Abnormal movements and pregnancy

Movimientos anormales y embarazo

Abnormal movements are one of the rare neurological conditions that present during pregnancy. With the exception of essential tremor and restless legs syndrome, the rest are rare. Studies on this patient group are limited and old, given the low prevalence. With this article, it is sought to provide information to general medical professionals on the clinical characteristics of diseases including, among others, chorea gravidarum, dystonia, and Huntington’s disease, as well as their relationship with pregnancy, their frequency, and appropriate treatment options, given the susceptibility of the patients and the high risk of adverse effects in the foetus with their respective short and long-term complications. A structured strategy was employed for the review of the literature, using the terms, abnormal movements, pregnancy, chorea gravidarum, restless legs syndrome, dystonia, Parkinson’s disease (MeSH and non-MeSH), which were formulated with Boolean operators in the following data bases: PubMed, EBSCOhost and Embase, filtering the results for review articles.

1. Lee KA, Zaffke ME, Baratte-Beebe K. Restless legs syndrome and sleep disturbance during pregnancy: The role of folate and iron. J Womens Health Gend Based Med. 2001;10(4):335–41.

2. Manconi M, Govoni V, de Vito A, Economou NT, Cesnik E, Casetta I, et al. Restless legs syndrome and pregnancy. Neurology. 2004;63(6):1065–9.

3. Allen RP, Earley CJ. Restless legs syndrome: A review of clinical and pathophysiologic features. J Clin Neurophysiol. 2001;18(2):128–47.

4. Chokroverty S. Sleep disorders. En: Bradley WG, Daroff RB, Fenechel GM, Jankovic J, editores. Neurology in cinical practice. 3rd ed. Woburn: Butterworth-Heinemann; 2000. p. 1781–827.

5. Sahota PK, Jain SS, Dhand R. Sleep disorders in pregnancy. Curr Opin Pulm Med. 2003;9(6):477–83.

6. O’Keeffe ST, Gavin K, Lavan JN. Iron status and restless legs syndrome in the elderly. Age Ageing. 1994;23(3):200–3.

7. Winkelman JW, Chertow GM, Lazarus JM. Restless legs syndrome in end-stage renal disease. Am J Kidney Dis. 1996;28(3):372–8.

8. Iannaccone S, Zucconi M, Marchettini P, Ferini-Strambi L, Nemni R, Quattrini A, et al. Evidence of peripheral axonal neuropathy in primary restless legs syndrome. Mov Disord. 1995;10(1):2–9.

9. Minagar A. Neurological disorders and pregnancy. Amsterdam: Elsevier; 2011. p. 205.

10. Earley CJ. Clinical practice. Restless legs syndrome. N Engl J Med. 2003;348(21):2103–9.

11. Hening W, Allen R, Earley C, Kushida C, Picchietti D, Silber M. The treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Review. Sleep. 1999;22(7):970–99.

12. Chesson AL Jr, Wise M, Davila D, Johnson S, Littner M, Anderson WM, et al. Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 1999;22(7):961–8.

13. Ekbom KA. Restless legs syndrome. Neurology. 1960;10:868–73.

14. Wilson P, Preece AA. Chorea gravidarum. Arch Intern Med. 1932;49:471–533.

15. Cardoso F. Chorea gravidarum. Arch Neurol. 2002;59(5):868–70.

16. Kranick SM, Mowry EM, Colcher A, Horn S, Golbe LI. Movement disorders and pregnancy: A review of the literature. Mov Disord. 2010;25(6):665–71.

17. Palanivelu LM. Chorea gravidarum. J Obstet Gynaecol. 2007;27(3):310.

18. Donaldson JO. Neurologic emergencies in pregnancy. Obstet Gynecol Clin North Am. 1991;18(2):199–212.

19. Ichikawa K, Kim RC, Givelber H, Collins GH. Chorea gravidarum. Report of a fatal case with neuropathological observations. Arch Neurol. 1980;37(7):429–32.

