Definition

Uncontrolled or slow movement is a problem with muscle tone, usually in large muscle groups. The problem leads to slow, uncontrollable, jerky movements of the head, limbs, trunk, or neck.

Alternative Names

Dystonia; Involuntary slow and twisting movements; Choreoathetosis; Leg and arm movements - uncontrollable; Arm and leg movements - uncontrollable; Slow involuntary movements of large muscle groups; Athetoid movements

Considerations

The abnormal movement may be reduced or disappear during sleep. Emotional stress makes it worse.

Abnormal and sometimes strange postures may occur because of these movements.

Causes

The slow twisting movements of muscles (athetosis) or jerky muscle contractions (dystonia) may be caused by one of many conditions, including:

• Cerebral palsy
• Drug side effects
• Encephalitis
• Genetic diseases
• Hepatic encephalopathy
• Huntington disease
• Stroke

Sometimes two conditions (such as a brain injury and medication) interact to cause the abnormal movements when neither one alone would cause a problem.

What to Expect at Your Office Visit

The doctor will perform a physical exam. This may include a detailed examination of the nervous and muscle systems.

The doctor will ask about your medical history and symptoms, including:

• When did you develop this problem?
• Is it always the same?
• Is it always present or only sometimes?
• Is it getting worse?
• Is it worse after exercise?
• Is it worse during times of emotional stress?
• Have you been injured or in an accident recently?
• Have you been sick recently?
• Is it better after you sleep?
• Does anyone else in your family have a similar problem?
• What other symptoms do you have?
• What medications are you taking?

Tests that may be ordered include:

• Blood studies (such as metabolic panel, complete blood count (CBC), blood differential)
• CT scan of the head or affected area
• EEG
• EMG and nerve conduction velocity studies (sometimes done)
• Genetic studies
• Lumbar puncture
• MRI of the head or affected area
• Urinalysis

Treatment

Treatment is based on the movement problem the person has and on the condition that may be causing the problem. If medicines are used, the health care provider will decide which medicine to prescribe based on the person’s symptoms and signs.

Home Care

Get enough sleep and avoid too much stress. In severe cases, take safety measures to avoid injury. Follow the treatment your health care provider prescribed.

When to Contact a Medical Professional

Call your health care provider if:

• You have unexplained movements that you cannot control
• The problem is getting worse
• Uncontrolled movements occur with other symptoms

References

Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA:Elsevier Saunders; 2011:chap 403.

Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 417.