Pour interpréter la sémioïque des troubles moteurs, il est nécessaire de connaître la hierarchie du contrôle du système moteur.

  • Rigidité.
  • Distorsion
  • Spasticité.
Pyramidalisme.
19955111 {19955111:EGBWNQFK} 1 Vancouver 50 défaut 4970 https://neuropediatoolkit.org/wp-content/plugins/zotpress/
%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22EGBWNQFK%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Sanger%20et%20al.%22%2C%22parsedDate%22%3A%222003-01-01%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BSanger%20TD%2C%20Delgado%20MR%2C%20Gaebler-Spira%20D%2C%20Hallett%20M%2C%20Mink%20JW.%20Classification%20and%20Definition%20of%20Disorders%20Causing%20Hypertonia%20in%20Childhood.%20PEDIATRICS%20%5BInternet%5D.%202003%20Jan%201%20%5Bcited%202016%20Jan%2021%5D%3B111%281%29%3Ae89%26%23x2013%3B97.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttp%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcgi%5C%2Fdoi%5C%2F10.1542%5C%2Fpeds.111.1.e89%26%23039%3B%26gt%3Bhttp%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcgi%5C%2Fdoi%5C%2F10.1542%5C%2Fpeds.111.1.e89%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Classification%20and%20Definition%20of%20Disorders%20Causing%20Hypertonia%20in%20Childhood%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22T.%20D.%22%2C%22lastName%22%3A%22Sanger%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22M.%20R.%22%2C%22lastName%22%3A%22Delgado%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22D.%22%2C%22lastName%22%3A%22Gaebler-Spira%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22M.%22%2C%22lastName%22%3A%22Hallett%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22J.%20W.%22%2C%22lastName%22%3A%22Mink%22%7D%5D%2C%22abstractNote%22%3A%22OBJECTIVE%3A%20This%20report%20describes%20the%20consensus%20outcome%20of%20an%20interdisciplinary%20workshop%20that%20was%20held%20at%20the%20National%20Institutes%20of%20Health%20in%20April%202001.%20The%20purpose%20of%20the%20workshop%20and%20this%20article%20are%20to%20define%20the%20terms%20%26quot%3Bspasticity%2C%26quot%3B%20%26quot%3Bdystonia%2C%26quot%3B%20and%20%26quot%3Brigidity%26quot%3B%20as%20they%20are%20used%20to%20describe%20clinical%20features%20of%20hypertonia%20in%20children.%20The%20definitions%20presented%20here%20are%20designed%20to%20allow%20differentiation%20of%20clinical%20features%20even%20when%20more%20than%201%20is%20present%20simultaneously.%20METHODS%3A%20A%20consensus%20agreement%20was%20obtained%20on%20the%20best%20current%20definitions%20and%20their%20application%20in%20clinical%20situations.%20RESULTS%3A%20%26quot%3BSpasticity%26quot%3B%20is%20defined%20as%20hypertonia%20in%20which%201%20or%20both%20of%20the%20following%20signs%20are%20present%3A%201%29%20resistance%20to%20externally%20imposed%20movement%20increases%20with%20increasing%20speed%20of%20stretch%20and%20varies%20with%20the%20direction%20of%20joint%20movement%2C%20and%5C%2For%202%29%20resistance%20to%20externally%20imposed%20movement%20rises%20rapidly%20above%20a%20threshold%20speed%20or%20joint%20angle.%20%26quot%3BDystonia%26quot%3B%20is%20defined%20as%20a%20movement%20disorder%20in%20which%20involuntary%20sustained%20or%20intermittent%20muscle%20contractions%20cause%20twisting%20and%20repetitive%20movements%2C%20abnormal%20postures%2C%20or%20both.%20%26quot%3BRigidity%26quot%3B%20is%20defined%20as%20hypertonia%20in%20which%20all%20of%20the%20following%20are%20true%3A%201%29%20the%20resistance%20to%20externally%20imposed%20joint%20movement%20is%20present%20at%20very%20low%20speeds%20of%20movement%2C%20does%20not%20depend%20on%20imposed%20speed%2C%20and%20does%20not%20exhibit%20a%20speed%20or%20angle%20threshold%3B%202%29%20simultaneous%20co-contraction%20of%20agonists%20and%20antagonists%20may%20occur%2C%20and%20this%20is%20reflected%20in%20an%20immediate%20resistance%20to%20a%20reversal%20of%20the%20direction%20of%20movement%20about%20a%20joint%3B%203%29%20the%20limb%20does%20not%20tend%20to%20return%20toward%20a%20particular%20fixed%20posture%20or%20extreme%20joint%20angle%3B%20and%204%29%20voluntary%20activity%20in%20distant%20muscle%20groups%20does%20not%20lead%20to%20involuntary%20movements%20about%20the%20rigid%20joints%2C%20although%20rigidity%20may%20worsen.%20CONCLUSION%3A%20We%20have%20provided%20a%20set%20of%20definitions%20for%20the%20purpose%20of%20identifying%20different%20components%20of%20childhood%20hypertonia.%20We%20encourage%20the%20development%20of%20clinical%20rating%20scales%20that%20are%20based%20on%20these%20definitions%2C%20and%20we%20encourage%20research%20to%20relate%20the%20degree%20of%20hypertonia%20to%20the%20degree%20of%20functional%20ability%2C%20change%20over%20time%2C%20and%20societal%20participation%20in%20children%20with%20motor%20disorders.%22%2C%22date%22%3A%222003-01-01%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1542%5C%2Fpeds.111.1.e89%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22http%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcgi%5C%2Fdoi%5C%2F10.1542%5C%2Fpeds.111.1.e89%22%2C%22PMID%22%3A%22%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%220031-4005%2C%201098-4275%22%2C%22language%22%3A%22en%22%2C%22collections%22%3A%5B%227L3LPGBN%22%2C%228FUWZNIP%22%2C%22KZ25FYRR%22%5D%2C%22dateModified%22%3A%222026-07-15T22%3A38%3A53Z%22%7D%7D%5D%7D
1.
Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW. Classification et définition des troubles provoquant une hypertonie chez l'enfant. PÉDIATRIE [Internet]. 1er janvier 2003 [cité le 21 janvier 2016];111(1):e89-97. Disponible à partir de : http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.111.1.e89
Technique d'exploration.

