Definition and classification of hyperkinetic movements in childhood.
Hyperkinetic movements are unwanted or excess movements that are frequently seen in children with neurologic disorders. They are an important clinical finding with significant implications for diagnosis and treatment. However, the lack of agreement on standard terminology and definitions interferes with clinical treatment and research. We describe definitions of dystonia, chorea, athetosis, myoclonus, tremor, tics, and stereotypies that arose from a consensus meeting in June 2008 of specialists from different clinical and basic science fields. Dystonia is a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. Chorea is an ongoing random-appearing sequence of one or more discrete involuntary movements or movement fragments. Athetosis is a slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture. Myoclonus is a sequence of repeated, often nonrhythmic, brief shock-like jerks due to sudden involuntary contraction or relaxation of one or more muscles. Tremor is a rhythmic back-and-forth or oscillating involuntary movement about a joint axis. Tics are repeated, individually recognizable, intermittent movements or movement fragments that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement. Stereotypies are repetitive, simple movements that can be voluntarily suppressed. We provide recommended techniques for clinical examination and suggestions for differentiating between the different types of hyperkinetic movements, noting that there may be overlap between conditions. These definitions and the diagnostic recommendations are intended to be reliable and useful for clinical practice, communication between clinicians and researchers, and for the design of quantitative tests that will guide and assess the outcome of future clinical trials.
Sanger
Terence D
TD
Deptartments of Biomedical Engineering, Biokinesiology, and Neurology, University of Southern California, Los Angeles, California 90089-1111, USA. terry@sangerlab.net
Chen
Daofen
D
Fehlings
Darcy L
DL
Hallett
Mark
M
Lang
Anthony E
AE
Mink
Jonathan W
JW
Singer
Harvey S
HS
Alter
Katharine
K
Ben-Pazi
Hilla
H
Butler
Erin E
EE
Chen
Robert
R
Collins
Abigail
A
Dayanidhi
Sudarshan
S
Forssberg
Hans
H
Fowler
Eileen
E
Gilbert
Donald L
DL
Gorman
Sharon L
SL
Gormley
Mark E
ME
Jinnah
H A
HA
Kornblau
Barbara
B
Krosschell
Kristin J
KJ
Lehman
Rebecca K
RK
MacKinnon
Colum
C
Malanga
C J
CJ
Mesterman
Ronit
R
Michaels
Margaret Barry
MB
Pearson
Toni S
TS
Rose
Jessica
J
Russman
Barry S
BS
Sternad
Dagmar
D
Swoboda
Kathy J
KJ
Valero-Cuevas
Francisco
F
D006801:Humans; D006948:Hyperkinesis / Q000145:classification* / Q000175:diagnosis*; D010372:Pediatrics