Hyperkinesia: Definition, Classification and Diagnosis

It refers to an increase in muscle activity that can cause excessive abnormal movements, excessive regular movements, or both.

Hyperkinesia is a state of excessive restlessness that occurs in various disorders that affect the ability to control motor movement, such as Huntington’s disease.

It is the opposite of hypokinesia, which refers to decreased body movement, as commonly manifested in Parkinson’s disease.

Many hyperkinetic movements are the result of inadequate regulation of the circuits of the thalamocortical basal ganglia.

The hyperactivity of a direct pathway combined with decreased activity of the indirect pathway results in the activation of thalamic neurons and the excitation of cortical neurons, which increases motor power.

Often, hyperkinesia is combined with hypotonia, a decrease in muscle tone.

Many hyperkinetic disorders are psychological and are typically prominent in childhood.


Depending on the specific type of hyperkinetic movement, there are different treatment options available to minimize symptoms, including other medical and surgical therapies.


The basic hyperkinetic movements can be defined as any unwanted excessive movement. These abnormal movements can be distinguished from each other depending on whether or not they are, or to what degree they are, rhythmic, discrete, repeated, and random.

When evaluating the individual with a suspected form of hyperkinesia, the physician will record a comprehensive medical history that includes a clear description of the movements in question, medications prescribed in the past and present, family history of similar diseases, and medical history, including past infections.

Also, any previous exposure to toxic chemicals.

Hyperkinesia is a defining characteristic of many childhood movement disorders, although it differs clearly from hypertonia and negative signs, which are also often involved.

Several prominent forms of hyperkinetic movements include:


Ataxia refers to a group of progressive neurological diseases that alter coordination and balance.


Athetosis is a slow, continuous, and involuntary twisting movement that prevents the individual from maintaining a stable posture.


Chorea is a continuous sequence of random appearances of one or more discrete involuntary movements or fragments of movement.


Dystonia is a movement disorder in which involuntarily sustained or intermittent muscle contractions are caused by twisted or repetitive movements, abnormal postures, or both.


Typically caused by damage to the nucleus or subthalamic nuclei, the movements of hemiballism are non-rhythmic, rapid, non-suppressible, and violent. They usually occur in an isolated part of the body, such as the proximal arm.

Hemifacial spasm:

Hemifacial spasm (HFS) is characterized by involuntary contraction of the facial muscles, which usually occurs only on one side of the face.


Myoclonus is a sequence of repetitive jerks, often non-rhythmic, brief, and beating-like, due to sudden involuntary contraction or relaxation of one or more muscles.


Stereotypes are repetitive, rhythmic, and simple movements that can be voluntarily suppressed. Like tremors, they are usually back and forth movements, and most commonly, they occur bilaterally.

Late dyskinesia / late dystonia:

Tardive dyskinesia or late dystonia, referred to as TD, refers to a wide variety of stereotypical involuntary movements caused by prolonged use of dopamine receptor blocking agents.


A tic can be defined as a repeated movement, individually recognizable, intermittent, or fragments of action that are almost always briefly suppressible and are generally associated with the awareness of the urgency to perform the movement.


A tremor can be defined as an involuntary rhythmic movement, forward and backward or oscillating around an articulation axis.

Volatile Hiperquinesia:

Volitional hyperkinesia refers to any involuntary movement described above that interrupts voluntary, intentional muscle movement.

These movements tend to be jerks that occur suddenly during a coordinated action without skeletal muscle problems.


Diseases that present one or more hyperkinetic movements as prominent symptoms include:

Huntington’s disease:

Hyperkinesia, more specifically chorea, is the characteristic symptom of Huntington’s disease, formerly known as Huntington’s chorea.

Hyperkinesis exhibited in the disease can vary from just the little finger to the whole body, resembling intentional involuntary movements.

In children, stiffness and seizures are also symptoms.

Other hyperkinetic symptoms include:

  • Turn the head to change the position of the eye.
  • Facial movements, including grimaces.
  • Slow and uncontrollable movements.
  • Rapid, sudden, and sometimes wild erratic movements of the arms, legs, face, and other body parts.
  • Unstable march.
  • Abnormal reflexes

Wilson’s disease:

Wilson’s disease (WD) is a rare inherited disorder in which patients have a problem metabolizing copper. In patients with WD, copper accumulates in the liver and other body parts, especially the brain, eyes, and kidneys.

After accumulation in the brain, patients may experience speech problems, incoordination, swallowing problems, and prominent hyperkinetic symptoms, including tremors, dystonia, and walking difficulties.

Also standard are psychiatric disorders such as irritability, impulsivity, aggression, and mood alterations.

Uneasy leg syndrome:

Restless legs syndrome is a disorder in which patients feel unpleasant sensations in their legs.

These sensations usually occur at night while the patient is sitting or lying down and relaxed.

Patients feel that they have to move their legs to relieve the sensations, and walking usually causes the symptoms to disappear.

In many patients, this can cause insomnia and excessive daytime sleepiness. This is a widespread problem and can occur at any age.

Repercussions after stroke:

Many movement disorders have been observed after an ischemic or hemorrhagic stroke.

Examples include athetosis, chorea with or without hemiballism, tremor, dystonia, and segmental or focal myoclonus. However, the prevalence of these manifestations after the stroke is relatively low.

The amount of time that elapses between the event of the stroke and the presentation of hyperkinesia depends on the type of hyperkinetic movement since their pathologies differ slightly.

Atrophy Dentatorubral-pallidoluysian:

DRPLA is a rare disorder of trinucleotide recurrence (polyglutamine disease) that may be juvenile-onset, early onset in the young adult, or late-onset in the adult.