essential tremor, chorea, tics and related disorders

Question 1

treatment with this can be considered after an acquired non-progressive brain injury if rapid onset spasticity causes postural or functional difficulties

Answer 1

botulinum toxin type A

Question 2

which drug is mainly used to control movement disorders in Huntington’s chorea and related disorders?

Answer 2

tetrabenazine

Question 3

tetrabenazine is mainly used to …

Answer 3

control movement disorders in Huntington’s chorea and related disorders

Question 4

which drug can be prescribed for the treatment of tardive dyskinesia (involuntary movements of face and jaw) if switching or withdrawing the causative antipsychotic drug is not effective?

Answer 4

tetrabenazine

Question 5

how does tetrabenazine work?

Answer 5

depletes nerve endings of dopamine

Question 6

tetrabenazine is only effective in a proportion of patients and its use may be limited by development of …

Answer 6

depression

Question 7

these 4 antipsychotics, unlicensed indications, can be used to suppress chorea in Huntington’s disease

Answer 7

haloperidol
olanzapine
risperidone
quetiapine

Question 8

what is chorea

Answer 8

symptom that causes involuntary, irregular or unpredictable muscle movements. It affects your arms, legs and facial muscles

Question 9

this antipsychotic can improve motor tics and symptoms of Tourette syndrome and related choreas

Answer 9

haloperidol

Question 10

Haloperidol can also improve motor tics and symptoms of Tourette syndrome and related choreas. Other treatments for Tourette syndrome include …. (3)

Answer 10

pimozide (unlicensed indication) - ECG monitoring required
clonidine (unlicensed)
sulpiride (unlicensed)

Question 11

trihexylphenydil in high dosage can also improve some movement disorders but sometimes it is necessary to ..

Answer 11

build the dose up over many weeks

Question 12

these 2 antipsychotics are used to relieve intractable hiccup

Answer 12

• chlorpromazine
• haloperidol

Question 13

this drug is used to extend life in pt with motor neurone disease who have amyotrophic lateral sclerosis

Answer 13

riluzole

Question 14

this drug is used as an adjunctive treatment for myoclonus of cortical origin. after an acute episode, attempts should be made every ….. to decrease or discontinue treatment

Answer 14

piracetam
every 6 months

Question 15

This drug in some cases provides relief from benign essential tremor; the dose is increased slowly to reduce side-effects.

Answer 15

primidone (AED)

Question 16

propranolol or another b-adrenoceptor blocking drug may be useful in ….

Answer 16

treating essential tremor or tremors associated with anxiety or thyrotoxicosis