[Some reflections on the pathophysiology of abnormal movements]. / Algunas reflexiones sobre la patofisiología de los movimientos anormales.

INTRODUCTION: The field of abnormal movements is an area that is in continual expansion within Neurology and treatment is currently available for many of them, at least as far as the symptoms are concerned. Yet, the exact mechanisms of operation of the neurological structures involved in movement are not fully understood. DEVELOPMENT: It seems clear that the basal ganglia play an important role, fundamentally in pseudo-automatic movements, but because they are interconnected with many other structures it is difficult to gain a precise understanding of their individual functions. There are theories based solely on anatomical data, which are not enough to account for everything. The theory of the existence of neuronal circuits seems to explain a wider part of movement, although it still has a number of shortcomings. Another theory of movement disorders is that based on neurochemistry, according to which the imbalance of certain neurotransmitters would be the causation of the disease, but this theory does not enable us to explain all the pathologies related to movement either. A number of clinical observations and the use of animal models, however, have made it possible to draw up pathophysiological hypotheses about the generation of some abnormal movements. CONCLUSIONS: All these approaches have enabled researchers to find symptomatic treatments for certain diseases, but our knowledge of the pathophysiology involved is still far from complete and the chances of enhancing the therapeutic capacity available in such cases in the future are therefore immense.

Algunas reflexiones sobre la patofisiología de los movimientos anormales / Some reflections on the pathophysiology of abnormal movements

Introducción. El campo de los movimientos anormales esun área en continua expansión dentro de la Neurología, y existe enla actualidad tratamiento, al menos sintomático, para multitud deellos. Sin embargo, no está claro el mecanismo exacto de funcionamientode las estructuras neurológicas implicadas en el movimiento.Desarrollo. Parece cierto que los ganglios basales desempeñanun papel importante, fundamentalmente en los movimientos pseudoautomáticos,pero debido a que están interconectados con muchasotras estructuras es difícil conocer con precisión su función individual.Hay teorías basadas únicamente en datos anatómicos, que noson suficientes para explicar todo. La teoría de la existencia de circuitosneuronales parece explicar una parte más amplia del movimiento,aunque tampoco es completa. Otra teoría de los trastornosdel movimiento es aquella basada en la neuroquímica, según la cualel desequilibrio entre algunos neurotransmisores produciría laenfermedad; pero esta teoría tampoco permite explicar por completotoda la patología relacionada con el movimiento. Por otra parte,algunas observaciones clínicas y el uso de modelos animales hanpermitido elaborar hipótesis fisiopatológicas de la generación dealgunos movimientos anormales. Conclusión. Todas estas aproximacioneshan hecho posible encontrar algunos tratamientos sintomáticospara determinadas enfermedades, pero todavía el conocimientofisiopatológico está lejos de ser completo y, por tanto, lacapacidad terapéutica tiene grandes posibilidades de seguir mejorando

Introduction. The field of abnormal movements is an area that is in continual expansion within Neurology andtreatment is currently available for many of them, at least as far as the symptoms are concerned. Yet, the exact mechanisms ofoperation of the neurological structures involved in movement are not fully understood. Development. It seems clear that thebasal ganglia play an important role, fundamentally in pseudo-automatic movements, but because they are interconnected withmany other structures it is difficult to gain a precise understanding of their individual functions. There are theories based solelyon anatomical data, which are not enough to account for everything. The theory of the existence of neuronal circuits seems toexplain a wider part of movement, although it still has a number of shortcomings. Another theory of movement disorders is thatbased on neurochemistry, according to which the imbalance of certain neurotransmitters would be the causation of the disease,but this theory does not enable us to explain all the pathologies related to movement either. A number of clinical observations andthe use of animal models, however, have made it possible to draw up pathophysiological hypotheses about the generation of someabnormal movements. Conclusions. All these approaches have enabled researchers to find symptomatic treatments for certaindiseases, but our knowledge of the pathophysiology involved is still far from complete and the chances of enhancing thetherapeutic capacity available in such cases in the future are therefore immense