Hyperkinesia refers to an increase in muscular activity that can result in excessive abnormal movements, excessive normal movements, or a combination of both. Hyperkinesia is a state of excessive restlessness which is featured in a large variety of disorders that affect the ability to control motor movement, such as Huntington
Huntington's Disease
A condition that leads to progressive degeneration of nerve cells in the brain.
What are hyperkinetic movements?
The word hyperkinesis comes from the Greek hyper, meaning "increased," and kinein, meaning "to move." Hyperglycemia -induced involuntary movements ( hemichorea and bilateral dystonia) in a 62-year-old Japanese woman with type 1 diabetes. Basic hyperkinetic movements can be defined as any unwanted, excess movement.
How does hyperkinetic syndrome affect the brain?
In vascular, infectious, toxic, metabolic and other pathological factors, hyperkinetic syndrome in adults can also have a symptomatic effect on the brain. The following groups of brain lesions are known which have a hyperkinetic syndrome:
Can a child with hyperkinetic syndrome play sports?
Just as important is the understanding of parents that a child suffering from hyperkinetic syndrome can not play sports and participate in games in which emotions are strongly expressed. It can be all sorts of competitions, team games, such as: football, hockey, basketball, etc., every possible show that will make the child nervous.
What is hyperkinesis and what causes it?
Unconsciously produced and inexpedient from the point of view of physiology active movements - hyperkinesis - refer to pathologies of nervous regulation of muscles of different localization and arise as a result of the defeat of the central and somatic nervous system.
Diagnosis
Management
History
What is the most common hyperkinetic movement disorder?
Tremor, especially essential tremor (ET), is the most frequent type of HMD seen in clinical practice.
What are the symptoms of hyperkinetic?
A specific and common behavior disorder in children, the hyperkinetic syndrome, may be due to organic causes and is characterized by: hyperactivity; short attention span and poor powers of concentration; impulsiveness; irritability; explosiveness; variability; and poor school work.
What is hyperkinetic condition examples?
Hyperkinetic movement disorders include tremors, dystonia, chorea, tics, myoclonus, stereotypies, restless legs syndrome, and various other disorders with abnormal involuntary movements.
What causes hyperkinetic movement?
Hypokinesia is caused by a loss of dopamine in the brain. Dopamine — a neurotransmitter, which helps your nerve cells communicate — plays an important role in your motor function. Though Parkinson's disease is a main cause of hypokinesia, it can also be a symptom of other disorders.
How do you treat hyperkinesia?
Hyperkinesis may be treated medically or surgically. Botulinum toxin injected into muscles involved in hyperkinesis causes temporary paralysis and temporary relief from hyperkinesis. When the effects of the botulinum toxin dissipate (3 to 6 months after injection), injection can be repeated.
What is hyperkinesia mean?
excessive movementHyperkinesia means excessive movement and generally refers to a wide variety of abnormal involuntary movements or dyskinesias. From: Textbook of Clinical Neurology (Third Edition), 2007.
What is the difference between hypokinetic conditions and hyperkinetic conditions?
Hypokinetic movement disorders are those in which there is an abnormally reduced amount of intentional motor activity. Hyperkinetic movement disorders are characterized by two types of behavior: rhythmical and irregular.
What is a hypokinetic movement?
Hypokinesis is the term used to refer to slow or reduced movement. Hypokinetic movement disorders are often referred to as parkinsonisms because they display clinical features of idiopathic Parkinson's disease (IPD).
What is hypokinetic movement disorder?
Hypokinesia is one of the classifications of movement disorders, and refers to decreased bodily movement. Hypokinesia is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia.
What causes uncontrolled muscle movements?
What causes involuntary muscle movements? Involuntary muscle movements could be caused by several factors, including chronic diseases, medication side effects, brain injury, stroke, trauma, or lack of oxygen in the brain.
What is a hyperkinetic movement disorder?
