Improving Recognition and Treatment of Hyperkinetic Movement Disorders: Zoltan Mari, MD

WATCH TIME: 7 minutes | Captions are auto-generated and may contain errors.

“The bottom line is that the phenomenology, and the way that it looked, helped me identify the movement.”

Hyperkinetic movement disorders are characterized by excessive, involuntary movements, including tremor, dystonia, chorea, myoclonus, tics, and dyskinesias.¹ Because many of these conditions have overlapping clinical features, accurate diagnosis depends on a thorough clinical evaluation and careful characterization of abnormal movements, including assessment of movement distribution, speed, rhythmicity, and pattern.² Advances in therapies such as VMAT inhibitors, botulinum toxin, and deep brain stimulation have expanded treatment options, underscoring the importance of early recognition and accurate diagnosis.³

At the 2026 Advanced Therapeutics in Movement & Related Disorders® (ATMRD) Congress, held June 5-7 in Washington, DC, movement disorder experts gathered to discuss advances in the diagnosis and management of a range of neurologic conditions. Among the featured presentations was “TD and Other Hyperkinetic Disorders,” delivered by Zoltan Mari, MD, director of the Parkinson's Disease and Movement Disorders Program at the Cleveland Clinic Lou Ruvo Center for Brain Health.

Within the session, Mari reviewed practical strategies for distinguishing among common and uncommon hyperkinetic movement disorders, emphasizing the role of clinical observation and phenomenologic characterization in guiding diagnosis and treatment decisions. During the meeting, NeurologyLive sat down with Mari to gain more insight on his presentation.

In the interview, Mari emphasized the importance of detailed history-taking and phenomenologic examination in diagnosing hyperkinetic movement disorders. The discussion highlighted how movement characteristics and patient-recorded home videos can improve diagnostic accuracy, while also reviewing advances in treatment, including the growing use of VMAT inhibitors. Mari stressed that accurate characterization remains essential, as multiple movement disorders can coexist and require different therapeutic approaches.

REFERENCES
1. Abdo WF, van de Warrenburg BPC, Burn DJ, Quinn NP, Bloem BR. The clinical approach to movement disorders. Nat Rev Neurol. 2010;6(1):29-37. doi:10.1038/nrneurol.2009.196.
2. van Egmond ME, Kuiper A, Eggink H, et al. Treatable hyperkinetic movement disorders not to be missed. Front Neurol. 2021;12:659805. doi:10.3389/fneur.2021.659805.
3. Soland VLM, Bohlhalter S, Kaelin-Lang A, et al. Symptomatic treatment of extrapyramidal hyperkinetic movement disorders. Curr Neuropharmacol. 2024;22(9):1467-1494. doi:10.2174/1570159X22666240409161925.