Movement Disorders in Asia Dr. Roongroj Bhidayasiri, MD, FRCP, FRCPI. Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330; and Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles 90095, USA The spectrum of movement disorders in Asia is probably different from that seen in other geographical regions. This is not surprising given the unique combination of environmental and population characteristics in Asia. For Parkinson’s disease (PD), recent cross sectional and prospective cohort studies suggested that the age-adjusted prevalence and incidence of PD in Asia are comparable with that in Western countries. Genetically, mutation in Parkin was first described in Japanese, but this mutation has nowadays been reported worldwide in young-onset and autosomal recessive parkinsonism. Among monogenic forms of PD in Asia, a common LRRK2 G2019S mutation accounts for 1-2% of sporadic and 5-6% of familial PD, in contrast to a high prevalent in Ashkenazi Jews (40%). Among other forms of parkinsonism, SCA2 parkinsonism is more common in Chinese than Caucasian populations and forms an important differential diagnosis of familial parkinsonism in this region. A special form, the ALS/parkinsonism-dementia complex of Kii is an endemic disease with a diverse phenotypic expression with clinical and neuropathological manifestations similar to a syndrome found in Guam. In primary dystonia, two common forms originated in Asia; sex-linked recessive dystonia parkinsonism (XDP) in Panay, Phillippines, and dopa-responsive dystonia in Japan. For symptomatic dystonia, the majority (up to 75%) of patients with adult-onset GM1 gangliosidoses are of Japanese origin. Drug-induced dystonia from the use of traditional herbs have been reported in Asia. For hereditary ataxia in Asia, SCA3 is found to be the most common subtype among Chinese, Japanese, Singaporean, and Thai, and the worldwide spread mutation may have first occurred in Asia with a founding effect in Portugal. For SCA6, one of the highest prevalence was reported in Chugoku and Kansai areas in western Japan. In contrast to earlier literature, DRPLA is probably not exclusive to the Japanese and recent evidence has documented its worldwide occurrence. In addition, there are several other disorders reported to be more common in Asia, such as a group of neuropsychiatric startle, known as Latah in Southeast Asia. For acquired etiology, infections need to be considered in this region, comprising a group of HIV, tuberculous meningitis, Japanese B encephalitis, and certain parasitic infections which can be associated with different forms of movement disorders. Other particularities of movement disorders in the ethnically diverse population in Asia will be summarized during the presentation. While it is scientifically interesting to study particular disorders in different population groups, the access to movement disorders treatment is considered a major public health issue in certain Asian regions and resources should be put together to improve a better health standard of affected patients.