open access

Vol 54, No 4 (2020)
Invited review article
Published online: 2020-07-24
Submitted: 2020-05-23
Accepted: 2020-07-16
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Stereotypies in adults: a systematic review

Tanvi Shukla, Sanjay Pandey
DOI: 10.5603/PJNNS.a2020.0058
·
Pubmed: 32706097
·
Neurol Neurochir Pol 2020;54(4):294-304.

open access

Vol 54, No 4 (2020)
Invited review article
Published online: 2020-07-24
Submitted: 2020-05-23
Accepted: 2020-07-16

Abstract

Stereotypies are abnormal involuntary non-goal-directed movement patterns or vocalisations which repeat continuously in the same fashion over a period of time and on multiple occasions and are typically distractible. Stereotypies are common in both children and adults, but they are extensively reviewed only in children. There are very few studies, mainly in the form of case reports and case series, focusing on stereotypies occurring in adults as part of different neurological disorders. In adults, stereotypies can be both physiological and pathological. Common physiological stereotypies in adults are leg shaking, face touching, playing with pens or hair, nail biting, hand tapping, foot tapping, and body rocking. Pathological stereotypies in adults are associated with a variety of neuropsychiatric conditions like neurodegenerative disorders, viral encephalitis, autoimmune encephalitis, stroke, psychiatric illness, and drug use. In this review, we focus on the various causes of stereotypic movements in adults, and their pathophysiology, clinical manifestations, and treatment.

Abstract

Stereotypies are abnormal involuntary non-goal-directed movement patterns or vocalisations which repeat continuously in the same fashion over a period of time and on multiple occasions and are typically distractible. Stereotypies are common in both children and adults, but they are extensively reviewed only in children. There are very few studies, mainly in the form of case reports and case series, focusing on stereotypies occurring in adults as part of different neurological disorders. In adults, stereotypies can be both physiological and pathological. Common physiological stereotypies in adults are leg shaking, face touching, playing with pens or hair, nail biting, hand tapping, foot tapping, and body rocking. Pathological stereotypies in adults are associated with a variety of neuropsychiatric conditions like neurodegenerative disorders, viral encephalitis, autoimmune encephalitis, stroke, psychiatric illness, and drug use. In this review, we focus on the various causes of stereotypic movements in adults, and their pathophysiology, clinical manifestations, and treatment.

Get Citation

Keywords

stereotypy, physiological, autoimmune encephalitis, drugs, psychiatry, stroke

About this article
Title

Stereotypies in adults: a systematic review

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 54, No 4 (2020)

Pages

294-304

Published online

2020-07-24

DOI

10.5603/PJNNS.a2020.0058

Pubmed

32706097

Bibliographic record

Neurol Neurochir Pol 2020;54(4):294-304.