Pour évaluer une articulation hypertonique, le clinicien doit obtenir la description des parents concernant le tonus anormal et les mouvements involontaires, notamment si les mouvements se produisent pendant l'action ou au repos, et s'il existe des mouvements déclencheurs particuliers ou une spécificité de la tâche. Observez la posture au repos et la position des membres par rapport à la gravité. Observez l'enfant allongé, assis, marchant et courant, si possible. Si les plaintes incluent des performances ou des postures anormales en réponse à des activités ou des tâches spécifiques, l'enfant doit alors être observé pendant l'exécution de la tâche concernée. Toute posture anormalement fixe, tordue ou répétitive doit être notée ainsi que le degré de limitation fonctionnelle.

Les observations suivantes doivent être effectuées pour chaque joint à tester. Reconnaissant la contribution de l'anxiété au tonus, l'enfant doit être détendu autant que possible pendant l'examen et la partie du corps examinée doit être soutenue contre la gravité. La tête doit être maintenue sur la ligne médiane pour éviter les contributions au tonus du réflexe tonique du cou. De plus, en position couchée, la tête et le tronc doivent reposer confortablement.

  1. Palpatez les muscles pour déterminer si une contraction se produit à l'état reposant.
  2. Mesure la résistance au mouvement de la jointe affectée en position allongée, assise et debout, si possible, ainsi que lorsqu'elle est distraite.
  3. Mesurez l'amplitude de mouvement passive à des vitesses très lentes (3 secondes pour terminer le mouvement), intermédiaires (0,5 seconde pour terminer le mouvement) et rapides (aussi rapidement que possible). Notez la résistance au début du mouvement, la présence ou l’absence d’un « accrochage » se produisant quelque temps après le début du mouvement et l’angle de l’articulation auquel se produit l’accrochage.
  4. Effectuez un rétablissement soudain du sens de mouvement à des vitesses lentes, intermédiaires et rapides, et notez la présence ou l'absence d'une résistance accrue immédiatement après le rétablissement (suggérant une co-contraction) ou à certains moments après (suggérant une catch spasmodique), ainsi que toute dépendance de vitesse.
  5. Instruez l'enfant à déplacer le même joint de l'autre côté et à observer un mouvement involontaire, puis testez pour une modification de la résistance au mouvement lent et passif. Instruez l'enfant à déplacer un joint éloigné et non lié (par exemple, en ouvrant et fermant le poing) de l'autre côté et ensuite du même côté, et observez un mouvement involontaire ou une modification de la résistance au mouvement passif.
Symptômes moteurs déficitaires.
  • Débilité (insuffisance musculaire). Il est important de distinguer la faiblesse musculaire du débilité pyramidale.
  • Contrôle moteur réduit (incapacité d'activer un motif spécifique de muscles).
  • Ataxie (incapacité pour activer le motif correct de muscles pendant le mouvement).
  • Apraxie et dyspraxie du développement (inaptitude à activer le bon modèle musculaire pour réaliser une tâche, orientée sur les tâches).
19955111 {19955111:LYSX3CY6} 1 Vancouver 50 défaut 4970 https://neuropediatoolkit.org/wp-content/plugins/zotpress/
%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22LYSX3CY6%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Sanger%20et%20al.%22%2C%22parsedDate%22%3A%222006-11-01%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BSanger%20TD%2C%20Chen%20D%2C%20Delgado%20MR%2C%20Gaebler-Spira%20D%2C%20Hallett%20M%2C%20Mink%20JW%2C%20et%20al.%20Definition%20and%20Classification%20of%20Negative%20Motor%20Signs%20in%20Childhood.%20Pediatrics%20%5BInternet%5D.%202006%20Nov%201%20%5Bcited%202016%20Jan%2021%5D%3B118%285%29%3A2159%26%23x2013%3B67.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttp%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcontent%5C%2F118%5C%2F5%5C%2F2159%26%23039%3B%26gt%3Bhttp%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcontent%5C%2F118%5C%2F5%5C%2F2159%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Definition%20and%20Classification%20of%20Negative%20Motor%20Signs%20in%20Childhood%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Terence%20D.