{"id":4970,"date":"2023-03-14T08:25:08","date_gmt":"2023-03-14T08:25:08","guid":{"rendered":"https:\/\/neuropediatoolbox.org\/?p=4970"},"modified":"2023-12-29T18:31:52","modified_gmt":"2023-12-29T18:31:52","slug":"semiologia-del-movimiento-pediatricos","status":"publish","type":"post","link":"https:\/\/neuropediatoolkit.org\/en\/semiologia-del-movimiento-pediatricos\/","title":{"rendered":"Semiolog\u00eda de los trastornos del movimiento pedi\u00e1tricos."},"content":{"rendered":"\n<p>Para interpretar la semiolog\u00eda de los trastornos motores, es necesario conocer la <a href=\"http:\/\/neuropediatoolkit.org\/jerarquia-del-control-del-sistema-motor\/\">jerarqu\u00eda del control del sistema motor. <\/a><\/p>\n\n\n\n<div id=\"wp-block-themeisle-blocks-accordion-ce6a1f82\" class=\"wp-block-themeisle-blocks-accordion exclusive\">\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><a href=\"https:\/\/es.wikipedia.org\/wiki\/Hiperton%C3%ADa_muscular\">Hiperton\u00eda<\/a>. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<ul class=\"wp-block-list\">\n<li>Rigidez.<\/li>\n\n\n\n<li>Diston\u00eda. <\/li>\n\n\n\n<li>Espasticidad. <\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"757\" height=\"553\" src=\"http:\/\/neuropediaclinic.com\/wp-content\/uploads\/2023\/03\/imagen-50.png\" alt=\"\" class=\"wp-image-5016\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-50.png 757w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-50-300x219.png 300w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-50-16x12.png 16w\" sizes=\"(max-width: 757px) 100vw, 757px\" \/><figcaption class=\"wp-element-caption\">Piramidalismo.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"305\" src=\"http:\/\/neuropediaclinic.com\/wp-content\/uploads\/2023\/03\/imagen-46-1024x305.png\" alt=\"\" class=\"wp-image-4990\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-46-1024x305.png 1024w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-46-300x89.png 300w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-46-768x229.png 768w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-46-18x5.png 18w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2023\/03\/imagen-46.png 1272w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><div id=\"zotpress-75aaae24bd101d675f56853fee154e65\" class=\"zp-Zotpress zp-Zotpress-Bib wp-block-group\">\n\n\t\t<span class=\"ZP_API_USER_ID ZP_ATTR\">332710<\/span>\n\t\t<span class=\"ZP_ITEM_KEY ZP_ATTR\">{332710:JHTN2PFT}<\/span>\n\t\t<span class=\"ZP_COLLECTION_ID 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class=\"ZP_HIGHLIGHT ZP_ATTR\"><\/span>\n        <span class=\"ZP_POSTID ZP_ATTR\">4970<\/span>\n\t\t<span class=\"ZOTPRESS_PLUGIN_URL ZP_ATTR\">https:\/\/neuropediatoolkit.org\/wp-content\/plugins\/zotpress\/<\/span>\n\n\t\t<div class=\"zp-List loading\">\n\t\t\t<div class=\"zp-SEO-Content\">\n\t\t\t\t<span class=\"ZP_JSON ZP_ATTR\">%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22JHTN2PFT%22%2C%22library%22%3A%7B%22id%22%3A332710%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Sanger%20et%20al.%22%2C%22parsedDate%22%3A%222003-01-01%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BSanger%20TD%2C%20Delgado%20MR%2C%20Gaebler-Spira%20D%2C%20Hallett%20M%2C%20Mink%20JW.%20Classification%20and%20Definition%20of%20Disorders%20Causing%20Hypertonia%20in%20Childhood.%20PEDIATRICS%20%5BInternet%5D.%202003%20Jan%201%20%5Bcited%202016%20Jan%2021%5D%3B111%281%29%3Ae89%26%23x2013%3B97.