Acceleration of movements (tachykinesia) is observed in hyperactivity syndrome, bipolar disorder, delirious disorder, schizophrenia and neuroleptic syndrome. Accompanied by impatience and restlessness, which decrease against the background of physical activity. To determine the cause of the symptom, the patient is interviewed, they talk with relatives, study the anamnesis of life and disease, and according to indications, instrumental and laboratory tests are prescribed. Treatment is neuroleptics, benzodiazepines, other drugs, psychotherapy, sometimes ECT.
Acceleration of movements is manifested by an increase in speed and the number of motor acts: fidgeting, constant changes in body position, scratching, twitching, etc. The reason that encourages patients to such behavior is a feeling of internal restlessness. The symptom is caused by a lesion of the extrapyramidal system, it is not hyperkinesis. Often there is a combination with pathologically fast speech, replete with repetitions, hesitations, repetitions, swallowing letters and syllables.
In the prepubertal period, the most common cause of tachykinesia is ADHD, which occurs in 4-18% of the total number of children. In half of the patients, the pathology persists into adulthood. A combination of hyperactivity and impaired attention is characteristic, the predominance of hyperactivity is less common. Patients are restless, inattentive, impulsive, cannot sit still, move, talk, get up, walk even during lessons. The acceleration of movements is often combined with tics and stereotypes.
In bipolar affective disorder, the acceleration of movements develops in the manic phase. With hypomania, there is an increase in motor activity, talkativeness, energy, absent-mindedness. With moderate mania, the symptoms are more noticeable, sharp mood swings, the disappearance of the need for sleep, and ideas of greatness are determined. In severe cases, tachykinesia turns into psychomotor agitation, delirium and hallucinations are detected.
Delirium is characterized by disturbances of emotions and behavior with a partial loss of the ability to orientate in place and time. The acceleration of movements appears even at the stage of the prodrome, complemented by irritability, insomnia, nightmares, loss of appetite. Disorders of consciousness gradually increase, especially in the evening and at night. Illusions and hallucinations arise. Delusions of relationship or persecution develop. In the emotional sphere, fear predominates, it is possible to harm others in an attempt to "protect" from the threat. The cause of delirium is:
In addition, signs of delirium can be observed after major operations, especially in the case of hypoxia in the preoperative period.
Minor paroxysmal tachykinesia is detected even in the premorbid period of schizophrenia, complemented by dysphoria, sharpening of certain character traits, and a tendency to social isolation. At the stage of the prodrome, the periodic acceleration of movements increases and occurs against the background of developing psychotic disorders. At the stage of developed psychosis, it can reach the degree of catatonic arousal. Delusions, hallucinations, violations of thinking and speech are found.
Acceleration of movements is a typical sign of catatonic excitation. In the pathetic form, exaltation and pathos speeches are determined, turning into foolishness and non-purposeful motor activity. With the impulsive variant, the acceleration appears suddenly, the actions are cruel, fast and destructive. The mute form is characterized by the silent infliction of damage to oneself or others. Excitation can proceed continuously or pass into a stupor. Along with schizophrenia, catatonia is caused by the following conditions:
Develops when taking neuroleptics. Acceleration of motor acts and akathisia are part of the hyperkinetic syndrome. Constant tachykinesia and attacks of motor excitation are possible against the background of expressed anxiety, fear, feelings of painful anxiety, which decrease after performing various movements. Along with akathisia, the symptom is found in neuroleptic malignant syndrome. There is an increase in temperature and muscle tone, vegetative reactions, disorders of consciousness.
Diagnostic measures are carried out by a psychiatrist. Hyperactive children are examined by a child psychologist. If a chemical dependence or an organic disease is suspected, patients are examined by a narcologist, neurologist, infectious disease specialist and other specialists. As part of the conversation, the psychiatrist assesses the psycho-emotional state of the patient, his ability to establish and maintain productive contact, orientation in place, time and his own personality.
The acceleration of movements often accompanies mental pathologies with psychotic symptoms, impaired adequate perception of reality. Taking into account this circumstance, in order to clarify the overall picture of what is happening, to clarify the anamnesis of life and disease, a conversation is held with relatives. Parents of patients with suspected ADHD are asked about the peculiarities of the course of pregnancy and childbirth, the stages of the age development of the child, and family relationships.
Conduct psychological testing. Apply tests and drawing techniques. In hyperactive children, behavioral characteristics, the level of development of speech, movements, and cognitive sphere are evaluated. When determining the severity of mania or depression in patients with bipolar disorder, special scales are used. In schizophrenia, the compliance of the symptoms with the established criteria is checked, the psychological and emotional status is examined using the MMMI, Leary and Luscher tests, the Carpenter scale.
If indicated, the following diagnostic procedures can be prescribed:
Hyperactive children are observed on an outpatient basis. In other cases, as a rule, hospitalization is indicated in a psychiatric, less often in a narcological or neurological hospital, general departments. Therapeutic tactics depends on the cause of the change in the nature of movements: