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Understanding Hyperkinesia

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Medically Reviewed Fact Checked

Last Updated on January 7, 2023 by Carol Gillette

Understanding Hyperkinesia

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

Involuntary and unwanted muscle movements can indicate hyperkinesia, a symptom often associated with neurological disorders. Hyperkinesia is often seen in children but can affect individuals of any age. If you or a loved one is experiencing unwanted body movements, such as facial muscle spasms, restless legs, difficulty walking, or other muscular spasms, it is important to seek the care of a medical professional. This is the best way to determine what form of hyperkinesia you may be experiencing and what you can do to help reduce or eliminate symptoms.

It is also important to be aware that hyperkinesia and hypokinesia are two distinct conditions. Unlike hyperkinesia, hypokinesia refers to a decrease in bodily movements, often associated with Parkinson’s disease, obesity, or other conditions that result in a decrease in movement. These conditions may exist on their own or as the result of another serious medical condition.

While hypokinesia is a decrease in movement, hyperkinesia is an increase in muscular activity. Hyperkinesia is often paired with other medical issues, such as hypotonia which is a decrease in muscle tone. Most of these disorders are psychological in nature, which is why they tend to be more prominent in childhood.

What Is the Medical Term Hyperkinesia?

The term hyperkinesia can be directly translated to “excessive movement or activity.” This describes the associated hyperkinetic movements, which are considered abnormal in most individuals. These abnormal movements can vary in degree and distinguishability and can be repetitive, rhythmic, discreet, or completely random.

If a physician suspects you may have hyperkinesia, they will take several steps to evaluate your condition, including exploring your medical records, exploring prior medication use, examining family history, and checking for any past infections or exposure to harmful chemicals. It is important to obtain a proper diagnosis to ensure that you receive the appropriate treatment and get relief.

Types of Hyperkinetic Movement

During an examination, a medical professional will look for both negative signs and hypertonia. Negative signs include insufficient control of muscular movement as well as insufficient muscular movement. Hypertonia refers to an unusual increase of resistance when movement is imposed externally.

There are several types of defined movements 1 that fall under the category of hyperkinesia. In combination with negative signs and hypertonia, these movements can indicate hyperkinesia. Hyperkinetic movements can happen voluntarily or involuntarily without outside influence. Examining the specific type of movement helps medical professionals determine what category the movement falls under.

Dystonia

Dystonia is a movement disorder defined by involuntary muscle contractions on either a sustained or intermittent basis. These contractions can cause repetitive twisting movements, abnormal posture, or a combination of the two. Dystonia can be localized to certain body parts or affect multiple muscle groups. Common examples of dystonia include ulnar wrist deviation, lordotic trunk postures, and foot inversions.

Athetosis

This condition is defined as a slow, sustained, involuntary writhing movement that makes it nearly impossible for a person to maintain a stable posture. The key indicators associated with athetosis are smooth and seemingly random movements that do not follow a rhythmic pattern. Areas of the body that are commonly affected by athetosis include the extremities, face, neck, and trunk.

Chorea

Choreatic movements tend to be discreet but can be strung together, which makes it difficult to pinpoint when the movements begin and end. These movements are continuous and appear random, and commonly involve the face, neck, tongue, and extremities. Children with chorea tend to have more rapid, unpredictable movements and can appear fidgety, often leading to a misdiagnosis. There are various disorders that could cause choreatic movements, including thalamus disorders, hyperthyroidism, encephalitis, dysfunctional basal ganglia, and Huntington’s Disease. Exposure to neuroleptic, antiepileptic, and antidepressant drugs can also cause or worsen choreatic movements.2

Chorea

Ataxia

Ataxia refers to poor muscle control and is caused by a group of neurological diseases that can alter the coordination and balance of an individual. It is often experienced through poor hand/eye coordination, difficulties in speech, and an unsteady gait when walking. Ataxia can be caused by stroke, infection, tumors, and trauma.

Myoclonus

Myoclonus is caused by sudden contractions and relaxation of one or more muscles. It is often experienced as a sequence of nonrhythmic but repetitive movements that mimic shock-like jerks. These movements are involuntary and can affect multiple muscle groups of the body. Myoclonus movements are often associated with dementia, delirium, seizures, and other neurological diseases.

Stereotypies

Unlike many other movements that fall under hyperkinetic movement, stereotypies are one group of movements that can be voluntarily suppressed. These movements are typically rhythmic and repetitive and commonly affect the fingers, wrists, and upper extremities. Stereotypies are commonly associated with syndromes that affect development, including autism. For that reason, they are often seen in preschool-aged children.

Tics

Tics are abnormal movements that can occur within normal movements. However, this repeated, recognizable movement can usually be suppressed when addressing the urge to perform the movement. These movements tend to be predictable and can be triggered by excitement or stress. Tics are often displayed as muscular movements of the face or neck, as well as vocal sounds.

Hemifacial Spasms

As you might suspect, hemifacial spasms are specific to facial muscles and are often characterized by involuntary contractions. These movements commonly only affect one side of the face. Frequency can vary from rare spasms to frequent or constant spasms. Botox has been used as a treatment option to provide relief.

