How best to address these common movement disorders

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Abstract

This review describes how to manage everything from Parkinson's disease and tic disorders to restless legs syndrome and ataxia.

PRACTICE RECOMMENDATIONS

> Initiate neuroprotective therapy with a monoamine oxidase B inhibitor to slow the progression of Parkinson's disease. With onset of functional impairment, give levodopa at the lowest effective dose.Symbol

PRACTICE RECOMMENDATIONS

> Give propranolol for essential tremor causing a patient distress, starting at 20 to 40 mg twice daily and increasing the dose (to a maximum of 320 mg/d) until relief is achieved.Symbol

PRACTICE RECOMMENDATIONS

> Consider giving a dopamine receptor blocker for Tourette syndrome or other tic disorder; alternative agents are clonidine or a newer agent, tetrabenazine.Symbol

Strength of recommendation (SOR)

Symbol Good-quality patient-oriented evidence

Strength of recommendation (SOR)

Symbol Inconsistent or limited-quality patient-oriented evidence

Strength of recommendation (SOR)

Symbol Consensus, usual practice, opinion, disease-oriented evidence, case series

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