Movement disorders are disorders that cause the body to move abnormally or involuntarily. There are many different types seen in children including: tics, tremors, dystonia, and spasticity among others.
A “tic” is a brief, repetitive, involuntary movement (motor tic) or vocalization (vocal tic). Tics can be “simple” or “complex”. Simple tics involve one muscle group (eye blinking, head jerking) or a simple sound (throat clearing, sniffing) whereas complex tics involve multiple muscle groups (touching objects, jumping, spinning) or verbal utterances (repeating a phrase). Transient tic disorders are very common in children. Tourette Syndrome is simply the diagnoses given when both motor and vocal tics have been present on and off for at least one year. There is no known cure for tics. Medications are used to control tics if they become bothersome to the child.
Tremors refer to repetitive, involuntary movements. They most often occur in the hands but can involve the legs, head and voice. Benign essential tremors can be seen in children although they typically present as adults. Tremors can sometimes be seen in other disorders such as Cerebral palsy and anxiety. Medications can be used to control the tremor if bothersome to the child.
Dystonia is an involuntary, sustained movement such as twisting of the trunk, forceful mouth opening or eye closure among others. They can be due to genetic conditions, Cerebral palsy, head trauma, brain tumors or stroke. Medications can be used to control the movements and for more severe patients, a deep brain stimulator can be implanted as well.
Spasticity refers to muscle stiffness that is more noticeable the faster you try to stretch. It is usually related to cerebral palsy, strokes, brain tumors, head trauma or other genetic disorders. Medications such as muscle relaxants can help. If only certain muscles are involved, Botox injections are helpful but effects are temporary. For more severe cases, an intrathecal baclofen pump can be used. This consists of a pump containing medication that is implanted in the patient’s abdomen and delivers medication directly into the spine via a catheter. A spine surgery called selective dorsal rhizotomy can also permanently improve spasticity and improve the child’s function.