Definition

Uncontrolled or slow movement is a problem with muscle tone, usually in the 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 (group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking)
• Side effects of drugs, especially for mental disorders
• Encephalitis (irritation and swelling of the brain, most often due to infections)
• Genetic diseases
• Hepatic encephalopathy (loss of brain function when the liver is unable to remove toxins from the blood)
• Huntington disease (disorder that involves breakdown of nerve cells in the brain)
• Stroke
• Head and neck trauma
• Pregnancy

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

Home Care

Get enough sleep and avoid too much stress. Take safety measures to avoid injury. Follow the treatment plan your health care provider prescribes.

When to Contact a Medical Professional

Contact your provider if:

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

What to Expect at Your Office Visit

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

You'll be asked 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 medicines 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
• Pregnancy test

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 provider will decide which medicine to prescribe based on the person's symptoms and any test results.

References

Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 24.

Okun MS, Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 382.