%22%2C%22lastName%22%3A%22Sanger%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Daofen%22%2C%22lastName%22%3A%22Chen%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mauricio%20R.%22%2C%22lastName%22%3A%22Delgado%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Deborah%22%2C%22lastName%22%3A%22Gaebler-Spira%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mark%22%2C%22lastName%22%3A%22Hallett%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Jonathan%20W.%22%2C%22lastName%22%3A%22Mink%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22the%20Taskforce%20on%20Childhood%20Motor%22%2C%22lastName%22%3A%22Disorders%22%7D%5D%2C%22abstractNote%22%3A%22In%20this%20report%20we%20describe%20the%20outcome%20of%20a%20consensus%20meeting%20that%20occurred%20at%20the%20National%20Institutes%20of%20Health%20in%20Bethesda%2C%20Maryland%2C%20March%2012%20through%2014%2C%202005.%20The%20meeting%20brought%20together%2039%20specialists%20from%20multiple%20clinical%20and%20research%20disciplines%20including%20developmental%20pediatrics%2C%20neurology%2C%20neurosurgery%2C%20orthopedic%20surgery%2C%20physical%20therapy%2C%20occupational%20therapy%2C%20physical%20medicine%20and%20rehabilitation%2C%20neurophysiology%2C%20muscle%20physiology%2C%20motor%20control%2C%20and%20biomechanics.%20The%20purpose%20of%20the%20meeting%20was%20to%20establish%20terminology%20and%20definitions%20for%204%20aspects%20of%20motor%20disorders%20that%20occur%20in%20children%3A%20weakness%2C%20reduced%20selective%20motor%20control%2C%20ataxia%2C%20and%20deficits%20of%20praxis.%20The%20purpose%20of%20the%20definitions%20is%20to%20assist%20communication%20between%20clinicians%2C%20select%20homogeneous%20groups%20of%20children%20for%20clinical%20research%20trials%2C%20facilitate%20the%20development%20of%20rating%20scales%20to%20assess%20improvement%20or%20deterioration%20with%20time%2C%20and%20eventually%20to%20better%20match%20individual%20children%20with%20specific%20therapies.%5Cn%5Cu201cWeakness%5Cu201d%20is%20defined%20as%20the%20inability%20to%20generate%20normal%20voluntary%20force%20in%20a%20muscle%20or%20normal%20voluntary%20torque%20about%20a%20joint.%20%5Cu201cReduced%20selective%20motor%20control%5Cu201d%20is%20defined%20as%20the%20impaired%20ability%20to%20isolate%20the%20activation%20of%20muscles%20in%20a%20selected%20pattern%20in%20response%20to%20demands%20of%20a%20voluntary%20posture%20or%20movement.%20%5Cu201cAtaxia%5Cu201d%20is%20defined%20as%20an%20inability%20to%20generate%20a%20normal%20or%20expected%20voluntary%20movement%20trajectory%20that%20cannot%20be%20attributed%20to%20weakness%20or%20involuntary%20muscle%20activity%20about%20the%20affected%20joints.%20%5Cu201cApraxia%5Cu201d%20is%20defined%20as%20an%20impairment%20in%20the%20ability%20to%20accomplish%20previously%20learned%20and%20performed%20complex%20motor%20actions%20that%20is%20not%20explained%20by%20ataxia%2C%20reduced%20selective%20motor%20control%2C%20weakness%2C%20or%20involuntary%20motor%20activity.%20%5Cu201cDevelopmental%20dyspraxia%5Cu201d%20is%20defined%20as%20a%20failure%20to%20have%20ever%20acquired%20the%20ability%20to%20perform%20age-appropriate%20complex%20motor%20actions%20that%20is%20not%20explained%20by%20the%20presence%20of%20inadequate%20demonstration%20or%20practice%2C%20ataxia%2C%20reduced%20selective%20motor%20control%2C%20weakness%2C%20or%20involuntary%20motor%20activity.%22%2C%22date%22%3A%222006%5C%2F11%5C%2F01%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1542%5C%2Fpeds.2005-3016%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22http%3A%5C%2F%5C%2Fpediatrics.aappublications.org%5C%2Fcontent%5C%2F118%5C%2F5%5C%2F2159%22%2C%22PMID%22%3A%2217079590%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%220031-4005%2C%201098-4275%22%2C%22language%22%3A%22en%22%2C%22collections%22%3A%5B%228FUWZNIP%22%2C%22KZ25FYRR%22%5D%2C%22dateModified%22%3A%222026-07-15T22%3A38%3A53Z%22%7D%7D%5D%7D
