Movement - uncontrolled or slow

Definition

Uncontrolled or slow movement is defined as a problem with muscle tone, usually in large muscle groups, that leads to slow involuntary contractions of the head, limbs, trunk, or neck.

See also:

• Movement - unpredictable or jerky
• Stereotypic movement disorder
• Tremor
• Uncoordinated movement
• Uncontrollable movements

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, a liver disease called hepatic encephalopathy, and Huntington's chorea.

Additionally, there are situations where two conditions, for example both a brain injury and a medication, interact to cause the abnormal movement when neither alone would cause a problem.

The abnormal movement may be reduced or disappear during sleep, but emotional stress makes it worse. Abnormal and sometimes grotesque postures may occur because of these movements.

Common Causes

• Encephalitis
• Hepatic encephalopathy
• Medication side effects
• Cerebral palsy
• Genetic diseases
• Stroke

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

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

• When did you develop this problem?
• How long have you had it?
• Is it always the same?
• Is it always present or only occasionally?
• Is it getting worse?
• Is it worse after exercise?
• Is it worse during times of emotional stress?
• Has you been injured or in an accident recently?
• Has 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?

Diagnostic tests that may be performed include:

• CT scan or MRI of the head or affected area
• EEG
• Lumbar puncture
• Urinalysis
• Blood studies (such as CBC or blood differential)
• Genetic studies known gene abnormalities
• EMG and nerve conduction velocity studies (occasionally done)

References

Fahn S. Hypokinesia and hyperkinesia. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 16.

Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.