Scope and List of Topics


Movement Disorders, a subspeciality of Neurology, include conditions such as idiopathic Parkinson's disease, progressive supranuclear palsy, multiple system atrophy and other akinetic-rigid syndromes, Huntington's disease, dystonia, tremor, and tic disorders.

Movement disorders also occur in other neurological conditions which are investigated by other Cochrane Review Groups. For instance, the Movement Disorders Group reviews work on the dyskinesias seen in cerebral palsy, stroke, multiple sclerosis and head injury. The commonest of these conditions is Parkinson's disease which is a chronic and progressive disease affecting about 0.3% of the total population and 1% of those aged 60 years and older. The mean age of onset is 65 years and men are more frequently affected than women. The vast majority of the cases are of idiopathic etiology. No cure is available for this disease although many new pharmacological and non-pharmacological treatment options have emerged in the last 15 years. 

Patients with such disorders are cared for by neurologists, geriatricians, pediatricians and other physicians, along with primary health care workers and paramedical therapists such as physiotherapists, speech and language therapists and occupational therapists.

Considerable work has been published on the treatment of these conditions over the years and numerous non-systematic reviews have been written. The largest and most contentious area of work surrounds the treatment of idiopathic Parkinson's disease. Although there tends to be a broad consensus amongst movement disorder specialists on the pharmacological treatment of this condition, this is based on an empirical view of the existing literature rather than on systematic reviews of research. It has recently been shown that the use of levodopa preparations in Parkinson's disease rose in a linear fashion taking over 12 years to plateau, long after it was widely recognized as the most effective treatment for the condition. Such delays in instituting the most appropriate therapy for a condition must be reduced.



List of Topics