Adult Movement Disorders Flashcards Preview

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Flashcards in Adult Movement Disorders Deck (26):
1

MC Movement D/O

Parkinsons

2

MC Neurodegenerative D/O

AD
#2 Parkinsons

3

Environmental exposure that put patient at risk for parkinsosn

-herbicide/pesticides
-metals
-well water
-farming, rural
-wood/steel mills

4

% of dopaminergic neurons lost at symptom onset in parkinsons

60-80%

5

Lewy Bodies/Neurites:
appearance

-eosinophilic
-intracytoplasmic inclusions

6

Sleep change assc with Parkinsons

REM Behavior D/O

7

Autonomic changes assc with parkinsons

constipation
urinary frequency
sweating
drooling
orthostatic hypotension

8

Only parkinsons drug shown to slow progression of disease

MAO-Bi
(selegiline, rasageline)

9

Sites for DBS in Parkinsons

-STN (tremor, dyskinesia)
-GPe (dystonia)
-VIM (tremor)

10

In NPH, what should be done before performing LP?

-MOCA
-number steps over 10 meters
-walking speed

(then determine improvement after LP)

11

NPH appearance on imaging

-ventricles dilated
-atrophic cortex

12

PSP Symptoms

-Parkinsonism
-Neck Dystonia
-Pseudobulbar palsy
-Supranuclear ophtalmoplegia

13

Describe ophthalmoplegia

loss of vertical gaze initially

14

HD genetic change

AD CAG repeat chromosome 4 with genetic anticipation

15

Juvenile Onset HD appears as ______

parkinsonism

parkinsonism in kid --> think HD

16

HD = caudate atrophy
What is the microscopic finding?

-loss of spiny striatal neurons with gliosis

17

Treatments for HD

-Tetrabenazine (dopa depleting agent)
-Antipsychotics
-SSRIs

18

ADRs assc with tetrabenazine

-depression (combine with SSRI)
-orthostatic hypotension

19

MC cause action tremor

benign essential tremor (familial)

20

What improves benign essential tremor?

alcohol

21

Contrast PD and BET tremors

-Parkinsons is lower frequency and at rest
-BET is higher frequency and assc with action/ postures

22

DOC for BET

propranolol

23

Secondary treatments for BET

-topiramate
-primidone

24

Drug known to cause parkinsonism

metaclropromide

25

DOC for parkinsonism

Levodopa Carbidopa (sinemet)

26

Drug for parkinsonism to avoid in bipolar patients

dopa agonists
(ronipirole, pramiprexole)