Tremors

Tremors are defined as rhythmic or oscillating involuntary movements that take place around a joint axis. Unlike most other hyperkinetic movements, there are no jerking movements associated with a tremor. Essential tremors are the most common movement disorder and can affect people of all ages. These movements are often seen in the hands and arms but can also affect other parts of the body.

Tremors

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What Causes Hyperkinesia?

As indicated above, there are several different disorders that can cause hyperkinesia. Most often, these disorders involve some type of issue within the brain. However, vascular disorders, endocrine disorders, metabolic disorders, and traumatic disorders can also cause hyperkinesia. In addition, exposure to drugs meant to treat psychosis, depression, and seizures can cause or worsen hyperkinesia.

Most causes of hyperkinetic movements can be traced to improper modulation of the basal ganglia, an important group of nuclei located near the center of the forebrain. The basal ganglia have many connections with the frontal lobe of the brain, which is why hyperkinesia can be associated with neurobehavioral symptoms like inappropriate behavior, mood changes, anxiety, and cognitive impairment. Hyperkinesia often occurs when dopamine receptors in the cortex and brainstem are abnormally sensitive to dopamine, sometimes as the result of a disease.

What Are Some Hyperkinetic Diseases?

Hyperkinetic diseases are diverse and can include the following.

Huntington’s Disease

Huntington’s Disease

Hyperkinesia is the main symptom of Huntington’s Disease. The type of movements associated with this disease is typically choreatic. The way hyperkinesia is experienced can vary from individual to individual and may affect a localized part of the body or the full body. Choreatic movements caused by Huntington’s Disease can mimic purposeful movements, but they occur involuntarily.

Symptoms include:
  • Rigidity and seizures
  • Head turning
  • Shifting eyes
  • Slow, uncontrolled movements
  • Unsteady gait
  • Quick, sudden jerky movements
  • Facial movements, commonly experienced as a grimace
In addition to involuntary movements, this disease often involves an onset of behavior and cognition changes, such as dementia and speech impediments. These are usually experienced later in life.

Stroke

After experiencing an ischemic (blood vessel blockage) or hemorrhagic stroke, (bleeding in the brain caused by a ruptured blood vessel), many individuals develop a movement disorder with hyperkinesia. 5 6These could include chorea, athetosis, tremor, and other uncontrollable muscle movements. The type of movement disorder can vary depending on the type of stroke as well as the age of the individual.

Wilson’s Disease

This is a rare disorder that is genetically inherited and involves difficulty metabolizing copper. As a result, copper can accumulate in the liver, brain, eyes, and kidneys. This accumulation can cause issues with speech, swallowing, and coordination. Individuals with this disorder can develop hyperkinetic symptoms such as dystonia, tremors, and difficulty walking.

Restless Leg Syndrome

Restless Leg Syndrome, or RLS, is signified by a persistent urge to move the legs. This is a common issue that can happen at any age, often as the result of other medical conditions. For example, RLS is a common pregnancy symptom that presents at the beginning of pregnancy but soon disappears after childbirth. Symptoms are often experienced later in the evening when a person is relaxing and attempting to sleep. As a result, dealing with this disorder can lead to insomnia and daytime sleepiness.

Restless Leg Syndrome

How Is Hyperkinesia Diagnosed?

Diagnosing hyperkinesia can be a challenge since it often occurs in conjunction with other symptoms. The movements described above should be evaluated by a medical professional, including movements that affect the posture, a period where movement should be minimal. The physician should focus on the frequency of the movement, your ability to suppress the movement, and your awareness level during the movements.

It is also important to explore your medical history, including family history, previous health concerns, and any traumatic instances that could affect the brain or other important systems within the body. A history of medications also needs to compiled as many instances of dyskinesia (movement disorders) are medication-induced. 9The physician should also perform an assessment of the medications and other substances you are currently taking. Evaluating these factors can help your physician determine the cause of the movements and their potential treatment.

When the examination is complete, the physician may order a variety of different diagnostic procedures, such as a CAT scan or an MRI. These procedures can help provide a better picture of what is happening within the brain to affect the coordination of the muscles throughout the body.

How Do You Treat Hyperkinesia?

So, how are most hyperkinetic movement disorders treated? There are a variety of options available for treatment. These options typically depend on the age of the individual, as well as the severity of the movements and the cause behind them. If hyperkinesia is caused by a neurological disorder, a doctor may prescribe dopamine-blocking medication or beta-blockers to suppress the abnormal movement. Botulinum toxin injections may also be used to reduce activity in muscles on a surface level.

Does Hyperkinesia Go Away?

If hyperkinesia is caused by prescription medications like anti-nausea or antipsychotic drugs, symptoms very similar to Parkinson’s Disease can develop. Fortunately, ceasing the use of these drugs is often a valuable first step to reversing hyperkinesia, as is treatment with dopamine agonists. 3 Depending on the severity of the condition, many individuals have found additional relief via alternative therapies, as well as avoiding certain stimuli such as caffeine and stressors. Learning and practicing relaxation and mindfulness techniques can aid in decreasing the frequency and severity of the involuntary muscle movements associated with hyperkinesia.

