurological Diseases and Stroke in Bethesda, Maryland (who had trained in the clinical physiology of movement disorders with Professor Marsden), and neuropharmacologist Peter Jenner, PhD (Professor Marsden's longtime colleague and collaborator), to join the faculty and share in delivering the majority of the lectures that Professor Marsden had given. In subsequent years, through 2008, Drs Hallett and Jenner continually updated the portion of the course syllabus that was originally written by Dr Marsden and also incorporated additional topics.
When the book project was resumed, Fahn and Jankovic determined to retain the principle of an integrated work, taking on the responsibility of editing the chapters written by all four authors by incorporating the contributions from Drs Hallett and Jenner. This resulted in the first edition of this book, published in 2007.
Beginning in 2009, the faculty of the Aspen course resumed the three-person format for teaching the course, with Dr Hallett joining Fahn and Jankovic as an equal partner. All three of us have been responsible for lecturing, annually updating the syllabus, and now writing specific sections of the second edition of this book, and each has edited and contributed to all the chapters so that the final product remains an integrated whole.
The three of us greatly miss the intellectual and personal interaction that we enjoyed with our close friend and collaborator David Marsden for so many years and we, therefore, dedicate this book to his memory. We believe that he would be gratified with the extraordinary success of the first edition. This second edition of the book provides a comprehensive update of our current understanding of Parkinson disease and other movement disorders. The main stimulus for preparing this second edition has come from our desire to highlight the rapidly expanding knowledge in the field of movement disorders with clinical, scientific, and therapeutic advances taking place at breath-taking speed. In presenting treatment options, the second edition continues to emphasize evidence based on randomized, controlled trials while also sharing the authors’ personal experiences when such data are lacking. We believe this combination of evidence-based medicine and practical “know-how” will greatly aid clinical practitioners in caring for their patients.
The text is divided into three sections – overview, hypokinetic disorders, and hyperkinetic disorders – following the organization of the Aspen course. It is accompanied by an expanded collection of videos – videos from the Aspen course supplemented by new videos that illustrate the rich phenomenology and etiology of movement disorders and provide a visual guide to this most therapeutically oriented specialty of neurology. We hope that readers find the volume comprehensive, current, and enjoyable.
-- Stanley Fahn, MD, Joseph Jankovic, MD and Mark Hallett, MD --
Key Features
- Get just the information you need for a clinical approach to diagnosis and management, with minimal emphasis on basic science.
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- Apply the latest advances to diagnosis and treatment of pediatric movement disorders, Parkinson disease, and much more.
- View the characteristic presentation of each disorder with a complete collection of professional-quality, narrated videos online.
- Better visualize every concept with new full-color illustrations throughout.
Website Features
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Contents
Section I - Overview
Chapter 1 - Clinical overview and phenomenology of movement disorders
- Fundamentals
- Differential diagnosis of hypokinesias
- Evaluation of a dyskinesia
- Differential diagnosis of dyskinesias
- The clinical approach to differentiate the dyskinesias
- Conclusions
- References
Chapter 2 - Motor control
- Segmental inputs onto the alpha motoneuron
- Supraspinal control of the alpha motoneuron
- The basal ganglia
- Parkinson disease
- Dystonia
- Dyskinesias
- Cerebellum
- Ataxia
- Cortical control mechanisms
- Apraxia
- What is a voluntary movement?
