Stereotypical movement disorder: symptoms, causes and treatments

Each of us has our own way of seeing the world, perceiving it and interacting with it. We think, we relate, we express, we speak or even we move in different ways. This is because our being and our identity derive primarily from the interplay between our biology and our experiences and learnings.

However, we are still members of the same species, so biologically we are submissive and share a genome and the same basic structure, having a very similar growth process in most people. Among the many systems that arise from this development is our brain.

However, they can sometimes cause alterations or problems during development, capable of impairing aspects such as the ability to perform or inhibit our own movements. An example of this is found in stereotypical movement disorder, A neurodevelopmental problem which we will discuss below.

    Stereotypical movement disorder

    It is known as a stereotypical movement disorder a any of the motor disorders of neurodevelopment or neurodevelopment, Which is characterized by the habitual presence of repetitive, aimless and apparently guided motor behaviors, which occur in the early stages of development and cause interferences in the life of the suffering child, in a period which must include at least four weeks .

    Some common movements are nodding, shaking hands and arms, or rocking, but it is also possible that the stereotype in question is an act of self-harm such as hitting or banging your head. that’s why some stereotypes can be dangerous and lead to injury, Which could even neutralize or result in death. In this sense, during the diagnosis, it should be clarified whether it occurs with or without self-harm and whether protective measures are necessary to avoid injury.

    As we have seen, stereotypical movement disorder is one of the disorders of neurodevelopment, which is characterized by its origin in nervous development different from the usual or by the presence of problems, slowing or alterations of maturation of the nervous system during growth.

    These problems start in childhood (In this case, it usually appears before the age of three), and may cause limitations or difficulties in the subject’s functionality or adaptation relative to his peers. It is common for the movements to last during childhood and reach their peak in adolescence. It can also affect socialization and learning, which makes it difficult or can generate social rejection.

    Symptoms: stereotypes

    These movements are called stereotypes, and they are known as a kind of hyperkinetic movement or by excess of it. These are partially involuntary movements that appear in a coordinated and usually rhythmic manner. This semi-involuntary character implies that although they are not carried out for a specific purpose on a conscious level but arise spontaneously and uncontrollably, they can voluntarily stop.

    They usually appear impulsively and while this can make it difficult to track actions, it does not prevent the execution of complex movements. Their purpose is not clear, although it is suggested that they aim to manage and regulate the child’s internal stress. In addition, they only occur during awakening and in most cases distraction or initiation of activity can stop the execution of movements.

    differential diagnosis

    It is important to note that the diagnosis of stereotypical movement disorder cannot be made if there is another neurodevelopmental disorder explaining these behaviors, or a diagnosed intoxication or neurological disease.

    In this sense, it should be noted that it is common for stereotypes to appear in people with intellectual disabilities or autism, in children with psychotic problems or in some cases of childhood obsessive-compulsive disorder, although in these cases the diagnosis of stereotypical movement disorder is not considered.

    It should also be borne in mind that this disorder differs from that of complex motor tics, with which it can be confused but whose movements are less rhythmic and more involuntary and uncontrollable. Another problem that can be confused is trichotillomania, in which the affected person compulsively tears their hair. as a method of anxiety management.

      Theories about their causes

      The mechanisms that cause this disorder are not yet fully understood. However, as a neurodevelopmental disorder, its presence is due to a problem arising from the process of maturation and development of a child’s brain. There are different theories on how this happens.

      One of them establishes a possible alteration in neurotransmitters, and there is a possible excess of dopamine and other catecholamines. In the brain, there may also be some type of degeneration or alteration in the temporal areas.

      At the psychological level, there is also talk of a possible unconscious purpose of these movements, being the result of an attempt to discharge energy caused by tension. sometimes some theories have linked the existence of excessive demands on the part of the environment or in the pursuit of pleasure and pain reduction when provoking self-harm the use of substances that temporarily inhibit pain (which means that in nature we may not feel pain in its fullest intensity until we can get out of harm’s way).

      It has also been observed that they seem to be more frequent in environments where there has been a weak physical or social stimulation of the child or, conversely, an overstimulation which pushes him to seek balance by movement. It is more common in people with sensory or institutionalized disabilities.

      treatment

      Stereotypical movement disorder can be treated with a multidisciplinary approach, so that stereotypes can be reduced and the possible impairment of functionality and participation in society of affected subjects can be reduced. The treatment used in each case will depend on the specific symptoms, age and time of development, and possible causes.

      In some cases, stereotypes they may end up disappearing as the child grows, although in other cases they remain for life. In any case, beyond the possible difficulty that the stereotypes can assume that they are not dangerous (unless they are of the self-mutilating type) and in many occasions it does not manage to achieve a treatment .

      Psychological therapy of a behavioral psychological type is mainly used. Some strategies used may be those of differential reinforcement of other behaviors and inversion of habits. One can try to decrease the potential for self-stimulation of stereotypes by trying to get the patient to stimulate in another way. In cases of under-stimulated patients it will be advisable to move the subject closer to an environment with a higher level of stimulation, while in some with excess it may be beneficial to reduce it.

      In the case of patients with self-injurious movements, it will also be necessary to modify the environment so as to avoid injury and protect the integrity of the affected person. This type of alteration can be a great cause of anxiety for parents and the environment, so they will benefit from psychoeducation and contact with families with children who suffer from the same problem.

      Sometimes they can also end up using drugsUsually benzodiazepines and other drugs that lower the level of physiological activation. Antidepressants are also often used.

      Finally, at the level of education, the possibility that certain types of learning may be more complex must be taken into account, having to make adjustments that allow good development.

      Bibliographical references:

      • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
      • NIH. (2018). Stereotypical movement disorder. MedlinePlus. Available at: https://medlineplus.gov/spanish/ency/article/001548.htm

      Leave a Comment