Hyperkinesia FAQs

What Is Hyperkinesis of the Heart?

Hyperkinetic heart syndrome is characterized by a higher rate of blood ejected with each beat of the heart.4 This syndrome can affect anyone of any age, from childhood to late life. With proper care and diagnosis, this syndrome can be monitored and treated.

What Is Hyperkinetic Behavior?

Hyperkinetic behavior is most experienced in children. While adults can have hyperkinetic disorders, they don’t typically experience changes in behavior at the same intensity as a child—if at all. A child who experiences hyperkinetic movements may also experience behavioral issues such as an inability to concentrate, impulsive tendencies, irritability, short attention span, and a higher likelihood to react in an explosive manner under stressful or emotional circumstances.

Is Hyperkinetic a Type of Mental Health Disorder?

Hyperkinesia can indicate a mental health disorder, and can also present after head trauma, spinal injury, certain prescription drugs, and other causes. 8 Hyperkinetic disorder is commonly associated with improper activity within the brain, which can cause increased sensitivity to dopamine. Many issues associated with hyperkinesia can be traced back to improper connectivity or communication within the brain, neuron damage, and other sources of dysfunction in the central nervous system.

Is Hyperkinesis the Same as ADHD?

ADHD is commonly referred to as a hyperkinetic disorder. In fact, ADHD and hyperkinesis share 18 similar symptoms. 9 However, it is important to remember that a variety of other symptoms and treatments define these disorders. Hyperkinesia can be associated with many diseases and disorders.

Is Hyperkinetic Disorder a Disability?

Yes. Hyperkinetic disorders are considered a disability, as hyperkinesia can affect an individual mentally and physically. Especially in children, hyperkinesia can make it difficult to concentrate, learn, and achieve expected milestones. In adults, hyperkinesia can cause pain, an inability to perform the tasks associated with daily life, and increased difficulty with travel.

Understanding What’s Behind Your Hyperkinesia

Hyperkinesia is often caused by a neurological disorder, especially in children. However, it is important to recognize that certain types of hyperkinetic movements may be the result of long-term exposure to certain prescription medications, including anti-nausea, anti-seizure, antipsychotic, and antidepressant medications. Determining the cause of your hyperkinesia is essential to seeking effective treatment.


References:

  1. Sanger, T. D., Chen, D., Fehlings, D. L., Hallett, M., Lang, A. E., Mink, J. W., … & Valero‐Cuevas, F. (2010). Definition and classification of hyperkinetic movements in childhood. Movement Disorders, 25(11), 1538-1549. Retrieved October 3, 2022, from https://doi.org/10.1002%2Fmds.23088
  2. Zesiewicz, T. A., & Sullivan, K. L. (2011). Drug-induced hyperkinetic movement disorders by nonneuroleptic agents. Handbook of clinical neurology, 100, 347–363. https://doi.org/10.1016/B978-0-444-52014-2.00027-6
  3. Greene, Paul E. (2015) ‘Drug-Induced Movement Disorders’, Hyperkinetic Movement Disorders, Contemporary Neurology Series https://doi.org/10.1093/med/9780199925643.003.0010
  4. Gorlin, R. (1962). The hyperkinetic heart syndrome. Jama, 182(8), 823-829. https://jamanetwork.com/journals/jama/article-abstract/1388288
  5. Unnithan AKA, M Das J, Mehta P. Hemorrhagic Stroke. [Updated 2022 Sep 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559173/
  6. Hui C, Tadi P, Patti L. Ischemic Stroke. [Updated 2022 Jun 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499997/
  7. Jankovic J. Treatment of hyperkinetic movement disorders. Lancet Neurol. 2009 Sep;8(9):844-56. doi: 10.1016/S1474-4422(09)70183-8. PMID: 19679276.https://pubmed.ncbi.nlm.nih.gov/19679276/
  8. Termsarasab P, Thammongkolchai T, Frucht SJ. Spinal-generated movement disorders: a clinical review. J Clin Mov Disord. 2015 Dec 24;2:18. doi: 10.1186/s40734-015-0028-1. Erratum in: J Clin Mov Disord. 2016 Nov 22;3:18. PMID: 26788354; PMCID: PMC4711055.https://pubmed.ncbi.nlm.nih.gov/26788354/
  9. Loonen AJ, Ivanova SA. New insights into the mechanism of drug-induced dyskinesia. CNS Spectr. 2013 Feb;18(1):15-20. doi: 10.1017/s1092852912000752. PMID: 23593652.https://pubmed.ncbi.nlm.nih.gov/23593652/
  10. Schachar R, Chen S, Crosbie J, Goos L, Ickowicz A, Charach A. Comparison of the predictive validity of hyperkinetic disorder and attention deficit hyperactivity disorder. J Can Acad Child Adolesc Psychiatry. 2007;16(2):90-100.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242647/
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