Movement - uncontrolled or slow

• Alternative Names

  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

• Considerations

  The slow sinuous twisting movements of muscles (athetosis) or sustained muscle contraction (dystonia) may be caused by a number of conditions, including cerebral palsy, encephalitis, drug side effects, a liver disease called hepatic encephalopathy, and Huntington's chorea.

  Additionally, there are situations where two conditions, for example both a brain injury and a medication, interact to cause the abnormal movement when neither alone would cause a problem.

  The abnormal movement may be reduced or disappear during sleep, but emotional stress makes it worse. Abnormal and sometimes grotesque postures may occur because of these movements.

• Common Causes
  • Encephalitis
  • Hepatic encephalopathy
  • Medication side effects
  • Cerebral palsy
  • Genetic diseases
  • Stroke
• Home Care

  Get adequate sleep and avoid excessive stress. In severe cases, take safety measures to avoid injury. Follow prescribed therapy for treatment of the underlying cause.

• Call your health care provider if
  • There is unexplained dystonia.
  • The problem is getting worse.
  • Uncontrolled movements are accompanied by other symptoms.
• What to expect at your health care provider's office

  The doctor will perform a physical exam. The physical examination may include a detailed examination of the nervous and muscular systems.

  The doctor will ask questions about your medical history and symptoms, including:

  • When did you develop this problem?
  • How long have you had it?
  • Is it always the same?
  • Is it always present or only occasionally?
  • Is it getting worse?
  • Is it worse after exercise?
  • Is it worse during times of emotional stress?
  • Has you been injured or in an accident recently?
  • Has 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 medications are you taking?

  Diagnostic tests that may be performed include:

  • CT scan or MRI of the head or affected area
  • EEG
  • Lumbar puncture
  • Urinalysis
  • Blood studies (such as CBC or blood differential)
  • Genetic studies known gene abnormalities
  • EMG and nerve conduction velocity studies (occasionally done)
• 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.

Review Date: 3/26/2009

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.