3Abnormal(usually high)muscle toneWeaknessImpaired motor control
4Dystonia Involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, and/or abnormal postures ‘Inserted postures and movements’
5ChoreaGreek, khoreia, meaning danceInvoluntary, random (appearing), quick jerking movementsAbrupt, non-repetitive and arrthymicVariable frequency and intensity
6AthetosisDescribed by Hammond (1871) as “an inability to retain the fingers and toes in any position they might be placed, and by their continual motion”Hyperkinetic movement disorder characterised by involuntary writhing movements of the distal extremities and peri-oral musclesSome consider athetosis as a variant of dystonia
7Symmetrical high signal in ventro-lateral thalamus and putamen following acute near total hypoxic-ischaemic injury in term infant
8TreatmentsOrthosis e.g. lycra, second skin etcMedication for dystonia e.g. Trihexiphenidyl, Clonidine, L-DopaMedication for chorea e.g. Levitarecetam, Valproate, TetrabenzineIntra-thecal BaclofenDeep brain stimulationStem cells ???
9Thanks to Birmingham colleagues past and present Thanks to children and families for allowing me to use videos for teaching and educationThanks to Birmingham colleagues past and presentDr Hardev PallDr Manju KurianDr Stuart Green