Other abnormal movements

Page most recently updated 14 October 2026

In addition to the abnormal movement phenotypes described in their respective dedicated pages (parkinsonism ➚ , ataxia ➚ , and chorea ➚), this page discusses other types of abnormal movement for which a dedicated page was not created. This reflects the relatively limited discriminatory value of many of these movements when present in isolation, unaccompanied by other neurologic, cognitive, or systemic findings, in which circumstances they may yield a broad differential diagnosis. In many cases, it is the accompanying findings that help narrow the differential to a smaller, clinically useful set of possibilities. This approach is consistent with the overall function of the movement lens within the diagnostic lenses framework, which prioritizes findings with greater discriminatory value in neuropsychiatric differential diagnosis.

● Tremor

Tremor is a rhythmic, involuntary oscillatory movement of a body part, resulting from alternating or simultaneous muscle contractions. Its diagnostic specificity is enhanced by accompanying findings and varies depending on the type of tremor.

Rest tremor: This occurs when the affected body part is relaxed. It may be accompanied by other features that support a picture of parkinsonism ➚.
Kinetic tremor: This occurs during voluntary movement. It may be accompanied by other features that support a picture of ataxia ➚. The International Parkinson and Movement Disorder Society classifies kinetic tremor into simple kinetic tremor, which remains relatively consistent throughout a movement, and intention tremor, which increases in amplitude as the moving body part approaches a target. Intention tremor is therefore a specific subtype of kinetic tremor.
Postural tremor: This occurs when a body part is maintained in a position against gravity. It may be encountered frequently in the setting of psychiatric disorders, often in the form of enhanced physiologic tremor associated with psychotropic medications (e.g., valproic acid, lithium, and several antidepressants), CNS stimulant use, anxiety disorders, and insomnia.

Rest and (re-emergent) postural tremor associated with Parkinson disease

The video demonstrates a right-hand rest tremor in a patient with Parkinson disease, including re-emergence of tremor after a delay when maintaining a posture or performing repetitive movements. The tremor is transiently suppressed by a brisk voluntary wrist movement (resetting).

Video credit: Swinnen BEKS, de Bie RMA, Hallett M, Helmich RC, Buijink AWG. “Reconstructing Re-emergent Tremor.” Movement Disorders Clinical Practice. 2023;10(9):1293–1296. Video 1. Licensed under CC BY-NC-ND 4.0.

Intention tremor associated with ataxia

The video demonstrates an intention tremor on finger-to-nose testing. The patient has limb and gait ataxia, with impaired finger-to-nose and heel-to-shin testing and difficulty with tandem walking. Mild dysarthria and gaze-evoked nystagmus are also present. The patient has an ITPR1-related disorder causing congenital ataxia.

Video credit: Holla VV, Kamble N, Yadav R, Pal PK. “Congenital Ataxic Phenotype of ITPR1-Related Disorders Due to Novel Missense Variants: A Video Case Series.” Journal of Movement Disorders. 2026;19(2):217–220. Supplementary Video 2. Licensed under CC BY-NC 4.0.

● Dyskinesia

Dyskinesia is a broad term encompassing various involuntary hyperkinetic movements and therefore has limited diagnostic specificity when considered in isolation. Dyskinesias may occur in association with other hyperkinetic movements, including chorea ➚ and tremor, and diagnostic significance depends on the phenomenology of the movement and the broader clinical context. Exposure to medications such as dopamine receptor-blocking agents or levodopa is an important diagnostic consideration.

Tardive dyskinesia is a persistent or recurrent hyperkinetic movement disorder associated with exposure to dopamine receptor-blocking agents, particularly antipsychotic medications. It most commonly manifests as repetitive oro-bucco-lingual movements, although other body regions may also be affected, and it may coexist with other tardive movement phenomena such as dystonia, akathisia, or stereotypies. Early recognition is important because tardive dyskinesia may persist despite withdrawal of the offending medication and, in some cases, may be permanent.

Tardive dyskinesia

The video demonstrates rapid, repetitive, involuntary movements of the tongue and jaw, characteristic of orofacial tardive dyskinesia.

Video credit: Solanki S, Velugoti LSDR. “Delayed Presentation of Antipsychotic Withdrawal Tardive Dyskinesia: A Case Report.” Cureus. 2023;15(8):e43693. Licensed under CC BY 4.0.

● Dystonia

Dystonia consists of sustained or intermittent muscle contractions that produce abnormal movements or postures, often with a twisting or patterned quality. When present in isolation, dystonia has a broad differential diagnosis, and diagnostic specificity is enhanced by the presence of other neurological or systemic findings, in addition to consideration of age at onset, distribution, temporal pattern, medication exposure, and other clinical factors

Dystonia

The video demonstrates dystonia during handwriting, standing posture and walking. Writer's cramp is more pronounced in the right hand than the left. The patient also exhibits rightward torticollis, with dystonia affecting the trunk and left foot that becomes more pronounced during walking. The patient has VPS16-related dystonia.

Video credit: Park J, Reilaender A, Petry-Schmelzer JN, et al. “Transcript-Specific Loss-of-Function Variants in VPS16 Are Enriched in Patients With Dystonia.” Neurology Genetics. 2022;8(1):e644. Supplementary Video 2. Licensed under CC BY-NC-ND 4.0.

