Abstract
Autoimmune movement disorders are rare but potentially treatable entities. They can
present with an excess or paucity of movement and may have other associated neurological
symptoms. These disorders were originally recognized by their classic clinical presentations
and the cancers associated with them. Recent emphasis has been targeted on associated,
and sometimes causative, antibodies. Although some disorders have stereotypical presentations,
the spectrum of abnormalities reported in association with antibodies is widening.
Determining whether antibodies are incidental or pathogenic and, hence, foregoing
or commencing immunotherapy treatment can be challenging for practicing neurologists.
Physicians often have to make the decision to empirically treat patients while awaiting
test results. Due to the lack of randomized controlled trials, the ideal immunotherapy
treatments and regimens are unknown. Patients with intracellularly targeted antibodies
tend to fare less well, while those with extracellularly targeted antibody disorders
often respond to treatments reducing antibody production. This review aims to summarize
reported adult-onset autoimmune movement disorders to date, and to provide a template
for the workup and treatment of suspected disorders. Rarer antibodies that are not
yet fully characterized, or reported in a few cases only, will not be covered in detail
as these are not likely to be readily commercially available. Childhood disorders
will be only be mentioned briefly in the discussion, as there is a separate article
in this issue on autoimmune neurologic diseases in children.
Keywords
autoimmune - encephalitis - movement disorder - paraneoplastic
