Movement Disorders Flashcards
Huntington’s Dz
Autosomal dominant
Affects motor function (chorea), cognition and behavior
Mean onset at 40
Mean duration is 20 yrs
Chorea movement =?
Huntingtons dance like movements
Huntington’s Patho
Gene mutation on chromosome 4 causes brain cells to waste away.
Decrease of GABA and GABA receptors in basal ganglia
Early signs of huntingtons
Depression Personality changes Lack of initiative Inability to concentrate Fidgeting Restlessness
Late signs of huntingtons
Chorea Dystonic posturing Progressing rigidity Akinesia Dementia
Huntingtons dx
Caudate atrophy on MRI and PET
Genetic testing
Huntingtons Tx
No meds can affect the course Treat symptoms Suppress chorea -Tetrabenazine -Neuroleptics Anticonvulsants Antipsychotic Antidepressant
Essential Tremor
Most common cause of tremors
Inherited
Wide range of severities
Essential tremor characteristics
Affects both sides symmetrically
More prominent with action than rest
Frequency of tremor is constant
ETOH relieves this tremor
Essential tremor is aggravated by:
Stress, sleep deprivation, stimulants
Essential tremor tx
Propranolol
Atenolol (of bronchospasm)
Mysoline (promidone) - anticonvulsant
Gabapentin (Neurontin) - anticonvulsant
Parkinson’s Dz
A progressive neurodegenerative disorder
Affects 1 million in the US
Leading cause of neurologic dz over 65
Usually begins after 50
TRAP
Parkinsons characteristics Tremor (resting and postural) Rigidity Akinesia Postural instability
Parkinsons patho
marked loss of dopaminergenic nerve terminals in the substantia nigra.
Parkinsons tremor manifestations
Hand and foot tremors what appear at rest, and go away with movement and sleep.
“pill rolling”
