AANN Core Curriculum, 7th Edition, Ch. 15 Movement Disorders: Digital Version-Chapter 15

Chapter 15

Pdf Summary

This chapter reviews Parkinson disease (PD), essential tremor (ET), dystonia, Tourette syndrome (TS), Huntington disease (HD), Wilson disease (WD), and restless legs syndrome (RLS), emphasizing assessment, treatment, and nursing care.<br /><br />PD results from dopamine-producing neuron loss and causes bradykinesia, rigidity, resting tremor, and postural instability. Nonmotor features—including mood, cognitive, sleep, autonomic, and swallowing problems—are also common. Nursing priorities include timely medication administration, monitoring side effects and “on/off” fluctuations, fall and aspiration prevention, nutrition and bowel care, and patient/family education. Exercise, rehabilitation, adaptive strategies, and support for psychological symptoms can help maintain function.<br /><br />ET primarily causes action tremor; dystonia causes involuntary muscle contractions and abnormal postures. TS involves motor and vocal tics, often alongside ADHD or other psychiatric conditions. HD is an inherited progressive disorder involving motor, cognitive, and behavioral changes. WD causes copper accumulation that can affect the liver, brain, and other organs; lifelong specialist-directed treatment is essential. RLS causes an urge to move the legs, typically worse at rest and in the evening, and relieved by movement. Across disorders, care should address functional independence, safety, sleep, emotional well-being, and caregiver needs.<br /><br />Treatment varies by disorder and may include medication, botulinum toxin, behavioral therapy, exercise, and occupational, physical, or speech therapy. Nurses should recognize medication risks and coordinate multidisciplinary care. In PD, medications must not be delayed or omitted in hospital; drugs that block dopamine can worsen symptoms.<br /><br />Deep brain stimulation (DBS) may be considered for medically refractory tremor in ET or PD, selected PD symptoms responsive to levodopa, and medication-refractory dystonia. It can reduce selected motor symptoms but is not a cure and generally does not improve cognitive, speech, gait, or postural instability problems. Candidate selection, realistic expectations, ongoing programming and medication adjustment, wound and device monitoring, and coordinated follow-up are essential.

Keywords

Parkinson disease

essential tremor

dystonia

Tourette syndrome

Huntington disease

Wilson disease

restless legs syndrome

dopamine deficiency

deep brain stimulation

nursing care