Hyperkinetic syndrome may be either secondary to an organic disease or a psycho-effective disorder (mood and/or anxiety disorder), or primary as part of an attention deficit hyperactivity disorder. Precise diagnosis is essential before any therapeutic decision; this requires a complete anamnestic, behavioural, psychological, sensorial, and neurological evaluation. It is only when a reliable diagnosis has been made that a relevant therapeutic project can be proposed. An evaluation procedure and a decisional tree are presented.