Athetosis is a type of involuntary movement that can occur with illness. It is characterized as slow, writhing movements of the extremities. While it can be used to describe movement patterns, athetosis also refers to athetoid cerebral palsy, also known as dyskinetic cerebral palsy.
If you or your child has athetosis, you may need to do diagnostic tests so your doctors can determine the cause and prescribe therapy for you. There is no cure for the condition, but some interventions can reduce it and make it more bearable.
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Athetosis can begin at any age and generally does not improve on its own. The severity may increase and become more frequent over time. Athetosis can affect one or more limbs and occur intermittently, without a uniform pattern, or almost constantly.
The movements are involuntary, not rhythmic and can put the body in uncomfortable, twisted positions. They can appear as slow, fluid, rotating movements that usually involve the distal extremities, including the arms below the elbows, hands, fingers, and feet. Athetosis can also affect the neck.
Sometimes the limb will remain in a twisted position for a few minutes or more before it relaxes. Equilibrium is often compromised by athetosis.
Athetosis is not the same as muscle weakness, tremors, or convulsions – although it can be associated with decreased motor control. as well as other involuntary movements.
Often the limbs affected by athetotic movements can be rigid at rest. Chorea – an involuntary, abrupt, jerky movement of the extremities – is often associated with athetosis.
Athetosis is a symptom of an underlying disorder and several conditions can cause athetosis, including:
- Cerebral palsy: Athetoid cerebral palsy and mixed cerebral palsy are the most common causes of athetosis. These lifelong congenital conditions are characterized by decreased motor control, often with other effects, such as: B. decreased cognitive abilities.
- Neurological diseases, brain damage or stroke: Sometimes a brain injury, tumor, or stroke can lead to athetosis when certain parts of the brain that mediate voluntary movement are affected.
- Medication: Some of the drugs used to treat Parkinson’s disease or other psychiatric disorders can cause athetosis as a side effect.
- Huntington’s Disease: This hereditary disorder involves symptoms of dementia and involuntary movements, including athetosis, beginning in adulthood.
- Metabolic disorders: Some metabolic disorders have been linked to athetosis, including Wilson’s disease, which causes copper to build up in the brain and other parts of the body.
Athetosis occurs because of a dysfunction in the basal ganglia, an area of the brain that is involved in voluntary motor control. The basal ganglia include caudates, globus pallidus, putamen, and parts of the midbrain.
Most often, athetosis results from damage to the basal ganglia due to a malformation of the brain or a lack of oxygen during development of the fetus (leading to athetotic cerebral palsy). This area can also be affected by problems that develop in adulthood.
A number of other symptoms, including chorea and hemiballism (sudden involuntary twitching of one side of the body), can also develop when these structures are compromised, which can result in a combination of symptoms common with athetosis.
Your doctor would determine if you have athetosis by observing your movements. Sometimes athetosis develops after a condition such as cerebral palsy has been diagnosed. However, it can be one of the early symptoms of a neurological disorder.
Diagnosis is based on the age at which symptoms began, as well as other factors such as medical history and other symptoms.
As part of your assessment of athetosis, your doctor would perform a comprehensive neurological exam to identify any signs of your underlying condition.
In addition, you may have diagnostic tests.
- In athetosis that begins before the age of 2, cerebral palsy or metabolic disorders are considered a possible cause. Magnetic resonance imaging (MRI) may be ordered to identify abnormalities or other changes in the brain.
- Adults who may have had a stroke or other form of brain damage may have an imaging exam of the brain to identify a possible causal lesion.
- Adults who are at risk for Huntington’s disease can have a genetic test done to see if this could be the cause.
While athetosis has no cure, there are treatments that can help reduce it. The underlying conditions are usually treated to control other related symptoms as well.
Treatments to control athetosis generally include physical therapy and occupational therapy, which can help improve muscle control and the ability to perform activities of daily living.
Music therapy can also be useful to reduce movement problems and improve balance in cerebral palsy, including athetosis.
Medical interventions include:
- Medications, including muscle relaxants and anti-epileptic drugs (AEDs), are used to reduce muscle tone.
- Injections of botulinum toxin can help weaken the muscle, thereby reducing the movements the muscle can make.
- Deep brain stimulation (DBS) is a procedure that has been investigated as a possible treatment for athetosis. This treatment involves surgically implanting a stimulator near the globus pallidus. It has shown some beneficial effects, but it is unclear whether the procedure offers permanent benefits or an improved quality of life.
Living with athetosis can be challenging. It is important to speak to your doctor and physical therapist about this symptom.
You may be able to use devices designed for people with athetosis. For example, a power wheelchair with a special handle for people with athetosis can help improve your mobility.
A word from Verywell
Athetosis can be one of the more uncomfortable symptoms of cerebral palsy and some other conditions. Management of athetosis involves a number of strategies.
This movement problem generally occurs with other symptoms, and the overall effect of athetosis can be reduced if other effects are treated.