Definition. Hyperkinetic movement disorders (HMDs) or dyskinesias, refer to a group of excessive, abnormal and involuntary movements. There are five major types of HMDs (Table 1). 1 Some authors also define ballism separately or as chorea that affects proximal joints. 2 Other HMDs include athetosis, stereotypies and in the amputee population “jumpy ...
When does peak tic severity occur?
Peak tic severity is usually experienced before mid-teens. Tics decrease in severity and may even disappear in adult life in a large proportion of patients. HMDs due to stroke or brain injury are usually static and do not progress if the precipitating factor is no longer active.
What is the role of oral medications in dystonia?
anti-epileptics, anticholinergics, dopamine depletors, beta blockers, GABA agonists) primarily act via inhibitory pathways in attempt to suppress abnormal movement except for dopa-responsive dystonia which improves with use of dopaminergics such as levodopa.
What is the treatment for ticosis hyperkinesis?
Treatment of ticosis hyperkinesis. Drug treatment of ticosis hyperkinesis includes pharmaceuticals based on analogues or derivatives of GABA (see the previous section), as well as drugs that improve cerebral circulation.
What is the name of the movement of the facial muscles?
Choreiiform hyperkinesis, which also has such names as choreic hyperkinesis, generalized hyperkinesis or chorea, are manifested in the form of arrhythmic expressive movements of facial muscles in the eyebrows, eyes, mouth, nose, and limb muscles.
Which hyperkinetic disorder is the least understood?
As a result, large amplitude movements of ballism are limited to one side of the body, contralateral to the site of the injury (hence, hemiballism ). Dystonia is arguably the least understood hyperkinetic disorder.
What is the term for involuntary, high-amplitude, flinging movements typically generated prox
Ballism refers to involuntary, high-amplitude, flinging movements typically generated proximally. These movements may be brief or continual and may occur in conjunction with chorea. Often, one side of the body is affected, that is, hemiballism.
Can RLS be provoked by posture?
RLS is not provoked only by specific postures, but some younger patients with mild RLS are able to lie down and fall asleep within such a short time that symptoms do not emerge, and consequently report symptoms when only sitting. View chapter Purchase book. Read full chapter.
Is athetosis a movement disorder?
In contrast to dystonia, in which there is a sustained, twisting, patterned movement, athetosis is typically a continual, nonsustained form of movement. Athetosis sometimes occurs as part of a mixed spastic, hyperkinetic movement disorder in children with static encephalopathy (cerebral palsy).
Does dystonia cause hyperkinetic disorder?
Pathological examination of patients with dystonia shows changes in the basal ganglia in a substantial percentage of cases; however, in many other cases, there are no clear problems with the basal ganglia. Hyperkinetic disorders may also develop in patients who have been taking certain medications for a long time.
What is the focus of the chapter on hyperkinesia?
The focus of this chapter is hyperkinesias, which include involuntary movements such as chorea, dystonia, myoclonus, tics, and tremor (see Tremor chapter). Most movement disorders result from impairment of the basal ganglia circuitry. The key to diagnosis of hyperkinesias is history and neurologic examination. A.
What is the term for a movement that is irregular and nonsustained?
The key to diagnosis of hyperkinesias is history and neurologic examination. A. Chorea is defined as brief, irregular, nonsustained movements that flow between muscle groups and can be partially suppressible. Other similar types of irregular, flowing movements include athetosis and ballism.
How does gymnastics help children with hyperkinetic syndrome?
In children with hyperkinetic syndrome, due to exercise, proper coordination of movements appears, sleep is normalized, and most importantly, the child's bones are strengthened and muscles develop.
How effective is hyperkinetic syndrome?
Treatment of hyperkinetic syndrome in children is medically effective in the case of 75-80% of treatment. Due to the fact that medical treatment is symptomatic, it is carried out in children for several years, and if there is such a need, then drug treatment continues in young and in adulthood.
What are the symptoms of hyperkinetic syndrome?
Symptoms of the hyperkinetic syndrome. Hyperkinetic syndrome, as a rule, takes one of the four most common forms: tics, tremors, chorea and dystonia. The intensity of such symptoms increases with arbitrary movements, with walking and writing, speech activity and in states of emotional and mental stress.