Keywords

stereotypy
physiological
autoimmune encephalitis
drugs
psychiatry
stroke

Authors

Tanvi Shukla
Sanjay Pandey

References (83)
  1. Edwards MJ, Lang AE, Bhatia KP. Stereotypies: a critical appraisal and suggestion of a clinically useful definition. Mov Disord. 2012; 27(2): 179–185.
  2. Katherine M. Stereotypic Movement Disorders. Semin Pediatr Neurol. 2018; 25: 19–24.
  3. Singer HS. Motor stereotypies. Semin Pediatr Neurol. 2009; 16(2): 77–81.
  4. Maltête D. Adult-onset stereotypical motor behaviors. Rev Neurol (Paris). 2016; 172(8-9): 477–482.
  5. Muthugovindan D, Singer H. Motor stereotypy disorders. Curr Opin Neurol. 2009; 22(2): 131–136.
  6. Harris KM, Mahone EM, Singer HS. Nonautistic motor stereotypies: clinical features and longitudinal follow-up. Pediatr Neurol. 2008; 38(4): 267–272.
  7. Oakley C, Mahone EM, Morris-Berry C, et al. Primary complex motor stereotypies in older children and adolescents: clinical features and longitudinal follow-up. Pediatr Neurol. 2015; 52(4): 398–403.e1.
  8. Freeman RD, Soltanifar A, Baer S. Stereotypic movement disorder: easily missed. Dev Med Child Neurol. 2010; 52(8): 733–738.
  9. Jankovic J. Leg stereotypy disorder. J Neurol Neurosurg Psychiatry. 2016 Feb 1. ; 87(2): 220–1.
  10. Niehaus DJ, Emsley RA, Brink P, et al. Stereotypies: prevalence and association with compulsive and impulsive symptoms in college students. Psychopathology. 2000; 33(1): 31–35.
  11. Sarkhel S, Praharaj SK, Akhtar S. Cheek-biting disorder: another stereotypic movement disorder? J Anxiety Disord. 2011; 25(8): 1085–1086.
  12. Chisholm T, Morehouse RL. Adult headbanging: sleep studies and treatment. Sleep. 1996; 19(4): 343–346.
  13. Alves RS, Alóe F, Silva AB, et al. Jactatio capitis nocturna with persistence in adulthood. Case report. Arq Neuropsiquiatr. 1998; 56(3B): 655–657.
  14. Vijayakumar D, Jankovic J. Drug-Induced Dyskinesia, Part 2: Treatment of Tardive Dyskinesia. Drugs. 2016; 76(7): 779–787.
  15. Peña MS, Yaltho TC, Jankovic J. Tardive dyskinesia and other movement disorders secondary to aripiprazole. Mov Disord. 2011; 26(1): 147–152.
  16. Kaneko K, Yuasa T, Miyatake T, et al. Stereotyped hand clasping: an unusual tardive movement disorder. Mov Disord. 1993; 8(2): 230–231.
  17. Madruga-Garrido M, Mir P. Tics and other stereotyped movements as side effects of pharmacological treatment. Int Rev Neurobiol. 2013; 112: 481–494.
  18. Margolius A, Fernandez HH. Current treatment of tardive dyskinesia. Parkinsonism Relat Disord. 2019; 59: 155–160.
  19. Niemann N, Jankovic J. Treatment of Tardive Dyskinesia: A General Overview with Focus on the Vesicular Monoamine Transporter 2 Inhibitors. Drugs. 2018; 78(5): 525–541.
  20. Scorr LM, Factor SA. VMAT2 inhibitors for the treatment of tardive dyskinesia. J Neurol Sci. 2018; 389: 43–47.
  21. Pandey S, Shukla T. Stereotypy in Neuroleptic Malignant Syndrome. Movement Disorders Clinical Practice. 2019; 6(5): 411–412.
  22. Rylander G. Psychoses and the punding and choreiform syndromes in addiction to central stimulant drugs. Psychiatr Neurol Neurochir. 1972; 75(3): 203–212.
  23. Rusyniak DE. Neurologic manifestations of chronic methamphetamine abuse. Psychiatr Clin North Am. 2013; 36(2): 261–275.
  24. Fasano A, Petrovic I. Insights into pathophysiology of punding reveal possible treatment strategies. Mol Psychiatry. 2010; 15(6): 560–573.
  25. Fasano A, Barra A, Nicosia P, et al. Cocaine addiction: from habits to stereotypical-repetitive behaviors and punding. Drug Alcohol Depend. 2008; 96(1-2): 178–182.
  26. Spencer AH, Rickards H, Fasano A, et al. The prevalence and clinical characteristics of punding in Parkinson's disease. Mov Disord. 2011; 26(4): 578–586.
  27. Silveira-Moriyama L, Evans A, Katzenschlager R, et al. Punding and dyskinesias. Movement Disorders. 2006; 21(12): 2214–2217.
  28. Lawrence AJ, Blackwell AD, Barker RA, et al. Predictors of punding in Parkinson's disease: results from a questionnaire survey. Mov Disord. 2007; 22(16): 2339–2345.
  29. Vijayakumar D, Jankovic J. Drug-Induced Dyskinesia, Part 1: Treatment of Levodopa-Induced Dyskinesia. Drugs. 2016; 76(7): 759–777.
