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Movement - uncoordinated

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Definition:

Uncoordinated movement is an abnormality of muscle control or an inability to finely coordinate movements, resulting in a jerky, unsteady, to-and-fro motion of the trunk or the limbs.

Alternative Names:

Lack of coordination; Loss of coordination; Incoordination and irregularity of voluntary movements; Coordination impairment; Ataxia; Clumsiness

Considerations:

Smooth graceful movement results from a fine balance between opposing muscle groups. This balance is coordinated by a portion of the brain called the cerebellum.

Diseases that damage the cerebellum, spinal cord, and peripheral nerves (connecting the cerebellum to the muscle groups) can interfere with the fine tuning of muscular movement and result in coarse, jerky, uncoordinated movement. This condition is called ataxia, and is easily seen in the jerky, to-and-fro motion of the trunk and unsteady gait (walking style).

Ataxia may appear as a congenital defect, or follow a simple viral infection such as chicken pox . It may also appear following encephalitis , head trauma , and diseases affecting the central nervous system or spinal cord. Appearance as a genetic disorder, or as a toxic reaction to drugs, medications, alcohol or environmental toxins is also possible.

Common Causes:

• Transient ischemic attack (TIA)
• Stroke
• Multiple sclerosis
• Vertebral abnormalities (such as compression fractures of the back )
• Poisoning by heavy metals such as mercury, thallium, and lead, or solvents such as toluene or carbon tetrachloride
• Alcohol or other drug intoxication
• Drugs such as aminoglutethimide, anticholinergics, phenytoin (in high doses), carbamazepine, phenobarbital and tricyclic antidepressants
• Paraneoplastic syndromes (ataxia may appear months or years before cancer is diagnosed -- an affected person produces antibodies against the neurons in the cerebellum)
• Post-infectious condition (typically following chickenpox)
• Hereditary condition (congenital cerebellar ataxia, Friedreich's ataxia , ataxia telangiectasia, Wilson's disease )

References:

Goetz, CG. Textbook of Clinical Neurology . 2nd ed. St. Louis, Mo: WB Saunders; 2003: 713-736.

Goldman L, Ausiello D. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: WB Saunders; 2004:2305-2306.

• Review Date: 3/5/2007
• Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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