Mini Review
Volume 10 Issue 17 - 2021
Pediatric Dyskinesias: Need for a Careful Approach of Inclusive Exclusions
Arumugam Subramanian Senthilkumar*
Senior Assistant Professor, Diagnostic Neuropsychiatry Unit, Department of Psychiatry, Government Ariyalur Medical College, The Tamil Nadu Dr. MGR Medical University, India
*Corresponding Author: Arumugam Subramanian Senthilkumar, Senior Assistant Professor, Diagnostic Neuropsychiatry Unit, Department of Psychiatry, Government Ariyalur Medical College, The Tamil Nadu Dr. MGR Medical University, India.
Received: April 14, 2021; Published: November 19, 2021




Abstract

Movement disorders in children need fast and elaborate evaluation to not to miss any of the rare, variegated and usually eponymous diagnoses, ranging from basal ganglia lesions proper, DRD2 genetic disorders, Lance-Adams syndrome, traipsing focal dystonias in facial muscle groups - similar to the Edgar alien (of MIB, the film), and the neck and truncal (opisthotonus to Pisa) dystonias, to myoclonic seizures. Amelioration of the distress improves the quality of life of the children and caregivers. Dyskinesias as side effects of antipsychotics and psychogenic presentations are more common than organic causes. Ambiguous responses from the child pose us difficulty in differentiating from stereotypical movements, more so if accompanied by intellectual difficulty. An inclusive approach to the diagnosis of pediatric dyskinesias, starting from ruling out the commoner causes like infections, inflammation (central or musculoskeletal), toxins and electrolyte imbalance. History of fever, behavioral disturbances especially self-mutilation, drug intake, family history of genetic disorders, previous intensive care admissions, comorbid psychiatric conditions including mood disorders and OCD, intellectual disability, and interpersonal conflicts form important cues in clinching the primary diagnosis. A probable high incidence of suicidal ideation in dyskinesia syndromes is a worrisome observation. Early diagnosis and treatment of dyskinesia should improve functional capacity and self-esteem. Emphasis on routine genetic screening, neuro-imaging studies, EEG, assessment of suicidal risk, and managing to minimize the patient’s physical and psychological disabilities with appropriate drugs beginning at the earliest, monitoring, support and psychosocial rehabilitation, ensures a favourable outcome.

Keywords: Pediatric Dyskinesias; Movement Disorders; DRD2 Genetic Disorders; Lance-Adams Syndrome

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Citation: Arumugam Subramanian Senthilkumar. “Pediatric Dyskinesias: Need for a Careful Approach of Inclusive Exclusions”. EC Paediatrics 10.12 (2021): 45-50.

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