Definition and classification of hyperkinetic movements in childhood

Terence D. Sanger, Daofen Chen, Darcy L. Fehlings, Mark Hallett, Anthony E. Lang, Jonathan W. Mink, Harvey S. Singer, Katharine Alter, Hilla Ben-Pazi, Erin E. Butler, Robert Chen, Abigail Collins, Sudarshan Dayanidhi, Hans Forssberg, Eileen Fowler, Donald L. Gilbert, Sharon L. Gorman, Mark E. Gormley, H. A. Jinnah, Barbara KornblauKristin J. Krosschell, Rebecca K. Lehman, Colum MacKinnon, C. J. Malanga, Ronit Mesterman, Margaret Barry Michaels, Toni S. Pearson, Jessica Rose, Barry S. Russman, Dagmar Sternad, Kathy J. Swoboda, Francisco Valero-Cuevas

Research output: Contribution to journalReview articlepeer-review

330 Scopus citations


Hyperkinetic movements are unwanted or excess movements that are frequently seen in children with neurologic disorders. They are an important clinical finding with significant implications for diagnosis and treatment. However, the lack of agreement on standard terminology and definitions interferes with clinical treatment and research. We describe definitions of dystonia, chorea, athetosis, myoclonus, tremor, tics, and stereotypies that arose from a consensus meeting in June 2008 of specialists from different clinical and basic science fields. Dystonia is a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. Chorea is an ongoing random-appearing sequence of one or more discrete involuntary movements or movement fragments. Athetosis is a slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture. Myoclonus is a sequence of repeated, often nonrhythmic, brief shock-like jerks due to sudden involuntary contraction or relaxation of one or more muscles. Tremor is a rhythmic back-and-forth or oscillating involuntary movement about a joint axis. Tics are repeated, individually recognizable, intermittent movements or movement fragments that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement. Stereotypies are repetitive, simple movements that can be voluntarily suppressed. We provide recommended techniques for clinical examination and suggestions for differentiating between the different types of hyperkinetic movements, noting that there may be overlap between conditions. These definitions and the diagnostic recommendations are intended to be reliable and useful for clinical practice, communication between clinicians and researchers, and for the design of quantitative tests that will guide and assess the outcome of future clinical trials.

Original languageEnglish (US)
Pages (from-to)1538-1549
Number of pages12
JournalMovement Disorders
Issue number11
StatePublished - Aug 15 2010


  • Athetosis
  • Chorea
  • Dystonia
  • Hyperkinetic
  • Pediatric


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