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttp%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcgi%5C%2Fdoi%5C%2F10.1542%5C%2Fpeds.111.1.e89%26%23039%3B%26gt%3Bhttp%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcgi%5C%2Fdoi%5C%2F10.1542%5C%2Fpeds.111.1.e89%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Classification%20and%20Definition%20of%20Disorders%20Causing%20Hypertonia%20in%20Childhood%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22T.%20D.%22%2C%22lastName%22%3A%22Sanger%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22M.%20R.%22%2C%22lastName%22%3A%22Delgado%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22D.%22%2C%22lastName%22%3A%22Gaebler-Spira%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22M.%22%2C%22lastName%22%3A%22Hallett%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22J.%20W.%22%2C%22lastName%22%3A%22Mink%22%7D%5D%2C%22abstractNote%22%3A%22%22%2C%22date%22%3A%222003-01-01%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1542%5C%2Fpeds.111.1.e89%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22http%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcgi%5C%2Fdoi%5C%2F10.1542%5C%2Fpeds.111.1.e89%22%2C%22PMID%22%3A%22%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%220031-4005%2C%201098-4275%22%2C%22language%22%3A%22en%22%2C%22collections%22%3A%5B%22DR7XPVGS%22%2C%22FRRGKHP5%22%2C%22TJMB4TF8%22%5D%2C%22dateModified%22%3A%222025-11-09T20%3A59%3A07Z%22%7D%7D%5D%7D<\/span>\n\n\t\t\t\t<div id=\"zp-ID-4970-332710-JHTN2PFT\" data-zp-author-date='Sanger-et-al.-2003-01-01' data-zp-date-author='2003-01-01-Sanger-et-al.' data-zp-date='2003-01-01' data-zp-year='2003' data-zp-itemtype='journalArticle' class=\"zp-Entry zpSearchResultsItem\">\n<div class=\"csl-bib-body\" style=\"line-height: 1.35; \">\n  <div class=\"csl-entry\" style=\"clear: left; \">\n    <div class=\"csl-left-margin\" style=\"float: left; padding-right: 0.5em; text-align: right; width: 1em;\">1.<\/div><div class=\"csl-right-inline\" style=\"margin: 0 .4em 0 1.5em;\">Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW. Classification and Definition of Disorders Causing Hypertonia in Childhood. PEDIATRICS [Internet]. 2003 Jan 1 [cited 2016 Jan 21];111(1):e89\u201397. Available from: <a class='zp-ItemURL' href='http:\/\/pediatrics.aappublications.org\/cgi\/doi\/10.1542\/peds.111.1.e89'>http:\/\/pediatrics.aappublications.org\/cgi\/doi\/10.1542\/peds.111.1.e89<\/a><\/div>\n  <\/div>\n<\/div>\n\t\t\t\t<\/div><!-- .zp-Entry .zpSearchResultsItem -->\n\t\t\t<\/div><!-- .zp-zp-SEO-Content -->\n\t\t<\/div><!-- .zp-List -->\n\t<\/div><!--.zp-Zotpress-->\n\n<\/figcaption><\/figure>\n\n\n\n<div id=\"wp-block-themeisle-blocks-accordion-c83d2d8f\" class=\"wp-block-themeisle-blocks-accordion exclusive\">\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>T\u00e9cnica de exploraci\u00f3n. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p>For evaluating a hypertonic joint, the clinician should elicit the parents\u2019 description of abnormal tone and involuntary movements, including whether movements occur with action or at rest, and whether there are particular trigger movements or task specificity. Observe posture at rest and the position of the limbs with respect to gravity. Observe the child lying, sitting, walking, and running, if possible. If complaints include abnormal performance or postures in response to specific activities or tasks, then the child should be observed while performing the affected task. Any abnormal fixed, twisted, or repetitive posture should be noted, as well as the degree of functional limitation.