20. Patterson JF. Treatment of chorea gravidarum with haloperidol. South Med J. 1979;72(9):1220–1.

21. Miller LJ. Clinical strategies for the use of psychotropic drugs during pregnancy. Psychiatr Med. 1991;9(2):275–98.

22. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: A reference guide to fetal and neonatal risk. Baltimore: Williams & Wilkins; 1994. p. 975.

23. Dike GL. Chorea gravidarum: A case report and review. Md Med J. 1997;46(8):436–9.

24. Auerbach JG, Hans SL, Marcus J, Maeir S. Maternal psychotropic medication and neonatal behavior. Neurotoxicol Teratol. 1992;14(6):399–406.

25. Sexson WR, Barak Y. Withdrawal emergent syndrome in an infant associated with maternal haloperidol therapy. J Perinatol. 1989;9(2):170–2.

26. Committee on, Drugs, American Academy of Pediatrics. Use of psychoactive medication during pregnancy and possible effects on the fetus and newborn. Pediatrics. 2000;105(4):880–7.

27. Smith MS, Evatt ML. Movement disorders in pregnancy. Neurol Clin. 2004;22(4):783–98.

28. Lesca G, Goizet C, Durr A. Predictive testing in the context of pregnancy: Experience in Huntington’s disease and autosomal dominant cerebellar ataxia. J Med Genet. 2002;39(7):522–5.

29. Quinn N, Schrag A. Huntington’s disease and other choreas. J Neurol. 1998;245(11):709–16.

30. Altshuler LL, Szuba MP. Course of psychiatric disorders in pregnancy. Dilemmas in pharmacologic management. Neurol Clin. 1994;12(3):613–35.

31. Miller LJ. Psychiatric medication during pregnancy: Understanding and minimizing risks. Psychiatr Ann. 1994;24(2):69–75.

32. MacKenzie WE. Pregnancy in women with Friedreich’s ataxia. Br Med J (Clin Res Ed). 1986;293(6542):308.

33. Berardelli A, Rothwell JC, Hallett M, Thompson PD, Manfredi M, Marsden CD. The pathophysiology of primary dystonia. Brain. 1998;121 Pt 7:1195–212.

34. Hallett M. The neurophysiology of dystonia. Arch Neurol. 1998;55(5):601–3.

35. Watts RL, Koller WC. Movement disorders: Neurologic principles and practice. New York: McGrawHill; 1997. p. 779.

36. Bressman SB, de Leon D, Brin MF, Risch N, Burke RE, Greene PE, et al. Idiopathic dystonia among Ashkenazi Jews: Evidence for autosomal dominant inheritance. Ann Neurol. 1989;26(5):612–20.

37. Routiot T, Lurel S, Denis E, Barbarino-Monnier P. [Parkinson’s disease and pregnancy: Case report and literature review]. J Gynecol Obstet Biol Reprod (Paris). 2000;29(5):454–7.

38. Sawada H, Ibi M, Kihara T, Honda K, Nakamizo T, Kanki R, et al. Estradiol protects dopaminergic neurons in a MPP + Parkinson’s disease model. Neuropharmacology. 2002;42(8):1056–64.

39. Fishman J. Biological action of catechol oestrogens. J Endocrinol. 1981;89 Suppl:59P–65P.

40. Hagell P, Odin P, Vinge E. Pregnancy in Parkinson’s disease: A review of the literature and a case report. Mov Disord. 1998;13(1):34–8.

41. Dostal M, Weber-Schoendorfer C, Sobesky J, Schaefer C. Pregnancy outcome following use of levodopa, pramipexole, ropinirole, and rotigotine for restless legs syndrome during pregnancy: A case series. Eur J Neurol. 2013;20(9):1241e6.

42. Jacquemard F, Palaric JC, Allain H, Giraud JR. Parkinson disease and pregnancy. Apropos of a case. J Gynecol Obstet Biol Reprod (Paris). 1990;19:461e3.

43. Sethi Kapil D, Tremor. Curr Opin Neurol. 2003;16(4):481–5.

44. Tanner CM, Goldman SM. Epidemiology of movement disorders. Curr Opin Neurol. 1994;7(4):340–5.

45. Hubble JP, Busenbark KL, Koller WC. Essential tremor. Clin Neuropharmacol. 1989;12(6):453–82.