How does hyperkinetic syndrome affect children?
Hyperkinetic syndrome in children is determined by the distracted attention of the child, his heightened anxiety and impulsive actions. This syndrome adversely affects the progress in learning and the social adaptation of children in school, which is why academic performance suffers. Hyperkinetic syndrome in children causes hyperactive behavior and shortens sleep time. Most often, these children are twice as fast as their peers wear clothes and shoes, they are not capable of assiduity and are struggling to cope with class and home affairs that require concentration, are more likely to be distracted by occasional external stimuli.
Which type of circulation is characterized by a hyperkinetic type of circulation and is accompanied by three hemodynamic symptoms
Which is characterized by a hyperkinetic type of circulation and is accompanied by three hemodynamic symptoms. Hyperkinetic cardiac syndrome is characterized by three hemodynamic symptoms: Increased shock and minute volumes of the heart, which are many times greater than the metabolic needs of heart tissue.
Is hyperkinetic syndrome idiopathic?
Diagnostics of the hyperkinetic syndrome. In many cases, hyperkinetic syndrome in adults is characterized by idiopathic character. For its diagnosis, it is required to exclude all other, secondary forms, especially those associated with curative diseases such as endocrinopathies and tumors.
Does hyperkinetic syndrome show itself in sleep?
During sleep, hyperkinetic syndrome also does not show itself. Tremor, the symptom of which is the trembling of the body, is one of the most frequent cases. In tremor, hyperkinetic syndrome manifests itself in the form of involuntary rhythmic vibrational movements of the head and limbs, or the entire body.
What is hyperkinetic movement disorder?
Hyperkinetic movement disorder is a group of movement disorders in which excessive involuntary movements and reduced voluntary movements appear at the same time. It is seen more commonly in children who have neurological disorders like cerebral palsy. It is caused due to malfunction or dysfunction of the brain.
What is the disorder that affects the balance and coordination of muscles?
Ataxia – it is a disorder that disrupts the balance and control of muscles functioning for walking, running and other activities related to locomotion. 2 It affects posture and coordination of muscles leading to staggered gait. It is characterized by poor coordination of eyes and limbs with speech problems. Alcohol consumption is the main cause of this disorder. Other causes are a stroke, injury, infection, degenerative disorders.
Overview
Hyperkinesia refers to an increase in muscular activity that can result in excessive abnormal movements, excessive normal movements, or a combination of both. Hyperkinesia is a state of excessive restlessness which is featured in a large variety of disorders that affect the ability to control motor movement, such as Huntington's disease. It is the opposite of hypokinesia, which refers to decreased bodily movement, as commonly manifested in Parkinson's disease.
Classification
Basic hyperkinetic movements can be defined as any unwanted, excess movement. Such abnormal movements can be distinguished from each other on the basis of whether or not, or to what degree they are, rhythmic, discrete, repeated, and random. In evaluating the individual with a suspected form of hyperkinesia, the physician will record a thorough medical history, including a clear description of the movements in question, medications prescribed in the past and present, …
Pathophysiology
The causes of the majority of the above hyperkinetic movements can be traced to improper modulation of the basal ganglia by the subthalamic nucleus. In many cases, the excitatory output of the subthalamic nucleus is reduced, leading to a reduced inhibitory outflow of the basal ganglia. Without the normal restraining influence of the basal ganglia, upper motor neurons of the circuit tend to become more readily activated by inappropriate signals, resulting in the characteri…
Diagnosis
There are various terms which refer to specific movement mechanisms that contribute to the differential diagnoses of hyperkinetic disorders.
