5. Motor control

Motor control is dependent on sensory information and internal planning. There is teamwork between sensory cortical areas, basal nuclei and the cerebellum. In the case of basal ganglia dysfunction, movements are restricted, and in the case of cerebellar problems they are too large. This can be seen by observing body movements: especially gait and eye movement and speech may be dysarthric. In the case of unilateral disturbances, the contralateral basal ganglia or the ipsilateral cerebellum may be involved. It is fairly easy to identify the pyramidal tract, the basal ganglia, the cerebellum or deep sensation as the cause of a movement disorder. Functional neurological problems frequently present as a disorder of movement. The first section describes how movement is initiated in a process of constant feedback and feedforward with existing motor programmes and sensory information (sect. 5.1). The testing of motor functions as part of a full neurological examination is described in the central section of this chapter (sect. 5.2). Lastly, we discuss posture and gait pattern (sect. 5.3).