Hyperkinetic syndrome

Hyperkinetic syndrome is a complex of various involuntary, violent movements.

This syndrome manifests itself mainly as one of the symptoms accompanying many neurological diseases.

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Causes hyperkinetic syndrome

The course of this pathology has not yet been sufficiently studied. Hyperkinetic syndrome occurs due to a violation of metabolic processes in neurotransmitters (complex chemical substances and hormones of the body, such as adrenaline, serotonin, dopamine) of neurons of the brain. The syndrome causes the occurrence of an excess of catecholamine and dopamine, while glycine, serotonin and acetylcholine are not produced sufficiently.

Hyperkinetic syndrome in adults causes high clinical polymorphism and significant differences in the signs of severity, prevalence, localization, tempo, rhythm and symmetry. With vascular, infectious, toxic, metabolic and other pathological factors, hyperkinetic syndrome in adults can also have a symptomatic effect on the brain. The following groups of brain damage are known, which are caused by hyperkinetic syndrome:

• Hyperkinesis of the brainstem level manifests itself in the form of tremor, tics, paraspasm of facial muscles and facial hemispasm, myorhythmia, myocolony, myokymia. They are characterized by rhythmicity, relative simplicity and stereotypy of violent movements.
• Subcortical hyperkinesis - its symptoms include torsion dystonia, chorea, athetosis, ballismus, Rülf's intentional spasm. It is characterized by arrhythmia, complexity of violent movements and polymorphism, with a dystonic component.
• Subcortical-cortical hyperkinesias are characterized by the presence of Kozhevnikovsky and myoclonus epilepsy, Hunt's myoclonic dyssynergia. It manifests itself in the form of frequent epileptic seizures and generalization.

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Symptoms hyperkinetic syndrome

Hyperkinetic syndrome usually takes one of four most common forms: tics, tremor, chorea and dystonia. The intensity of such symptoms increases with voluntary movements, walking and writing, speech activity and in states of emotional and mental stress. Through volitional efforts they can be weakened and suppressed for a short time. During sleep, hyperkinetic syndrome also does not manifest itself in any way.

Tremor, the symptom of which is shaking of the body, is one of the most common cases. In tremor, hyperkinetic syndrome manifests itself in the form of involuntary rhythmic oscillatory movements of the head and limbs, or the whole body. The state of tremor can take one of two forms: action tremor and rest tremor. The first type of tremor can be divided into postural, which occurs during movement, and isometric, as a consequence of isometric muscle contractions. Rest tremor is more inherent in Parkinsonism syndrome and Parkinson's disease. Another type of tremor is distinguished - orostatic, which can accompany the transition of the body to a vertical position and standing, as well as kinetic tremor, selective, occurring only with certain movements, such as during writing - writer's tremor.

Dystonia is a slow, tonic or fast rhythmic, colonicotonic movements that cause spinning, rotation (“torsion dystonia” - from the Latin torsio - rotation, twisting), flexion and extension of the arms and legs and fixation in pathological positions.

Chorea manifests itself as a stream of rapid irregular and chaotic multifocal movements. Hyperkinetic syndrome involves the distal parts of the limbs, trunk muscles, facial muscles, and sometimes the larynx and pharynx. Muscle contractions cause involuntary grimacing and grimaces, causing deliberate grimaces and dance movements (choreia in Greek means dance). Chorea often acts as a symptom of Huntington's disease, which is a hereditary disease that is transmitted in an autosomal dominant manner and occurs against the background of progressive degeneration of neurons in the subcortical nuclei and cortex, accompanied by dementia.

Tics are characterized by the activation of muscles and individual muscle groups or body parts, causing repetitive arrhythmic movements. Tics can be caused by normal motor activity, they resemble fragments of purposeful actions. Tics can be weakened up to complete suppression for a short time by using willpower.

Hypotonic-hyperkinetic syndrome manifests itself in amyostatic symptoms combined with rhythmic small-amplitude picking tremor. There are oculomotor disorders of the following two types: transient - which include diplopia and persistent - paresis of gaze and convergence, nystagmus, anisocoria, Argyll-Robertson symptom. The degrees of pyramidal disorders in hypotonic-hyperkinetic syndrome are represented by mild hemiparesis, bilateral pathological signs, central paresis of the 7-9-10-12 nerves, sensitive as pain hemihypersesthesia, may also occur.

