Involuntary Movements

Tremor:

• Location:
• Such as fingers, arms, legs, etc.
• Is it unilateral or bilateral?
• Quality:
• Is it fine or coarse, rhythmic or erratic?
• Is it a resting tremor (present only at rest), intention tremor (only exacerbated by purposeful movement such as pointing or reaching for something), or postural tremor (only when muscles are stretched and extended, such as spreading the fingers)?
 

Definitions Derived from Dorland’s Dictionary

Convulsions - 1. a violent involuntary contraction or series of contractions of the voluntary muscles 2. seizure

• Central convulsion – a convulsion not excited by any external cause, but due to a lesion of the central nervous system; called also essential convulsion
• Clonic convulsion – a convulsion marked by alternating contracting and relaxing of the muscles.
• Crowing convulsion – laryngismus stridulus
• Essential convulsion – central convulsion
• Febrile convulsion – those associated with high fever, occurring in infants and children
• Hysterical / Hysteroid convulsion – conversion hysteria with symptoms that resemble convulsions
• Local convulsion – any minor spasm affecting but one muscle or only one part or member, as in Jacksonian epilepsy
• Mimetic / Mimic convulsion – facial spasm
• Puerperal convulsion – involuntary spasms in women just before, during, or just after childbirth
• Salaam convulsion – infantile spasms
• Tetanic convulsion – a tonic spasm without loss of consciousness;see tetanus and tetany
• Tonic convulsion – Prolonged contraction of the muscles as a result of an epileptic discharge
• Uremic convulsion – one due to uremia or retention in the blood of material that should have been expelled by the kidneys

Epilepsy - any of a group of syndromes characterized by paroxysmal transient disturbances of the brain function that may be manifested as episodic impairment or loss or consciousness, abnormal motor phenomena, psychic or sensory disturbances, or perturbation of the autonomic nervous system. A single episode is called a seizure. Many types of epilepsy are combinations of different kinds of seizures. Symptoms are due to paroxysmal disturbance of the electrical activity of the brain. Epilepsy is classified as either symptomatic or idiopathic according to whether the cause is known or unknown. Both of these types may be further subdivided into partial and generalized types depending on whether the seizures are due to a localized, limited brain lesion or to widespread brain lesions, respectively.

