PT  - JOURNAL ARTICLE
AU  - Jan-Frederik Fischer
AU  - Tina Mainka
AU  - Yulia Worbe
AU  - Tamara Pringsheim
AU  - Kailash Bhatia
AU  - Christos Ganos
TI  - Self-injurious behaviour in movement disorders: systematic review
AID  - 10.1136/jnnp-2019-322569
DP  - 2020 Jul 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 712--719
VI  - 91
IP  - 7
4099  - http://jnnp.bmj.com/content/91/7/712.short
4100  - http://jnnp.bmj.com/content/91/7/712.full
SO  - J Neurol Neurosurg Psychiatry2020 Jul 01; 91
AB  - Self-injurious behaviours (SIBs) are defined as deliberate, repetitive and persistent behaviours that are directed towards the body and lead to physical injury and are not associated with sexual arousal and without suicidal intent. In movement disorders, SIBs are typically associated with tic disorders, most commonly Tourette syndrome, and neurometabolic conditions, such as classic Lesch-Nyhan syndrome. However, beyond these well-known aetiologies, a range of other movement disorder syndromes may also present with SIBs, even though this clinical association remains less well-known. Given the scarcity of comprehensive works on this topic, here we performed a systematic review of the literature to delineate the spectrum of movement disorder aetiologies associated with SIBs. We report distinct aetiologies, which are clustered in five different categorical domains, namely, neurodevelopmental, neurometabolic and neurodegenerative disorders, as well as disorders with characteristic structural brain changes and heterogeneous aetiologies (eg, autoimmune and drug-induced). We also provide insights in the pathophysiology of SIBs in these patients and discuss neurobiological key risk factors, which may facilitate their manifestation. Finally, we provide a list of treatments, including practical measures, such as protective devices, as well as behavioural interventions and pharmacological and neurosurgical therapies.