This issue of Continuum, the penultimate issue under my editorship of this journal, is devoted to the contemporary diagnosis and evolving management options available for our patients with disorders of movement. To accomplish this goal, I am indebted to our guest editor, Dr Kathleen Poston, who assembled such a well-organized and inclusive set of topics and outstanding content experts to cover the wide variety of movement disorders, whether hypokinetic or hyperkinetic, that present to us.
The issue aptly begins with the article by Dr Lana M. Chahine, who discusses the assessment, management, and counseling of individuals who are prodromal or at risk for an α-synucleinopathy. Next, Drs Avner Thaler and Roy N. Alcalay review the key symptoms, genetic basis, diagnosis, and contemporary medical management of Parkinson disease. This is followed by the article from Dr Ashley E. Rawls, who discusses the surgical therapies for Parkinson disease, including anticipated outcomes and appropriate patient selection for these management options. Drs Daniel Weintraub and David Irwin then review the diagnosis and management of the range of cognitive and neuropsychiatric symptoms that may occur in patients with Parkinson disease and dementia with Lewy bodies.
Dr Aparna Wagle Shukla then discusses the diagnosis and treatment of essential tremor, including distinguishing essential tremor from other tremor disorders. Dr Daniel O. Claassen next provides a review of the current diagnostic criteria and management approach to patients with multiple system atrophy. This is followed by the article from Dr Alexander Pantelyat, who reviews the diagnosis and management of progressive supranuclear palsy and corticobasal syndrome.
Drs Erin Furr Stimming and Danny Bega then discuss the broad differential diagnosis, diagnostic approach, and management strategies for patients with hereditary and acquired causes of chorea.
In the following article, Dr Liana S. Rosenthal describes the differential diagnosis, classification, evaluation, and management of neurodegenerative causes of cerebellar ataxia. Dr Christopher D. Stephen then reviews the classification of genetic and idiopathic dystonias, their medical and surgical management options, and the recognition and emergency management of dystonic storm.
Dr Jennifer A. O’Malley next provides an extensive review of common movement disorders in children, providing us with the information needed to distinguish benign versus pathologic movements in infancy and childhood and to recognize those movement disorders that are symptomatic of treatable and “not to be missed” conditions.
In the final review article of the issue, Dr Maya Katz reviews the role of palliative care in the treatment of neurodegenerative movement disorders, describing advance care planning and the specialized approach palliative care provides in clinical communication and symptom management.
After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs Adam G. Kelly and D. Joanne Lynn, and edited by Dr Joseph E. Safdieh, associate editor of Continuum and associate editor of self-assessment and CME, readers may earn up to 20 AMA PRA Category 1 CreditsTM toward self-assessment CME or, for Canadian participants, a maximum of 20 hours toward the Self-Assessment Program (Section 3) of the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Additional credit can be obtained by listening to Continuum Audio interviews associated with this and other Continuum issues, available to all subscribers, and completing tests on the Continuum Audio web platform or mobile app. Continuum Audio is also accredited by the Royal College of Physicians and Surgeons of Canada.
This issue also features Continuum articles read aloud. Different from Continuum Audio, these are recordings read verbatim from the print articles by Dr Michael Kentris and other narrators. The audio files are available to all Continuum subscribers in the AAN’s Online Learning Center at continpub.com/CME. I encourage you to listen and submit the survey with your feedback.
I would like to offer my deepest thanks to Dr Poston for her outstanding work assembling this encyclopedic issue and for enlisting such an amazing group of expert clinicians to provide us with such clear guidance on the current diagnosis of, and available management options for, the spectrum of hypokinetic and hyperkinetic movement disorders that we may encounter in practice.
—STEVEN L. LEWIS, MD, FAAN