Anatomy of self-injurious, stereotypic, and aggressive movements: evidence for involuntary explanation.
Self-injurious movements, common in persons diagnosed with Tourette syndrome, or mental retardation, are typically difficult to eliminate. The author considers the possibility that certain self-injurious movements are involuntary phenomena. An anatomical analysis of high-frequency movements in a patient with severe head slapping is presented by tracing the muscles and nerves involved. The median nerve innervates muscles that bring the hand/arm to the head and also muscles that control this patient's other frequent movements, viz., pill-rolling, thumb-gouging, wrist-flapping, and pinching the neck or cheek. Other patients underwent similar investigation: one who headbangs, one who hits out repetitively, and one with non-injurious stereotypic movements. An anatomical explanation suggests that certain self-injurious, aggressive, and stereotypic movements are involuntary muscle contractions that reflect abnormal innervation along specific nerves.
Gedye
A
A
Provincial Facility for Mentally Handicapped Adults, New Westminster, British Columbia, Canada.
D000328:Adult; D000374:Aggression / Q000502:physiology*; D001921:Brain / Q000503:physiopathology; D001925:Brain Damage, Chronic / Q000503:physiopathology* / Q000523:psychology; D001931:Brain Mapping; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D009042:Motivation; D009132:Muscles / Q000294:innervation; D010525:Peripheral Nerves / Q000503:physiopathology; D012640:Seizures / Q000503:physiopathology / Q000523:psychology; D016728:Self-Injurious Behavior / Q000503:physiopathology* / Q000523:psychology; D013127:Spinal Nerves / Q000503:physiopathology; D013239:Stereotyped Behavior / Q000502:physiology*; D005879:Tourette Syndrome / Q000503:physiopathology* / Q000523:psychology