Historical and More Common Nongenetic Movement Disorders From Asia

Abstract

Nongenetic movement disorders are common throughout the world. The movement disorders encountered may vary depending on the prevalence of certain disorders across various geographical regions. In this paper, we review historical and more common nongenetic movement disorders in Asia. The underlying causes of these movement disorders are diverse and include, among others, nutritional deficiencies, toxic and metabolic causes, and cultural Latah syndrome, contributed by geographical, economic, and cultural differences across Asia. The industrial revolution in Japan and Korea has led to diseases related to environmental toxin poisoning, such as Minamata disease and β-fluoroethyl acetate-associated cerebellar degeneration, respectively, while religious dietary restriction in the Indian subcontinent has led to infantile tremor syndrome related to vitamin B12 deficiency. In this review, we identify the salient features and key contributing factors in the development of these disorders.

Keywords: ALS Kii; Hemichorea; Latah syndrome; Minamata disease; Movement disorders.

Figure 1.

Map of Japan depicting the locations of the Minamata disease outbreak and the Kii Peninsula. A: Minamata city. B: Koza city. C: Kii Peninsula.

Figure 2.

Clinical photographs of a child with infantile tremor showing external rotation of the left upper and lower limb suggestive of left-sided weakness (A), hypopigmented sparse hair (B), and knuckle hyperpigmentation with leukonychia of nails (C). Five days after starting treatment, there was improvement in the appearance with mild left-sided weakness (D). Three months after treatment, there was good eye contact, an active child, and improvement in the left-sided weakness (E, F).

Figure 3.

Axial T2WI showing hyperintensities in the right globus pallidus (arrow) (A) and crus cerebri (arrow) (B), with corresponding bright signal on DWI (arrows) (C, D). ADC maps demonstrating diffusion restriction in the right globus pallidus (arrow) (E) and crus cerebri (arrow) (F) in a child with infantile tremor syndrome. T2WI, T2 weighted image; DWI, diffusion-weighted image; ADC, apparent diffusion coefficient.

Figure 4.

FLAIR axial images show bilateral, symmetrical mildly increased signal intensity changes along the globus pallidus (A) and medial aspect of both temporal lobes (B) with no diffusion restriction in kernicterus. FLAIR axial images of follow-up magnetic resonance imaging show partial regression of the bilateral symmetrical increased signal intensity along the medial globus pallidus (C) and the medial temporal lobes (D), representing radiological improvement in postkernicterus changes. FLAIR, fluid attenuated inversion recovery.

Figure 5.

T1-weighted magnetic resonance imaging of a patient with left hemichorea. Hyperdensity in the right putamen correlating to left hemichorea in Supplementary Video 3 in the online-only Data Supplement.