Movement - uncontrolled or slow
Dystonia; Involuntary slow and twisting movements; Choreoathetosis; Leg and arm movements - uncontrollable; Arm and leg movements - uncontrollable; Slow involuntary movements of large muscle groups; Athetoid movements
Uncontrolled or slow movement is a problem with muscle tone, usually in the large muscle groups. The problem leads to slow, uncontrollable jerky movements of the head, limbs, trunk, or neck.
The words cerebral palsy or (CP) may conjure up an image of a twisted, wheel chair-bound child. But sometimes the disease is so mild it doesn't limit any activity at all. Let's talk about cerebral palsy. So, what causes cerebral palsy? CP is caused by injuries or abnormalities of the brain. Most of the problems occur as the baby grows in the womb. Premature babies have a slightly higher risk of developing CP. Cerebral palsy may also occur during early infancy as a result of several conditions, including Bleeding in the brain, Brain infections, Head injuries, infections in the mother during pregnancy or from severe jaundice. CP can affect one limb, one side of the body, both arms or legs, three limbs, or all four limbs. The limbs might be floppy, rigid, or spastic. They might have a tremor, move on their own, or be uncoordinated. The limbs might function so well most people would not notice, or they might even be unusable. Children with CP might have normal or superior intellect. Up to a quarter of children with CP have developmental delays or mental retardation. Your child's doctor will do a full neurological exam of your child to verify the symptoms. Tests might include a CT scan or MRI of the head, an EEG, and vision and hearing tests. There is no cure for CP. The goal of treatment is to help your child be as independent as possible. Your child may need a team consisting of a primary care doctor, dentist, social worker, nurses, specialists, and occupational, physical, and speech therapists. A variety of medicines can prevent or reduce the frequency of seizures, help with spasticity, and treat tremors. CP is a lifelong disorder. But with good care it shouldn't get worse over time. CP varies in each individual...your child may need lifelong care, or your child may be able to live independently. It all depends on the severity of your child's CP. Keep in mind that stress and burnout among parents of children with severe CP is common, so make sure that you get the support you need, as well as the support for your child.
Considerations
The abnormal movement may be reduced or disappear during sleep. Emotional stress makes it worse.
Abnormal and sometimes strange postures may occur because of these movements.
Causes
The slow twisting movements of muscles (athetosis) or jerky muscle contractions (dystonia) may be caused by one of many conditions, including:
- Cerebral palsy (group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking)
- Side effects of drugs, especially for mental disorders
- Encephalitis (irritation and swelling of the brain, most often due to infections)
- Genetic diseases
- Hepatic encephalopathy (loss of brain function when the liver is unable to remove toxins from the blood)
- Huntington disease (disorder that involves breakdown of nerve cells in the brain)
- Stroke
- Head and neck trauma
- Pregnancy
Sometimes two conditions (such as a brain injury and medicine) interact to cause the abnormal movements when neither one alone would cause a problem.
Home Care
Get enough sleep and avoid too much stress. Take safety measures to avoid injury. Follow the treatment plan your health care provider prescribes.
When to Contact a Medical Professional
Contact your provider if:
- You have unexplained movements that you cannot control
- The problem is getting worse
- Uncontrolled movements occur with other symptoms
What to Expect at Your Office Visit
The provider will perform a physical exam. This may include a detailed examination of the nervous and muscle systems.
You'll be asked about your medical history and symptoms, including:
- When did you develop this problem?
- Is it always the same?
- Is it always present or only sometimes?
- Is it getting worse?
- Is it worse after exercise?
- Is it worse during times of emotional stress?
- Have you been injured or in an accident recently?
- Have you been sick recently?
- Is it better after you sleep?
- Does anyone else in your family have a similar problem?
- What other symptoms do you have?
- What medicines are you taking?
Tests that may be ordered include:
- Blood studies, such as metabolic panel, complete blood count (CBC), blood differential
- CT scan of the head or affected area
- EEG
- EMG and nerve conduction velocity studies (sometimes done)
- Genetic studies
- Lumbar puncture
- MRI of the head or affected area
- Urinalysis
- Pregnancy test
Treatment is based on the movement problem the person has and on the condition that may be causing the problem. If medicines are used, the provider will decide which medicine to prescribe based on the person's symptoms and any test results.
References
Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 24.
Okun MS, Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 382.
Version Info
Last reviewed on: 1/23/2023
Reviewed by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