1.
Sanger TD, Chen D, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW et al. Définition et classification des signes moteurs négatifs dans l'enfance. Pédiatrie [Internet]. 1er novembre 2006 [cité le 21 janvier 2016];118(5):2159-67. Disponible à partir de : http://pediatrics.aappublications.org/content/118/5/2159
  • Distorsion
  • Corée.
  • Atétose
  • Myoclonus
  • Étincelle.
  • Éclats.
  • Stereotypes.
19955111 {19955111:3FZKVE28} 1 Vancouver 50 défaut 4970 https://neuropediatoolkit.org/wp-content/plugins/zotpress/
%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%223FZKVE28%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Sanger%20et%20al.%22%2C%22parsedDate%22%3A%222010-08-15%22%2C%22numChildren%22%3A2%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BSanger%20TD%2C%20Chen%20D%2C%20Fehlings%20DL%2C%20Hallett%20M%2C%20Lang%20AE%2C%20Mink%20JW%2C%20et%20al.%20DEFINITION%20AND%20CLASSIFICATION%20OF%20HYPERKINETIC%20MOVEMENTS%20IN%20CHILDHOOD.%20Mov%20Disord%20%5BInternet%5D.%202010%20Aug%2015%20%5Bcited%202015%20June%2015%5D%3B25%2811%29%3A1538%26%23x2013%3B49.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttp%3A%5C%2F%5C%2Fwww.ncbi.nlm.nih.gov%5C%2Fpmc%5C%2Farticles%5C%2FPMC2929378%5C%2F%26%23039%3B%26gt%3Bhttp%3A%5C%2F%5C%2Fwww.ncbi.nlm.nih.gov%5C%2Fpmc%5C%2Farticles%5C%2FPMC2929378%5C%2F%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22DEFINITION%20AND%20CLASSIFICATION%20OF%20HYPERKINETIC%20MOVEMENTS%20IN%20CHILDHOOD%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Terence%20D.%22%2C%22lastName%22%3A%22Sanger%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Daofen%22%2C%22lastName%22%3A%22Chen%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Darcy%20L.%22%2C%22lastName%22%3A%22Fehlings%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mark%22%2C%22lastName%22%3A%22Hallett%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Anthony%20E.%22%2C%22lastName%22%3A%22Lang%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Jonathan%20W.%22%2C%22lastName%22%3A%22Mink%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Harvey%22%2C%22lastName%22%3A%22Singer%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Katharine%22%2C%22lastName%22%3A%22Alter%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Hilla%22%2C%22lastName%22%3A%22Ben-Pazi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Erin%22%2C%22lastName%22%3A%22Butler%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Robert%22%2C%22lastName%22%3A%22Chen%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Abigail%22%2C%22lastName%22%3A%22Collins%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sudarshan%22%2C%22lastName%22%3A%22Dayanidhi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Hans%22%2C%22lastName%22%3A%22Forssberg%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Eileen%22%2C%22lastName%22%3A%22Fowler%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Donald%20L.%22%2C%22lastName%22%3A%22Gilbert%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sharon%20L.%22%2C%22lastName%22%3A%22Gorman%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mark%20E.%22%2C%22lastName%22%3A%22Gormley%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22H.%20A.%22%2C%22lastName%22%3A%22Jinnah%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Barbara%22%2C%22lastName%22%3A%22Kornblau%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kristin%22%2C%22lastName%22%3A%22Krosschell%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Rebecca%20K.%22%2C%22lastName%22%3A%22Lehman%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Colum%22%2C%22lastName%22%3A%22MacKinnon%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22C.%20J.%22%2C%22lastName%22%3A%22Malanga%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Ronit%22%2C%22lastName%22%3A%22Mesterman%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Margaret%20Barry%22%2C%22lastName%22%3A%22Michaels%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Toni%20S.