UPDOX - PATIENT PORTAL

Available Forms

Abnormal Involuntary Movement Scale (AIMS)

MOVEMENT RATINGS: Rate highest severity observed. Rate movements that occur upon activation one less than those observed spontaneously. Select code number that applies

Patients Name *

Patients DOB *

MOVEMENT RATINGS: 0=None 1=Minimal, may be extreme normal 2=Mild 3=Moderate 4=Severe

Facial and Oral Movement

1.) Muscle of Facial Expression

e.g. movements of forehead, eyebrows, periorbital area, cheeks, including frowning, blinking, smiling, grimacing

2.) Lips and Perioral Area

e.g., Puckering, pouting, smacking

3.) Jaw

e.g., biting, clenching, chewing, mouth opening, lateral movement

4.) Tongue

e.g., Rate only increases in movement both in and out of mouth. NOT inability to sustain movement. Darting in and out of mouth.

Extremity Movements

5 .) Upper (arms, wrists,hands,fingers)

Include choreic movements (i.e. rapid, objectively purposeless, irregular, spontanious) athetoid movements (i.e. slow, irregular, complex, serpentine). DO NOT INCLUDE TREMOR(i.e. repetitive, regular, rhythmic)

6.) Lower (legs, knees, ankles, toes)

e.g. lateral knee movement, foot tapping, heal dropping, foot squirming, inversion and eversion of foot

Trunk movement

7.) Neck, shoulders, hips

e.g. rocking, twisting, squirming, pelvic gyrations

Global Judgments

8.) Severity of abnormal movements overall

9.) Incapacitation due to abnormal movements

10.) Patient's awareness of abnormal movements

0= no awareness 1= Aware, no distress 2=Aware, mild distress 3= Aware, moderate distress 4= Aware, severe distress

Dental Status

11.) Current problems with teeth and/or dentures?

Yes

12.) Are dentures usually worn?

Yes

13.) Edentia?

Yes

14.) Do movements disappear in sleep?

Yes

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