Demyelinating syndromes and movement disorders

Multiple sclerosis is, by far, the most common demyelinating disorder of the central nervous system. Besides multiple sclerosis, other syndromes may cause both central and peripheral nervous system demyelination. A wide range of movement disorders have been associated with demyelinating disorders. While tremor and dystonia are the most common movement disorders, chorea, ballism, restless leg syndrome, parkinsonism, myoclonus, and dyskinesia have also been associated with demyelinating syndromes. In this chapter, we will provide an update of movement disorders associated with primary demyelinating disorders of the central nervous system such as multiple sclerosis, neuromyelitis optica, acute disseminated encephalomyelitis, and osmotic demyelinating syndrome, describing the association between demyelinating processes and movement disorders. We will also provide a possible diagnostic workout to follow when movement disorder is present in the context of demyelinating disorders. Finally, we will describe the available treatment option for each form of movement disorders summarizing available efficacy evidence.