• Abnormal epilepsy – paroxysmal abdominal pain, the expression of an abnormal neuronal discharge from the brain; called also Moore’s syndrome
• Absence epilepsy – epilepsy characterized by absence seizures,usually having its onset in childhood or adolescence
• Acquired epilepsy – symptomatic epilepsy
• Activated epilepsy – epileptic seizures induced by electrical or drug stimulation for the purpose of observing the pattern
• Audiogenic epilepsy – reflex epilepsy caused by auditory stimuli
• Baltic Myoclonic epilepsy – a progressive, autosomal recessive form of myoclonic epilepsy seen in Finland. Onset is between the ages of 6 and 13 and there are degenerative changes in the brain without presence of Lafora bodies. Mental deterioration is milder and survival is longer than in Lafora’s myoclonic epilepsy.
• Benign with Centrotemporal spikes, Benign Rolandic, Benign with Rolandic Spikes epilepsy – a self-limited, autosomal dominant disorder of childhood consisting of partial seizures manifested by facial movements and grimaces, often followed by tonic-clonic seizures. The electroencephalogram from the primary somatomotor area (rolandic area) shows characteristic repetitive high-voltage spikes.
• Bravais-Jacksonian epilepsy – Jacksonian epilepsy
• Chronic Focal epilepsy – epilepsia partialis continua
• Cortical epilepsy – seizure phenomena originating in the cerebral cortex
• Cryptogenic epilepsy – idiopathic
• Diurnal epilepsy – Epileptic attacks occurring in the daytime or when the patient is awake
• Essential epilepsy – idiopathic
• Focal epilepsy – epilepsy consisting of focal seizures
• Gelastic epilepsy – temporal lobe epilepsy in which the automatisms consist of fits of uncontrollable mirthless laughter
• Generalized epilepsy – epilepsy in which the seizures are generalized; they may have a focal onset or be generalized from the beginning.
• Generalized Flexion epilepsy – hypsarrhythmia
• Grand Mal epilepsy – a symptomatic form of epilepsy often proceeded by an aura; characterized by loss of consciousness with generalized tonic-clonic seizures.
• Haut Mal epilepsy – grand mal
• Hysterical epilepsy – pseudoseizure
• Idiopathic epilepsy – epilepsy of unknown origin, possibly associated with some inherited predisposition for seizures, called also cryptogenic epilepsy or essential epilepsy
• Jacksonian epilepsy – epilepsy characterized by focal motor seizures with unilateral clonic movements that start in one group of muscles and spread systemically to adjacent groups, reflecting the march of the epileptic activity through the motor cortex. The seizures are due to a discharging focus in the contralateral motor cortex
• Juvenile Myoclonic epilepsy – a syndrome of sudden myoclonic jerks, occurring particularly in the morning or under conditions of stress or fatigue; seen primarily in children and adolescents. Occasionally the jerks may progress to generalized tonic-clonic seizures, but there is no mental deterioration.
• Koshevnikoff’s (Koschewnikow’s, Kozhevnikov’s) epilepsy – epilepsia partialis continua
• Lafora’s myoclonic epilepsy – a slowly progressive autosomal recessive form of epilepsy beginning in childhood and characterized by attacks of intermittent or continuous clonus of muscle groups, resulting in difficulties in voluntary movement; there is mental deterioration, sometimes progressing to complete dementia and the presence of Lafora bodies in various cells, including those of the nervous system, retina, heart, muscle and liver.
• Larval epilepsy – unerupted epileptic seizure, represented only by characteristic waves in the electroencephalogram
• Late epilepsy – epilepsy beginning in middle age or later
• Latent epilepsy – larval
• Localized epilepsy – focal
• Major epilepsy – grand mal
• Matutinal epilepsy – epileptic seizures occurring in the morning on awakening.
• Menstrual epilepsy - epileptic seizures associated with menstruation
• Minor epilepsy – Absence epilepsy
• Minor Focal epilepsy - simple partial seizures
• Musicogenic epilepsy – reflex epilepsy occurring to a musical stimulus
• Myoclonic, Myoclonus epilepsy – any form of epilepsy accompanied by myoclonus, such as juvenile myoclonic, Baltic myoclonic and Lafora’s myoclonic
• Nocturnal epilepsy – epileptic attacks occurring at night or while the patient is asleep
• Organic epilepsy – symptomatic epilepsy
• Partial epilepsy – focal epilepsy
• Petit Mal epilepsy – absence epilepsy
• Photic, photogenic epilepsy – reflex epilepsy in which seizures are induced by a flickering light
• Physiologic epilepsy - biologic or electrobiologic seizures based on physiologic and not on organic or structural abnormalities of the brain
• Post-traumatic epilepsy – epileptic seizures that occur after head injury
• Procursive epilepsy - temporal lobe epilepsy in which the automatisms consist of aimless running
• Progressive Familial Myoclonic epilepsy – myoclonic epilepsy that is hereditary
• Psychic, Psychomotor epilepsy – temporal lobe epilepsy
• Reflex epilepsy – epileptic seizures occurring in response to sensory stimuli
• Rolandic epilepsy – benign rolandic epilepsy
• Rotatory epilepsy – temporal lobe epilepsy in which the automatisms consist of rotating body movements
• Sensory epilepsy – 1. seizures manifested by paresthesias or hallucinations of sight, smell or taste 2. reflex epilepsy
• Somatosensory epilepsy – sensory epilepsy with paresthesias such as tingling, numbness or burning.
• Symptomatic epilepsy – acquired epileptic seizures caused by disease of the central nervous system itself, a generalized systemic disorder, such as hypoglycemia or uremia, or poisoning, as with lead or pentylenetetrazol
• Tardy epilepsy – late epilepsy
• Temporal Lobe epilepsy – a form of epilepsy characterized by complex partial seizures
• Traumatic epilepsy – post-traumatic epilepsy
• Uncinate epilepsy – temporal lobe epilepsy caused by a lesion in the uncinate region and therefore associated with hallucinations of smell and taste
• Vertiginous epilepsy – focal seizures giving rise to a sensation of vertigo; occasionally these are auras of more general seizures
• Visual epilepsy – sensory epilepsy in which there are visual hallucinations such as flashes of light or colors.

