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Movement - unpredictable or jerky

Chorea; Muscle - jerky movements (uncontrolled); Hyperkinetic movements; Myoclonus; Ballismus

Jerky body movement is a condition in which a person makes fast movements that they cannot control and that have no purpose. These movements interrupt the person's normal movement or posture.

When abnormal movements are excessive, they are called ‘hyperkinetic’ movements and include myoclonus (jerking and twitching) and ballismus (violent flinging of extremities), chorea (slow, twisting, or continued movements), among others.

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Considerations

This condition can affect one or both sides of the body. Typical movements of chorea include:

• Bending and straightening the fingers and toes
• Grimacing in the face
• Raising and lowering the shoulders

These movements do not usually repeat. They can look like they are being done on purpose. But the movements are not under the person's control. A person with chorea may look jittery or restless.

Chorea can be a painful condition, making it hard to do daily living activities.

Causes

There are many possible causes of unpredictable, jerky movements, including:

• Antiphospholipid syndrome (disorder that involves abnormal blood clotting)
• Benign hereditary chorea (a rare inherited condition)
• Disorders of calcium, glucose, or sodium metabolism
• Degenerative diseases (disorders that involve breakdown of nerve cells in the brain), such as Alzheimer disease and Huntington disease
• Medicines (such as levodopa, antidepressants, anticonvulsants)
• Polycythemia rubra vera (bone marrow disease)
• Sydenham chorea (movement disorder that occurs most often in children after infection with bacteria called group A streptococcus)
• Wilson disease (disorder that involves too much copper in the body)
• Pregnancy (chorea gravidarum)
• Stroke or lack of oxygen to the brain (hypoxic brain injury)
• Systemic lupus erythematosus (disease in which the body's immune system mistakenly attacks healthy tissue)
• Tardive dyskinesia (a condition that can be caused by medicines such as antipsychotic drugs)
• Thyroid disease
• Other rare disorders

Home Care

Treatment is aimed at the cause of the movements.

• If the movements are due to a medicine, the medicine should be stopped, if possible.
• If the movements are due to a disease, the disorder should be treated.
• If the movements are severe and affect the person's life, medicines such as tetrabenazine may help control them.

Excitement or fatigue can make hyperkinetic movement worse. Rest helps improve chorea. Try to reduce emotional stress.

Safety measures should also be taken to prevent injury from the involuntary movements.

When to Contact a Medical Professional

Contact your health care provider if you have unexplained body motions that are unpredictable and do not go away.

What to Expect at Your Office Visit

The provider will perform a physical exam. This will include a detailed examination of the nervous and muscle systems.

You'll be asked about your medical history and symptoms, including:

• What kind of movement occurs?
• What part of the body is affected?
• What other symptoms are there?
• Is there irritability?
• Is there weakness or paralysis?
• Is there restlessness?
• Are there emotional problems?
• Are there facial tics?

Tests that may be ordered include:

• Blood tests such as metabolic panel, complete blood count (CBC), blood differential
• Blood tests for heavy metals, ceruloplasmin, and copper
• CT scan of the head or affected area
• EEG (in rare cases)
• EMG and nerve conduction velocity (in rare cases)
• Genetic studies to help diagnose certain diseases, such as Huntington disease
• Lumbar puncture
• MRI of the head or affected area
• Urinalysis

Treatment is based on the type of hyperkinetic movement disorder the person has. If medicines are used, the provider will decide which medicine to prescribe based on the person's symptoms and test results.

References

Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 24.

Okun MS, Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 382.

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Review Date: 1/23/2023  

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. 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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