<\/p>\n\n\n\n<p>The following observations should be performed for each joint to be tested. Recognizing the contribution of anxiety to tone, the child should be relaxed as much as possible during the examination and the body part being examined should be supported against gravity. The head should be maintained in the midline to avoid contributions to tone from the tonic neck reflex. In addition, if lying supine, then the head and trunk should be resting comfortably.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Palpate the muscles to determine whether contraction occurs at rest.<\/li>\n\n\n\n<li>Measure resistance to movement of the affected joint with the child supine, seated, and standing, if possible, as well as while distracted.<\/li>\n\n\n\n<li>Measure passive range of motion at very slow (3 seconds to complete the movement), intermediate (0.5 second to complete the movement), and fast (as rapidly as possible) speeds. Note the resistance at the onset of movement, the presence or absence of a \u201ccatch\u201d occurring at some time after the onset of movement, and the joint angle at which the catch occurs.<\/li>\n\n\n\n<li>Perform sudden reversal in the direction of movement at slow, intermediate, and fast speeds, and note the presence or absence of increased resistance immediately on reversal (suggesting co-contraction) or at some time after (suggesting a spastic catch), as well as any velocity dependence.<\/li>\n\n\n\n<li>Instruct the child to move the same joint on the contralateral side and observe for involuntary movement, then test for a change in resistance to slow, passive movement. Instruct the child to move a distant and unrelated joint (eg, by opening and closing 1 fist) on the contralateral side and then the ipsilateral side, and observe for involuntary movement or a change in resistance to passive movement.<\/li>\n<\/ol>\n<\/div><\/details>\n<\/div>\n<\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div><a href=\"https:\/\/es.wikipedia.org\/wiki\/Hipoton%C3%ADa\">Hipoton\u00eda<\/a>. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"http:\/\/neuropediatoolkit.org\/pull-to-sit\">Pull to sit.<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/neuropediatoolkit.org\/suspension-horizontal-collis\/\">Suspensi\u00f3n horizontal (Collis).<\/a><\/li>\n<\/ul>\n<\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>S\u00edntomas motores deficitarios. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<ul class=\"wp-block-list\">\n<li>Debilidad (activaci\u00f3n muscular insuficiente). Es importante diferenciar la <a href=\"http:\/\/neuropediatoolkit.org\/child-muscle-weakness\/\">debilidad muscular<\/a> de la <a href=\"http:\/\/neuropediatoolkit.org\/escala-de-fuerza-mrc\/\">debilidad piramidal<\/a>. <\/li>\n\n\n\n<li>Control motor selectivo reducido (inhabilidad para activar un patr\u00f3n espec\u00edfico de m\u00fasculos).  <\/li>\n\n\n\n<li>Ataxia (inhabilidad para activar el patr\u00f3n correcto de m\u00fasculos durante el movimiento). <\/li>\n\n\n\n<li>Apraxia y dispraxia del desarrollo (inhabilidad para activar el patr\u00f3n correcto de m\u00fasculos para realizar una tarea, task-oriented). <\/li>\n<\/ul>\n\n\n<div id=\"zotpress-e4f91954a929798a745d242cc922075f\" class=\"zp-Zotpress zp-Zotpress-Bib wp-block-group\">\n\n\t\t<span class=\"ZP_API_USER_ID ZP_ATTR\">332710<\/span>\n\t\t<span class=\"ZP_ITEM_KEY ZP_ATTR\">{332710:7QUUFCUB}<\/span>\n\t\t<span class=\"ZP_COLLECTION_ID ZP_ATTR\"><\/span>\n\t\t<span class=\"ZP_TAG_ID ZP_ATTR\"><\/span>\n\t\t<span 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id=\"zp-ID-4970-332710-7QUUFCUB\" data-zp-author-date='Sanger-et-al.