Approach to Movement Disorders

Question 1

Bradykinetic movements are ____

Answer 1

Slow

Question 2

Hyperkinetic movements involve ____

Answer 2

Extra movements

Question 3

What is another name for Bradykinetic Disorders that classifies the main symptoms?

Answer 3

Akinetic Rigid Syndromes

= SLOW AND STIFF

Question 4

What are the cardinal features of Parkinson’s Disease?

Answer 4

1. Resting, unilateral pill rolling tremor
2. Rigidity (stiff)
3. Bradykinesia (slow)

Question 5

What type of tremor will be seen with Parkinson’s Disease?

Answer 5

Resting, often unilateral at first, pill rolling quality

Question 6

Besides Parkinson’s Disease, what are 3 other Akinetic Rigid Syndromes (Bradykinetic/Stiff)?

Answer 6

• Progressive Supranuclear Palsy
• Multiple Systems Atrophy
• Corticobasal Degeneration

Question 7

Besides bradykinesia and rigidity, what symptoms present with Progressive Supranuclear Palsy?

Answer 7

Loss of VOLUNTARY control of eye movements especially vertical gaze

Question 8

A patient presents with bradykinesia and rigidity with loss of voluntary control of vertical gaze of the eyes

Answer 8

Progressive Supranuclear Palsy

Question 9

Besides bradykinesia and rigidity, what symptoms will present with Multiple Systems Atrophy?

Answer 9

Autonomic Dysfunction

Question 10

A patient presents with bradykinesia, rigidity and autonomic dysfunction

Answer 10

Multiple Systems Atrophy

Question 11

Besides bradykinesia and rigidity, what symptoms will present with Corticobasal Degeneration?

Answer 11

Cortical dysfunction

– sensory/motor issues

Question 12

A patient presents with bradykinesia, rigidity and cortical dysfunction

Answer 12

Corticobasal Degeneration

Question 13

Do anti-parkinsonian medications work well for the other Akinetic Rigid Syndromes?

Answer 13

NO

Question 14

Dancelike movements that may be incorporated into purposeful movements

Answer 14

Chorea

Question 15

Writhing, sinuous (curvy) movement

Answer 15

Athetosis

Question 16

Athetosis (writhing and sinuous movements) often occur in combination with?

Answer 16

Chorea

Question 17

Sustained muscle contractions that produce twisting and abnormal postures

Answer 17

Dystonia

Question 18

Large flinging movement of the upper extremity

Answer 18

Ballism

Question 19

Brief, rapid and repetitive action

Answer 19

Tic

Question 20

What are the symptoms of Huntington’s Disease?

Answer 20

Chorea and Dementia

Question 21

When do symptoms usually arise for Huntington’s Disease patients and is there a cure?

Answer 21

30-50

– no cure

Question 22

In what age of patients does Sydenham’s Chorea occur?

Answer 22

Children and adolescents

Question 23

What cause Sydenham’s Chorea?

Answer 23

Previous infection with Group A Hemolytic Streptococcus

Question 24

What is Sydenham’s Chorea?

Answer 24

Unilateral chorea movements which can be mild and confused with fidgeting

Question 25

What will be seen with Idiopathic Torsion Dystonia?

Answer 25

Dystonic movements and postures only

Question 26

What will be seen with Focal Torsion Dystonia?

Answer 26

Dystonia confined to a FOCAL area

Question 27

What medication can be helpful to weaken the involved muscles with FOCAL Torsion Dystonia?

Answer 27

BOTOX injections

Question 28

Wilson's Disease is a disorder of ____ metabolism

Answer 28

Copper

Question 29

When does Wilson's Disease usually present and what are the general dysfunctions?

Answer 29

Presents in childhood or young adult life | = Neurological and Hepatic Dysfunction

Question 30

What types of movements will be seen with Wilson's Disease?

Answer 30

Bradykinetic and Hyperkinetic

Question 31

What will the levels of copper be in the urine and ceruloplasmin in the serum with Wilson's Disease?

Answer 31

- HIGH copper in the urine | - LOW ceruloplasmin in the serum (copper is not bound)

Question 32

Tic Disorders are usually single motoc tics that are benign. If they are not benign, what is a common syndrome?

Answer 32

Tourette's Syndrome

Question 33

Tourette's Syndrome

Answer 33

Multiple motor and vocal tics before 21

Question 34

Multiple motor and vocal tics with onset before age 21

Answer 34

Tourette's Syndrome

Question 35

When are Essential Tremors often pronounced?

Answer 35

Kinetic -- trying to do a task

Question 36

Essential Tremors often affect which parts of the body?

Answer 36

Both hands and head

Question 37

Essential tremors progress very slowly, what can weirdly decrease the tremor temporarily?

Answer 37

Alcohol

Question 38

Tremor of both hands or head when trying to complete a task

Answer 38

Essential Tremor