%22%2C%22lastName%22%3A%22Pearson%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Jessica%22%2C%22lastName%22%3A%22Rose%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Barry%22%2C%22lastName%22%3A%22Russman%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Dagmar%22%2C%22lastName%22%3A%22Sternad%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kathy%22%2C%22lastName%22%3A%22Swoboda%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Francisco%22%2C%22lastName%22%3A%22Valero-Cuevas%22%7D%5D%2C%22abstractNote%22%3A%22Hyperkinetic%20movements%20are%20unwanted%20or%20excess%20movements%20that%20are%20frequently%20seen%20in%20children%20with%20neurologic%20disorders.%20They%20are%20an%20important%20clinical%20finding%20with%20significant%20implications%20for%20diagnosis%20and%20treatment.%20However%2C%20the%20lack%20of%20agreement%20on%20standard%20terminology%20and%20definitions%20interferes%20with%20clinical%20treatment%20and%20research.%20We%20describe%20definitions%20of%20dystonia%2C%20chorea%2C%20athetosis%2C%20myoclonus%2C%20tremor%2C%20tics%2C%20and%20stereotypies%20that%20arose%20from%20a%20consensus%20meeting%20in%20June%202008%20of%20specialists%20from%20different%20clinical%20and%20basic%20science%20fields.%20Dystonia%20is%20a%20movement%20disorder%20in%20which%20involuntary%20sustained%20or%20intermittent%20muscle%20contractions%20cause%20twisting%20and%20repetitive%20movements%2C%20abnormal%20postures%2C%20or%20both.%20Chorea%20is%20an%20ongoing%20random-appearing%20sequence%20of%20one%20or%20more%20discrete%20involuntary%20movements%20or%20movement%20fragments.%20Athetosis%20is%20a%20slow%2C%20continuous%2C%20involuntary%20writhing%20movement%20that%20prevents%20maintenance%20of%20a%20stable%20posture.%20Myoclonus%20is%20a%20sequence%20of%20repeated%2C%20often%20non-rhythmic%2C%20brief%20shock-like%20jerks%20due%20to%20sudden%20involuntary%20contraction%20or%20relaxation%20of%20one%20or%20more%20muscles.%20Tremor%20is%20a%20rhythmic%20back-and-forth%20or%20oscillating%20involuntary%20movement%20about%20a%20joint%20axis.%20Tics%20are%20repeated%2C%20individually%20recognizable%2C%20intermittent%20movements%20or%20movement%20fragments%20that%20are%20almost%20always%20briefly%20suppressible%20and%20are%20usually%20associated%20with%20awareness%20of%20an%20urge%20to%20perform%20the%20movement.%20Stereotypies%20are%20repetitive%2C%20simple%20movements%20that%20can%20be%20voluntarily%20suppressed.%20We%20provide%20recommended%20techniques%20for%20clinical%20examination%20and%20suggestions%20for%20differentiating%20between%20the%20different%20types%20of%20hyperkinetic%20movements%2C%20noting%20that%20there%20may%20be%20overlap%20between%20conditions.%20These%20definitions%20and%20the%20diagnostic%20recommendations%20are%20intended%20to%20be%20reliable%20and%20useful%20for%20clinical%20practice%2C%20communication%20between%20clinicians%20and%20researchers%2C%20and%20for%20the%20design%20of%20quantitative%20tests%20that%20will%20guide%20and%20assess%20the%20outcome%20of%20future%20clinical%20trials.%22%2C%22date%22%3A%222010-8-15%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1002%5C%2Fmds.23088%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22http%3A%5C%2F%5C%2Fwww.ncbi.nlm.nih.gov%5C%2Fpmc%5C%2Farticles%5C%2FPMC2929378%5C%2F%22%2C%22PMID%22%3A%2220589866%22%2C%22PMCID%22%3A%22PMC2929378%22%2C%22ISSN%22%3A%220885-3185%22%2C%22language%22%3A%22%22%2C%22collections%22%3A%5B%228FUWZNIP%22%2C%22KZ25FYRR%22%5D%2C%22dateModified%22%3A%222026-07-15T22%3A38%3A53Z%22%7D%7D%5D%7D
1.
Sanger TD, Chen D, Fehlings DL, Hallett M, Lang AE, Mink JW et al. DÉFINITION ET CLASSIFICATION DES MOUVEMENTS HYPERKINÉTIQUES CHEZ L'ENFANCE. Mouvement Disord [Internet]. 15 août 2010 [cité le 15 juin 2015];25(11):1538-49. Disponible à partir de : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929378/
Troubles hipocondriaques (parkinsonisme).
Subtype de ParkinsonismeDéfinition selon 4 axes