-2006-11-01' data-zp-date-author='2006-11-01-Sanger-et-al.' data-zp-date='2006-11-01' data-zp-year='2006' data-zp-itemtype='journalArticle' class=\"zp-Entry zpSearchResultsItem\">\n<div class=\"csl-bib-body\" style=\"line-height: 1.35; \">\n  <div class=\"csl-entry\" style=\"clear: left; \">\n    <div class=\"csl-left-margin\" style=\"float: left; padding-right: 0.5em; text-align: right; width: 1em;\">1.<\/div><div class=\"csl-right-inline\" style=\"margin: 0 .4em 0 1.5em;\">Sanger TD, Chen D, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW, et al. Definition and Classification of Negative Motor Signs in Childhood. Pediatrics [Internet]. 2006 Nov 1 [cited 2016 Jan 21];118(5):2159\u201367. Available from: <a class='zp-ItemURL' href='http:\/\/pediatrics.aappublications.org\/content\/118\/5\/2159'>http:\/\/pediatrics.aappublications.org\/content\/118\/5\/2159<\/a><\/div>\n  <\/div>\n<\/div>\n\t\t\t\t<\/div><!-- .zp-Entry .zpSearchResultsItem -->\n\t\t\t<\/div><!-- .zp-zp-SEO-Content -->\n\t\t<\/div><!-- .zp-List -->\n\t<\/div><!--.zp-Zotpress-->\n\n\n<\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Trastornos <a href=\"http:\/\/neuropediatoolkit.org\/springer-video-atlas-of-movement-disorders\/\">hipercin\u00e9ticos<\/a>.<\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<ul class=\"wp-block-list\">\n<li>Diston\u00eda. <\/li>\n\n\n\n<li>Corea. <\/li>\n\n\n\n<li>Atetosis. <\/li>\n\n\n\n<li>Mioclonus. <\/li>\n\n\n\n<li>Temblor. <\/li>\n\n\n\n<li>Tics. <\/li>\n\n\n\n<li>Estereotipias. <\/li>\n<\/ul>\n\n\n\n<figure 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id=\"zp-ID-4970-332710-G3ZPMQF6\" data-zp-author-date='Sanger-et-al.-2010-08-15' data-zp-date-author='2010-08-15-Sanger-et-al.' data-zp-date='2010-08-15' data-zp-year='2010' data-zp-itemtype='journalArticle' class=\"zp-Entry zpSearchResultsItem\">\n<div class=\"csl-bib-body\" style=\"line-height: 1.35; \">\n  <div class=\"csl-entry\" style=\"clear: left; \">\n    <div class=\"csl-left-margin\" style=\"float: left; padding-right: 0.5em; text-align: right; width: 1em;\">1.<\/div><div class=\"csl-right-inline\" style=\"margin: 0 .4em 0 1.5em;\">Sanger TD, Chen D, Fehlings DL, Hallett M, Lang AE, Mink JW, et al. DEFINITION AND CLASSIFICATION OF HYPERKINETIC MOVEMENTS IN CHILDHOOD. Mov Disord [Internet]. 2010 Aug 15 [cited 2015 June 15];25(11):1538\u201349. Available from: <a class='zp-ItemURL' href='http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2929378\/'>http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2929378\/<\/a><\/div>\n  <\/div>\n<\/div>\n\t\t\t\t<\/div><!-- .zp-Entry .zpSearchResultsItem -->\n\t\t\t<\/div><!-- .zp-zp-SEO-Content -->\n\t\t<\/div><!-- .zp-List -->\n\t<\/div><!--.zp-Zotpress-->\n\n\n<\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Trastornos hipocin\u00e9ticos (parkinsonismo).<\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<figure class=\"wp-block-table\"><table><thead><tr><th><strong>Parkinsonism subtype<\/strong><\/th><th><strong>Definition according to 4 axes<\/strong><br><br><strong>I. Age of onset<\/strong><a href=\"https:\/\/www.prd-journal.com\/article\/S1353-8020(20)30777-X\/fulltext#\"><sup>a<\/sup><\/a><br><br><strong>II. Clinical features<\/strong><br><br><strong>III. Outcome<\/strong><br><br><strong>IV. Etiology<\/strong><\/th><\/tr><\/thead><tbody><tr><td><strong>Developmental parkinsonism<\/strong><\/td><td>I. Infancy or early childhood<br><br>II. Hypotonia, hypokinesia, bradykinesia, derangement of postural development, GDD, rest tremor or other coarse oscillatory jerks, periodic fluctuation of symptoms, dysautonomia, OGC, persistence of fetal motor patterns<br><br>III. Persistent