  30. Fan CC, Lin SKu, Huang MC. Disulfiram-induced punding. J Clin Psychopharmacol. 2008; 28(4): 473–474.
  31. Kornetsky C. Brain-stimulation reward, morphine-induced oral stereotypy, and sensitization: implications for abuse. Neurosci Biobehav Rev. 2004; 27(8): 777–786.
  32. Jacobsen LK, Chappell P, Woolston JL. Bupropion and compulsive behavior. J Am Acad Child Adolesc Psychiatry. 1994; 33(1): 143–144.
  33. Costall B, Naylor RJ. The involvement of dopaminergic systems with the stereotyped behaviour patterns induced by methylphenidate. J Pharm Pharmacol. 1974; 26(1): 30–33.
  34. Kulik AV, Wilbur R. Delirium and stereotypy from anticholinergic antiparkinson drugs. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 1982; 6(1): 75–82.
  35. Baizabal-Carvallo JF, Jankovic J. Functional (psychogenic) stereotypies. J Neurol. 2017; 264(7): 1482–1487.
  36. Luchins DJ, Goldman MB, Lieb M, et al. Repetitive behaviors in chronically institutionalized schizophrenic patients. Schizophr Res. 1992; 8(2): 119–123.
  37. Daniels JE, Wirth JB, Herrera DG, et al. Head banging on an inpatient psychiatric unit: a vicious circle. Harv Rev Psychiatry. 2007; 15(2): 70–79.
  38. Compton MT, Fantes F, Wan CR, et al. Abnormal movements in first-episode, nonaffective psychosis: dyskinesias, stereotypies, and catatonic-like signs. Psychiatry Res. 2015; 226(1): 192–197.
  39. Stein DJ, Grant JE, Franklin ME, et al. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V. Depress Anxiety. 2010; 27(6): 611–626.
  40. Odlaug BL, Grant JE. Clinical characteristics and medical complications of pathologic skin picking. Gen Hosp Psychiatry. 2008; 30(1): 61–66.
  41. Pertusa A, Fullana MA, Singh S, et al. Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? Am J Psychiatry. 2008; 165(10): 1289–1298.
  42. Sani G, Gualtieri I, Paolini M, et al. Drug Treatment of Trichotillomania (Hair-Pulling Disorder), Excoriation (Skin-picking) Disorder, and Nail-biting (Onychophagia). Curr Neuropharmacol. 2019; 17(8): 775–786.
  43. Pettorruso M, Di Nicola M, De Risio L, et al. Punding behavior in bipolar disorder type 1: case report. J Neuropsychiatry Clin Neurosci. 2014; 26(4): E8–E9.
  44. Seneviratne U, Reutens D, D'Souza W. Stereotypy of psychogenic nonepileptic seizures: insights from video-EEG monitoring. Epilepsia. 2010; 51(7): 1159–1168.
  45. Herskovitz M. Stereotypy of psychogenic nonepileptic seizures. Epilepsy Behav. 2017; 70(Pt A): 140–144.
  46. Cipriani G, Vedovello M, Ulivi M, et al. Repetitive and stereotypic phenomena and dementia. Am J Alzheimers Dis Other Demen. 2013; 28(3): 223–227.
  47. Ames D, Cummings JL, Wirshing WC, et al. Repetitive and compulsive behavior in frontal lobe degenerations. J Neuropsychiatry Clin Neurosci. 1994; 6(2): 100–113.
  48. Kobayashi R, Hayashi H, Tokairin T, et al. Suicide as a result of stereotypic behaviour in a case with semantic dementia. Psychogeriatrics. 2019; 19(1): 80–82.
  49. Hwang JP, Tsai SJ, Yang CH, et al. Repetitive phenomena in dementia. Int J Psychiatry Med. 2000; 30(2): 165–171.
  50. Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011; 134(Pt 9): 2456–2477.
  51. Prioni S, Fetoni V, Barocco F, et al. Stereotypic behaviors in degenerative dementias. J Neurol. 2012; 259(11): 2452–2459.
  52. Prioni S, Redaelli V, Soliveri P, et al. Stereotypic behaviours in frontotemporal dementia and progressive supranuclear palsy. Cortex. 2018; 109: 272–278.
  53. Cagnin A, Formentin C, Pompanin S, et al. Simple motor stereotypies are not specific features of behavioural frontotemporal dementia. J Neurol Neurosurg Psychiatry. 2014; 85(8): 945–946.
  54. Mateen FJ, Josephs KA. The clinical spectrum of stereotypies in frontotemporal lobar degeneration. Mov Disord. 2009; 24(8): 1237–1240.
  55. Nyatsanza S, Shetty T, Gregory C, et al. A study of stereotypic behaviours in Alzheimer's disease and frontal and temporal variant frontotemporal dementia. J Neurol Neurosurg Psychiatry. 2003; 74(10): 1398–1402.
  56. Josephs KA, Whitwell JL, Jack CR. Anatomic correlates of stereotypies in frontotemporal lobar degeneration. Neurobiol Aging. 2008; 29(12): 1859–1863.
