hyperkinetic

Hyperkinetic is an adjective used in medicine to describe conditions in which excessive, involuntary movements are a prominent feature. It is contrasted with hypokinetic states, where movement is reduced. In neurology, hyperkinetic movement disorders encompass a range of patterns, often involving dysfunction of the basal ganglia and related thalamocortical circuits.

Common hyperkinetic movement patterns include chorea (rapid, irregular, unpredictable movements); dystonia (sustained or intermittent muscle contractions causing twisting or abnormal postures); myoclonus (brief, sudden jerks); tics (repetitive, nonrhythmic movements or sounds); tremor (rhythmic oscillations); ballismus (violent flinging movements) and athetosis (slow, writhing motions). Disorders may present with one pattern or a combination, and severity can vary over time and with activity.

Causes of hyperkinetic movements are diverse. They include genetic disorders such as Huntington disease; metabolic or toxic conditions like Wilson’s disease; autoimmune processes such as Sydenham chorea; neurodegenerative diseases; and drug-induced states (notably dopamine antagonists causing tardive dyskinesia or dopamine withdrawal). In psychiatry, the term hyperkinetic disorder was historically used in some classifications to describe attention-deficit/hyperactivity disorder, though modern usage separates ADHD as a developmental disorder with attention and activity components.

Diagnosis relies on clinical observation and neurological examination, with targeted laboratory tests or imaging to identify underlying etiologies (for example, tests for Wilson’s disease, thyroid function, autoimmune markers) as indicated. Treatment focuses on addressing the underlying cause and on symptom management. Therapies may include medications that modulate neurotransmitter systems (such as dopamine antagonists, VMAT2 inhibitors, benzodiazepines), botulinum toxin for focal dystonias or tics, physical and occupational therapy, and, in selected cases, deep brain stimulation. Outcomes vary with diagnosis and response to treatment.