responsiveness to dopaminergic drugs and\/or precursors of biogenic amines. Normal neurological development in early treated subjects, variable degrees of ID with or without MDs in late treated subjects, non-degenerative progression in untreated\/late treated subjects<br><br>IV. Primary Neurotransmitter disorders (e.g. TH, SR, AADC, PTPS deficiency)<\/td><\/tr><tr><td><strong>Infantile and early childhood degenerative parkinsonism<\/strong><\/td><td>I. Infancy or early childhood<br><br>II. Severe rigid-hypokinetic syndrome, multifocal myoclonic jerks or coarse oscillatory jerks, dystonia, lack of postural development, progressive GDD, dysautonomia, OGC<br><br>III. Initial dramatic response to dopaminergic drugs followed by response deterioration in WARS2 deficiency. No available treatment for DAT deficiency. Progressive course also documented by the remarkable alteration of DaTSCAN imaging<br><br>IV. Primary or secondary Neurotransmitter disorders (e.g. DAT, WARS2 deficiency)<\/td><\/tr><tr><td><strong>Parkinsonism in the setting of neurodevelopmental disorders<\/strong><\/td><td>I. Childhood to adolescence<br><br>II. Early-onset neurodevelopmental disorder (GDD, ID) followed by emergence of parkinsonian features over time. Epilepsy frequently associated<br><br>III. No clear progression over time. Possible phases of regression followed by stabilization<br><br>IV. Neurodevelopmental disorders (e.g. <em>MECP2<\/em>)<\/td><\/tr><tr><td><strong>Parkinsonisms in the setting of multisystemic brain diseases<\/strong><\/td><td>I. Childhood to adolescence<br><br>II. Association with signs of multisystem brain involvement (spasticity, ataxia, myoclonus, dystonia, chorea, cognitive deterioration\/dementia, epilepsy, etc.). Phenotype can be dominated by the other features associated with parkinsonism<br><br>III. Progression over time associated with specific brain imaging abnormalities or metabolic alterations<br><br>IV. Neurodegenerative or neurometabolic disorders with multisystem involvement (see <a href=\"https:\/\/www.prd-journal.com\/article\/S1353-8020(20)30777-X\/fulltext#tbl2\">Table 2<\/a>, <a href=\"https:\/\/www.prd-journal.com\/article\/S1353-8020(20)30777-X\/fulltext#appsec1\">Table S1<\/a> for a list of conditions)<\/td><\/tr><tr><td><strong>Juvenile parkinsonism and dystonia-parkinsonism<\/strong><\/td><td>I. Childhood (rarely), adolescence<br><br>II. Parkinsonism is the predominant manifestation, mainly in the form of atypical parkinsonism, with or without dystonia, myoclonus, and cognitive decline<br><br>III. Levodopa response, onset of motor complications, and progression of parkinsonian signs can vary according to the specific genetic condition (e.g. good levodopa response in <em>DNAJC6<\/em>, <em>SYNJ1<\/em>, <em>PINK1<\/em>, no response in <em>PRKRA<\/em>, <em>ATP1A3;<\/em> early motor complications in <em>Parkin<\/em> and <em>PINK1<\/em>; slow progression in <em>SYNJ1<\/em>, rapid progression in <em>DNAJC6)<\/em><br><br>IV. Primary dystonia or monogenic parkinsonism genes (e.g. <em>PRKRA<\/em>, <em>ATP1A3<\/em>, <em>Parkin<\/em>, <em>PINK1<\/em>, <em>SYNJ1, DNAJC12, DNAJC6<\/em>)<\/td><\/tr><tr><td><strong>Acquired parkinsonism<\/strong><\/td><td>I. Infancy to adolescence<br><br>II and III. Clinical features and outcome variable depending on etiology<br><br>IV. 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Parkinsonism in children: Clinical classification and etiological spectrum. Parkinsonism & Related Disorders [Internet]. 2021 Jan 1 [cited 2023 Mar 14];82:150\u20137. 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