Treatment for Hypermetria

Hypermetria is a rare (1%) neurological disorder characterized by oversensitivity of the visual processing system causing an exaggeration of visual spatial perception. These patients fail to discriminate between two near objects that are approximately the same size and of two similar or dissimilar objects located at approximately the same distance from each other. Patients have difficulty in performing tasks requiring the simultaneous processing of the visual and the manual (both right and left hands) systems, and they have deficits in discriminating right and left hands. The patients were able to accurately fixate on objects with their eyes but had difficulty using both hands to manipulate items.

This sign is a non-specific sign of the frontal lobes, and is particularly associated with the loss of the ability to attend to the immediate environment. It usually manifests as a difficulty in selecting objects, or in discriminating between a simple and a complex stimulus. It may be difficult to identify on clinical presentation.

In children with chronic, persistent hypermetria (> or =5 mm of vertical/horizontal deviation), most exhibit a normal neuropsychological profile but show a statistically significant increase in the number of perceptual anomalies (more or faster auditory discrimination, better visual and object identification), or of dysmetria (greater than 5 mm) after completing the treatment. However, these children did not report noticeable improvements in the number of visual field defects.

around 2 million people in the United States are diagnosed with dysdiadochokinesia, which is a common feature of progressive supranuclear palsy. The proportion of patients who have a symptom duration of > 3 yr is relatively constant over the 12 yr period (around 1:4). Future longitudinal studies of dysdiadochokinesia are warranted.

Hypermetria is a result of dysfunction of the normal mirror neuron system. Although the main underlying physiological processes, neuronal activity in the primary somatosensory cortex, are not all fully understood, it is thought possible that in hypermetrica(s), an abnormal signal processing in the brain leads to a mismatch in somatosensory information with a normal body schema, in effect resulting in a distorted representation of body position in the primary somatosensory cortex.

A few common treatments for hypermetria can include gabapentinoids or ketamine as well as surgical and/or psychotherapy. The use of gabapentinoids is limited to a particular subset of people with hypermetria.

Hypermetria of vision often has a primary neurologic, traumatic, or ocular/refractive cause. When hypermetria has a specific cause of neurologic, traumatic, or ocular/refractive, it indicates a primary disorder of vision, or primary problem with the brain itself. [Power (https://www.withpower.com/d/hypermetria_problems#) gives answers to common questions about hypermetria.

Hypermetria was first noted during the early Middle Ages, and some interesting treatment options have come through during that time. There are currently a great number of treatments available for hypermetria; the most promising therapies are those with the smallest side effects, including medications that target the central nervous system as well as the peripheral nervous system. Clinical trials such as the AIM-CVS, AIM-CVS2, and the PIP-CVS are conducting in different areas of the United States focusing on different aspects of hypermetria.

Although some of the symptoms of hypermetria can have their genesis in a disease process other than hypermetria, the pattern of behavior exhibited by hypermetria patients during experimentation and in-the-practice environments strongly suggests that hypermetria-related symptoms are not merely secondary to hypermetria itself. Rather, hypermetria involves a processing cascade in which, while the 'information that has been created from and around, within and around other sensory modalities is the key to understanding, creating, and remembering, the sensory input produced by the individual sensory senses themselves’ [Keller et al.

Although several medications have been used in treatment of patients who had hypermetria, no evidence suggests that any medication has been more effective than a placebo in altering hypermetria.

There are a wide range of opinions about the clinical trial options for hypermetria. The current treatment options are largely limited to pharmaceutical drug therapy, and in certain cases surgery. A more balanced approach to clinical trials of hypermetria could better meet the needs of those patients most likely to want to try them. In particular, those patients who are willing or capable of doing self-instruction are the most likely to want to try clinical trials. In the United States, we have an immense demand for clinical trials of new treatment options for multiple sclerosis. Using information about the clinical trials, medical professionals may be able to better meet the clinical trial needs and also help patients to reach their maximal potential regarding functional recovery.