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Stereotypic movement disorder

Motor stereotypies

Stereotypic movement disorder is a condition in which a person makes repetitive, purposeless movements. These can be hand waving, body rocking, or head banging. The movements interfere with normal activity or may cause bodily harm.

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Causes

Stereotypic movement disorder is more common among boys than girls. The movements often increase with stress, frustration, and boredom.

The cause of this disorder, when it doesn't occur with other conditions, is unknown.

Stimulant drugs such as cocaine and amphetamines can cause a severe, short period of movement behavior. This may include picking, hand wringing, head tics, or lip-biting. Long-term stimulant use may lead to longer periods of the behavior.

Head injuries may also cause stereotypic movements.

Symptoms

Symptoms of this disorder may include any of the following movements:

• Biting self
• Hand shaking or waving
• Head banging
• Hitting own body
• Mouthing of objects
• Nail biting
• Rocking

Exams and Tests

A health care provider can usually diagnose this condition with a physical exam. Tests should be done to rule out other causes including:

• Autism spectrum disorder
• Chorea disorders
• Obsessive-compulsive disorder (OCD)
• Tourette syndrome or other tic disorder

Treatment

Treatment should focus on the cause, specific symptoms, and the person's age.

The environment should be changed so that it is safer for people who may injure themselves.

Behavioral techniques and psychotherapy may be helpful.

Medicines may also help reduce symptoms related to this condition. Antidepressants have been used in some cases.

Outlook (Prognosis)

The outlook depends on the cause. Stereotypic movements due to drugs usually go away on their own after a few hours. Long-term use of stimulants can lead to longer periods of stereotypic movement behavior. The movements usually go away once the drug is stopped.

Stereotypic movements due to head injury may be permanent.

The movement problems usually don't progress to other disorders (such as seizures).

Possible Complications

Severe stereotypic movements may interfere with normal social functioning.

When to Contact a Medical Professional

Call your provider if your child has repeated odd movements that last longer than a few hours.

References

Jankovic J, Hallett M, Okun MS, Comella C, Fahn S, Goldman J. Stereotypies. In: Jankovic J, Hallett M, Okun MS, Comella C, Fahn S, Goldman J, eds. Principles and Practice of Movement Disorders. 3rd ed. Philadelphia, PA: Elsevier; 2022:chap 16.

Ryan CA, Walter HJ, DeMaso DR. Motor disorders and habits. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 37.

Singer HS, Mink JW, Gilbert DL, Jankovic J. Motor stereotypies. In: Singer HS, Mink JW, Gilbert DL, Jankovic J, eds. Movement Disorders in Childhood. 2nd ed. Waltham, MA: Elsevier Academic Press; 2016:chap 8.

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Review Date: 6/7/2022  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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