Involuntary movements can occur in anyone - both in children and the elderly. Within this group of neurological problems, several different disorders are distinguished, ranging from tremors to expressive chorea movements. The occurrence of involuntary movements in patients always requires the implementation of extensive diagnostics - the cause of these disorders can even be life-threatening conditions.
Involuntary movementsare various motor activities that occur without the patient's will or awareness. They appear as a result of disturbances in the functions of the so-called the extrapyramidal system, which under normal conditions is responsible for controlling motor coordination and precision of movements. In the case of dysfunction of the extrapyramidal system, it may be spontaneously - without the participation of the patient's will - generate motor activity, and it is as a result of this phenomenon that involuntary movements may appear.
Unintentional motor activities can be a consequence of both diseases present from the beginning of life (e.g. cerebral palsy) and a consequence of diseases experienced in adulthood - examples include, for example, a stroke or neoplastic diseases related to the structures of the nervous system .
Involuntary movements: tremors
Tremors are oscillating, rhythmic involuntary movements. There are several types of them:
- resting tremor,
- intentional tremor (appearing at the end of an activity),
- postural tremor (in other words, positional tremor, related to assuming a certain body position),
- kinetic tremor (occurring during the entire duration of a movement).
The cause of tremors is a number of various disease states, but not only - the problem may also occur as a result of medications taken by the patient. These types of involuntary movements are most often associated with:
- Parkinson's disease and other parkinsonian syndromes,
- Minor's disease (so-called essential tremor),
- hyperthyroidism,
- diseases of the cerebellum,
- Wilson's disease,
- poisoning (e.g. with alcohol, drugs or heavy metals),
- pharmacotherapy (e.g. antidepressants, mood stabilizers or anxiolytics).
The basis for the occurrence of tremorsthere are also mental disorders - in such a situation, involuntary movements are referred to as psychogenic tremors.
Involuntary movements: chorea
The dance movements are coordinated, sudden, twisting movements around the long axis of the body, and may involve different parts of the body - movement disorders may affect both the limbs and the axial muscles. The movements take place in a plane perpendicular to the long axis of the body, they remain while awake, but disappear during sleep. Their intensity may be extremely high when undertaking some other conscious activity, dancing movements may be accompanied by involuntary facial movements (e.g. frowning of the forehead). Choreal involuntary movements may result from:
- Huntington's disease (another name for this condition is Huntington's chorea)
- Wilson's disease
- neuroacanthocytosis
- perinatal hypoxia
- pląsawicy Sydenham
- viral encephalitis
- medication use (e.g. antipsychotics, mood stabilizers, phenytoin, dopaminergic drugs; chorea is also a rare but potentially possible side effect of oral contraceptives)
- endocrine disorders (hyperthyroidism, hypoparathyroidism or adrenal cortex)
- stroke
- systemic lupus erythematosus
- polycythemia vera
- antiphospholipid syndrome
- subdural hematoma
Involuntary movements: athetosis
Athetotic movements are slow, twisting and twisting motor activities (an example may be excessive twisting of the fingers). They mainly affect the distal parts of the limbs (especially the forearms and hands), the movement takes place in a plane parallel to the axis of the limb. Involuntary movements in the form of athetosis are found mainly in cerebral palsy, Wilson's disease and Huntington's disease. They are also caused by various rare genetic diseases, as well as stroke or inflammation within the nervous system. The causes of athetosis are also disorders experienced at a very early stage of life, because the problem may be caused by severe hypoxia in the perinatal period.
Involuntary movements: ballism
Ballism is said to occur when the patient experiences involuntary, jerky movements of throwing limbs in front of him - it is similar to the situation of the patient throwing his own limbs away from himself. The disorder mainly affects the proximal limb muscles (the so-called densifying muscles). These types of movements appear suddenly and are very fast. Ballism is caused by all states in whichmileage, the so-called the lowthalamic nucleus, which is part of the central nervous system. These damages may be related to, inter alia, with inflammatory, autoimmune or neoplastic processes, their cause may also be cerebral vascular diseases (e.g. stroke).
Involuntary movements: tics
Tikami are short-term, coordinated, involuntary movements of certain parts of the body. They can appear as eyelid blinking, head shaking or raising eyebrows, tics can also take a vocal character (in the form of grunting or screaming - this situation occurs due to the simultaneous contraction of the larynx, throat and mouth muscles). Tics can occur as one of the main symptoms of certain diseases (as is the case with Gilles de la Tourette syndrome), as well as be one of the ailments in the course of other conditions (tics can occur in the case of strokes, neurodegenerative diseases or as a result of the use of certain drugs, e.g. neuroleptics)
Involuntary movements: dystonias
In dystonia, the patient experiences a simultaneous contraction of opposing muscle groups. The effect of this phenomenon is the assumption by the patient of a bizarre position or an unusual, forced setting of one of the limbs in a certain position. Incorrect movements can take many forms, such as: cervical dystonia, torticollis or eyelid spasm, the so-called writer's cramp or musicians' dystonia. Dystonias are accompanied by increased muscle tension and a feeling of stiffness, a phenomenon associated with these involuntary movements is often pain. A type of dystonia are torsion contractions, which, although similar in nature to chorea, last for a long time and have a more twisting form. Dystonias can appear in a number of different diseases, examples of such units are:
- Parkinson's disease,
- Wilson's disease,
- multiple sclerosis,
- tumors of the central nervous system,
- strokes,
- syphilis,
- Creutzfeldt-Jakob disease,
- AIDS,
- malformations of cerebral vessels.
The occurrence of dystonia can also be a side effect of taking certain medications, examples include neuroleptics, metoclopramide, levodopa or bromocriptine.
Involuntary movements: myoclonus
Myoclonus are also called muscle jerks. These are quick, short contractions of part of the fibers or the whole of the muscle. The episodes of myoclonus appear either spontaneously or are provoked by some factors - they can be triggered by, for example, light or tactile stimuli orauditory.
Myoclonus may appear in the course of various pathologies of the nervous system - their occurrence may be associated with both dementia and metabolic diseases, myoclonic involuntary movements may also be a consequence of a head injury.
Involuntary movements: diagnostics
What the patient's diagnostic process will be based on depends primarily on what type of disease is suspected in the patient. Imaging tests (e.g. computed tomography or magnetic resonance imaging) and laboratory tests (both basic, such as blood counts, and specialized, such as determination of serum ceruloplasmin concentration) are used. Detailed genetic tests may be carried out when a genetically determined disease is suspected. It should be emphasized that tests of this kind are performed not only in young patients - for example, the symptoms of Huntington's disease do not begin until the age of 50, and it is precisely this late-emerging ailments that may lead to genetic diagnostics.
In the case of involuntary movements, both ailments that appeared for the first time and those that have been present in the patient for some time are important. In the latter situation, the patient should pay close attention to their intensification, because increasing the intensity or range of involuntary movements may indicate an exacerbation of the disease process that caused involuntary motor activities, and this in turn may be a signal indicating the need to modify the so far used treatment.
Involuntary movements: healing
Involuntary movements are a symptom, not a disease - therefore the treatment is based on the therapy of the underlying condition of the patient's movement disorders. Additionally, neuroleptics (typically used as antipsychotics) may be administered to patients to alleviate the intensity of involuntary movements.