A nervous tic is a sudden, repetitive movement that occurs as a result of involuntary contraction of a specific muscle group. For example, it is often said that “the eye twitches.” Twitching can affect different muscles, spread from one muscle group to another, and even cover almost the entire body.
Movements during tics are obsessive and a person cannot control them. When you try to suppress a tic, the tension increases and as a result the tic only gets worse.
The most common tic occurs in childhood, and it is detected somewhat more often in boys than in girls. It is believed that tics occur in 13% of boys and 11% of girls.
Causes of pathology
The main cause of hyperkinesis is dysfunction of the cerebral motor system. This disorder can be caused by various factors:
- degenerative processes in the central nervous system that are hereditary in nature;
- conditions associated with perinatal trauma;
- suffered traumatic brain injuries;
- brain tumors;
- various toxic lesions - alcoholism, CO2 poisoning;
- previous neuroinfections – meningitis, encephalitis;
- cerebrovascular accidents;
- endocrine diseases;
- psychogenic factors – neuroses, psychoses, anxiety disorders.
Hyperkinesis in some cases occurs as a side effect when taking psychostimulants or antipsychotics.
Why does the shoulder muscle twitch?
Spontaneous twitching of the muscles of the shoulder joint can be caused by physical activity. This phenomenon is usually observed in athletes or people whose profession is related to loading and unloading. If the twitching is constant, then it may be due to a lack of potassium in the body. In this case, after consulting a doctor, drug treatment, including vitamin therapy, will be prescribed. In addition, twitching of the left shoulder may be associated with heart disease, so if such a symptom occurs, it is recommended to consult a physician or cardiologist.
General symptoms
The main symptoms of hyperkinesis include motor acts performed by patients against their will, the so-called violent ones. Patients themselves describe them as the result of an irresistible desire that they cannot resist.
The list of symptoms representing hyperkinesis includes:
- frequent blinking and squinting of the eyes (tics);
- convulsive tilting or turning of the head;
- tremor of various parts of the body, most often the limbs;
- myoclonus – sudden muscle twitching of the arms or neck;
- chorea - arrhythmic movements of facial expressions, involuntary sounds arising from rapid contractions of the muscles of the larynx;
- ballism - sudden rotation of the hip or shoulder;
- Blapharospasm is a pathological closure of the eyelids, as one of the signs of various diseases.
Forms of hyperkinesis can vary from intermittently frequent to constant. Some patients manage to control certain forms of hyperkinesis (for example, tics) by force of will, but after a while the attack of violent movements manifests itself again with even greater force.
Symptoms of a nervous tic
Involuntary movements can affect only one muscle group - such tics are called local
.
There are also simple and complex tics. A simple tic is a complex of the simplest movements of the same type. With a complex tic, involuntary movements affect several muscle groups. A severe type of the disease is a generalized tic
, affecting almost the entire body. With this type of tic, involuntary movements usually begin in the face, then involve the muscles of the neck, shoulders, arms, chest, abdomen and back, and even legs.
Most often, tics affect the facial muscles. In this case, such movements as blinking, moving the lips, opening the mouth, moving the eyebrows, and twitching the nose are characteristic. When a tic spreads to the neck and shoulders, nodding and shaking of the head are typical. Tic spreading to the limbs is expressed in the form of flapping of arms, clapping of palms, stamping and jumping.
A group of vocal manifestations is also distinguished. In this case, screams, coughing, howling, uttering curses, and incoherent speech may be observed.
Types of hyperkinesis
There are various criteria that are used to classify pathology. Thanks to them, the following types of hyperkinesis can be distinguished:
- childhood forms - hyperkinesis up to one year, in the age category from one to five, during puberty;
- by type of occurrence - spontaneous, reflex (reaction to external phenomena), actional (provoked by a certain condition), induced (can be controlled by the patient);
- along the flow – constant (tremors) and episodic (tics);
- by speed of movement - fast and slow;
- by localization - hyperkinesis of the face, limbs, tongue;
- by origin - a distinction is made between primary (congenital) and secondary hyperkinesis acquired as a result of injury or taking medications.
Hyperkinesis in cerebral palsy in children begins to appear at the age of 1.5-2 years. Children with this pathology have difficulty coordinating their movements, which often look like pushing, jerking and twisting. Repetitive movements can be fast and rhythmic or, conversely, slow and erratic.
Hyperkinesis in cerebral palsy may be accompanied by swallowing disorders, speech delays and disorders, and lability of the emotional system.
Treatment of nervous tics
Nervous tics are treated by a neurologist. In case of primary tic, a psychotherapist can help. Primary tics in children usually go away with age. To relieve symptoms and speed up recovery, it is recommended:
- normalization and adherence to the daily routine. It is necessary to get up, eat and go to bed at approximately the same time;
- proper and balanced nutrition;
- active lifestyle, sports, walks in the fresh air;
- eliminating excessive mental stress;
- reduction of psycho-emotional stress. Normalization of relationships in the family, and for the child also at school, is of great importance.
