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Brain Motor Centers and Pathways
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
Whereas hypokinesia is associated with increased inhibition of the thalamus by the basal ganglia, a decrease in this inhibition results in hyperkinesia, or excessive, involuntary movement. These include rapid uncoordinated movement of body parts (chorea), twisting movements and sustained abnormal postures in the neck, trunk, and extremities (dystonia); and hemiballism, characterized by involuntary movements of the limbs on one side of the body. Hemiballism is caused by damage to the STN, which reduces excitation of the GPi and disinhibits the thalamus. The increased excitation and altered firing pattern of thalamocortical neurons cause these neurons to respond in an exaggerated manner or to discharge spontaneously, resulting in rapid, involuntary, and repetitive movements associated with violent flailing and swinging of the limbs and usually accompanied by a decrease in muscle tone.
Cerebral
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
Hyperkinetic movements are involuntary and excess movements that include dystonia, chorea, athetosis, myoclonia, tics and tremor. Of these, tremor is the most common type in children, which is a rhythmic, involuntary oscillation of part of the body, usually the hands, neck or head (titubation). It is classified as rest tremor (e.g. Parkinson's disease or drug induced), which is noted when the hands are resting on the lap, and the more common action tremor, which is produced by voluntary muscle contraction. Action tremor is either postural when affected arms are extended in front of the body (e.g. physiological or essential tremor) or target-directed movement such as intention (e.g. cerebellar tremor). Tremor is absent during sleep. It may be associated with serious neurological or metabolic disease. Tremor needs to be differentiated from tics and chorea.
Hyperkinetic Disorder
Published in MS Thambirajah, Case Studies in Child and Adolescent Mental Health, 2018
Ben exhibited most of the typical features of Hyperkinetic Disorder (HKD). The descriptions of his behaviour obtained from several sources indicate that he showed the three cardinal features of HKD: impulsivity, hyperactivity and inattention. These features were seen in more than one situation – school, home, clinic and after-school club. The onset of the difficulties had been around the age of two years. Thus the clinical features fulfil the criteria for a diagnosis of Hyperkinetic Disorder. Yet it is important to exclude other possible reasons for such behaviour. A similar clinical picture may occur in a number of conditions or situations:
Comorbidity of mental health and autism spectrum disorder: perception of practitioners in management of their challenging behaviour
Published in International Journal of Developmental Disabilities, 2023
Edward Khasakhala, Kennedy Bota, Godfrey Ayaga, Manson Sichari, Benard Wesonga, Donald Kokonya
This necessitates adequate detection and treatment of these significant occurrences in order to prevent morbidity among children with ASD. According to meta-analyses and randomized and non-randomized controlled trials conducted in Germany by Schulte-Körne (2016), the prevalence of hyperkinetic disorder ranges from 1% to 6%. This expressed itself through motor hyperactivity, a lack of concentration, and impulsive behaviour. This study however did not investigate specific mental health problems manifested by children and adolescents with ASD but rather the perception of practitioners of mental health and ASD based on challenging behaviours presented by these children and adolescents. There is need to carry out a study on specific mental health problems presented by children and adolescents with ASD and how practitioners perceive them. In conclusion, these findings may support the contention that the comorbidity between mental health disorders and ASD is complex and poorly understood.
VMAT2 Inhibitors for the Treatment of Tardive Dyskinesia
Published in Issues in Mental Health Nursing, 2022
Barbara Warren, Dawn Vanderhoef, Jessica Johnson
The key features of TD and other common antipsychotic-induced movement disorders (parkinsonism, acute akathisia, and acute dystonia) are summarized in Figure 2. The differentiation of TD can be challenging, as the movements associated with TD can look similar to those of other movement disorders. Additionally, TD can present together with other drug-induced disorders (e.g., parkinsonism) in the same patient. Finally, TD movements are sometimes mistaken for abnormal movements or behaviors associated with advanced age or underlying psychiatric conditions (Caroff & Campbell, 2016; Hauser et al., 2020; Savitt & Jankovic, 2018). It is helpful to consider the timing of onset (acute versus tardive), along with the type of movement (hypokinetic versus hyperkinetic). Acute syndromes usually present within hours or days of initiating antipsychotic treatment, while tardive syndromes often develop after more prolonged antipsychotic exposure (i.e., months or years). Hypokinetic syndromes (e.g., parkinsonism) are characterized by slow or insufficient movements. In contrast, hyperkinetic syndromes (e.g., TD, akathisia, and dystonia) are characterized by excessive abnormal movements with increased velocity, frequency, and amplitude. For an excellent summary of TD and other drug-induced movements, along with helpful video links depicting the various movements, we recommend a recent publication by Hauser et al. (Hauser et al., 2020).
A novel mutation in ATM gene in a Saudi female with ataxia telangiectasia
Published in International Journal of Neuroscience, 2021
Hussein Algahtani, Bader Shirah, Raghad Algahtani, Mohammad H. Al-Qahtani, Angham Abdulrahman Abdulkareem, Muhammad Imran Naseer
Ataxia telangiectasia is a multi-system disorder in which the neurodegenerative process usually begins between the ages of 6 to 18 months and lead to wheelchair confinement by the age of 10 years. The cerebellar degeneration leads to truncal swaying, gait ataxia, dyssynergia, muscle hypotonia, and sudden falls [13]. The involvement of the basal ganglia is a common occurrence, which could be the initial presenting symptoms or as a part of the spectrum of the disease. Basal ganglia involvement may manifest as chorea, dystonia, dysphagia, athetosis, myoclonic jerks, or various tremors [14]. This association was illustrated more than five decades ago by Sedgwick and Boder’s report in 15 out of 20 patients [15]. Involuntary movements in ataxia telangiectasia are progressive, being mild in children and become more symptomatic in adults. Chorea is more common than dystonia in children, while dystonia becomes more aberrant with advancing age. Hypokinetic movement disorders are much less common than hyperkinetic movement disorders. Some patients may develop parkinsonian features with rigidity and resting tremors [16]. Our patients had an onset of ataxia at the age of 14 with slow progression and lack of basal ganglia manifestations, which may indicate that her mutation led to less severe neurodegenerative effects compared to other mutations in the ATM gene.