  57. McMurtray AM, Chen AK, Shapira JS, et al. Variations in regional SPECT hypoperfusion and clinical features in frontotemporal dementia. Neurology. 2006; 66(4): 517–522.
  58. Ondo WG. Tetrabenazine treatment for stereotypies and tics associated with dementia. J Neuropsychiatry Clin Neurosci. 2012; 24(2): 208–214.
  59. Defebvre L, Krystkowiak P. Movement disorders and stroke. Rev Neurol (Paris). 2016; 172(8-9): 483–487.
  60. Mehanna R, Jankovic J, Mehanna R, et al. Movement disorders in cerebrovascular disease. Lancet Neurol. 2013; 12(6): 597–608.
  61. Ghika-Schmid F, Ghika J, Regli F, et al. Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry. J Neurol Sci. 1997; 146(2): 109–116.
  62. Alarcón F, Zijlmans JCM, Dueñas G, et al. Post-stroke movement disorders: report of 56 patients. J Neurol Neurosurg Psychiatry. 2004; 75(11): 1568–1574.
  63. Pandey S, Sarma N. Stereotypy After Acute Thalamic Infarct. JAMA Neurol. 2015; 72(9): 1068.
  64. Maraganore DM, Lees AJ, Marsden CD. Complex stereotypies after right putaminal infarction: a case report. Mov Disord. 1991; 6(4): 358–361.
  65. Lee D, Lee D, Ahn TB. Stereotypy after cerebellar infarction. J Neurol Sci. 2014; 344(1-2): 227–228.
  66. Inatomi Y, Nakajima M, Yonehara T, et al. Ipsilateral Tremor-Like Grasp Reaction in a Patient With Ischemic Stroke. Cogn Behav Neurol. 2017; 30(1): 37–41.
  67. Nguyen FN, Pauly RR, Okun MS, et al. Punding as a complication of brain stem stroke?: report of a case. Stroke. 2007; 38(4): 1390–1392.
  68. Yasuda Y, Akiguchi I, Ino M, et al. Paramedian thalamic and midbrain infarcts associated with palilalia. J Neurol Neurosurg Psychiatry. 1990; 53(9): 797–799.
  69. Duffey P, Jenkins N, King D. Palatal tremor and orofacial stereotypies within the locked-in syndrome. Mov Disord. 2007; 22(4): 593–595.
  70. McGrath CM, Kennedy RE, Hoye W, et al. Stereotypic movement disorder after acquired brain injury. Brain Inj. 2002; 16(5): 447–451.
  71. Mohammad SS, Fung VSC, Grattan-Smith P, et al. Movement disorders in children with anti-NMDAR encephalitis and other autoimmune encephalopathies. Mov Disord. 2014; 29(12): 1539–1542.
  72. Granata T, Matricardi S, Ragona F, et al. Pediatric NMDAR encephalitis: A single center observation study with a closer look at movement disorders. Eur J Paediatr Neurol. 2018; 22(2): 301–307.
  73. Dash D, Ihtisham K, Tripathi M, et al. Proportion and spectrum of movement disorders in adolescent and adult patients of autoimmune encephalitis of non-neoplastic aetiology. J Clin Neurosci. 2019; 59: 185–189.
  74. Baizabal-Carvallo JF, Stocco A, Muscal E, et al. The spectrum of movement disorders in children with anti-NMDA receptor encephalitis. Mov Disord. 2013; 28(4): 543–547.
  75. Edwards MJ, Dale RC, Church AJ, et al. Adult-onset tic disorder, motor stereotypies, and behavioural disturbance associated with antibasal ganglia antibodies. Mov Disord. 2004; 19(10): 1190–1196.
  76. Baizabal-Carvallo JF, Jankovic J. Autoimmune and paraneoplastic movement disorders: An update. J Neurol Sci. 2018; 385: 175–184.
  77. Twardowschy CA, De Paola L, Teive HAG, et al. Stereotypies after herpetic encephalitis with bitemporal lesions. Mov Disord. 2010; 25(16): 2888–2889.
  78. Dale RC, Webster R, Gill D. Contemporary encephalitis lethargica presenting with agitated catatonia, stereotypy, and dystonia-parkinsonism. Mov Disord. 2007; 22(15): 2281–2284.
  79. Picard F, de Sa, Salmon E, et al. Postencephalitic stereotyped involuntary movements responsive to L‐Dopa. Movement disorders: official journal of the Movement Disorder Society. 1996 Sep. ; 11(5): 567–70.
  80. Jankovic J, Gelineau-Kattner R, Davidson A. Tourette's syndrome in adults. Mov Disord. 2010; 25(13): 2171–2175.
  81. Szejko N, Jakubczyk A, Dunalska A, et al. Dystonic tics in patients with Gilles de la Tourette syndrome. Neurol Neurochir Pol. 2019; 53(5): 335–340.
  82. Szejko N, Jakubczyk A, Janik P. Prevalence and Clinical Correlates of Self-Harm Behaviors in Gilles de la Tourette Syndrome. Front Psychiatry. 2019; 10: 638.
  83. Janik P, Szejko N. Aripiprazole in treatment of Gilles de la Tourette syndrome - New therapeutic option. Neurol Neurochir Pol. 2018; 52(1): 84–87.

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