Comforting behavior mistaken for movement disorder

The comforting behavior of thumb-sucking wouldn't land a 1-year-old girl in a neurologist's office, but the twisting and unusual movements of the comforting act of infantile masturbation can lead parents and physicians to believe a child is suffering from a movement disorder.

An article published in December's Pediatrics describes a dozen cases of young girls who were referred to pediatric movement disorder clinics between 1997 and 2002 for evaluation of paroxysmal (episodic) dystonic posturing, which is characterized by involuntary muscle contractions that force the body into abnormal movements and positions. Many of the children were subjected to invasive testing and medication before neurologists discovered the dystonic-like symptoms were actually normal muscle contractions that accompany masturbation.

"Masturbation is a normal human behavior. It's not harmful to anybody," said Jonathan W. Mink, M.D., Ph.D., Chief of Child Neurology at the University of Rochester Medical Center's Golisano Children's Hospital at Strong, lead author of the article. "But these children have had invasive procedures and have been treated with medication because their doctors either hadn't witnessed the movements or didn't recognize the behavior."

Mink theorizes that the cases studied were all female because boys' masturbation is more recognizable because of the tendency to have direct hand contact with the genitals. Girls don't necessarily directly touch the genitals when masturbating. An episode may begin in a car seat or high chair where straps place pressure on the genital area. Many of the episodes come on when a child is tired or bored.

By viewing the episodes video-taped by parents, Mink was able to determine that the children were not having seizures nor were they suffering from paroxysmal dystonic posturing. One child was distracted out of the episode with the promise of a cookie. Another stopped to play with a toy truck. Children having seizure

Contact: Heather Hare
University of Rochester Medical Center

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