Movement Disorders

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What is a movement disorder?

Movement disorders are a group of neurological conditions that cause involuntary changes in the nature or quality of movement.

Voluntary movements are intentional, like standing up. Movement disorders are involuntary, meaning the movements are not something the child wants to do. Movement disorders can cause movements to be increased, reduced or slower than intended, inaccurate or clumsy, or it can prevent movement altogether.

Types of movement disorders

There are two main types of movement disorders based on the abnormal movement they cause:

• Hyperkinetic Movement Disorders (increased movement). Sometimes referred to as dyskinesias, these movement disorders cause excessive, often repetitive, involuntary movements that disrupt a person’s regular activity. Common movement disorders in this category include chorea, dystonia, myoclonus, stereotypies, tics and tremors.
• Hypertonic Movement Disorders (increased stiffness). Hypertonic movement disorders increase the stiffness of joints and make it difficult for parents or caregivers to change clothing or provide other assistance. Common disorders in this category include spasticity, dystonia and rigidity.
• Hypokinetic Movement Disorders (decreased or slowed movement). These movement disorders, sometimes referred to as “Negative Signs” cause slowed movement (bradykinesia), reduced range of movement (hypokinesia) and/or loss of movement (akinesia). They can also reduce the control or coordination of simple movements (ataxia) or the ability to perform complex movements (dyspraxia).

Movement disorder symptoms

Symptoms of movement disorders vary depending on the specific condition causing the abnormal movements. However, some early warning signs could warrant a visit to your child’s doctor. Early warning signs of movement disorders in children include:

• Difficulty with fine motor skills
• Unusual postures of the arms, legs, neck, back or face
• Changes in walking or clumsiness
• More difficulty on one side of the body compared to the other
• Increased stiffness of joints, or inability to move into otherwise normal positions
• Difficulty learning or performing complex motor tasks that should otherwise be easy

What causes a movement disorder?

Movement disorders in children can be caused by:

• Tumors
• Genetic disorders
• Brain, spinal or nerve injury
• Infections
• Inflammation of the brain
• Medication side effects
• Autoimmune conditions
• Metabolic disorders
• Toxins

Movement Disorder Diagnosis and Treatment

To diagnose movement disorders, your child’s doctor needs to classify the condition and determine the underlying cause of the abnormal movement. Our doctors will perform a thorough physical evaluation and a medical and family history for each child. Further diagnostic tests may include:

• Lab tests, including genetic and metabolic studies
• Lumbar puncture (spinal tap)
• MRI of the head, neck, or back
• Video recording of the abnormal movement
• Computer-assisted gait evaluation
• EEG (electroencephalogram)
• Referral for testing by other specialists

Movement Disorder Treatment

Treatment for movement disorders will depend on the exact condition, a child’s age and the severity of the disease, but can include:

• Medication to help control symptoms
• Physical therapy to restore control of movements
• Occupational therapy to improve daily living skills
• Speech therapy to increase talking, memory and attention
• Hippotherapy to improve core coordination and strength using horseback riding
• Botulinum Toxin injections to reduce involuntary muscle contraction
• Neurosurgery such as deep brain stimulation and intrathecal baclofen pumps
• Orthopedic surgery to correct problems with bones, joints or tendons