Movements of forehead, eyebrows, periorbital area, cheeks, including frowning, blinking, smiling, grimacing.
How to Examine:
Observe patient's face during conversation and rest. Look for involuntary movements of eyebrows, forehead wrinkling, excessive blinking, or grimacing.
Puckering, pouting, smacking of lips.
How to Examine:
Observe lip movements during conversation and at rest. Look for lip smacking, puckering, or pouting movements.
Biting, clenching, chewing, mouth opening, lateral movement.
How to Examine:
Observe jaw movements during conversation and at rest. Look for chewing motions, jaw clenching, or lateral jaw movements.
Rate only increases in movement both in and out of mouth. NOT inability to sustain movement. Darting in and out of mouth.
How to Examine:
Ask patient to open mouth and observe tongue at rest. Look for darting movements, not normal movements or inability to keep tongue still.
Arms, wrists, hands, fingers. Include choreic movements (rapid, objectively purposeless, irregular, spontaneous) and athetoid movements (slow, irregular, complex, serpentine). DO NOT INCLUDE TREMOR (repetitive, regular, rhythmic).
How to Examine:
Observe arms and hands at rest and during conversation. Look for irregular, purposeless movements. Exclude tremor or parkinsonian movements.
Legs, knees, ankles, toes. Examples: lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot.
How to Examine:
Have patient seated and observe legs and feet. Look for involuntary movements while patient is at rest and during conversation.
Neck, shoulders, hips. Examples: rocking, twisting, squirming, pelvic gyrations.
How to Examine:
Observe patient seated and standing. Look for involuntary movements of the trunk, neck, and shoulders.
Degree to which abnormal movements interfere with the patient's ability to function.
How to Examine:
Assess how much the movements interfere with daily activities, work, or social functioning.