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Stereotypic movement disorder

Stereotypic movement disorder is a condition in which a person makes repetitive, purposeless movements (such as hand waving, body rocking, or head banging) for at least four weeks. The movements interfere with normal activity or have the potential to cause bodily harm.

Causes, incidence, and risk factors

Stereotypic movement disorder is more common among boys than girls. The repetitive movements appear to increase with stress, frustration, and boredom.

The cause of this disorder, when it occurs in the absence of other conditions, is unknown.

Stimulants such as cocaine and amphetamines can prompt a severe, but short period of stereotypic movement behavior. The behavior may include repetitive and purposeless picking, hand wringing, head tics, or lip-biting. Long-term abuse of stimulants may lead to longer periods of stereotypic movement behavior.

Head injuries may also cause stereotypic movements.

Symptoms

  • Biting self
  • Hand shaking or waving
  • Head banging
  • Hitting own body
  • Mouthing of objects
  • Nail biting
  • Rocking

Signs and tests

A doctor can usually diagnose this condition with a physical exam. Tests should be done to rule out other potential causes of such behaviors, including Tourette syndrome or other tic disorder, chorea disorders, and autism or obcessive compulsive disorder in young children.

Treatment

Treatment should focus on the cause, specific symptoms, and patient's age.

The environment should be changed so that it is safer for patients who cause injury to themselves.

Behavioral techniques and psychotherapy have been the most successful treatment methods.

Some medications, including naltrexone, may also help reduce symptoms related to this condition. Antidepressants have been used in some cases.

Expectations (prognosis)

The outlook depends on the cause. Stereotypic movements due to drugs usually goes away on its own after a few hours. Long-term abuse of stimulants, however, may lead to longer periods of stereotypic movement behavior. The movements usually go away once the drug or drugs are stopped.

Stereotypic movements due to head injury may be permanent.

The movement problems usually do not progress to other disorders (such as seizures).

Complications

Severe stereotypic movements may interfere with normal social functioning.

Calling your health care provider

Call your health care provider if your child has repeated, odd movements that last longer than a few hours.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Arlington, Va: American Psychiatric Association; 2000.

Updated: 6/15/2012

John Goldenring, MD, MPH, JD, Pediatrics, Sharp Rees-Stealy Medical Group, San Diego, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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