What is Dysdiadochokinesia?
Dysdiadochokinesia, sometimes shortened to diadochokinesia, refers to a person’s inability to carry out quick, alternating muscle movements. These movements can simultaneously include the repeated turning of the wrist from palm up to palm down, fast finger tapping, opening and closing fists, and tapping the foot. Medical professionals typically check for this condition when they think a patient might have a disease related to the cerebellum, which is the part of the brain that controls coordination and balance.
The inability to do these quick movements is also related to various lifetime measures of disability. It’s a type of disorder called ataxia, which causes coordinated movement and speech to get worse. Health professionals often use something called the Alternate Motion Rate (AMR) to measure this. For example, they can measure how quickly a person can repeat a syllable within a certain time frame (usually less than a minute) to assess speech AMR.
What Causes Dysdiadochokinesia?
Dysdiadochokinesia, a condition that affects your ability to perform rapid, alternating movements, is often a result of problems with the part of your brain called the cerebellum. There are numerous causes of cerebellar dysfunction that could lead to dysdiadochokinesia. These include:
– Blood flow issues in the brain, like a stroke or bleed.
– Certain drugs or medications, such as sleeping pills or drugs for anxiety.
– Exposure to harmful substances, like alcohol abuse, illegal drug use, or certain toxins.
– Metabolic health problems like celiac disease, or Hashimoto’s disease, an autoimmune condition that affects the thyroid.
– Lack of certain vitamins such as B, E, or thiamine.
– Hereditary diseases like Friedrich ataxia or spinocerebellar muscle wasting.
– Structural brain issues that cause fluid build-up or brain herniation, like a brain tumor.
– Physical trauma to the brain.
– Brain infections like Lyme disease, inflammation of the cerebellum, or brain abscesses.
– Conditions that cause brain inflammation, like multiple sclerosis.
– Progressive brain conditions, like Huntington or Parkinson’s disease.
– Mental health disorders, such as schizophrenia.
Risk Factors and Frequency for Dysdiadochokinesia
Dysdiadochokinesia is an important term used to describe a problem with coordination that often points to issues with a part of the brain known as the cerebellum. This problem should usually be looked for in patients who are showing signs of difficulties with speech and movement. While it can show up even in healthy cerebellum, there’s no established data on how commonly it tends to appear.
Interestingly, research has shown that as people age, their ability to rapidly tap, a test for dysdiadochokinesia, tends to decline. Also, men have been found to perform faster than women on this tapping test.
- Dysdiadochokinesia can also be found in young children, even if they don’t have other signs of neurological problems or intellectual disabilities.
- When tested, it was seen in 8% to 20% of kids under the age of 13.
- This condition seems to peak in the 7 to 8-year age bracket.
- These occurrences in children might be due to their brains still being in the process of development – specifically, the connections between the cortex and the cerebellum might not be fully formed yet.
Signs and Symptoms of Dysdiadochokinesia
Dysdiadochokinesia is a symptom of a dysfunctional cerebellum – the part of your brain that controls coordination and regulation of muscle activity. However, there are other signs that can help pinpoint cerebellar dysfunction.
The dysfunction often impacts the smooth operation of your alternating movements and walking. This could affect both your arms and legs. It could even impact the muscles that operate your voice box leading to speech problems. Other signs include stiffness, slow movements, issues with speech and swallowing, abnormal sensations, or tremors. Even your eyes are not left out. Issues with the alignment, stability, and precision of your eye movements could be a telltale sign of cerebellar dysfunction.
During a check-up, your doctor may look for the following additional signs to confirm cerebellar dysfunction:
- Problems with mental functions such as visual-spatial procedural memory, language, and mood regulation
- Articulation and planning of speech, verbal fluency, finding the right word, grammar, reading, and writing might be affected
- Issues with eye movements such as misalignment, uncontrolled eye movements, issues with tracking moving objects, and issues with eye movements when your head moves
- Problems with orderly and articulate speech
Your doctor might also look for signs such as slowed or clumsy hand rotation movements, difficulty in performing tasks like turning a doorknob or changing a lightbulb, issues with tapping your foot or abdomen, deviation in reaching straight to a target, decreased muscle tone, tremors when reaching for an object, issues grasping objects, and unsteady walk.
Testing for Dysdiadochokinesia
What tests are needed to find the cause of your symptoms depends on what those symptoms might be indicating. Here are the different types of tests for different potential problems:
- Vascular: If your symptoms suggest a blood vessel problem, tests might include checking your diabetes and cholesterol status, a basic CT scan of your head, or more detailed scans of specific blood vessels. Other types of scans might also be appropriate.
- Trauma: If you’ve had a head injury, a head CT scan can check for things like swelling in the brain or serious problems like the brain pushing into areas where it shouldn’t be.
- Metabolic: Test to check for metabolic diseases can include a complete blood panel to test for things like kidney and liver function and blood sugar levels, as well as specific tests for thyroid disease.
- Malnutrition: If your symptoms might be caused by not getting enough nutrients, tests for specific vitamin deficiencies may be ordered.
