Original ArticlesRepetitive arm and hand movements (complex motor stereotypies) in children
Section snippets
Study patients
Charts of children seen between 1993 and 2003 in a referral-based pediatric neurology movement-disorders clinic specializing in tic disorders at Johns Hopkins Hospital were reviewed. Records were identified for those otherwise typically developing children referred for evaluation and treatment of persistent repetitive movements involving the arms and hands. Forty-three individuals were identified from approximately 1000 new patient visits. The senior pediatric neurologist (HSS), with expertise
Results
From the record review, 43 children with complex motor stereotypies (ie, those affecting the upper extremities) were identified. Three children were removed from the data set because they failed to meet inclusion criteria: 2 had mood disorders requiring pharmacotherapy, and 1 had a history of hearing loss and possible autism. On presentation, no patient had the diagnosis of motor stereotypies; the majority had been referred for tics, compulsions, or possible seizure activity. A small number of
Discussion
Physiologic stereotypies can be divided into one of 3 major subdivisions on the basis of the type of movements observed: (1) common (eg, body-rocking, thumb-sucking, and nail-biting), which are circumscribed and smooth8; (2) head nodding9; and (3) complex.2 The complex category, which is the focus of this report, differs from the others on the basis of its primary involvement of the arms and hands bilaterally, use of multiple muscle groups, irregular movements, and similarity to movements seen
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Supported by grant NS-25806, Neurodevelopmental Pathways to Learning Disabilities; Mental Retardation and Developmental Disabilities Research Center, HD-24061, and Friends of Tourette Syndrome Research.