L'âge d'apparitiona

II. Caractéristiques cliniques

Troisième. Résultat

IV. Étologie
Parkinsonisme développementalI. L'infance ou l'enfance précoce

II. Hypotonie, hypokinésie, bradikinesie, désorganisation du développement postural, DDPG, tremblement à repos ou autres sauts oscillatoires grossiers, fluctuation périodique des symptômes, dysautonomie, OGC, persistance des modèles motrices fétus

Troisième. Résistance persistante aux médicaments dopaminergiques et/ou aux prédécesseurs des amines biogènes. Développement neurologique normal dans les sujets traités tôt, degrés variables d'ID avec ou sans MDs dans les sujets traités tardivement, progression non dégénérative chez les sujets non traités/tardivement traités

IV. Troubles neurotraumatisants primaires (ex. TH, SR, AADC, déficit de PTPS)
Parkinsonisme infantile et précoce dégénératifI. L'infance ou l'enfance précoce

II. Syndrome rigide-hypokinétique sévère, crises myoclino-multiples ou crampes oscillatoires grossières, dystonie, absence de développement postural, progression de la GDD, dysautonomie, OGC

Troisième. Réponse dramatique initiale aux médicaments dopaminergiques suivie d'une dégradation de la réponse dans le cas de la déficiance WARS2. Pas de traitement disponible pour la déficiance DAT. Le cours progressif est également documenté par une modification remarquable des images DaTSCAN.

