ABNORMAL MOVEMENTS

Abnormal movements which are of clinical significance can be broadly divided into seizures and movement disorders.

Movement disorders:

They tend to affect the way a child’s body moves. These problems can lead to too much or too little movement, or balance problems.

Movement disorders may be caused by trauma to the brain, infections, genetic or metabolic conditions, drugs, inflammatory or autoimmune disorders, etc.

Few signs and symptoms of movement disorders include:

• Repetitive eye blinking, facial movements, sniffing, coughing, throat clearing, squeaks, squeals or speech (tics)
• Shock like jerks of the neck or body (myoclonus)
• Difficulties with balance and coordination (ataxia)
• Uncontrolled jerky movements (chorea)
• Repetitive, simple movements , rhythmic, suppressible, stops if distracted (Stereotypy)
• Involuntary sustained / repetitive muscle contractions cause twisting & repetitive movements or abnormal postures or both (dystonia)
• Rhythmic back and forth motions of a body part (tremor)

A seizure is the abnormal physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. Seizure can present with symptoms like sudden stiffening of muscles of back, arms and legs causing fall; repeated or rhythmic, jerking muscle movements affecting the neck, face and arms; sudden brief jerks or twitches of child’s arms and legs; subtle body movements such as eye blinking or lip smacking, etc.

Some benign or harmless movements commonly observed in children are:

• Neonatal sleep myoclonus: It is seen as jerks occurring only during sleep and presenting in the first month of life. The condition is self-limited, requiring no treatment and is not associated with any developmental and neurological problems.
• Benign paroxysmal torticollis: It is an episodic disorder that occurs in the early months of life in healthy children. The child’s head tilts to one side for a few hours or days, usually without any associated symptoms.
• Shuddering attacks: It is a benign disorder occurring during infancy or early childhood. The attacks seem to involve shivering movements occurring daily for several seconds in an otherwise healthy child.

If possible one should videotape the child’s abnormal movements before visiting the doctor and bring this video to the appointment, especially if the movements occur infrequently. This will help the doctor in making a diagnosis if abnormal movements don’t occur during the visit.