title: Definition and classification of hyperkinetic movements in childhood.
abstract: 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.
authors.affiliation: Deptartments of Biomedical Engineering, Biokinesiology, and Neurology, University of Southern California, Los Angeles, California 90089-1111, USA. terry@sangerlab.net
authors.forename: Terence D
authors.initials: TD
authors.lastname: Sanger
authors.forename: Daofen
authors.initials: D
authors.lastname: Chen
authors.forename: Darcy L
authors.initials: DL
authors.lastname: Fehlings
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Mink
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Singer
authors.forename: Katharine
authors.initials: K
authors.lastname: Alter
authors.forename: Hilla
authors.initials: H
authors.lastname: Ben-Pazi
authors.forename: Erin E
authors.initials: EE
authors.lastname: Butler
authors.forename: Robert
authors.initials: R
authors.lastname: Chen
authors.forename: Abigail
authors.initials: A
authors.lastname: Collins
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Dayanidhi
authors.forename: Hans
authors.initials: H
authors.lastname: Forssberg
authors.forename: Eileen
authors.initials: E
authors.lastname: Fowler
authors.forename: Donald L
authors.initials: DL
authors.lastname: Gilbert
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Gorman
authors.forename: Mark E
authors.initials: ME
authors.lastname: Gormley
authors.forename: H A
authors.initials: HA
authors.lastname: Jinnah
authors.forename: Barbara
authors.initials: B
authors.lastname: Kornblau
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Krosschell
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Lehman
authors.forename: Colum
authors.initials: C
authors.lastname: MacKinnon
authors.forename: C J
authors.initials: CJ
authors.lastname: Malanga
authors.forename: Ronit
authors.initials: R
authors.lastname: Mesterman
authors.forename: Margaret Barry
authors.initials: MB
authors.lastname: Michaels
authors.forename: Toni S
authors.initials: TS
authors.lastname: Pearson
authors.forename: Jessica
authors.initials: J
authors.lastname: Rose
authors.forename: Barry S
authors.initials: BS
authors.lastname: Russman
authors.forename: Dagmar
authors.initials: D
authors.lastname: Sternad
authors.forename: Kathy J
authors.initials: KJ
authors.lastname: Swoboda
authors.forename: Francisco
authors.initials: F
authors.lastname: Valero-Cuevas
mesh_terms: D006801:Humans; D006948:Hyperkinesis / Q000145:classification* / Q000175:diagnosis*; D010372:Pediatrics