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Movement Disorders Program
At CHOC, we know caring for a child with a complex movement disorder can feel overwhelming. Our pediatric neurologists and nurse practitioners are trained in treating children with movement disorders and dedicated to optimizing the potential of the kids and adolescents we treat. We partner with your child and family to identify your unique goals of care and deliver individualized treatment to meet your needs.
What is a movement disorder?
Movement disorders are a group of neurological conditions that cause involuntary changes in the nature or quality of movement.
Voluntary movements are intentional, like standing up. Movement disorders are involuntary, meaning the movements are not something the child wants to do. Movement disorders can cause movements to be increased, reduced or slower than intended, inaccurate or clumsy, or it can prevent movement altogether.
Types of movement disorders
There are two main types of movement disorders based on the abnormal movement they cause:
- Hyperkinetic Movement Disorders (increased movement). Sometimes referred to as dyskinesias, these movement disorders cause excessive, often repetitive, involuntary movements that disrupt a person’s regular activity. Common movement disorders in this category include chorea, dystonia, myoclonus, stereotypies, tics and tremors.
- Hypertonic Movement Disorders (increased stiffness). Hypertonic movement disorders increase the stiffness of joints and make it difficult for parents or caregivers to change clothing or provide other assistance. Common disorders in this category include spasticity, dystonia and rigidity.
- Hypokinetic Movement Disorders (decreased or slowed movement). These movement disorders, sometimes referred to as “Negative Signs” cause slowed movement (bradykinesia), reduced range of movement (hypokinesia) and/or loss of movement (akinesia). They can also reduce the control or coordination of simple movements (ataxia) or the ability to perform complex movements (dyspraxia).
Movement disorder symptoms
Symptoms of movement disorders vary depending on the specific condition causing the abnormal movements. However, some early warning signs could warrant a visit to your child’s doctor. Early warning signs of movement disorders in children include:
- Difficulty with fine motor skills
- Unusual postures of the arms, legs, neck, back or face
- Changes in walking or clumsiness
- More difficulty on one side of the body compared to the other
- Increased stiffness of joints, or inability to move into otherwise normal positions
- Difficulty learning or performing complex motor tasks that should otherwise be easy
What causes a movement disorder?
Movement disorders in children can be caused by:
- Genetic disorders
- Brain, spinal or nerve injury
- Infections
- Inflammation of the brain
- Medication side effects
- Autoimmune conditions
- Metabolic disorders
- Toxins
- Tumors
Movement Disorder Diagnosis and Treatment
To diagnose movement disorders, your child’s doctor needs to classify the condition and determine the underlying cause of the abnormal movement. Our doctors will perform a thorough physical evaluation and a medical and family history for each child. Further diagnostic tests may include:
- Lab tests, including genetic and metabolic studies
- Lumbar puncture (spinal tap)
- MRI of the head, neck, or back
- Video recording of the abnormal movement
- Computer-assisted gait evaluation
- EEG (electroencephalogram)
- Referral for testing by other specialists
Movement Disorder Treatment
Treatment for movement disorders will depend on the exact condition, a child’s age and the severity of the disease, but can include:
- Medication to help control symptoms
- Physical therapy to restore control of movements
- Occupational therapy to improve daily living skills
- Speech therapy to increase talking, memory and attention
- Hippotherapy to improve core coordination and strength using horseback riding
- Botulinum Toxin injections to reduce involuntary muscle contraction
- Neurosurgery such as deep brain stimulation and intrathecal baclofen pumps
- Orthopedic surgery to correct problems with bones, joints or tendons
Innovative Movement Disorder Care at CHOC
CHOC is home to one of the nation’s largest pediatric movement disorder groups, with two physicians and two nurse practitioners. With our team of experts and innovative research, CHOC is one of the top hospitals in the nation for treatment of secondary dystonia, including the use of advanced techniques for deep brain stimulation (DBS).
Clinical trials at CHOC
At CHOC, we participate in clinical trials to provide breakthrough treatments for patients who haven’t responded to traditional condition management. Dr. Allison Przekop is currently conducting pharmaceutical clinical trials for treatment of dyskinesia in cerebral palsy in children. Cerebral palsy often has movement disorder symptoms. Read more about the clinical trial.
Movement disorder research at CHOC
Dr. Terry Sanger is a renowned physician and research scientist specializing in movement disorders. He runs a pediatric movement disorder lab, in conjunction with UCI, dedicated to identifying new treatments and devices that improve motor function in children suffering from movement disorders. Explore more of Dr. Sanger’s work.
Movement Disorder FAQs
Tic disorders are the most common movement disorder in children. Spasticity and dystonia are the most common movement disorders in children with cerebral palsy.
Movement disorders are a group of neurological conditions that cause abnormal movement. They can include tremors, muscle spasms, involuntary movements in the face and body area and changes in walking.
Movement disorders that cause involuntary motions make someone move uncontrollably. These disorders include dystonia, chorea, essential tremors, myoclonus, spasticity, tardive dyskinesia and Tourette syndrome. Movement disorders not listed here cause abnormal motion with voluntary movements.
Diseases associated with movement disorders include:
- Cerebral Palsy
- Spinal abnormalities or injury
- Hypoxic brain injury
- Disorders of growth or degeneration of the cerebellum
- Tic disorders
- Essential tremor
- Primary Dystonias
- Functional movement disorders
- Huntington's disease
- Multiple system atrophy
- Myoclonus
- Progressive supranuclear palsy
- Restless leg syndrome
- Wilson's disease
- Tardive dyskinesia
- Tourette syndrome
- Juvenile Parkinson’s disease
- Systemic Lupus Erythematosus
- Autoimmune encephalitis
- Metabolic disorders, including glutaric acidura, methylmalonic aciduria and mitochondrial disorders
- Disorders of dopamine metabolism
- Kermicterus
- Tumors and chemotherapy
- Brain malformations
Meet the CHOC Movement Disorder Team
The CHOC Movement Disorder Team includes the providers below, as well as Amanda Kammer, RN, and Cindy Malvaez, medical assistant and financial counselor.
Sanger, Terence MD
Specialty:
Neurology
Appointments: 888-770-2462
Office: 714-509-7601
Dr. Sanger is board certified in child neurology and treats kids and teens in Orange County.
MacLean, Jennifer NP
Specialty:
Neurology
Jennifer MacLean is a nurse practitioner and is a member of the CHOC Specialists who treats kids and teens in Orange County.
Przekop, Allison DO
Specialty:
Neurology
Office: 714-509-7601
Dr. Allison Przekop is board certified in child neurology and treats kids and teens in Orange County.
Serna-Fonseca, Teresa NP
Specialty:
Neurology
Teresa Serna-Fonseca is a nurse practitioner and is a member of the CHOC Specialists who treats kids and teens in Orange County.