Hyperkinetic cardiac syndrome is a set of independent clinically determined varieties of symptoms of vegetative-vascular dystonia. Today, Western medical specialists reject the very existence of such a disease as vegetative-vascular dystonia, meanwhile in the countries of the former Soviet Union, vegetative-vascular dystonia is considered officially recognized. However, it is not considered a specific disease, but a complex of all sorts of symptoms. Hyperkinetic cardiac syndrome is a centrogenously caused vegetative disorder. Hyperkinetic cardiac syndrome is caused by high activity of beta-1-adrenoreceptors of the myocardium, the background of which is sympathoadrenal predominance. Which is characterized by a hyperkinetic type of blood circulation and is accompanied by three hemodynamic symptoms. Hyperkinetic cardiac syndrome is characterized by the following three hemodynamic symptoms:

• An increase in the stroke and minute volumes of the heart, which are many times greater than the metabolic needs of the heart tissue.
• By increasing the rate of blood pumping in the cardiac cavities.
• An increase in the compensatory decrease in all peripheral vascular resistance.

Hyperkinetic cardiac syndrome is an independent clinical type of VSD. It belongs to the group of vegetative disorders of centrogenic nature. In hyperkinetic cardiac syndrome, the activity of beta-1-adrenoreceptors of the myocardium increases, which is caused and accompanied by sympathoadrenal predominance. The consequence of this is the formation of blood circulation according to the hyperkinetic type, in which the following hemodynamic symptoms occur:

• The cardiac output and stroke volume increase to a degree that significantly exceeds the needs of tissue metabolism;
• The rate of expulsion of blood from the heart increases;
• The total peripheral vascular resistance of a compensatory nature decreases.

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Forms

Hyperkinetic syndrome in children

Hyperkinetic syndrome in children is defined by the child's distracted attention, increased anxiety and impulsive behavior. This syndrome negatively affects the children's academic success and social adaptation at school, which is why their academic performance suffers. Hyperkinetic syndrome in children causes hyperactive behavior and reduces sleep time. Most often, such children wear out their clothes and shoes twice as fast as their peers, they are unable to be patient and have difficulty coping with class and homework that requires concentration, and are more likely to be distracted by random external stimuli.

Hyperkinetic syndrome in children is often accompanied by thoughtless and unexpected actions of a child who can suddenly jump out onto the road or climb a tree, such children find it difficult to communicate with peers, as they show aggression and can speak rudely or tactlessly when communicating with peers or adults. Such a child is prone to nervous disorders caused by hyperexcitability, he may have poor, often interrupted sleep, often no or significant loss of appetite, such children are more impressionable, they are fearful and subject to mood swings. All this is aggravated by musculoskeletal imbalance and unstable perception. Hyperkinetic syndrome in children does not prevent them from easily making acquaintances and communicating in society, but their sympathies are short-lived, communication with them is complicated by their constant unwillingness to endure, wait, they strive to get maximum and immediate pleasure.

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Diagnostics hyperkinetic syndrome

In many cases, hyperkinetic syndrome in adults is idiopathic. To diagnose it, it is necessary to exclude all other secondary forms, especially those associated with curable diseases such as endocrinopathies and tumors. Also, when diagnosing, it is necessary to exclude Wilson-Konovalov disease. It is precisely because such cases are quite rare in clinical practice that they are subject to primary exclusion. Subsequent diagnostic measures are carried out using additional diagnostic tools, such as EEG, CT, MRI of the brain, and in addition, laboratory tests.

It should always be remembered that any hyperkinetic syndrome in adults first diagnosed before the age of fifty indicates that hepatolenticular degeneration is excluded. It can be excluded on the basis of a blood test for ceruloplasmin, and also by examining the cornea with a slit lamp to detect the Kayser-Fleischer pigment ring. It is also almost always advisable to diagnose hyperkinetic syndrome based on its psychogenic origin.

