“Cerebral palsy” that is getting worse? Think again. Early-onset hereditary spastic paraplegia (HSP) is an under-recognised mimic of CP, particularly when there is: -Progressive spastic gait -Loss of previously acquired motor skills -True weakness -Knee recurvatum -Dystonia or parkinsonism No family history does not exclude HSP. Early genetic testing can be key, especially as mechanism-targeted therapies begin to emerge. loom.ly/akigKf0

Shortening the MDS-UPDRS Part III rating scale risks hindering its prognostic reliability, per findings from a longitudinal item response theory model analyzed by @movedisorder #COA Program. movementdisorders.onlinelibr…

Your patient is motorically ON. But are they neuropsychiatrically ON? This excellent review reframes neuropsychiatric fluctuations in PD as dynamic, dopamine-linked phenomena that may precede, exceed or occur independently of motor fluctuations. -OFF: anxiety, apathy, low mood, fatigue, cognitive slowing -ON: increased drive, impulsivity, disinhibition, hyperactivity Don’t just ask “When do you wear OFF?” Ask how mood, thinking and behaviour change around each levodopa dose. loom.ly/Ow7EwZI

A post-void residual may tell you more than another scan. This practical review reframes lower urinary tract symptoms as diagnostic clues in parkinsonism: ✅ Storage symptoms → usually PD ⚠️ Early retention or PVR >100 mL → think MSA ⚠️ Urge incontinence + magnetic gait → think NPH The bladder deserves a place in the neurological examination. loom.ly/4xeEseE

New MDCP Clinical Pearl: High Prevalence and Clinical Impact of Fibromyalgia in Functional Motor Disorder doi.org/10.1002/mdc3.70674

"I'm not sleeping because I'm up 4 times every night." For many patients with advanced PD, nocturia can be as disabling as motor fluctuations. This real-world study found that overnight foslevodopa/foscarbidopa infusion improved nocturia, urinary symptoms and quality of life after 3 months of treatment. Don't just ask about OFF periods. Ask about nights. loom.ly/KsbAdOk

We measure tremor. We score bradykinesia. We quantify rigidity. But what about the symptoms that often determine whether a patient can safely eat, communicate with family, or avoid aspiration pneumonia? This review makes a compelling case that "Breathe, Eat, Talk" should become a routine part of every movement disorders assessment. loom.ly/_2L4COE

Viewpoint by @movedisorder Scientific Issues Committee deconstructs past reporting on levodopa use by patients with PD and the relative risk for developing melanoma to clarify a contemporary evidence-based clinical approach. movementdisorders.onlinelibr…

The level of diagnostic precision in clinical neurological assessments of speaking or swallowing dysfunction is often insufficient. Early referral to speech-language pathology can reduce such day-to-day complications in people living with movement disorders. @movedisorder loom.ly/_2L4COE

Can we identify patients at risk for a first fall before it occurs? Using routinely collected motor and cognitive data from clinic visits, we developed and validated a model to estimate first-fall risk in Parkinson’s disease, supporting earlier, proactive clinical assessment. loom.ly/F7Oxh14

The heart may diagnose Parkinson's before the brain. Cardiac sympathetic imaging isn't just a confirmatory test: ✅ PD+OH vs MSA-P ✅ Predicts phenoconversion ✅ Supports body-first PD ✅ Identifies ""sick-but-not-dead"" neurons Time to view cardiac denervation as a biomarker, not a bystander. loom.ly/Tg3LNiA

Congratulations to everyone who played a part in increasing our score. Your contributions are informing clinical practice and improving care across the world.  movementdisorders.onlinelibr…

DBS in PD: The hidden cost Half of patients report major communication decline after STN-DBS — even when formal language tests look fine. CPIB catches what objective measures miss! Counsel aggressively. Track patient-reported outcomes. Real life > test scores. loom.ly/RBZlks4

Chorea + cerebellar ataxia? Think beyond isolated syndromes. This practical review highlights key genetic overlaps: SCA17, HD, DRPLA, A-T, Wilson's, NPC, GLUT1 & more — with distinctive clues (oculomotor, systemic, MRI) & a clear stepwise diagnostic algorithm prioritizing treatable causes. Essential reading for refining your ataxia-chorea differential! loom.ly/9xVt4M8