Coordination impairment

Alternative names
Lack of coordination; Loss of coordination; Incoordination and irregularity of voluntary movements; Movement - uncoordinated; Ataxia; Clumsiness

Definition
Uncoordinated movement is an abnormality of muscle control or an inability to finely coordinate movements, resulting in a jerky “to-and-fro” unsteady motion of the trunk or the limbs.

Considerations

Smooth graceful movement results from a fine balance between opposing muscle groups. This balance is coordinated by a portion of the brain called the cerebellum.

Diseases that damage the cerebellum, spinal cord, and peripheral nerves (which connect from the cerebellum to the muscle groups) can interfere with the fine tuning of muscular movement and result in coarse, jerky, uncoordinated movement. This condition is called ataxia and is easily seen in the jerky “to-and-fro” motion of the trunk and unsteady gait of an affected person.

Ataxia may appear as a congenital defect, or following a simple viral infection such as chicken pox. It may also appear following encephalitis, head trauma, and diseases affecting the central nervous system or spinal cord. Appearance as a genetic disorder, or as a toxic reaction to drugs, medications, alcohol or environmental toxins is also possible.

Common Causes

     
  • Transient ischemic attack (TIA)  
  • Stroke  
  • Multiple sclerosis  
  • Vertebral abnormalities (such as compression fractures of the back)  
  • Poisoning  
  • Alcohol or other drug intoxication  
  • Drugs such as aminoglutethimide, anticholinergics, phenytoin (in high doses), carbamazepine, phenobarbital and tricyclic antidepressants  
  • Alcoholism  
  • Post-infectious condition (typically following chickenpox)  
  • Hereditary condition (congenital cerebellar ataxia, Friedreich’s ataxia, ataxia telangiectasia)

Home Care
Take safety measures around the home to compensate for difficulties in mobility that are inherent with this problem. For example, avoid clutter, leave wide walkways, and avoid throw rugs or other objects that might cause slipping or falling.

Other family members should encourage the affected person to participate in normal activities. Family members need to have extreme patience with people who suffer from poor coordination. Take time to demonstrate ways of performing tasks more simply, and taking advantage of the afflicted person’s strengths while avoiding weaknesses.

Call your health care provider if

     
  • There is unexplained incoordination.  
  • Incoordination lasts longer than a few minutes.

What to expect at your health care provider’s office
The medical history will be obtained, and a physical examination performed. In emergency situations, the patient will be stabilized first.

Medical history questions documenting uncoordinated movement in detail may include:

     
  • When did it begin?  
  • Is it continuous or do episodes come and go?  
  • Is it getting worse?  
  • What medications are being taken?  
  • Is alcohol used?  
  • Are illegal/illicit drugs being used?  
  • Has there been any exposure to something that may have caused poisoning?  
  • What other symptoms are also present?       o Weakness or paralysis       o Numbness or tingling or loss of sensation       o Confusion or disorientation       o Seizures

The physical examination may include detailed neurological and muscular examination.

Diagnostic tests that may be performed include:

     
  • Blood tests (such as a CBC or blood differential).  
  • CT scan of the head.  
  • MRI of the head.  
  • Romberg test.       o The patient is asked to stand erect with the feet together and the eyes closed. If the patient loses balance, this indicates a loss of the sense of position and the test is considered positive.

Referral to a specialist for counseling may be indicated.

After seeing your health care provider, you may want to add a diagnosis related to uncoordinated movement to your personal medical record.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.