IV. Troubles neurotransmetteurs primaires ou secondaires (ex. DAT, déficit de WARS2)
La parkinsonisme dans le contexte des troubles du développement neuronalI. Enfance à l'adolescence

II. Maladie neurodéveloppementale à onset précoce (GDD, ID), suivie par l'émergence de caractéristiques parkinsoniennes au fil du temps. L'épilepsie est souvent associée.

Troisième. Pas de progression claire au fil du temps. Des phases possibles de régression suivies d'une stabilisation.

IV. Troubles neurodéveloppementaux (ex. MECP2)
Les parkinsonismes dans le contexte des maladies neurologiques multisystémiquesI. Enfance à l'adolescence

II. Association avec des signes d'involvement cérébral multisystémique (spasticité, ataxie, myoclonus, dystonie, chorea, dégradation cognitive/dépression de la mémoire, épilepsie, etc.). Le phénotype peut être dominé par les autres caractéristiques associées au parkinsonisme.

Troisième. Progrès au fil du temps associé à des anomalies d'imagerie cérébrale spécifiques ou aux modifications métaboliques

IV. Maladies neurodégénératives ou neurométaboliques à impliquement multisystémique (voir Tableau 2, Tableau S1 pour une liste de conditions)
Parkinsonisme infantile et dystonie-parkinsonismeI. Enfance (rarement), adolescence

II. La parkinsonisme est la manifestation prédominante, principalement sous la forme de la parkinsonisme atypique, avec ou sans dystonie, myoclonus et déclin cognitif.

Troisième. La réponse au levodopam, le début des complications moteurs et la progression des signes parkinsoniens peuvent varier selon la condition génétique spécifique (par exemple, une bonne réponse au levodopam dans DNACJ6, SYNJ1, PINK1, pas de réponse dans PRKRA, ATP1A3; complications motrices précoce dans Parkin et PINK1; progression lente dans SYNJ1, progression rapide dans DNACJ6)

IV. Dystonie primaire ou gènes de la parkinsonisme mono-génétique (par exemple) PRKRA, ATP1A3, Parkin, PINK1, SYNJ1, DNAJC12, DNAJC6)
Parkinsonisme acquisI. L'infance à l'adolescence