Currently, hyperkinetic syndrome is practically non-existent among recorded cases. But this does not diminish the need for its diagnosis and timely updating, which will provide an opportunity to begin targeted treatment in the shortest possible time, which will allow the patient to avoid unnecessary, and sometimes life-threatening, therapy.

Treatment hyperkinetic syndrome

Hyperkinetic syndrome can be treated with medication using a specific sequence of drugs. Children and adolescents are prescribed levodopa preparations; high doses of anticholinergics (up to 100 mg of cyclodol per day); baclofen; clonazepam and other benzodiazepines; carbamazepine (finlepsin); drugs that deplete dopamine stores in presynaptic depots (reserpine); neuroleptics that block dopamine receptors (haloperidol, pimozide, sulpiride, fluphenazine); a combination of the above drugs (for example, an anticholinergic plus reserpine or in combination with a neuroleptic).

Chorea is treated with neuroleptics that block dopamine receptors on striatal neurons. Haloperidol, pimozide, and fluphenazine are mainly recommended for use. Sulpiride and tiapride are slightly less effective, but due to the fact that they cause fewer side effects, they are recommended as first-line treatments. Nowadays, treatment with atypical neuroleptics, such as risperidone, clozapine, and olanzapine, is becoming increasingly popular. A wide combination of treatments is also allowed, so in addition to neuroleptics, antiglutamatergic agents, anticonvulsants, and sympatholytics can be used.

In many cases, when treating tics, it is possible to achieve a positive effect without the use of medication. All that is needed is to instill calm in the patient and his relatives, by convincing them that the manifestation of a decrease in intelligence and a severe mental or neurological disorder is excluded, and such patients, as a rule, achieve good social adaptation.

Treatment of hyperkinetic syndrome in children

The regimen and diet in the treatment of hyperkinetic syndrome in children first of all begins with nutrition, since nutrition is an important aspect in the treatment of the child. But, perhaps it is not entirely reasonable to rely on a complete solution to the problem of a child with attention deficit by changing his diet. In cases where the problem is caused by improper nutrition in children, for example, the presence of preservatives or dyes in the child's diet, the exclusion of unhealthy products and menus can dramatically help your child in the treatment of hyperkinetic syndrome in children.

The most careful attention to the diet should be given to a child whose hyperkinetic syndrome appeared as a consequence of an allergy. Naturally, the diet for such a child should be based solely on the advice of his attending physician. It also would not hurt to check the child for all sorts of allergens. The menu for treating hyperkinetic syndrome in children should be based mainly on fresh vegetables, salads, which must be seasoned with vegetable oils (cold pressed necessarily), and sunflower oil should occupy only 5-10% of the diet due to its insufficient usefulness. Butter with at least 82% fat content is also suitable, which must be consumed without subjecting it to heat treatment. Instead of white wheat flour, wholemeal flour is introduced into the diet, preferably with bran. There are thousands of recipes for delicious dishes for children from these products and ways to decorate them in an original way. It is important to distract your child from eating harmful products, all kinds of crackers, cookies, chips and sweet carbonated drinks.

Recommended products for the treatment of hyperkinetic syndrome in children:

• Vegetables: white cabbage, green peas, carrots, soybeans, cauliflower, kohlrabi, red cabbage, broccoli, spinach, legumes, cucumbers.
• Greens: lettuce, dill, parsley, basil.
• Fruits: bananas, pears, apples.
• Side dishes: brown rice, potatoes, wholemeal noodles.
• Porridges: wheat, rye, barley, flaxseed, millet.
• Bakery products: wheat and rye bread prepared without milk.
• Fats: fermented milk butter, vegetable oils (sunflower oil should make up no more than 5-10% of the weekly diet).
• Meat: poultry, veal, fish, lamb, beef (no more than 2 times a week, not fried).
• Drinks: unsweetened tea, still water with a sodium content of about 50 mg/kg.
• Seasonings and spices: iodized salt, sea salt, sea salt with added seaweed.

