Complex movement disorders describe any combination of atypical movements that interfere with a person’s desired movements. Kids who have complex movement disorders might experience too much or too little movement, or they might have coordination problems. The term “movement disorders” refers to a group of nervous system (neurological) conditions that cause abnormal increased movements, which may be voluntary or involuntary. Movement disorders can also cause reduced or slow movements.
Types of Complex Movement Disorders
There are several types of complex movement disorders, but most are categorized as:
- Hypokinetic (too little) movement disorders are rare in children.
- Hyperkinetic (too much) movement disorders, occur more frequently in children than in adults and include unusual or unwanted movements. The most common types of hyperkinetic disorders in children involve involuntary, repetitive movements and vocalizations (tics) or repetitive movements (stereotypies).
Common hyperkinetic disorders include:
- Dystonia – Kids who have dystonia have muscles that tighten involuntarily, causing uncontrollable, repetitive, stiff, twisting, or exaggerated motions. Symptoms can range from mild to severe and might interfere with daily activities, depending on which areas of the body are affected. Dystonia causes include Brain injury from low oxygen levels in the bloodstream at birth causes cerebral palsy. Genetics—some forms of dystonia are inherited. Other disorders or conditions—such as severe jaundice after birth, infections, or reactions to certain medicines.
- Tardive Syndromes – The most common symptoms of this type of movement disorder are slow, repetitive, involuntary movements of the mouth and tongue. Tardive syndromes can also range from twisting movements of the entire body to quick dance-like (also known as choreatic) movements. Often, kids who have this condition also experience a sense of restlessness. Tardive syndromes are caused by exposure to certain antipsychotic medicines (such as haloperidol). Because Tardive syndromes are caused by medication, the symptoms usually appear after a child has been taking the medication for some time.
- Chorea – The term “chorea” comes from the Greek word meaning “to dance.” This disorder causes brief, irregular, and involuntary movements that appear to flow from one muscle to the next in different parts of the body. The form of chorea seen most often in children is called Sydenham’s chorea. It is extremely rare and occurs after strep (streptococcal) infections. Other rare causes of chorea disease in children include side effects from medication or toxins, stroke, and genetic metabolic conditions.
- Ataxia. This movement disorder affects the part of the brain that controls coordinated movement (cerebellum). Ataxia may cause uncoordinated or clumsy balance, speech or limb movements, and other symptoms.
- Cervical dystonia. This condition causes long-lasting contractions (spasms) or intermittent contractions of the neck muscles, causing the neck to turn in different ways.
- Chorea. Chorea is characterized by repetitive, brief, irregular, somewhat rapid, involuntary movements that typically involve the face, mouth, trunk, and limbs.
- Dystonia. This condition involves sustained involuntary muscle contractions with twisting, repetitive movements. Dystonia may affect the entire body (generalized dystonia) or one part of the body (focal dystonia).
- Functional movement disorder. This condition may resemble any of the movement disorders, but is not due to neurological disease.
- Huntington’s disease. This is an inherited progressive, neurodegenerative disorder that causes uncontrolled movements (chorea), impaired cognitive abilities and psychiatric conditions.
- Multiple system atrophy. This uncommon, progressive neurological disorder affects many brain systems. Multiple system atrophy causes a movement disorder, such as ataxia or parkinsonism. It can also cause low blood pressure and impaired bladder function.
- Myoclonus. This condition causes lightning-quick jerks of a muscle or a group of muscles.
- Parkinson’s disease. This slowly progressive, neurodegenerative disorder causes tremors, stiffness (rigidity), slow decreased movement (bradykinesia), or imbalance. It may also cause other nonmovement symptoms.
- Parkinsonism. Parkinsonism describes a group of conditions that has symptoms similar to those of Parkinson’s disease.
- Progressive supranuclear palsy. This is a rare neurological disorder that causes problems with walking, balance, and eye movements. It may resemble Parkinson’s disease but is a distinct condition.
- Restless legs syndrome. This movement disorder causes unpleasant, abnormal feelings in the legs while relaxing or lying down, often relieved by movement.
- Tardive dyskinesia. This neurological condition is caused by the long-term use of certain drugs used to treat psychiatric conditions (neuroleptic drugs). Tardive dyskinesia causes repetitive and involuntary movements such as grimacing, eye blinking, and other movements.
- Tourette syndrome. This is a neurological condition that starts between childhood and teenage years and is associated with repetitive movements (motor tics) and vocal sounds (vocal tics).
- Tremor. This movement disorder causes involuntary rhythmic shaking of parts of the body, such as the hands, head, or other parts of the body. The most common type is essential tremor.
- Wilson’s disease. This is a rare inherited disorder that causes excessive amounts of copper to build up in the body, causing neurological problems.
What Causes Complex Movement Disorders?
Many factors might increase a child’s risk of developing a complex movement disorder. Some of the most common include:
- Family history.
- Birth complications.
- Brain injury.
- Side effects from medication.
- Infection, trauma, tumors, or stroke.
- Other medical conditions and disorders.
- Genetics
- Infections
- Medicines
- Damage to the brain, spinal cord, or peripheral nerves
- Metabolic disorders
- Stroke and vascular diseases
- Toxins
Complex Movement Disorders Symptoms and Effects
Because the symptoms and effects of complex movement disorders in children vary depending on the type of disorder, the impact on quality of life differs from person to person.
Some common symptoms and effects of complex movement disorders include:
- Difficulty walking or running.
- Depression, anxiety, and social isolation.
- Sleep disorders.
- Speech and language difficulties.
- Difficulty swallowing, chewing, or eating.
- Difficulty writing, dressing, and manipulating small objects
Complex Movement Disorders Diagnosis and Treatment
Complex movement disorders can be difficult to diagnose and treat. That’s why Gillette Children’s Specialty Healthcare established a Complex Movement Disorders Clinic which includes specialists from neurology, rehabilitation medicine, neurosurgery, orthopedics, and rehabilitation therapies.
In most cases, specialists can make a diagnosis by visually examining a child’s movements. Because some complex movement disorders are caused by an underlying health condition or injury, however, additional testing and evaluation might be done to ensure that other medical conditions don’t need to be addressed.
If your child is being evaluated for complex movement disorders, your child might have common diagnosis tests like:
- Blood and urine analysis.
- Genetic or DNA tests.
- Gait and motion analysis.
- Rehabilitation therapies evaluation.
- Neurodiagnostic testing, including sleep studies (polysomnography) and electroencephalograms (EEGs).
- Neuropsychological evaluations—to address concerns with attention, memory, learning, and problem-solving.
- Nutrition and feeding evaluations, which might include swallowing studies.
- Radiology and imaging tests.
- A developmental assessment conducted by a neurologist, pediatric rehabilitation medicine specialist, and neurosurgeon
Some of the most common treatments and therapies associated with complex movement disorders are:
- Oral medication.
- Injected medicines like botulinum toxin and phenol.
- Implanted baclofen pump.
- Physical therapy.
- Occupational therapy.
- Speech and language therapy.
- Selective dorsal rhizotomy (SDR) surgery.
- Deep brain stimulation.
Integrated Care
If your child has a complex movement disorder, your family might see a wide range of specialists who work together to provide a comprehensive treatment plan using state-of-the-art technology.
Your care team at Gillette can help you determine if and when to work with experts in:
- Neurology.
- Pediatric orthopedics.
- Rehabilitation therapies.
- Sleep medicine.
- Child life.
- Neuropsychology.
- Nutrition and feeding.
- Psychology.
- Neuropsychology.
- Social work.
- Therapeutic recreation.
Our team of complex movement disorder specialists strives to help your child improve function and enhance their quality of life.