Seizure - 1. the sudden attack or recurrence of a disease. 2. a single episode of epilepsy; often a seizure is named for the kind of epilepsy it represents. Called also convulsion, fit and ictus epilepticus

• Absence seizure – the seizure seen in absence epilepsy, consisting of a sudden momentary break in consciousness of thought or activity, often accompanied by automatisms or clonic movements, especially of the eyelids. On the electroencephalogram it is characterized by a specific symmetrical spike and wave type occurring at three cycles per second.
• Adversive seizure – a type of focal motor seizure in which there is forceful sustained turning to one side by the head, eyes or entire body.
• Astatic seizure – atonic p.
• Atonic seizure – an absence seizure characterized by sudden loss of muscle tone.
• Automatic seizure – a type of complex partial seizure characterized by automatisms, often ambulatory and involving quasipurposive acts
• Centrencephalic seizure – generalized tonic-clonic seizure
• Clonic seizure – a rare kind of seizure in which there are generalized clonic contractions without a preceding tonic phase
• Complex partial seizure – a type of partial seizure associated with disease of the temporal lobe and characterized by varying degrees of impairment of consciousness; the patient performs automatisms and is later amnesic for them. An attack is often preceded by a hallucinatory aura, most often visual or auditory but sometimes involving the other senses.
• Focal seizure – partial seizure
• Focal Motor seizure – a simple partial seizure consisting of clonus or spasm of a muscle or muscle group; it may be single or in a continuous and repetitive series or may spread to adjacent muscles.
• Generalized Tonic-Clonic seizure – the seizure of grand mal epilepsy, consisting of a loss of consciousness and generalized tonic convulsions followed by clonic convulsions
• Hysterical seizure – pseudoseizure
• Jackknife seizure – infantile spasms
• Partial seizure – any seizure due to a lesion in a specific, known area of the cerebral cortex; symptoms vary with different lesion locations
• Psychogenic seizure – pseudoseizure
• Reflex seizure – an episode of reflex epilepsy
• Salaams seizure – infantile spasms
• Sensory seizure – 1. a simple partial seizure manifested by paresthesias or other hallucinations, including several types of aura 2. a reflex seizure in response to a sensory stimulus
• Serial seizure – seizures occurring in series, with return of consciousness between individual attacks
• Simple Partial seizure – the most localized type of partial seizure, with a discharge that is predominantly one-sided or that presents localized features, and without loss of consciousness. If it progresses to another kind of seizure it is called an aura. Symptoms are varied, including motor, somatosensory, autonomic, and psychic
• Tonic seizure – a seizure characterized by tonic but not clonic contractions, usually occurring in Lennox-Gastaut syndrome or multiple sclerosis.

Other Involuntary Movement Disorders

• Chorea - Chorea is demonstrated through jerking non-purposeful actions or contractions of an individual. When assessing grip strength if one receives a milking like motion while the individual is gripping your fingers request that they flex their wrist and hyperextend their fingers at the metacarpophalangeal joint. Usually, the practitioner has already suspected chorea from their observations demonstrated in the performances of the Tinetti Functional Test, due to erratic non-purposeful motion while walking and standing. However, if the condition is not advanced, it may not be demonstrated until specific coordinated action is requested.

 

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• Asterixis (flapping tremor) - a non-rhythmic involuntary jerking contraction which may best be elicited through the spreading of the fingers and dorsal flexing the hands after extending the arms. Observed in numerous metabolic and toxic disorders, most notably, Hepatic encephalopathy.

 

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• Athetosis – demonstrated through a slow somewhat sinuous rhythmic writhing involuntary motion of the hands, fingers, feet or toes; involving flexion, extension, pronation and supination; it is suggestive of extrapyramidal lesions such as cerebral palsy.
• Dystonia – Abnormal posture due to hyper or hypotonicity of the muscles; this abnormal tonus and posture results in dyskinesia
• Hemiballismus - Resulting from a lesion of the hypothalamic nucleus; violent dyskinetic movement is observed on one side of the body; involving the proximal muscles usually the upper extremities; it resembles a flailing motion with wild dyskinetic movement.
• Tetany – The neuromuscular hyperexcitability of nerves and muscles manifested through twitches, cramps or laryngospasms with inspiratory stridor, hyperreflexia and choreiform movements; due to the depletion of ionized calcium and occasionally magnesium. It is suggestive of CNS and/or PNS disorders. It is observed in vitamin D deficiency, hyperventilation, hypoparathyroidism, uremia and alkalosis or result from ingestion of alkaline salts.
• Tic – Is either psychogenic, or neurogenic in origin. It is an involuntary repetitive contraction of the face, neck or shoulder muscles; resembling a purposeful movement as it applies to the muscles conducting normal contraction function. However, it can only be voluntarily suppressed briefly through a distraction effort such as clearing the throat, coughing, etc. It is triggered through episodes of stress.
• Twitch - A momentary spontaneous repetitive contraction of a skeletal muscle, due to the spontaneous repetitive firing of a motor neuron supplying it.
• Fasciculation - A small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibers, innervated by a single motor nerve filament.

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