● Myoclonus

Myoclonus consists of sudden, brief, involuntary jerks caused by either muscle contraction (positive myoclonus) or brief loss of muscle tone (negative myoclonus). Myoclonus has a broad differential diagnosis and may be classified as physiologic, essential, epileptic, or symptomatic (secondary). Symptomatic myoclonus is particularly important diagnostically, as it may occur across a wide range of neurologic and systemic disorders and is often accompanied by other clinical manifestations, such as cognitive abnormalities, ataxia ➚ , or other movement disorders ➚ . The accompanying clinical and electrophysiological features may therefore provide greater diagnostic specificity than the myoclonus itself. Toxic-metabolic and medication-related causes are particularly important considerations in the hospital setting.

Myoclonus

The video demonstrates myoclonus, with jerks occurring at rest and exacerbated by action and tactile stimuli. The patient has Lance–Adams syndrome (chronic myoclonus following a hypoxic brain injury). The video shows the movements before and after treatment with clonazepam and levetiracetam.

Video credit: Chan AHW, Nichols J, Tse W, Ryan SL. “A Case of Lance-Adams Syndrome with Mixed Cortical and Reticular Reflex Myoclonus.” Tremor and Other Hyperkinetic Movements. 2022;12(1):9. Licensed under CC BY 4.0.

● Athetosis and ballism/hemiballism

These are discussed as part of the choreiform spectrum of movements ➚ .

● Akathisia

Akathisia is characterized by a subjective sense of inner restlessness accompanied by a compelling need to move, often manifested by repetitive movements such as pacing, shifting position, or repeated crossing and uncrossing of the legs. It is particularly important to recognize in psychiatric practice because it is commonly associated with dopamine receptor-blocking medications, especially antipsychotic agents, and may otherwise be mistaken for anxiety, agitation, or worsening psychiatric illness.

Akathisia

A patient experiencing the characteristic motor restlessness of akathisia is shown eating while standing, apparently unable to remain seated.

Video credit: Phrontis, via Wikimedia Commons, licensed under CC BY-SA 3.0. The beginning has been trimmed slightly to remove the screen-recording delay.

● Tics

Tics are sudden, rapid, recurrent, non-rhythmic movements or vocalizations. Their phenomenology, including the presence of premonitory urges, partial suppressibility, and waxing and waning over time, can help distinguish them from other repetitive or involuntary movements. They are characteristic of Tourette syndrome and other conditions collectively termed tic disorders, but may also occur in other neurologic and psychiatric contexts.

● Stereotypies

Stereotypies are repetitive, patterned, often rhythmic movements that may include hand flapping, body rocking, or repetitive finger movements. They typically begin in early childhood and are particularly common in neurodevelopmental disorders, especially autism spectrum disorder, but may also be seen in other developmental, neurological, and psychiatric contexts. Stereotypies often appear involuntary but may be modulated or interrupted by distraction. In contrast to tics, which are typically briefer, sudden, non-rhythmic, and more variable in form, stereotypies tend to be more prolonged and consistent in their pattern over time and are generally not associated with premonitory urges.

● Mannerisms

Mannerisms are distinctive, repetitive, or exaggerated patterns of movement, gesture, or behaviour that are typically recognizable as elaborations of otherwise normal actions. Examples include an exaggerated bow, an affected hand gesture, or an unusually theatrical style of movement. They are classically described in severe psychiatric disorders, including schizophrenia-spectrum disorders, but can also occur in other psychiatric, neurologic, and developmental conditions; their diagnostic significance therefore depends largely on the broader clinical context.

● Functional movement disorder

Functional movement disorder (FMD) refers to abnormal movements arising in the context of functional neurologic disorder (FND), and may manifest as tremor, dystonia, myoclonus, parkinsonism ➚ , chorea ➚ , ataxia ➚ , gait disturbance, or other movement phenotypes. Diagnosis is based on positive clinical features demonstrating incongruence with recognized neurologic patterns, rather than simply on the presence of psychiatric symptoms or psychological stressors. It is worth noting that FMD may coexist with other neurologic disorders, and a comorbid psychiatric diagnosis is neither necessary nor sufficient for the diagnosis.

Selected references and further reading — Movement lens

Jankovic J, Hallett M, Okun MS, Comella CL, Fahn S. Principles and practice of movement disorders. 3rd ed. Philadelphia: Elsevier; 2021.

Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, editors. Bradley and Daroff's neurology in clinical practice. 8th ed. Philadelphia: Elsevier; 2022.

Campbell WW. DeJong's the neurologic examination. 8th ed. Philadelphia: Wolters Kluwer; 2020.

Arciniegas DB, Yudofsky SC, Hales RE, editors. The American Psychiatric Association Publishing textbook of neuropsychiatry and clinical neurosciences. 6th ed. Washington (DC): American Psychiatric Association Publishing; 2018.

Agrawal N, Faruqui R, Bodani M, editors. Oxford textbook of neuropsychiatry. Oxford: Oxford University Press; 2020.

Dening T, Thomas A, editors. Oxford textbook of old age psychiatry. 3rd ed. Oxford: Oxford University Press; 2021.

Blazer DG, Steffens DC, Busse EW, editors. The American Psychiatric Publishing textbook of geriatric psychiatry. 5th ed. Washington (DC): American Psychiatric Publishing; 2015.