II et III. Caractéristiques cliniques et variable de résultat selon l'origine

IV. Asphyxie, infections, maladies immunitaires, intoxications, médicaments, tumeurs, hipothyroïdie et pseudo-hypothyroïdie, hépatocéphalie (voir Tableau 3, Tableau S2)
19955111 {19955111:34LMYZKM} 1 Vancouver 50 défaut 4970 https://neuropediatoolkit.org/wp-content/plugins/zotpress/
%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%2234LMYZKM%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Leuzzi%20et%20al.%22%2C%22parsedDate%22%3A%222021-01-01%22%2C%22numChildren%22%3A2%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BLeuzzi%20V%2C%20Nardecchia%20F%2C%20Pons%20R%2C%20Galosi%20S.%20Parkinsonism%20in%20children%3A%20Clinical%20classification%20and%20etiological%20spectrum.%20Parkinsonism%20%26amp%3B%20Related%20Disorders%20%5BInternet%5D.%202021%20Jan%201%20%5Bcited%202023%20Mar%2014%5D%3B82%3A150%26%23x2013%3B7.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fwww.prd-journal.com%5C%2Farticle%5C%2FS1353-8020%2820%2930777-X%5C%2Ffulltext%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fwww.prd-journal.com%5C%2Farticle%5C%2FS1353-8020%2820%2930777-X%5C%2Ffulltext%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Parkinsonism%20in%20children%3A%20Clinical%20classification%20and%20etiological%20spectrum%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Vincenzo%22%2C%22lastName%22%3A%22Leuzzi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Francesca%22%2C%22lastName%22%3A%22Nardecchia%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Roser%22%2C%22lastName%22%3A%22Pons%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Serena%22%2C%22lastName%22%3A%22Galosi%22%7D%5D%2C%22abstractNote%22%3A%22Infantile-%20and%20childhood-onset%20parkinsonism%20is%20mainly%20due%20to%20genetic%20alterations%20and%20is%20an%20exceedingly%20rare%20condition%2C%20unlike%20Parkinson%26%23039%3Bs%20disease%20%28PD%29%2C%20which%20is%20one%20of%20the%20most%20common%20neurologic%20disorders%20in%20adulthood.%20The%20clinical%20characterization%20of%20parkinsonism%20during%20early%20stages%20of%20neuromotor%20development%20is%20controversial%20due%20to%20the%20lack%20of%20consensus%20regarding%20the%20clinical%20criteria%20of%20PD%20or%20parkinsonism%20in%20the%20immature%20brain.%20The%20classification%20here%20proposed%20is%20based%20on%20a%20review%20of%20conditions%20that%20emerge%20during%20infancy%20and%20childhood%2C%20with%20key%20symptoms%20evocative%20of%20adult%20parkinsonism.%20The%20proposed%20nosography%20is%20based%20on%20age%20at%20presentation%2C%20clinical%20features%2C%20outcome%2C%20and%20etiological%20background.%20It%20includes%20developmental%20parkinsonism%2C%20infantile%20degenerative%20parkinsonism%2C%20parkinsonism%20in%20the%20setting%20of%20neurodevelopmental%20disorders%2C%20parkinsonism%20in%20the%20setting%20of%20multisystem%20brain%20diseases%2C%20juvenile%20parkinsonism%20and%20dystonia-parkinsonism%2C%20and%20acquired%20parkinsonism.%20The%20subgroups%20denoting%20peculiar%20clinical%20presentations%20as%20a%20consequence%20of%20disease%20impact%20on%20the%20immature%20brain%20are%20developmental%20parkinsonism%20due%20to%20monoamine%20metabolic%20disorders%20and%20infantile%20degenerative%20parkinsonism%20caused%20by%20DAT%20and%20WASR2%20defects.%20More%20tardive%20parkinsonisms%20occur%20in%20genetic%20conditions%20that%20cause%20a%20generalized%20derangement%20of%20neurodevelopmental%20processes%2C%20such%20as%20those%20due%20to%20MECP2%2C%20NR4A2%2C%20SCN1A%2C%20and%20RAB39B.%20Some%20conditions%20presenting%20with%20neurodevelopmental%20disorder%20can%20progress%20later%2C%20disclosing%20their%20neurodegenerative%20nature%20%28i.e.%20WDR45%20and%20KCND3%29.%20Finally%2C%20new%20emerging%20conditions%20with%20childhood-onset%20parkinsonism%20arise%20from%20the%20cumulative%20effect%20of%20multiple%20genetic%20lesions.%22%2C%22date%22%3A%222021-01-01%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1016%5C%2Fj.parkreldis.2020.10.002%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22https%3A%5C%2F%5C%2Fwww.prd-journal.com%5C%2Farticle%5C%2FS1353-8020%2820%2930777-X%5C%2Ffulltext%22%2C%22PMID%22%3A%2233109474%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%221353-8020%2C%201873-5126%22%2C%22language%22%3A%22English%22%2C%22collections%22%3A%5B%228FUWZNIP%22%5D%2C%22dateModified%22%3A%222026-07-15T22%3A38%3A30Z%22%7D%7D%5D%7D
1.
Leuzzi V, Nardecchia F, Pons R, Galosi S. Parkinsonisme chez l'enfant : classification clinique et spectre étiologique. Parkinsonisme et troubles associés [Internet]. 1er janvier 2021 [cité le 14 mars 2023] ; 82 : 150–7. Disponible à partir de : https://www.prd-journal.com/article/S1353-8020(20)30777-X/fulltext