Movement - uncontrollable

Answer 1

Definition

Uncontrollable movements are slow, twisting, continuous, and involuntary movements of the arms, legs, face, neck, or other parts of the body.

See also: Tardive dyskinesia

Alternative Names

Uncontrolled movements; Involuntary body movements; Body movements - uncontrollable; Dyskinesia; Athetosis

Considerations

This condition is usually a lifelong problem that begins during childhood and is characterized by involuntary neck, face, forearm, wrist, and hand movements. Facial grimaces along with tongue and jaw movements are often associated with involuntary neck movements.

Stress and activity often aggravate this condition, and relaxation and sleep help relieve the problem.

Common Causes

IN CHILDREN

• Hypoxia at birth
• Genetic disorder
• Kernicterus(excessive bilirubin in the central nervous system)

IN ADULTS

• Drug toxicity
• Degenerative disease
• Genetic disorder
• Neoplastic disease (tumors)
• Vascular (blood vessel) disease, usually stroke

Home Care

Swimming, stretching, walking, and balancing exercises can help coordination and slow down the deterioration process.

Family support is important, and open discussion of feelings is recommended. Self-help groups are available in many communities, and physical therapy should be sought as necessary.

Call your health care provider if

If there are any persistent involuntary movements that are unexplained, you should call your health care provider.

What to expect at your health care provider's office

The health care provider will perform a physical exam and ask questions about your symptoms and medical history. The physical examination may include detailed examination of both the nervous and the muscular systems.

Medical history questions may include:

• Does there seem to be prolonged muscle contractions causing the abnormal posture?
• Are the arms affected?
• Are the legs affected?
• When did this behavior begin?
• Did it occur suddenly?
• Has it been worsening gradually over months?
• Is it present continuously?
• At what age did this symptom begin?
• Is it worse after exercise?
• Is it worse when emotionally stressed?
• Is it better after sleep?
• What makes it better?
• What other symptoms are also present?

Tests that may be done include:

• CT scan or MRI of the head or affected area
• EEG
• Lumbar puncture
• Urinalysis
• Blood studies (such as CBC or blood differential)

Uncontrollable movements may be treated with various medications. Your health care provider will make recommendations based on your signs and symptoms.

References

Fahn S. Hypokinesia and hyperkinesia. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 16.

Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.

Answer 2

Definition

Uncontrollable movements include many types of movements you cannot control. They can affect the arms, legs, face, neck, or other parts of the body.

Examples of uncontrollable movements are:

• Loss of tone (asterixis)
• Slow, twisting, or continued movements (chorea, athetosis, or dystonia)
• Sudden jerking movements (myoclonus, hallismus)
• Uncontrollable repetitive movements that cause tremor

See also: Tardive dyskinesia

Alternative Names

Uncontrolled movements; Involuntary body movements; Body movements - uncontrollable; Dyskinesia; Athetosis; Myoclonus; Ballismus

Common Causes

There are many causes of uncontrolled movements. Some movements last only a short time. Others are due to a permanent condition of the brain and spinal cord and may get worse.

Some of these movements affect children. Others affect only adults.

Causes in children:

• Genetic disorder
• Lack of oxygen (hypoxia) at birth
• Kernicterus(too much bilirubinin the central nervous system)

Causes in adults:

• Drugs
• Genetic disorder
• Stroke or brain injury
• Tumors
• Worsening (degenerative) disease

Home Care

Physical therapy that includes swimming, stretching, walking, and balancing exercises can help with coordination and slow the damage.

Family support is important. It helps to openly discuss your feelings. Self-help groups are available in many communities. Try physical therapy as needed.

Call your health care provider if

Call your health care provider if you have any unexplained movements that you cannot control and that don't go away.

What to expect at your health care provider's office

The health care provider will perform a physical exam and ask questions about your symptoms and medical history. You may have a detailed examination of both the nervous and muscle systems.

Medical history questions may include:

• Are there muscle contractions that may be causing the abnormal posture?
• Are the arms affected?
• Are the legs affected?
• When did this movement begin?
• Did it occur suddenly?
• Has it been getting worse slowly over months?
• Is it present all the time?
• Is it worse after exercise?
• Is it worse when you are stressed?
• Is it better after sleep?
• What makes it better?
• What other symptoms are present?

Tests that may be done include:

• Blood tests (such as CBC or blood differential)
• CT scan of the head or affected area
• EEG
• Lumbar puncture
• MRI of the heador affected area
• Urinalysis

Treatment will depend on the cause. Many uncontrollable movements may be treated with medications. At other times, symptoms may improve on their own. Your health care provider will make recommendations based on your signs and symptoms.

References

Jankovic J, Lang AE. Movement disorders: diagnosis and assessment. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 23.

Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.

Reviewed By

Review Date: 02/05/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.