TABLE 3.

Hematologic tests which may be helpful based on presenting movement disorder. (Note this is not a comprehensive list, and it is focused on identifying abnormalities using common tests that may help with initial diagnostic work‐up)

Movement disorder	Recommended hematologic tests
Mixed movement disorder (includes some combination of chorea, ataxia, parkinsonism, tremor and/or dystonia)	‐ Peripheral blood smear (acanthocytes, giant inclusions in leukocytes, schistocytes) ‐ Prothrombin time (PT) and International normalization ratio (INR) ‐ Platelet count ‐ Leukocyte count with differential ‐ Hemoglobin, hematocrit, mean corpuscular volume ‐ Immunoglobulin levels ‐ Ferritin, iron, total iron binding capacity ‐ Ceruloplasmin ‐ Bilirubin, lactate dehydrogenase (LDH), haptoglobin and transaminase enzymes (screen for hemolytic process)
Chorea	‐ Hemoglobin, mean corpuscular volume, hematocrit, leukocytes and platelets ‐ Peripheral blood smear (sickle cells)
Ataxia	‐ Hemoglobin, mean corpuscular volume, hematocrit, leukocytes and platelets ‐ Peripheral blood smear (RBC morphology if anemic) ‐ Vitamin E, B12 and copper levels ‐ Serum protein electrophoresis ‐ Immunoglobulin levels
Parkinsonism	‐ Hemoglobin, mean corpuscular volume, hematocrit, leukocytes and platelets
Dystonia	‐ Hemoglobin, mean corpuscular volume, hematocrit, leukocytes and platelets ‐ Peripheral blood smear (schistocytes or fragmented cells, echinocytes) ‐ Bilirubin, lactate dehydrogenase (LDH), haptoglobin and transaminase enzymes (screen for hemolytic process)
Tremor (age <2)	‐ Hemoglobin, mean corpuscular volume ‐ Peripheral blood smear (RBC morphology) ‐ Vitamin B12, magnesium, calcium, zinc levels
Restless leg syndrome or periodic leg movements of sleep	‐ Hemoglobin, mean corpuscular volume ‐ Peripheral blood smear (sickle cells) ‐ Ferritin, iron, total iron binding capacity