Hyperkinetic syndrome

As early as the 1940s it became clear that amphetamine could also produce a calming effect in adults prone to aggression and agitation. Later, this so-called paradoxical effect was also seen in children with hyperkinetic syndrome, the precursor to ADHD. 

Tiapride has weak antipsychotic activity. It has been used as a adjunct in patients with tardive hyperkinetic syndrome caused by other antipsychotics. 

The therapeutic indications for the psychomotor stimulants are quite limited. They are beneficial in the treatment of the hyperkinetic syndrome (attention deficit-hyperactivity disorder with minimal brain dysfunction). This is generally a childhood disease characterized by hyperactivity, inability to concentrate, and impulsive behavior. Amphetamines and the more extensively used methylphenidate paradoxically are quite effective in calming a large proportion of children with this disorder. Pemoline Cylert) is also used in the treatment of attention deficit disorder with hyperkinetic behavior. The mechanism by which these compounds are effective in this disorder is not known. 

Arnold, L.E., Wender, P.H., McCloskey, K., and Snyder, S. (1972) Levoamphetamine and dextroamphetamine comparative efficacy in the hyperkinetic syndrome assessment by target symptom. Arch Gen Psychiatry 27 816-822. 

Amfetamine psychosis is relatively rare in children, even in hyperactive children taking large doses of amfetamine amfetamine psychosis has been reported in an 8-year-old child with a hyperkinetic syndrome (SED-8,12). Large doses of amfetamine can cause disruption of thinking, but amfetamine psychosis is not usually accompanied by the degree of disorganization normally seen in schizophrenia (SED-9, 8). 

Found at the other end of the spectrum are the hyperkinetic basal ganglia disorders, which are represented by HD and essential tremor. In these two conditions, excessive abnormal movements such as chorea or tremor are superimposed onto and interfere with normal voluntary movements. Although hyperkinetic basal ganglia disorders are probably as diverse as hypokinetic basal ganglia disorders, their specific disease markers such as gene mutations, which exist for several of the hyperkinetic syndromes create more accurate, less problematic, classifications. 

Conners CK, Goyette CH, SouthwickDA, et al Food additives and hyperkinesis a controlled double-blind experiment. Pediatrics 58 154-166,1976 Conners CK, Goyette CH, Newman EB Dose-time effect of artificial colors in hyperactive children. ] Learn Disahil 13 48-52, 1980 Cook PS, Woodhill JM The Feingold dietary treatment of the hyperkinetic syndrome. Med] Aust 2 85-90, 1976... 

David TJ Reactions to dietary tartrazine. Arch Dis Child 62 119-122, 1987 Egger], Graham P], Carter CM, et al Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome. Lancet 1 540-545,1985 Eich WF, Thim EB, Crowder JE Effect of the Feingold Kaiser Permanente diet in minimal brain dysfunction. Journal of the Medical Association of the State of Alabama 49 16-20, 1979... 

O Banion D, Armstrong B, Cummings RA, et al Disruptive behavior a dietary approach. Journal of Autism and Childhood Schizophrenia 8 325-337, 1978 O Shea JA, Porter SF Double-blind study of children with hyperkinetic syndrome treated with multi-allergen extract sublingually. J Learn Disabil 14 189-191, 237,1981 Palmer S, Rapoport JL, Quinn PO Food additives and hyperactivity. Clin Pediatr 14 956-959, 1975... 

Stunts growth. Narcolepsy, hyperkinetic syndrome of children, attention deficit disorder, Parkinson s disease. Hypertension, cerebral hemorrhage, convulsions, coma, confusion, anxiety, hallucinations, fever, tremor, restlessness. Treat toxicity by acidification of unne (it is a weak base) and administration of a blockers or nitroprusside (for hypertension), and antianxiety agents. 

Patients who have received neuroleptics for long periods of time may develop a hyperkinetic disorder of the extrapyramidal system characterized by involuntary, purposeless movements affecting many parts of the body. This is known as tardive dyskinesia. Most commonly, these are manifested in a syndrome involving abnormal movements of the tongue, mouth and masticatory muscles. There are also choreoathetoid movements of the extremities. The mechanism by which these symptoms develop remains unknown. 

Since the gamut of the clinical pharmacology of tics is broad, it is often difficult to differentiate tics from other hyperkinetic movement disorders. Of 373 cases of Gilles de la Tourette syndrome, 18 had both tics and other abnormal movements 12 were secondary to neuroleptic drug treatment (167). Akathisia was the most common movement disorder. 

Kompoliti K, Goetz CG. Hyperkinetic movement disorders misdiagnosed as tics in Gilles de la Tourette syndrome. Mov Disord 1998 13(3) 477-80. 

Trade names Nitoman (Lifehealth LTD) Xenazine Indications Hyperkinetic movement disorders Huntington s chorea, hemiballismus, senile chorea, Tourette syndrome, and tardive dyskinesia... 

Hepatorenal syndrome, functional renal failure in the setting of cirrhosis in the absence of intrinsic renal disease, occurs in patients with cirrhosis as a result of intense vasoconstriction within the renal cortical vasculature. It is common and develops in approximately 40% of patients with cirrhosis and ascites within 5 years. The resultant reduction in blood supply to the kidneys causes avid sodium retention and oliguria. The vasoconstriction that occurs in the kidneys is in stark contrast to the state of systemic vasodilation that is characteristic of chronic liver failure. The pathophysiologic mechanism responsible for these effects is unknown, but is linked to the systemic vasodilation, hypovolemia, and hyperkinetic circulation seen in chronic liver failure. ... 

T DA/ACh Hyperkinetic states Huntington chorea, Tourette syndrome, tardive dyskinesia Euphoria, paranoia, psychoses, schizophrenia Hypoprolactinemia... 

Tourette s syndrome (TS) is a hyperkinetic movement disorder with symptoms of sudden, rapid and brief, recurrent, stereotyped motor movements or sounds (tics) and can range from mild to severe. TS is commonly treated with dopamine antagonists such as haloperidol, which may be effective but has significant adverse side effects and is ineffective in up to 30% of cases. While the etiology is not known it is proposed that, unlike PD, TS represents a disorder of excess dopamine transmission in the striatum (Shapiro et al., 1989 Wolf et al., 1996), either through dopamine excess or receptor hypersensitivity. 

Celiprolol hydrochloride is a once-dedly, cardioselective g-adrenergic blocker useful in the management of hypertension, angina pectoris and hyperkinetic heairt syndrome. It is also being evaluated in glaucoma. 

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