Treatment of hyperkinetic syndrome in children with medications

Treatment of hyperkinetic syndrome in children with medication is effective in 75-80% of cases. Due to the fact that drug treatment is symptomatic, it is carried out in children for several years, and if such a need arises, drug treatment continues in adolescence and adulthood.

Drug treatment of hyperkinetic syndrome in children is based on several important factors. One of the most important principles is the dosage of drugs, which is based on the objective effects and sensations of the patient. Disputes that arise about interrupting or not interrupting the child's drug treatment during the holidays are easily resolved with the help of such factors as complications in the child's communication not only during classes, but also in his everyday relationships in society, with parents and friends. If, against the background of drug treatment, the child's mental stress during communication with others is relieved, then the treatment should not be interrupted during the holidays.

Psychostimulants have a beneficial effect on the general nervous state of the child, help him to become calmer, and also affect other symptoms during the treatment of hyperkinetic syndrome in children. Children taking psychostimulants have increased concentration, it becomes much easier for them to endure failures, children gain greater emotional stability, easily build their relationships with parents and friends. Today, it is customary to prescribe such amphetamines as dexamphetamine, methamphetamine, as well as methylphenidate and pemoline. In the treatment regimen, preference is initially given to methylphenidate or amphetamine, due to the fact that pemoline is often less effective.

Methylphenidate is prescribed two or three times a day: in the morning, in the afternoon and preferably after school. Unfortunately, to date, a specific treatment regimen that could ensure a uniform effect of methylphenidate on the body throughout the day has not yet been created. Often, the difficulty in taking this drug is the late daytime intake of methylphenidate, which can prevent the child from falling asleep normally in the evening. The intervals between doses of the drug range from two and a half to six hours. The negative side of methylphenidate overdose is considered to be complaints from parents about the slightly sluggish behavior of the child, who, as some parents also say: "behaves as if hypnotized."

Methylphenidate 10-60 mg per day, dexamphetamine and methamphetamine 5-40 mg per day, pemoline 56.25-75 mg per day. If there is a need for higher doses, it is necessary to consult a specialist. Often, treatment begins with a small dose, which is gradually increased until there is a result in the form of a positive therapeutic effect. Side effects when increasing the dose of the drug: loss of appetite, irritability, pain in the stomach, headache, insomnia. Children do not have physical dependence on psychostimulants.

Manufacturers do not recommend prescribing methylphenidate to children under 6 years of age, and dexamphetamine to children under 3 years of age.

Pemoline is usually prescribed if treatment with other drugs has not been effective. A negative factor when taking pemoline is the high activity of liver enzymes in the study, this side effect was found in 1-2% of children, which can cause jaundice.

When treating a child with pemoline, it is necessary to examine liver function. If the child has renal failure or is suspected of it, then during the administration of pemoline, children should be under the supervision of a specialist, due to the fact that 50% of pemoline is excreted unchanged through almost.

Pemoline is not recommended to be prescribed in full therapeutic dose. It is necessary to start with 18.75-37.5 mg in the morning, and then from the next week increase the daily dose by 18.75 mg until there is a result in the form of a positive therapeutic effect, or side effects when increasing the dose of the drug: loss of appetite, irritability, pain in the stomach, headache. Side effects become less over time. The maximum pediatric dose is 112.5 mg per day.

If psychostimulants do not provide the necessary therapeutic effect, the specialist prescribes neuroleptics and antidepressants. Neuroleptics, in particular chlorpromazine and thioridazine, are prescribed if the child is too hyperactive and behaves too aggressively. A side effect of these drugs is their ability to reduce attention, which complicates and even worsens the child's mental development and interferes with his social adaptation. However, this does not give a reason to treat hyperkinetic syndrome in children without the use of neuroleptics, they just need to be prescribed in a strictly limited manner.

In the treatment of hyperkinetic syndrome in children, such antidepressants as imipramine, desipramine, amfebutamone, phenelzine, tranylcypromine have shown the maximum positive effect. The dose of the antidepressant in each specific case is prescribed by a specialist.

Taking antidepressants in children is associated with very high risks. In case of taking them in children, it is necessary to conduct frequent ECG examinations, as three cases of death have been recorded among children suffering from hyperkinetic syndrome.

