Childhood abnormal involuntary movements clinical, MRI and laboratory study

ABSTRACT

Involuntary movements are usually associated with abnormalities of the basal ganglia and their connections and may occur in several different neurologic disorders. This work was carried out on 60 children patients included 39 males [65%] and 21 females [35%], their ages ranged between 6 and 15 years. They were suffering from different types of abnormal involuntary movements and divided into 6 groups according to the type of movement disorder [Chorea, Choreoathetosis, Dystonia, Tics, Myoclonus and Tremors]. A significant difference was observed between the six groups as regards history of other system affection with high incidence among patients suffering from choreic movements, as regards neurological manifestations associating the abnormal movements such as mental impairment, abnormal speech and abnormal gait, the highest incidence was observed in choreoathetotic patients where mentality and speech were abnormal in all patients, seizures and abnormal gait were observed in 80% of patients, motor weakness in 20% of patients, sphincteic troubles in 60% of patients, while incoordination was observed in only 20% of them However, the clinical evaluation of abnormal involuntary movement has the primary role in the diagnosis of the type of this movement, it is inefficient to study the etiology of this movement. A significant correlation was observed between abnormal MRI brain findings and neurological manifestation associating movement in patients suffering from chorea and tics. Abnormal MRI brain findings were observed in a different percentage in different types of movement disorders [70% in dystonic. 50% in choriec. 50% in choreoathetotic, 30% in tremor, 20% in tics and 20% in myoclonic patients. So, children with abnormal involuntary movements must be assessed via thorough clinical evaluation, structural imaging techniques [MRI], laboratory investigations, karyotyping and metabolic profile as a trial to know the possible etiology and the pathologic insult of the brain