Flashcards in Movement disorders Deck (36):
Hypokinetic movement disorders
What is a tremor?
Rhythmic sinusoidal oscillation of a body part
What are the different classifications of a tremor?
Rest; occurs when body at rest (5Hz)
Postural; occurs when the arms are outstretched
Kinetic; occurs during movement of a body part
What is an essential tremor?
Seen in hands at 5Hz when hold arms outstretched
Continues through moto execution
Ameliorated by alcohol intake
Describe a physiological tremor
Describe a wilson's disease tremor
Early stage postural
Describe a hepatic encephalopathy tremor
Repetitive drops of extended hands
What is chorea?
Brief irregular purposeless movement that flit and flow from one body part to another
Constantly restless or fidgety
Often generalised but can be focal
What can cause chorea?
Basal ganglia lesions
What is myoclonus?
Brief electric shock like jerks
Hiccups o hypnic jerks are common and normal forms of myoclonus
Arises from cortex, subcortical structures, spinal cord or nerve root and plexus
What is a tic?
Unvoluntary repetitive, stereotyped movements of vocalizations
They can be suppressed but there will be a growing feeling of anxiety and discomfort during tic suppression and when allowed to relax there will be a flurry of tics
What is a motor tic?
What is a vocal tic?
What is gilles de la tourette syndrome?
Typically onset of persistent multiple motor and vocal tics, often with assoc psych disturbance (ADHA, OCD, copropraxia, coprolalia)
What is dystonia?
Movement disorder characterized by sustained or intermittent muscle contractions causing abnormal often repetitive movements or posture
Tend to be patterned, twisting and may be tremulous
Often initiated o worsened by voluntary action and assoc with overflow muscle activation
Motor sy of PD
Postural and gait impairement
Non motor sy of PD
What tremor is assoc with PD?
Tx for dementia in PD?
Acetylcholinesterase inhibitor; rivastigmine
Tx for depression in PD?
Tx for REM sleep behavior disorder in PS?
Tx for constipation in PD?
Tx for GI motility in PD?
Tx for orthostatic hypotension in PD?
Tx for sialorrhoea in PD?
Tx for fatigue in PD?
What encomapsses bradykinesia?
Slowness of movement with progressive loss of amplitude or speed during rapid alternating movements
Which rigidity is felt in PD?
Positive froment's maneouvre
How is posture and gait affected in PD?
Impaired postural reflexes
Gait; slow, shuffling
Decreased arm swing
Red flags in PD?
Absence of asymmetry
Severe axial or lower limb
Fast disease progression
Eye movement; supranuclear palsy, dysmetric or slow saccades
Tics, myoclonus or choea
Pyramidal or cerebellar dysfunction
Bulbar or pseudobulbar features
Parietal assoc sensory disturbances
What is vascular parkinsonism?
Affects lower limbs
Rest tremor uncommon
Other neurological signs; spasticity, hemiparesis, pseudobulbar palsy
Poor levodopa response
What is drug induces parkinsonism?
Coarse postural tremor
Emergence of symptoms after drug exposure, and subsequent improvement after drug withdrawal
What is the triad of symptoms in multi system atrophy?
What is progressive supranuclear palsy?
Symmetric akinetic rigid syndrome with predominantly axial involvement
Gait and balance impairment
Vertical gaze supranuclear palsy
Continuous frontalis action
NO response to levodopa