Autistic spectrum disorder |
▸ Motor stereotypies ▸ Self-stimulatory behaviours (eg, compulsive Valsalva manoeuvre leading to reflex anoxic seizures) ▸ Sensory processing issues (eg, unusual visual experiences)
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Cerebral palsy (all types) |
▸ Associated dystonia (repetitive twisting movements) ▸ Status dystonicus ▸ Dyskinetic movement disorders (eg, choreoathetoid movements) ▸ Agitation episodes manifested by hypermotor or tonic spasm features (with or without autonomic accompaniments) due to undiagnosed or undertreated comorbidities that can cause pain such as gastro-oesophageal reflux, constipation, orthopaedic problems, dental pain … etc. Every effort should be made to assess for pain and to rule these causes out
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Post brain injury |
▸ Subcortical myoclonus ▸ Tonic spasms ▸ Paroxysmal autonomic instability with dystonia: tachycardia, hyperthermia, hypertension, agitation and extensor posturing
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Intellectual disability |
▸ Timeout phenomenon, in which, the child would appear to be staring blankly and become motionless. This is usually situational. It may be mistaken for absence seizures ▸ Self-stimulatory behaviours (eg, rocking, spinning … etc)
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Rett syndrome |
▸ Hand stereotypies ▸ Syncopal attacks secondary to hyperventilation, breath holding and prolonged QT interval ▸ Abnormal behaviours (eg, ‘screaming fits’)
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Neiman–Pick type C |
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Drug-related movement disorders |
▸ Tics and motor stereotypies: can complicate the treatment course with methylphenidate ▸ Oculogyric crisis: presents with dystonic ocular movements such as upward deviation of the eyes, periorbital twitching and prolonged staring. Agents may include domperidone, metoclopramide and carbamazepine ▸ Tardive dyskinesia: characterised by rhythmic movements of the tongue, face, trunk and extremities. Can complicate prolonged treatment (>3 months) with a dopamine antagonist such as risperidone ▸ Status dystonicus secondary to sudden withdrawal of baclofen or benzodiazepines
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