3 Abnormal(usually high)muscle toneWeaknessImpaired motor control
4 Dystonia Involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, and/or abnormal postures ‘Inserted postures and movements’
5 ChoreaGreek, khoreia, meaning danceInvoluntary, random (appearing), quick jerking movementsAbrupt, non-repetitive and arrthymicVariable frequency and intensity
6 AthetosisDescribed 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
7 Symmetrical high signal in ventro-lateral thalamus and putamen following acute near total hypoxic-ischaemic injury in term infant
8 TreatmentsOrthosis 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 ???
9 Thanks 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