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Repetitive arm and hand movements (complex motor stereotypies) in children
E Mark Mahone1, Dana Bridges, Cristine Prahme
1Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Avenue, Baltimore, MD 21231, USA. mahone@kennedykrieger.org
Insights
Complex motor stereotypies in children often begin before age three and persist for years. Early diagnosis and management are crucial as symptoms typically do not resolve spontaneously.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Movement Disorders
Background:
- Complex motor stereotypies (CMS) are repetitive, rhythmic movements.
- Understanding CMS in children without intellectual disability or pervasive developmental disorders is limited.
- Early identification is key for effective management.
Purpose of the Study:
- To characterize the clinical features of children with CMS.
- To identify associated problems and comorbidities.
- To determine the outcomes of children with CMS.
Main Methods:
- Retrospective record review of 40 children diagnosed with CMS.
- Data collected on age of onset, symptom frequency, triggers, and response to cues.
- Analysis of comorbid conditions, family history, and treatment interventions.
Main Results:
- 90% of children had onset by age 3, with daily symptoms in 90%.
- Excitement triggered symptoms in 70%; 98% could suppress movements when cued.
- Comorbidities included ADHD (25%) and learning disabilities (20%); 38% had family history of mood-anxiety disorders.
Conclusions:
- Complex motor stereotypies often have a chronic clinical course.
- Symptoms frequently persist for over five years, with resolution in only 5% of cases.
- Enhanced understanding of CMS clinical features is vital for primary care diagnosis and management.
Objective:
To characterize clinical features, associated problems, and outcomes for children with complex motor stereotypies who do not have mental retardation or pervasive developmental disorders.
Study Design:
We performed a record review for 40 children (63% male) aged 9 months to 17 years with complex motor stereotypies between 1993 and 2003.
Results:
Age at onset was at or before 3 years in 90% of the sample. Symptoms occurred at least once daily in 90%. Excitement was identified as a trigger in 70%. Movements stopped when cued in 98%, and none had stereotypies during sleep. A total of 25% had comorbid attention deficit hyperactivity disorder (ADHD), and 20% had a learning disability. Family history of stereotypies was identified in 25%, tics in 33%, ADHD in 10%, and mood-anxiety disorder in 38%. Pharmacotherapy to target associated conditions was used in 40%, and behavioral therapy was used in 23%. A total of 53% identified symptoms for more than 5 years. Movements resolved in 5% of the children, improved in 33%, were unchanged in 50%, and worsened in 13%.
Conclusions:
The clinical course of complex motor stereotypies appears chronic. Better understanding of the clinical features of complex stereotypies in primary care settings is essential for early diagnosis and management.
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