If tic manifestations are severe, the doctor may prescribe medication. For secondary tics, treatment is primarily aimed at combating the underlying disease that caused the tic. In most cases, with successful treatment of the underlying disease, the tic disappears.
Massage and reflexology are also used to treat tics.
Diagnostics
Before determining how to treat hyperkinesis, it is necessary to conduct an accurate and reliable diagnosis. At the same time, attention is paid to the clinical picture of the disease, assessment of the psychological and intellectual state of the patient.
In the diagnosis of hyperkinesis the following are used:
- general and biochemical blood tests - diagnose pathology resulting from toxic effects;
- CT and MRI of the brain - detect tumors and various degenerative changes;
- electroencephalography – determines brain activity, diagnoses epilepsy;
- study of cerebral blood flow, ultrasound examination of the vessels of the brain and neck;
- cerebrospinal fluid examination.
Some patients are prescribed genetic counseling. It is necessary if there is a suspicion that hyperkinesis is a symptom of hereditary diseases.
Diagnosing hyperkinesis is a long process that will take several weeks. Determining the causes of pathology will make it possible to treat hyperkinesis more effectively.
DIAGNOSIS—MYOCLONIC CONTRACTIONS
The main role of diagnosis is to distinguish myoclonic jerks from other movement disorders such as tics, tremors and chorea. In each case, the doctor begins the diagnosis with a detailed history, followed by a physical examination. During the physical examination, the doctor will look for similar symptoms in other family members, ask about the patient's medications and possible exposure to toxins.
If myoclonus is not classified as physiological, laboratory tests (morphology, ALT and ASPAT liver tests, glucose concentration, ionogram, creatinine, urea), EEG, EMG, neuroimaging (scalp computed tomography or magnetic resonance imaging) should be performed. If specialists suspect Creutzfeldt-Jakob disease or multiple sclerosis, a cerebrospinal fluid test should be performed.
However, if the medical history and physical examination indicate a genetic disorder as the cause of myoclonic contractions, laboratory tests for genetic mutations should be performed. Sometimes it is also necessary to perform laboratory tests, which can exclude paranoplastic syndromes as a cause of myoclonus.
Theories of involuntary movements
This question remains open. The most common reasons for such movements are given below.
Muscle relaxation
It is believed that during REM sleep, when a person can dream, his arm and leg muscles are paralyzed. But the brain continues to control the state of the body as a whole. For reasons that are still unclear, it happens that muscles relaxed during sleep are perceived by him as something wrong that requires intervention. The brain tries to change the state of the body, to wake it up. Limbs begin to twitch in sleep.
Stress
Also, the cause of involuntary twitching of the arms and legs, trembling of the body during sleep is considered to be a state of stress. Or just an uncomfortable body position on the bed. These conditions do not necessarily lead to the appearance of myoclonus. But the presence of these factors in people increases the likelihood of the syndrome occurring.
If a person tries to sleep after a noticeable nervous disorder, then sometimes the brain suddenly receives a danger signal, for example, the threat of a body falling. The signal is processed and the cause of the danger is sought. At this time, the person is in a state of half-asleep. And, as a rule, I dream about an unexpected fall. When a person wakes up, he usually remembers a dream in which he unexpectedly falls.
Restless legs syndrome
If involuntary and uncontrollable twitching of the limbs while falling asleep occurs regularly over a long period of time, you should consult a doctor. Since in this case, periodic limb movements syndrome may develop. It develops in different ways: in some people it manifests itself during the daytime, without bothering us at all at night.
The result of the development of SPD is a constant interruption of the deep sleep phase, but it does not lead to complete awakening. Therefore, a person does not realize that there is a problem, but the body cannot get proper rest during sleep. In turn, this leads to worsening nervous disorders.
Sleep apnea in adults
Periodic limb movements syndrome is very similar in its symptoms to another movement disorder, restless legs syndrome. These are different pathologies.
The main discomforts associated with restless legs syndrome:
- burning,
- tingling,
- numbness in the legs, including the feet.
Symptoms are relieved for a short time or disappear completely with any movement. Walking, squats, and bending will help remove unpleasant manifestations. The problem is that everything happens when a person is about to fall asleep. Consequently, the quality of sleep decreases. The body again cannot fully rest.
In Parkinson's disease, Huntington's disease, and apnea, involuntary movements of the limbs when falling asleep or during sleep are an almost constant symptom.
In themselves, such shudders or involuntary movements of the limbs do not cause harm. This is only a consequence of processes occurring in the peripheral nervous system, or existing pathologies