As defined by Hogan and Sternad, “posture” is a nonzero time period during which bodily movement is minimal. When a movement is called “discrete,” it means that a new posture is assumed without any other postures interrupting the process. “Rhythmic” movements are those …
Management
Before prescribing medication for these conditions which often resolve spontaneously, recommendations have pointed to improved skin hygiene, good hydration via fluids, good nutrition, and installation of padded bed rails with use of proper mattresses. Pharmacological treatments include the typical neuroleptic agents such as fluphenazine, pimozide, haloperidol and perphenazine which block dopamine receptors; these are the first line of treatment for hemiballis…
History
In the 16th century, Andreas Vesalius and Francesco Piccolomini were the first to distinguish between white matter, the cortex, and the subcortical nuclei in the brain. About a century later, Thomas Willis noticed that the corpus striatum was typically discolored, shrunken, and abnormally softened in the cadavers of people who had died from paralysis. The view that the corpus striatum played such a large role in motor functions was the most prominent one until the 19th c…
Research directions
Studies have been done with electromyography to trace skeletal muscle activity in some hyperkinetic disorders. The electromyogram (EMG) of dystonia sometimes shows rapid rhythmic bursts, but these patterns can almost always be produced intentionally. In the myoclonus EMG, there are typically brief, and sometimes rhythmic, bursts or pauses in the recording pattern. When the bursts last for 50 milliseconds or less they are indicative of cortical myoclonus, but when the…
See also
• Basal ganglia disease
Disease/Disorder
- Definition
Hyperkinetic movement disorders (HMDs) or dyskinesias, refer to a group of excessive, abnormal and involuntary movements. There are five major types of HMDs (Table 1).1 Some authors also define ballism separately or as chorea that affects proximal joints.2 Other HMDs include athetos… - Etiology
HMDs can be itself a disease entity or a sign of another underlying neurologic condition. They can result from genetic abnormalities and neurodegenerative diseases; structural lesions; infection; drugs and toxins; or psychogenic causes (Table 2).1,2,3,4,5However, in many cases they have n…
Essentials of Assessment
- History
Distinguish, based on description of the abnormal movement, if the HMD consists of tremors, jerky or shock like movements, tics or abnormal postures. History of distribution of the movements will help determine if the disorder is focal, multifocal, unilateral or generalized. Finall… - Physical examination
The examiner should pay attention to the character of the movements, pattern of involvement, speed, rhythmicity, duration, suppressibility and triggers. Resting tremor occurs when the extremity is relaxed. Action tremor occurs during attempts to sustain posture (postural tremor) …
Rehabilitation Management and Treatments
- Available or current treatment guidelines
Oral medications (e.g. anti-epileptics, anticholinergics, dopamine depletors, beta blockers, GABA agonists) primarily act via inhibitory pathways in attempt to suppress abnormal movement except for dopa-responsive dystonia which improves with use of dopaminergics such as levodopa. Cert… - At different disease stages
Early- Sub-acute The potential benefits of exercise in HMDs is well documented not only with improving patients’ strength and endurance but also with improving psychological wellbeing.11However, no definitive rehabilitation guidelines are available for addressing HMDs t…
Cutting Edge/Emerging and Unique Concepts and Practice
- Advances in neuromodulation and neurosurgery for the treatment of movement disorders continue to evolve.17,18DBS is being offered as a treatment option for other HMDs such as cerebellar outflow tremor, Holmes tremor, tics due to Tourette syndrome, cervical dystonia, Huntington’s chorea, tardive dyskinesia, myoclonus, and hemiballism with variable outcomes. Int…
Gaps in The Evidence-Based Knowledge
- Psychiatric illness and HMD are commonly associated suggesting the underlying pathophysiology is potentially intertwined. Studies of genetic and biochemical abnormalities and advanced neuroimaging (e.g. DaTscan, functional MRI and diffusion tensor imaging) on these patients may help elucidate the underlying abnormalities to yield more effective treatment strategies for both.
References
- 1. Fahn S, Jancovic J.Principles and Practice of Movement Disorders. 1st ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2007. 2. Sanger TD, Chen D, Fehlings DL, et al. Definition and classification of hyperkinetic movements in childhood. Movement Disorders2010:25(11):1538-1549. 3. Morgante F, Klein C. Dystonia. Continuum 2013;19(5):1225-1241. 4. Kumar H, Jog M. P…