- Disorders of willed movement
- Acknowledgment
- References
Chapter 3 - Functional neuroanatomy of the basal ganglia
- Introduction
- Neurotransmitters
- Components of the basal ganglia
- Circuitry of the basal ganglia
- Physiology
- References
Section II - Hypokinetic disorders
Chapter 4 - Parkinsonism
- Introduction
- Clinical features
- Bradykinesia
- Tremor
- Rigidity and flexed posture
- Loss of postural reflexes
- Freezing
- Other motor abnormalities
- Nonmotor manifestations
- Autonomic dysfunction
- Cognitive and neurobehavioral abnormalities
- Sleep disorders
- Sensory abnormalities
- Clinical-pathologic correlations
- Subtypes and natural history of Parkinson disease
- Differential diagnosis
- Clinical rating scales and other assessments
- Epidemiology
- Laboratory tests
- Presymptomatic diagnosis and biomarkers
- Pathologic findings
- References
Chapter 5 - Current concepts on the etiology and pathogenesis of Parkinson disease
- Anatomical and biochemical pathology of PD
- Interconnected pathogenic mechanisms of PD
- Genetics as an etiologic factor of PD
- Environmental factors contributing to etiology of or protection against PD
- Endogenous factors that contribute to the etiology of PD
- Where does PD pathology begin? How does it progress? Braak's staging system
- Clues on pathogenesis from monogenic PD
- Lewy bodies in fetal dopaminergic neurons; infectious protein hypothesis
- Multiple hit hypothesis with a central role of α-synuclein
- Animal models
- References
Chapter 6 - Medical treatment of Parkinson disease
- Introduction
- Therapeutic principles
- Therapeutic choices available for Parkinson disease
- Medications available for Parkinson disease
- Treatment of early-stage Parkinson disease
- Treatment of mild-stage Parkinson disease
- Treatment of moderate-stage Parkinson disease
- Treatment of advanced-stage Parkinson disease
- References
Chapter 7 - Surgical treatment of Parkinson disease and other movement disorders
- Introduction
- Functional anatomy of the basal ganglia
- Techniques of stereotactic surgery
- Thalamotomy
- Ablative lesions of the pallidum and subthalamic nucleus
- Deep brain stimulation
- Deep brain stimulation for hyperkinetic and other disorders
- Vagus nerve and other stimulation procedures
- Brain grafting
- References
Chapter 8 - Nonmotor problems in Parkinson disease
- Introduction
- Sensory symptoms
- Autonomic dysfunctions: bladder and sexual problems
- Other autonomic symptoms
- Respiratory distress
- Difficulties at night and daytime sleepiness
- Fatigue
- Depression, anxiety, and change in personality
- Cognitive problems
- Dementia and confusion
- Compulsive behaviors
- Psychosis: hallucinations and paranoia
- Quality of life
- References
Chapter 9 - Atypical parkinsonism, parkinsonism-plus syndromes, and secondary parkinsonian disorders
- Introduction
- Progressive supranuclear palsy
- Multiple system atrophy
- Corticobasal degeneration
- Parkinsonism–dementia syndromes
- Frontotemporal dementias and other tauopathies
- Parkinsonism–dementia–amyotrophic lateral sclerosis complex of Guam
- Heredodegenerative parkinsonism
- Secondary parkinsonism
- Appendix
- References
Chapter 10 - Gait disorders
- Balance
- Gait
- Gait disorders
- Therapeutic considerations
- References
Chapter 11 - Stiffness syndromes
- Spasticity
- Stiff-person (stiff-man) syndrome
- Syndromes of continuous muscle activity
- References
Section III - Hyperkinetic disorders
Chapter 12 - Dystonia
- Historical highlights
- Impact and overview of genetic discoveries
- Phenomenology of dystonic movements
- Epidemiology
- Classification of torsion dystonia
- Pseudodystonia
- Oppenheim dystonia (DYT1)
- Dopa-responsive dystonia (DRD)
- Rapid-onset dystonia–parkinsonism (RDP)
- Myoclonus–dystonia
- Secondary dystonias
- Lubag (X-linked dystonia–parkinsonism, XDP)
- Pathophysiology and pathoanatomy of primary dystonia
- Biochemistry and neuroimaging
- References
Chapter 13 - Treatment of dystonia
- Physical and supportive therapy
- Dopaminergic therapy
- Antidopaminergic therapy
- Anticholinergic therapy
- Other pharmacologic therapies
- Botulinum toxin
