Stereotypic Movement Disorder: Symptoms and Causes

Each and every one of us has our own way of seeing the world, perceiving it, and interacting with it. We think, relate to each other, express ourselves, speak or even move in different ways. This is because our being and identity arise mainly from the interaction between our biology and our experiences and learning.

However, we do not stop being members of the same species, in such a way that at a biological level we are subjected and we share a genome and the same basic structure, having a growth process that is very similar in most of people. Among the multiple systems that arise from this development is our brain.

However, sometimes alterations or problems can occur during said development, capable of altering aspects such as the ability to perform or inhibit our own movements. An example of this can be found in stereotyped movement disorder., a neurodevelopmental problem that we are going to talk about next.

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stereotypic movement disorder

It is known as stereotypic movement disorder. one of the neurodevelopmental or motor neurodevelopmental disorders, which is characterized by the habitual presence of behaviors and motor behaviors of a repetitive type, without objective and apparently guided that It arises in the early stages of development and causes interference in the life of the minor who suffers from it, in a period that must include at least four weeks.

Some common movements are nodding, shaking hands and arms or rocking, but it is also It is possible that the stereotyping in question is an act of self-harm such as hitting yourself or hitting yourself. headbutts. It is because of that some stereotypes can be dangerous and lead to injuries, which could even incapacitate or cause death. In this sense, when making the diagnosis, it must be specified if it occurs with or without self-harm, and if protective measures are required to prevent injuries.

As we have seen, the stereotyped movement disorder is one of the neurodevelopmental disorders, which are characterized by originating from a Nervous development other than usual or due to the presence of problems, slowdowns or alterations in the maturation of the nervous system during growth.

These problems start in childhood. (in the case at hand it usually appears before three years of age), and can cause limitations or difficulties in the subject's functionality or adaptation compared to their peers. It is common for the movements to persist during childhood and reach their maximum peak in adolescence. It can also affect socialization and learning, making it difficult or generating social rejection.

Symptoms: stereotypes

These movements are called stereotypes, and They are known as a type of hyperkinetic movement or by excess of this. These are partially involuntary movements that appear in a coordinated and generally rhythmic manner. This semi-involuntary nature implies that although they are not carried out with a specific purpose at the level conscious but arise spontaneously and uncontrolled, they can voluntarily become stop.

They usually appear impulsively and although it can make it difficult to follow actions, it does not prevent complex movements. Their purpose is not clear, although it is suggested that they may be aimed at managing and regulating the internal tension of the child. Likewise, they only occur during wakefulness and in most cases the distraction or the initiation of an activity can stop the performance of the movements.

differential diagnosis

It is important to note that the diagnosis of stereotypic movement disorder cannot be made if there is another neurodevelopmental disorder explaining these behaviors, or poisoning or neurological disease diagnosed.

In this sense, it should be noted that it is common for stereotypes to appear in people with intellectual disabilities or autism, in children with psychotic problems or in some cases of childhood obsessive-compulsive disorder, although in these cases the diagnosis of stereotypic movement disorder would not be considered.

It should also be taken into account that this disorder differs from that of complex motor tics, with the that can be confused but in which the movements are less rhythmic and more involuntary and uncontrollable. Another problem that can be confused with is trichotillomania, in which the affected person compulsively pulls their hair out. as a method of anxiety management.

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Theories about its causes

Even today, the mechanisms that cause this disorder are not completely known. However, as a neurodevelopmental disorder that is its presence, it obeys a problem derived from the process of maturation and development of the child's brain. There are different theories as to how it happens.

One of them establishes a possible alteration at the level of neurotransmitters, with a possible excess of dopamine and other catecholamines. At the brain level there may also be some type of degeneration or alteration in temporal areas.

At a psychological level, there is also talk of a possible unconscious purpose of these movements, being the result of an attempt to discharge energy caused by tension. Sometimes some theories have linked to the existence of excessive demands by the environment or in the search for pleasure and pain reduction by causing the use of substances that inhibit temporarily the pain (something that in nature means that we can not feel the pain in all its intensity until we can put on safe).

Likewise, it has been observed that they appear more frequent in environments in which there has been poor stimulation of the child to physical or social level or, on the contrary, an overstimulation that makes them seek balance through movement. It is more common in people with sensory disabilities or institutionalized.

Treatment

Stereotypic movement disorder can be treated with a multidisciplinary approach, so that the stereotypies can be reduced and reduce the possible affectation in the functionality and participation in society of the affected subjects. The treatment used in each case will depend on the specific symptoms, the age and moment of development and the possible causes.

In some cases, stereotypes they may end up disappearing as the child grows, although in other cases they remain for life. In any case, beyond the possible difficulty that stereotypes can pose, they are not dangerous (unless they are of a self-injurious type) and on many occasions a treatment.

Fundamentally, cognitive behavioral psychological therapy is used. Some strategies used may be differential reinforcement of other behaviors and habit reversal. Work can be done to try to reduce the self-stimulatory potential of the stereotypy by trying to get the patient to get stimulated in another way. In cases of under-stimulated patients it will be advisable to bring the subject closer to an environment with a higher level of stimulation, while in some with excess it could be beneficial to reduce it.

In the case of patients with self-injurious movements, it will also be necessary to modify the environment in such a way that injuries are prevented and the integrity of the affected person can be protected. This type of alteration can be a great reason for anguish for the parents and the environment, with which they will benefit from psychoeducation and contact with families with children who suffer from the same problem.

Sometimes drugs can also be used, in general benzodiazepines and other drugs that lower the level of physiological arousal. Antidepressants are also often used.

Finally, at the educational level, the possibility that some learning may be more complex will have to be taken into account, and adjustments must be made to allow good development.