Athetosis

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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Athetosis is a form of movement disorder. It is characterized by slow, worm-like or screw-like movements of the extremities (especially the hands). In most cases, athetosis is also accompanied by chorea, a restless movement with rapid, involuntary muscle contractions. Doctors then speak of choreoathetosis. Read more about the causes and treatment of athetosis here.

Athetosis: description

Athetosis is a form of movement disorder that occurs mainly in children. Those affected make slow, non-rhythmic, worm-like or screw-like movements of the extremities, especially the hands. Alternating bizarre misalignments are typical. In addition, the joints are often unnaturally overstretched. Sometimes both sides of the body are affected by the movement disorder (athetose doublé), in other cases only one (hemiathetosis).

Only rarely is athetosis the patient's only neurological symptom. Usually other neurological complaints and abnormalities occur at the same time. Examples are spastic paralysis, epileptic seizures, visual, hearing and speech disorders or a deficit in mental and emotional development. The athetosis occurs particularly often together with a so-called chorea. This form of agitation is characterized by abrupt, involuntary, and irregular muscle contractions. Such choreic-athetotic mixed hyperkinesis (hyperkinesis = pathologically increased mobility) are called choreaoathetosis.

Some experts regard athetosis as slow chorea or distal dystonia (distal = away from the center of the body; dystonia = movement disorder with persistent, involuntary muscle contractions).

Athetosis: causes and possible diseases

Athetosis (like chorea) is based on damage to the striatum and / or pallidum. These are two basal ganglia (i.e. nuclei made of gray brain matter) that lie below the cerebral cortex and whose main task is to regulate motor skills. The striatum (corpus striatum, striped body) is composed of two parts: putamen (outer lens nucleus) and caudate (nucleus caudatus, tail nucleus).

Athetosis in children

The brain damage that leads to athetosis is mostly of early childhood origin. For example, it can be the result of what is known as bilirubin encephalopathy (also known as kernicterus). The central nervous system of newborns is severely damaged by an excessive rise in the blood level of bilirubin (breakdown product of the red blood pigment).

Another possible cause of the movement disorder in early childhood is Little's disease. This is understood to mean severe brain damage that occurs before birth (prenatal) or around the time of birth (perinatal) and is due, for example, to vascular occlusions in the brain, pregnancy complications, oxygen deficiency (hypoxia) or infections that involve the brain.

Athetosis in adults

In adulthood, the movement disorder can develop as hemiathetosis, for example after a stroke such as a lens nucleus infarction.This form of cerebral infarction is caused by a sudden decrease in blood flow (ischemia) to the putamen (part of the striatum) and pallidum.

Athetosis: when should you see a doctor?

See a doctor if you notice a delay in motor development or other abnormalities in your child (epileptic seizures, bizarre misalignments of the hands, abrupt, involuntary movements, etc.).

Adults should consult a doctor if they develop movement disorders or other neurological complaints.

Athetosis: what does the doctor do?

The doctor will first take the medical history (anamnesis). He asks the parents of the affected child or the adult patient, for example, about the symptoms and any underlying or previous illnesses.

This is followed by a physical exam and imaging tests. The latter give the doctor an overview of possible damage to the brain that may be responsible for the movement disorder and other symptoms. Depending on the cause of the athetosis and any other symptoms, other examinations may be useful.

This is how the doctor treats athetosis

There are limited options for treating athetosis. Physiotherapy can most likely improve the movement disorder. For example, the Bobath method can be used: It provides special movement exercises to learn new natural posture and movement patterns.

In some cases, attempts are made to positively influence the athetosis with drugs (such as tiapride, haloperidol, clonazepam).

Athetosis: You can do that yourself

The causes of athetosis cannot be cured. Nevertheless, it can be improved with the help of special physiotherapy exercises. Do not be discouraged, but take advantage of the opportunities that are presented to you.

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