- Toxic: Tests for toxins in your system could include checks for prescription drugs, bacteria-produced toxins or illegal drugs in your blood and urine.
- Hereditary: If the cause of your symptoms might be a genetic disease that runs in families, your doctor will carefully review your personal health history and your family health history. Once they’ve done this review, you may be referred for genetics counseling and tests, which could include various methods of examining your DNA, RNA, and chromosomes.
- Neuroinflammatory or Autoimmune: If an autoimmune disease or inflammation in your nervous system could be causing your symptoms, a type of test called a lumbar puncture might be done. The fluid withdrawn during this procedure can be tested for glucose and protein levels, cell counts, and specific immune system components.
- Neuroinfectious: If an infection in your nervous system might be causing your symptoms, a lumbar puncture combined with laboratory tests can help diagnose the condition. The tests can check for signs of inflammation in the brain and spinal cord, sexually transmitted diseases, herpes, chickenpox, fungus, and other infections.
- Psychogenic: If a mental health condition might be causing your physical symptoms, a psychiatric evaluation might be useful. This can identify disorders in which stress or mental factors cause physical symptoms.
- Neurodegenerative: If your symptoms might be caused by a disease that causes progressive damage to your nervous system, a detailed assessment of your mental and neurological health might be done. This would document changes in your behavior, movement, and thinking abilities. Genetic testing may also be considered if the cause could be an inherited genetic disease.
Treatment Options for Dysdiadochokinesia
Conditions like dysdiadochokinesia and cerebellar ataxia can be hard to manage and it’s important that the root causes are properly addressed. Patients can benefit greatly from physical, speech and occupational therapy. Therapies like strength training, balance exercises, treadmill workouts, cycling, and special exercises known as Romberg exercises can help. These can enhance the function and quality of life of patients with damage to the cerebellum, an area of the brain. It might also be important to assess safety in the home and use medical equipment that is designed to last, to prevent accidental falls.
What else can Dysdiadochokinesia be?
When trying to understand certain health conditions, it’s helpful to consider that they can be caused by or associated with a variety of factors. Here are some related terms and their general meanings:
- Ataxic dysarthria: a type of speech disorder caused by muscle weakness.
- Dysarthria: another term for general speech issues often linked to muscle weakness or control.
- Friedreich ataxia: a genetic, nervous system disorder causing muscle weakness.
- Lesions to either the frontal lobe or cerebellar hemispheres or both: refers to damage in different parts of the brain, which could affect various functions including movement, personality, behavior and cognitive skills.
- Multiple sclerosis: a chronic illness where the immune system mistakenly attacks the protective covering of nerve fibers in the central nervous system.
- Mutation in SLC18A2, which encodes vesicular monoamine transporter 2: this phrase refers to a specific genetic mutation that could play a role in certain medical conditions.
These terms are often used in the medical field, and understanding them can help make conversations about health conditions more clear.
What to expect with Dysdiadochokinesia
The outcome of slowed alternating movements can vary, depending on their cause. For example, if caused by sudden trauma, blood vessel issues, or rapidly advancing inherited ataxias, the outlook might be worse for older patients with several medical conditions. However, if the cause is an infection, inflammation, or metabolism-related, the outlook can be better. These conditions could have improved outcomes if they are identified and treated promptly and vigorously.
Possible Complications When Diagnosed with Dysdiadochokinesia
Dysdiadochokinesia is a sign of issues with the cerebellum, the part of the brain that plays a vital role in motor control. Basically, it doesn’t necessarily cause any complications on its own since it’s just an indication of a larger problem. That said, issues with the cerebellum can lead to various problems.
These can include things like frequent falling, problems with speech and swallowing, and issues with coordination. If someone needs surgery on their cerebellum, there may be additional complications such as bleeding, swelling, or an abnormal accumulation of cerebrospinal fluid within the brain known as hydrocephalus.
The area at the base of the skull where the cerebellum sits is pretty small, so any issues there like hydrocephalus or pressure on the brainstem are a big deal. They need to be treated as soon as possible. If not, the pressure could cause permanent damage to the brainstem, leading to a coma or even death.
Summary of possible complications:
- Frequent falls
- Speech problems
- Swallowing difficulties
- Coordination issues
- Bleeding or swelling from surgery
- Hydrocephalus
- Damage to the brainstem
- Coma or death in severe cases
Preventing Dysdiadochokinesia
If someone has problems with something called cerebellar function, they might notice certain changes in their daily activities. If you suddenly find it hard to coordinate your hand or foot movements, it’s a good idea to go see a doctor. Quite a bit of the time, you can’t really avoid these problems related to the cerebellum. However, if you have high blood pressure, high cholesterol, or high blood triglycerides that aren’t being treated or kept under control, it is important that you receive medical attention and work on managing these conditions. This is because they increase your chances of having a specific type of artery disease and strokes.
You might notice these issues, which are clinical symptoms of cerebellar dysfunction:
- Problems with coordinating movements
- Difficulties with the muscles that help you talk
- Troubles with the muscles that move your eyes
- Challenges with decision-making, including issues with memory, puzzle-solving, and mood