Treatment of hyperkinetic syndrome in children with the help of physiotherapy can have a good prognosis. As numerous studies have shown, systematic physical exercises for a child with attention deficit syndrome make him much calmer and more balanced. And the most important thing is the fact that gymnastics has a positive effect on the child's body as a whole.

Children with hyperkinetic syndrome develop proper coordination of movements, normalize sleep, and most importantly, strengthen bones and develop muscles through sports. Physical education classes will be beneficial for the child if they are necessarily carried out under the supervision of the attending physician, neurologist, and physical therapy doctor. This does not mean that you cannot exercise with your child at home or outdoors.

It should be remembered that the positive effect of physiotherapy depends on its duration and regularity. It is important that all the exercises that you will do with your child at home are shown to you by a specialist. It is also important for parents to understand that a child suffering from hyperkinetic syndrome cannot play sports and participate in games in which emotions are strongly expressed. These can be all kinds of competitions, team games such as football, hockey, basketball, etc., all kinds of demonstration performances that will make the child nervous. And lastly, do not forget that when starting classes, your child will have to undergo a mandatory medical examination so that you can make sure that additional physical activity will not negatively affect other organs and systems of the child's body.

Treatment of hyperkinetic syndrome with folk methods

Warm baths with water flavored with sea salt and herbal baths (mint or lavender). It will be more beneficial for a child to take a bath shortly before bedtime and it should last about 14 minutes.

Infusion of oat grains. Method of preparation: 500 g of oat grains, rinse, add 1 liter of water, cook on low heat until the grains are half-cooked. After that, strain, add 1 teaspoon of honey to the decoction, take 1 glass orally.

A decoction of three herbs. Method of preparation: take 1 tablespoon of each of the herbs (violet tricolor, lemon balm leaves, motherwort), pour 1 liter of hot water, bring to a boil over low heat. Infuse for 2 hours, add 1 teaspoon of honey, take 1 glass orally.

A simple and very effective method of treatment is walking barefoot on the ground. In the summer, it will be useful for a child to walk barefoot on grass, earth, sand or pebbles on the beach. Walking barefoot on the ground will give the child pleasant sensations and will have a beneficial effect on his psyche.

Treatment of hyperkinetic syndrome in children at home

Treatment of hyperkinetic syndrome in children at home involves treating not only the child. It is probably not difficult to guess that no matter how much a specialist works with your child, if the atmosphere in the family and at home does not change, it will be difficult to achieve a positive therapeutic effect in treatment. After all, the health of the baby, first and foremost, depends on you, the parents!

Your child will cope with their problems much faster if they feel your kind, calm and consistent attitude. The most important thing that parents of a child with attention deficit syndrome should do is to categorically exclude two extremes that interfere with the child's treatment. The first is the manifestation of hypertrophied pity, which in turn gives rise to permissiveness. The second is setting unfairly high demands on the child, which will be difficult for him to fulfill. Excessive punctuality of parents and their cruelty in punishments are also very harmful. It is worth remembering that any frequent change in the mood of adults has a much greater negative impact on a child suffering from attention deficit syndrome than on other children. Parents need to learn to cope with their emotions.

An individual approach to the treatment of hyperkinetic syndrome in children in particular for each case implies an individual scheme. And therefore, you do not need to rely on any one method in treatment, be sure to try to select with the help of an experienced specialist a whole range of measures and methods that will help your child cope with this disease. The most important thing is to contact a specialist in a timely manner. And do not despair, because hyperkinetic syndrome in children is very well treated and receives the most optimistic prognosis if it is diagnosed in a timely manner in children from 5 to 10 years old. Try not to miss such valuable time.

Forecast

Hyperkinetic syndrome is a disease that tends to progress over time. Unfortunately, there are currently no effective medications or appropriate surgical intervention technologies for its treatment. As a rule, due to physical and mental disorders, the patient finds himself in a position in which he is unable to care for himself and move independently. There may also be problems with the swallowing process, and dementia may progress. Based on this, at deep stages of the disease, patients usually need hospitalization and treatment in a psychiatric hospital.

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