Hyperkinetic syndrome in children is primarily characterized by short attention span, distractibility, and excessive movement. It is also known as minimal brain dysfunction or attention deficit disorder.

bubble_chart Diagnosis

(1) Onset before the age of 7. (2) Duration of more than 6 months. (3) No intellectual disability. (4) Presence of at least 8 of the following behaviors: 1. Frequent fidgeting with hands or feet or squirming in seat. 2. Difficulty remaining seated when required. 3. Easily distracted by external stimuli. 4. Impatience in waiting for turns in games or group activities. 5. Often blurting out answers before questions are completed. 6. Difficulty following instructions to complete tasks (not due to defiance or lack of comprehension), such as failing to finish chores. 7. Difficulty sustaining attention in tasks or play. 8. Often shifting from one uncompleted activity to another. 9. Difficulty playing quietly. 10. Excessive talking. 11. Frequently interrupting or intruding on others' activities, such as disrupting other children's games. 12. Often seeming not to listen when spoken to directly. 13. Frequently losing items necessary for school or home activities (e.g., books, pencils, homework, toys). 14. Often engaging in physically dangerous activities without considering consequences (not for thrill-seeking), such as running into the street without looking. (5) Physical and laboratory examinations show no specific positive signs or pathological reflexes. Occasionally, clumsiness or slow movements may be observed, with slight difficulty in fine motor skills (e.g., buttoning, tying shoelaces). Intelligence tests are generally normal, and EEG shows no specific abnormalities. (6) Severity criteria for childhood hyperkinetic syndrome:

1. Grade I: Symptoms barely meet or slightly exceed the diagnostic threshold, with little to no impairment in learning or social functioning.
2. Grade II: Symptoms or functional impairment fall between Grade I and Grade III.
3. Grade III: Symptoms far exceed the diagnostic threshold, with significant and widespread impairment in family, school, and peer interactions.

bubble_chart Treatment Measures

﹝Treatment﹞

(1) General Treatment First, it should be clarified that this condition is pathological, and the child is not intentionally causing trouble. The child should not be discriminated against. Frequent scolding or punishment is not only ineffective but also harms their self-esteem, causing psychological injury. However, the child should not be left unchecked. Individualized education should be provided, pointing out their shortcomings, and any slight improvement should be encouraged to boost the child's confidence in learning and strengthen their resolve to overcome their shortcomings. (2) Drug Treatment Central nervous system stimulants are primarily used. Sedatives such as phenobarbital are not only ineffective but may also exacerbate symptoms.

1. 1. Methylphenidate (Ritalin): 0.2–0.5 mg/kg per day, with some cases requiring up to 0.7–1.0 mg/kg per day. Start with a small dose and gradually increase. If symptoms do not improve after 2–3 days, the dose may be further increased. The maximum daily dose should not exceed 30 mg. Take once in the morning half an hour before class and once in the afternoon before class. Avoid taking after 4 PM to prevent interference with nighttime sleep. Discontinue on Sundays and holidays. 2. Amphetamine: The dose is half that of methylphenidate, approximately 0.1–0.3 mg/kg per day. The drug's effects last 6–18 hours, so a single morning dose is sufficient. Long-term, high-dose use of these two drugs may suppress weight and height growth. However, if the daily dose does not exceed 20 mg, it is unlikely to affect weight or height. 3. Pemoline: The chemical name is phenylisohydantoin. Compared to methylphenidate, it has the following advantages: (1) After reaching a certain concentration, its half-life is about 12 hours, so only a single morning dose is needed. (2) Fewer side effects, with minimal impact on appetite. (3) Slow excretion, maintaining effects for several days after discontinuation. The therapeutic dose of pemoline is 1.5–5 mg/kg per day, with a maximum daily dose of 80 mg. It may take several days to 5–6 weeks for the effects to become apparent.