What is Athetosis?
Athetosis is a condition where the patient experiences slow, convoluted, involuntary and writhing movements of the hands, fingers, feet and toes.1 In some athetosis patients these movements can also occur in arms, neck, legs and tongue. The movements occurring in athetosis are also referred to as athetoid movements. The common cause for Athetosis is lesions or damage in the brain, especially in the corpus striatum, of which Athetosis is the symptom. Athetosis can also occur as a result of cerebral palsy, so is commonly accompanied with symptoms of cerebral palsy.2 The aim of treatment for athetosis is alleviating the uncontrollable movements.
Patient can also have choreoathetosis along with Athetosis due to damage to the basal ganglia. Other than choreoathetosis, patient can also have another movement disorder, pseudoathetosis, which is also a movement disorder caused by the proprioception.
Causes of Athetosis
There are multiple causes for developing Athetosis and there are lots of different factors, which accompany this condition. It is important to seek immediate medical attention so that early and correct diagnosis of athetosis can be made and a treatment plan can be worked out. Some of the causes for Athetosis are:
- Brain tumor.
- Damaged or injury to the basal ganglia.
- Cerebral infarction.
- Hepatic encephalopathy.
- Wilson disease.
- Huntington disease.
- Cerebral palsy.
- Athetosis can also occur as a side effect of antipsychotic medications such as phenothiazine.
- Diseases such as kernicterus, Tay-Sachs disease, Lesch-Nyhan syndrome, Phenylketonuria, Tardive dyskinesia, Segawa syndrome and Creutzfeldt–Jakob disease can lead to development of athetosis.
Signs & Symptoms of Athetosis
Athetosis varies in severity. Patient suffering from athetosis experiences slow and involuntary movement of body parts such as hands, feet, face, tongue, neck and muscles of the body. Patient also has facial spasms. Athetosis patient is not able to stand. It is also difficult for the patient suffering from athetosis to talk properly. There is excessive production of saliva. The movements of Athetosis consist of slow, involuntary and unbalanced movements of the muscle and patient has difficulty in maintaining a symmetrical posture. Depending on the patient and the severity of the symptoms of athetosis, these movements can be limited to only a part of a body or can be present throughout the body. Movements are more pronounced in the extremities with convoluted and writhing movement of the digits. Babies can show the signs of athetosis as early as 18 months old. The initial symptoms being: Difficulty in feeding, spasms, hypotonia and involuntary writhing movements of the face, hands and feet, which continue to get worse through adolescence period and during stress. The cause of Athetosis is lesions in various areas of the brain such as the motor thalamus, the hippocampus and the corpus striatum; due to which the children can also suffer from cognitive defects such as hearing loss, speech impairment, and delayed/failed sitting balance.
Treatment for Athetosis
Treatment for athetosis consists of different approaches, which include drugs, surgery and re-training the movements of the patient. Re-training and re-learning movements is beneficial in some patients. It is very important to diagnose and treat Athetosis as early as possible to prevent worsening of this condition.
There is not a single specific medicine for treating Athetosis and different types of medicines are used, such as artane, curare, cogentin, thiopropazate, tetrabenazine, haloperidol, and diazepam. Medicines can provide benefit and alleviate symptoms in mild cases of athetosis.
Surgical treatment is the most effective treatment for athetosis; however, it does not cure this condition completely. If the cause of athetosis is cerebral palsy, then subthalamotomy helps in reducing the severity of the athetosis in about 50% of the patients. There is considerable improvement seen in patients with surgical treatment in regards to the control of digits and limbs. However, the results of the surgery are good for a short-term period along with giving immediate results, but surgery does not have long lasting effects in treatment of athetosis.
Precautions in Athetosis
Even if there is no proper cure for athetosis, it is important to seek treatment to ease the uncontrollable movements of this disorder as they can cause harm to the patient such as falling down, poking the eyes and causing such type of accidents because of the inability of the patient to move around. Sharp objects should not be given to patients suffering from athetosis and patients should not be left unattended as there is a high risk of accidents, especially if the patient is stressed or violent.
Support & Care in Athetosis
It is very painful for the family members of the patient to see their loved ones suffering from this disorder, as patient having athetosis are usually wheelchair bound and need a constant companion to look after themselves. Patients suffering from athetosis are incapable of doing anything on their own and need assistance with simple activities of living such as standing, walking, eating, bathing etc. Patients suffering from athetosis need special attention, care, patience, understanding and love, as this disorder more or less stays for life and after a point is not treatable anymore. So, the patient’s family members should be considerate and be aware of that the patient has to carry this burden for the rest of his/her life. The most effective treatment for patients suffering from athetosis is love, patience and care by the family members and others.
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