Motor dysfunction disorders

Question 1

what is ataxia

Answer 1

abnormalities in movements
- widening base of support, impaired coordiation of joints, abnormal coupling of limbs during stepping

Question 2

what causes ataxia symptoms

Answer 2

improper timing of muscle activation
- usually a result of a damage to or atrophy of the cerebellum
- can also result from damage to the parietal cortex (misdirected reach or improper orientation of the hand) because there is missing info from dorsal visual stream

Question 3

what do people with cerebellar ataxia look like

Answer 3

drunken gait
- trouble with simple motor tasks, reaction time, movement trajectory, etc

Question 4

what is dystonia

Answer 4

slower, twisting mvmts and sustained abnormal postures

Question 5

what is dystonia a result of

Answer 5

antagonist and agonist co contraction
(can often be focal - occurs at a specific joint)

Question 6

what is focal hand dystonia

Answer 6

awkward postures are sometimes triggered by putting the hands into a highly familiar conformation

Question 7

what does botulinum neurotoxin (botox) do

Answer 7

neurotoxin that blocks synaptic vesicles from releasing ACh at the NM junction
cleaves SNARE proteins and blocks the fusion of synaptic vesicles onto the pre synaptic membrane
can’t have contraction of certain muscles

Question 8

what causes dystonia

Answer 8

may be heriditary or caused by other factors such as birth related trauma, infection, poisoning, or reaction to pharmaceutical drugs

Question 9

what is the treatment for dystonia

Answer 9

may include oral medications, botox, PT, or surgical procedures such as deep brain stimulation
(nothing fixes it, only treatments to improve quality of life)

Question 10

what is an essential tremor

Answer 10

most common motor disorder
- involuntary shaking mvmts that can affect your arms, eyelids, or other muscles
- during active mvmts such as eating and writing

Question 11

are essential tremors and parkinsons the same

Answer 11

no
- essential tremors = during active contractions
- parkinsons = resting tremors - occurs in a resting state

Question 12

what can cause essential tremors

Answer 12

different drugs, age related deterioration, damage to cerebellum, and exposure to neurotoxins (lead / harmane)

Question 13

what are the lines of treatment for essential tremors

Answer 13

medication
- first line = beta blockers
- second line = antiepileptics
- third line = antipsychotics
can also use deep brain stimulation

Question 14

what are the targets of deep brain stimulation

Answer 14

subthalamic nucleus
globus pallidus internal
ventral intermediate nucleus of the thalamus (less)

Question 15

what is deep brain stimulation

Answer 15

electrode into the brain
can either turn off or on the stimulation to make up for the lack of dopamine being produced
- on = smoother motor mvmts

Question 16

what is multiple sclerosis (MS)

Answer 16

immune system begins to attack and breakdown myelin in the CNS
- cause not entirely understood

Question 17

what are the symptoms of MS

Answer 17

pain, weakness, numbness, fatigue, blindness, dizziness/vertigo, poor balance control, and dexterity
- anything with sensory system or motor function is affected

Question 18

why is there a higher prevalence of MS in alberta and canada

Answer 18

less vitamin D in the northern hemisphere
- vit D has a big impact on the immune system

Question 19

what is the difference between primary progressive and relapse-remitting MS

Answer 19

primary progressive MS = continual progress of symptoms
relapse-remitting MS = symptoms have flare ups and remission of symptoms

Question 20

what causes the relapses in MS symptoms

Answer 20

CNS becoming de-myelinated (flare) and remyelinated (remission)

Question 21

what is amyotrophic lateral sclerosis (ALS)

Answer 21

progressive neurodegenerative disorder that results in the neuropathy of both lower and upper motor neurons
- lower = aMN
- upper = spinal tract MNs

Question 22

what is the difference in symptoms between upper and lower MN death

Answer 22

upper MN death = progressive weakness
lower MN death = gradual wasting/atrophy of skeletal muscle

Question 23

what is shown on a scan in patients with ALS

Answer 23

hyperintense (white) signal in the corticospinal tracts bilaterally in cervical spine
- from the death of neurons

Question 24

is there treatment for MS or ALS

Answer 24

MS = number of pharma treatments available
ALS = no method to reverse progression

Question 25

what is shown in the progression of ALS (not neuro symptoms)

Answer 25

mental capacity unchanged
usually die wihtin 5 years due to respiratory muscle failure