- Surgical treatment of dystonia
- Other therapies
- Therapeutic guidelines
- References
- Appendix
Chapter 14 - Huntington disease
- Introduction
- Epidemiology
- Clinical aspects
- Natural course
- Neuroimaging
- Neuropathology and neurochemistry
- Genetics
- Pathogenesis
- Treatment
- Experimental therapeutics
- References
- Appendix
Chapter 15 - Chorea, ballism, and athetosis
- Introduction
- Dentatorubral-pallidoluysian atrophy and HD-like disorders
- Other Huntington disease-like disorders
- Neuroacanthocytosis
- Neurodegeneration with brain iron accumulation
- Other familial choreas
- Infectious chorea
- Postinfectious and autoimmune choreas
- Other autoimmune choreas
- Other choreas
- Treatment of chorea
- Ballism
- Treatment of ballism
- Athetosis
- Treatment of athetosis
- References
- Appendix
Chapter 16 - Tics and Tourette syndrome
- Introduction
- Phenomenology of tics
- Clinical features of Tourette syndrome
- Pathogenesis
- Genetics
- Etiology of tics (secondary tourettism)
- Epidemiology
- Treatment
- References
- Appendix
Chapter 17 - Stereotypies
- Pathophysiology of stereotypies
- Physiologic stereotypies
- Developmental disorders
- Schizophrenia and catatonia
- Obsessive-compulsive disorder and tic disorders
- Other stereotypies
- Treatment
- References
Chapter 18 - Tremors
- Introduction
- Assessment of tremors
- Rest tremors
- Postural tremors
- Kinetic tremors
- Pathophysiologic mechanisms of rest and action tremors
- Other tremors
- References
- Appendix
Chapter 19 - The tardive syndromes
- Overview
- Fundamentals and definitions
- Dopamine receptors and their antagonists
- “Atypical” antipsychotics
- Neurologic side effects of dopamine D2 receptor antagonists
- Tardive syndromes
- Treatment of tardive syndromes
- References
Chapter 20 - Myoclonus
- Classification of myoclonus
- Neurophysiologic assessment
- Making the diagnosis
- Focal myoclonus
- Axial myoclonus
- Multifocal and generalized cortical myoclonus
- Drug treatment of generalized or multifocal myoclonus
- References
Chapter 21 - Ataxia
- Sporadic ataxia
- Genetic ataxia
- Diagnostic plan
- Recovery from cerebellar injury; therapy
- References
Chapter 22 - The paroxysmal dyskinesias
- Introduction
- Definitions: transient, paroxysmal, episodic, and periodic
- Historical aspects
- Classification of the paroxysmal dyskinesias
- Paroxysmal kinesigenic dyskinesia (PKD)
- Paroxysmal nonkinesigenic dyskinesia (PNKD)
- Paroxysmal exertional dyskinesia (PED)
- Episodic ataxias
- Molecular genetics of paroxysmal dyskinesias
- Miscellany
- Summary
- References
Chapter 23 - Restless legs and peripheral movement disorders
- Restless legs syndrome and periodic movements of sleep
- Peripheral movement disorders
- References
Chapter 24 - Wilson disease
- Wilson disease
- Treatment of Wilson disease
- Hereditary deficiency of ceruloplasmin
- References
Chapter 25 - Psychogenic movement disorders
- Introduction
- Degree of certainty of the diagnosis of a psychogenic movement disorder
- Definitions of psychiatric terminology
- Clues suggesting the presence of a psychogenic movement disorder
- Diagnostic approach and clinical features
- Psychogenic dystonia
- Psychogenic nondystonic movement disorders
- Approaches to the patient suspected of having a psychogenic movement disorder
- Results of treatment
- Movement disorders caused by psychiatric conditions but not regarded as psychogenic
About the Authors
- Stanley Fahn, MD, Houston Merritt Professor of Neurology and Director, Center for Parkinson's Disease and Other Movement Disorders, Department of Neurology, Columbia University Medical Center, The Neurological Institute, New York, New York.
- Joseph Jankovic, MD, Professor of Neurology, Distinguished Chair in Movement Disorders, Director, Parkinson's Disease Center, and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas.
- Mark Hallett, MD, Editor in Chief, World Neurology, World Federation of Neurology, Bethesda, Maryland.
Product Details
- Hardcover: 556 pages
- Publisher: Saunders; 2 edition (2011)
- Language: English
- ISBN-10: 1437723691
- ISBN-13: 978-1437723694
List Price: $219.00