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Niamh's Journey

Movement Disorder (Tremor)

Observations

At aged two and a half we noticed that during the time Niamh was awake she was almost constantly moving - with a very mild tremble/tremor. After prolonged periods of continuous movement Niamh became distressed.

EEG's confirmed that this movement was not seizure related but was likely to be another neurological phenomenon - a movement disorder.

What is a Movement Disorder?

When the balance of neurotransmitters in the brain get of sync, the brain is not able to correctly fine tune the body's movements. This loss of fine tuning in can present itself in many ways, but in Niamh it was initially represented by a constant tremor.

Movement disorders of this type are believed to be caused by the depletion of a neurotransmitter called dopamine. This loss, causes the level of dopamine to become out of balance with other neurotransmitters.

The treatment for this condition was therefore one of trying to re-dress the balance of neurotransmitters in the brain.

How can they be treated?

There are no cures for movement disorders, the only current appropriate treatment is drug therapy to reduce the distressing symptoms.

1. Replacing lost Dopamine

It is believed that by providing dopamine to replace that which has been depleted, may re-dress
the balance of neurotransmitters in the brain

The drug given is called Co-careldopa and contains two ingredients carbidopa and levodopa.
Levodopa is converted into dopamine, increasing the level in the brain but unfortunately it has
pretty nasty side effects on the rest of the body, so Carbidopa is added, which reduces these
unwanted side effects.

It is believed that by reducing the levels of a different neurotransmitter (Acetyl-choline) in the brain then a new lower level balance of neurotransmitters will be achieved.

The Drug that is given is called Trihexyphenydil (Broflex or Benzhexol). This drug prevents the activity of a neurotransmitter called acetyl-choline by blocking the receptors that acetylcholine acts on. This reduces the activity of the acetylcholine, and helps restore the balance of these neurotransmitters in the brain.
It is most effective at reducing the tremor and rigidity associated with the disorder.

Niamh started with Co-careldopa then we added Trihexyphenydil.

Although the abnormal movements were never totally under control, for Niamh, Trihexyphenydil was the more effective for reducing the discomfort of her constant tremor.

  + Information Sheet: Movement Disorders

  + Link: The Movement Disorder Society

  + Link: Tardive Dyskinesia - this website had some good information on different types of involuntary muscular movements.

2. Reducing the level of other neurotransmitters to re-dress the balance in the brain

Outcome

Info & Links

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