Dystonia

Alternative names
Movement - uncontrolled or slow; 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

Definition
Uncontrolled or slow movement is defined as an impairment of the muscle tone (usually in large muscle groups), causing slow involuntary contractions of the head, limbs, trunk, or neck.

Considerations
The slow sinuous twisting movements of muscles (athetosis) or sustained muscle contraction (dystonia) may be caused by a number of conditions, including cerebral palsy, encephalitis, drug side effects, hepatic encephalopathy, and Huntington’s chorea.

The abnormal movement may be reduced or disappear during sleep, but it is worsened by emotional stress. Abnormal and sometimes grotesque postures may be a manifestation of these movements.

Common Causes

     
  • Encephalitis  
  • Hepatic encephalopathy  
  • Medication side effects  
  • Cerebral palsy  
  • Genetic disease

Home Care
Get adequate sleep and avoid excessive stress. In severe cases, take safety measures to avoid injury. Follow prescribed therapy for treatment of the underlying cause.

Call your health care provider if

     
  • There is unexplained dystonia.  
  • The problem is getting worse.  
  • Uncontrolled movements are accompanied by other symptoms.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting uncontrolled-slow movement in detail may include:

     
  • Time pattern       o When did you develop this problem?       o How long have you had it?       o Is it always the same?       o Is it always present or only occasionally?       o Is it getting worse?  
  • Aggravating factors       o Is it worse after exercise?       o Is it worse during times of emotional stress?       o Has there been any injury or accident recently?       o Has there been any illness recently?  
  • Relieving factors       o Is it better after you sleep?  
  • Other       o What other symptoms are also present?

The physical examination may include a detailed examination of the nervous and muscular systems.

Diagnostic tests will be determined by the results of the history and physical exam findings.

After seeing your health care provider:
You may want to add a diagnosis related to uncontrollable slow movements to your personal medical record.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, 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.