Paratonia and gegenhalten in childhood and senescence

Paratonia and gegenhalten – the involuntary resistance to passive movement – are terms used in the field of neurology to describe a form of hypertonia often associated with dementia. It is however also found to be present in children suffering from developmental delay where it may be accompanied by signs of dyspraxia and learning disabilities. Its presence may cause an elderly patient to appear to be being deliberately difficult and the child to be misbehaving.

Objective

To bring an awareness of how common paratonia/gegenhalten are in a general patient population.

Method

An overview of the literature retrieved from searches of computerised databases, the world-wide web and authoritative texts.

Discussion

As paratonia in children and gegenhalten in the elderly population occur at significantly high rates, as has been found with many of the primitive reflexes, it is suggested that their retention and reappearance may be associated with the postnatal development of the brain and its demise associated with ageing.

Conclusion

With such a high percentage of both the juvenile and elderly population manifesting signs of resisted movement it is considered essential that practitioners dealing with either of these groups have a good working knowledge of this common neurological sign.