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Hyperkinetic muscle activity is a symptom of hyperkinetic movement disorders, which are characterised by abnormal, often repetitive, involuntary movements that overlap with normal motor activity. These disorders are often paired with other medical issues, such as hypotonia, a decrease in muscle tone, or neurological disorders. Dystonia, chorea, myoclonus, and tremor are some of the most common types of hyperkinetic movement disorders. Dystonia, for example, is defined by involuntary muscle contractions that cause twisting and repetitive movements or abnormal postures. Hyperkinetic movements can happen voluntarily or involuntarily and can be repetitive, rhythmic, discreet, or completely random.
| Characteristics | Values |
|---|---|
| Description | Hyperkinesia is a term used to describe "unwanted" or "excessive" movements. |
| Causes | Neurological disorders, prescription medication use, autoimmune disorders, infections of the central nervous system, metabolic disturbances, genetic diseases, drug-related causes, functional disorders, and virus-induced causes. |
| Types | Dystonia, chorea, myoclonus, tremor, tics, and stereotypies. |
| Diagnosis | A physician will examine medical records, medication history, family history, and past infections. They may also order a CAT scan or MRI. |
| Treatment | Dopamine-blocking medication, beta-blockers, botulinum toxin injections, and highly active antiretroviral therapies. |
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Dystonia
The key symptom of dystonia is uncontrollable muscle movements, often uncomfortable or even painful, and can feel like electric shocks. These movements are often repetitive, variable in duration, twisting or stretching in nature, and worsen when using the affected muscles. Dystonia can affect any part of the body, including the arms, legs, trunk, face, and vocal cords. It can be localised to certain body parts or affect multiple muscle groups. The condition can range from a short-term or temporary issue to a lifelong concern, and its effects can be worsened by factors such as fatigue, stress, caffeine, or alcohol consumption.
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Chorea
The causes of chorea are extensive and include both hereditary and acquired factors. The most common acquired causes are cerebrovascular disease and HIV infection in the developing world. Twenty per cent of children and adolescents with rheumatic fever develop Sydenham's chorea as a complication. Chorea gravidarum refers to choreic symptoms that occur during pregnancy. Hereditary causes include Huntington's disease, benign hereditary chorea, and various metabolic and endocrinological disorders such as hyperthyroidism and hypo/hyperglycemia.
The treatment of chorea focuses on addressing its root cause. Dopamine receptor-blocking agents and dopamine depleters are commonly used to reduce involuntary movements. However, no agent has been proven to slow or halt the progression of hereditary chorea, with the exception of copper-reducing therapies in Wilson's disease.
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Myoclonus
There are several types of myoclonus, including:
- Action myoclonus, which is triggered by voluntary movement or the intention to move.
- Epileptic myoclonus, which occurs within an epilepsy syndrome.
- Essential myoclonus, which occurs in the absence of epilepsy or other abnormalities in the brain or nerves.
- Stimulus-sensitive myoclonus, which is triggered by external events, such as noise, movement, light, or surprise.
- Sleep myoclonus, which occurs during sleep and sleep transitions, often as a person is falling asleep.
- Progressive myoclonus epilepsy (PME), a group of rare diseases characterised by myoclonus, epileptic seizures, and other serious symptoms.
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Tremor
Hyperkinetic movements are defined as "excessive movement or activity". These abnormal movements can be repetitive, rhythmic, discreet, or completely random. They can be voluntary or involuntary and are often associated with neurological disorders and prescription medication use. Tremors are one such type of hyperkinetic movement.
Resting tremors can also be caused by other factors such as sleep deprivation, caffeine, nicotine, alcohol withdrawal, and increased metabolic states such as hyperthyroidism. Tremors can also be a symptom of other conditions, such as Parkinson's disease.
In some cases, doctors may prescribe dopamine-blocking medications or beta-blockers to suppress abnormal movements. Botulinum toxin injections can also be used to reduce muscle activity. If the tremors are caused by prescription medications, symptoms similar to Parkinson's disease may develop, and deep brain stimulation surgery may be required.
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Tics
The presence of tics is an important clinical finding, with significant implications for diagnosis and treatment. However, the lack of standardised terminology and definitions can interfere with clinical treatment and research.
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Frequently asked questions
Hyperkinetic muscle activity is characterised by abnormal, often repetitive, involuntary movements that overlap with normal motor activity. These movements can be caused by excessive levels of dopamine in the brain.
Dystonia, chorea, myoclonus, tremor, tics, and stereotypies are all types of hyperkinetic movements. Dystonia is a movement disorder defined by involuntary muscle contractions that can cause repetitive twisting movements and abnormal posture. Chorea refers to irregular, abrupt, rapid movements that seem to flow from one body part to another. Myoclonus is a sudden, brief, shock-like jerk caused by a muscle contraction. Tremor is a rhythmic back-and-forth or oscillating involuntary movement about a joint axis. Tics are rapid, abrupt, repetitive movements or vocalisations that are almost always suppressible. Stereotypies are repetitive, simple movements that can be voluntarily suppressed.
Treatment depends on the age of the individual, the severity of the movements, and the cause behind them. If hyperkinetic muscle activity 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 muscle activity.
