ConditionBrain & nerves
Motor Dysfunction
Motor dysfunction is a general term for problems with controlling body movement. It includes weakness, stiffness or spasticity, slowness, tremor and other involuntary movements, poor coordination, and trouble planning movements. It can come from the brain, spinal cord, nerves or muscles. Common causes are stroke, Parkinson's disease, multiple sclerosis, cerebral palsy, nerve damage and muscle disease. Sudden loss of movement is an emergency. Gradual problems need a neurological assessment, and therapy can improve function.
Also called: Motor impairment, movement dysfunction, motor deficits, movement disorder, motor disorder
At a glance
- What it is
- Any impairment in producing or controlling movement.
- Main types
- Weakness, spasticity, slowness (bradykinesia), involuntary movements, ataxia, apraxia.
- Common causes
- Stroke, Parkinson's disease, MS, cerebral palsy, spinal cord injury, neuropathy, muscle disease, medicines.
- Diagnosis
- Neurological examination, brain or spine MRI, nerve tests, blood tests.
- Treatment
- Depends on the cause; physical, occupational and speech therapy are central.
When to get help
Call 911 or go to the ER
- Sudden weakness, numbness or loss of movement in the face, arm or leg, or sudden trouble speaking or walking: call 911
- Weakness in both legs with loss of bladder or bowel control or numbness in the saddle area
- Rapidly spreading weakness, or trouble breathing or swallowing
- Fever with stiff muscles and confusion after starting an antipsychotic or anti-nausea medicine
See a doctor within a day or two
- New involuntary movements, rigid muscles or jerks after a new medicine
- Weakness or clumsiness getting worse over days
Book a routine appointment
- Gradual slowness, stiffness, tremor or shuffling walk
- Clumsiness, frequent falls or unsteadiness developing over months
- A child who is late reaching motor milestones or unusually clumsy
Types of motor dysfunction
| Type | What it looks like | Typical source |
|---|---|---|
| Weakness (paresis, paralysis) | Reduced strength | Brain, spinal cord, nerves or muscles |
| Spasticity | Stiff, tight muscles, brisk reflexes | Brain or spinal cord (upper motor neuron) |
| Bradykinesia and rigidity | Slowness and stiffness | Basal ganglia, as in Parkinson's |
| Tremor | Rhythmic shaking | Essential tremor, Parkinson's, medicines |
| Dystonia | Twisting postures, sustained contractions | Basal ganglia |
| Chorea | Irregular, dance-like movements | Huntington's disease, medicines |
| Ataxia | Poor coordination and balance | Cerebellum or sensory nerves |
| Apraxia | Difficulty planning learned movements despite normal strength | Cortex, often after stroke |
| Developmental coordination problems | Clumsiness, poor motor skills in children | Developmental |
Causes
Brain
- Stroke: the most common cause of sudden motor dysfunction in adults
- Parkinson's disease: slowness, stiffness, tremor, shuffling gait
- Multiple sclerosis: weakness, spasticity, poor coordination in episodes
- Cerebral palsy: motor problems from early brain injury
- traumatic brain injury, brain tumors, dementias
- Essential tremor, dystonia and Huntington's disease
- cerebellar disorders, including alcohol-related degeneration
Spinal cord
- spinal cord injury, compression from discs or tumors, myelitis
Nerves and muscles
- peripheral neuropathy, Guillain-Barré syndrome
- motor neuron disease (ALS)
- myasthenia gravis
- muscular dystrophies and inflammatory myopathies
Medicines and toxins
- antipsychotics and some anti-nausea drugs (stiffness, tremor, restlessness, tardive dyskinesia)
- alcohol, sedatives, anti-seizure drug toxicity
- heavy metals and some solvents
Developmental
- developmental coordination disorder (dyspraxia)
- genetic and metabolic conditions in children
Diagnosis
A neurologist will ask about how and when problems began and their pattern, then examine strength, tone, reflexes, coordination, sensation, gait and involuntary movements. Depending on findings:
- MRI of the brain or spine
- nerve conduction studies and EMG
- blood tests: vitamin B12, thyroid, electrolytes, muscle enzymes, antibody tests
- genetic tests for inherited conditions
- DaTscan in some cases of suspected Parkinsonism
- developmental assessments in children
Treatment
Treatment targets the cause and maximizes function:
- Emergency stroke treatment within hours of onset
- Medicines: levodopa and other drugs for Parkinson's disease; disease-modifying therapy for MS; muscle relaxants such as baclofen for spasticity; propranolol or primidone for essential tremor
- Botulinum toxin injections for dystonia and focal spasticity
- Deep brain stimulation for selected people with Parkinson's disease, tremor or dystonia
- Physical therapy: strength, balance, gait training and fall prevention
- Occupational therapy: daily living skills, adaptive tools and home modifications
- Speech and swallowing therapy when speech or swallowing muscles are affected
- Mobility aids and orthoses: canes, walkers, braces, wheelchairs
- Stopping or changing medicines that cause movement problems
Living with motor dysfunction
- stay as active as possible within safe limits
- remove trip hazards at home and install grab bars
- get regular reviews of medicines and mobility needs
- seek support for mood, since depression and anxiety are common with movement disorders
Frequently asked questions
What is motor dysfunction?
Motor dysfunction is any problem with controlling movement, including weakness, stiffness, slowness, tremor, involuntary movements and poor coordination. It is a description, not a diagnosis, and has many possible causes in the brain, spinal cord, nerves or muscles.
What causes motor dysfunction?
Common causes include stroke, Parkinson's disease, multiple sclerosis, cerebral palsy, spinal cord injury, peripheral neuropathy, muscle diseases and side effects of some medicines. In children, developmental coordination disorder is common.
Can motor dysfunction be improved?
Often yes. Physical, occupational and speech therapy improve function in many conditions, and specific treatments help diseases such as Parkinson's and MS. Recovery after stroke can continue for months with rehabilitation.
When is motor dysfunction an emergency?
Sudden weakness, numbness, difficulty speaking, or loss of balance can be a stroke and need a 911 call. Rapidly spreading weakness or trouble breathing or swallowing also need emergency care.
Sources
This guide was written from current patient and clinical guidance, including:
- National Institute of Neurological Disorders and Stroke: Movement disorders; Motor neuron diseases
- American Academy of Neurology: Brain health and neurologic conditions
- Parkinson's Foundation: Movement symptoms
- MedlinePlus: Movement disorders
- American Physical Therapy Association: Neurologic physical therapy