Hyperkinetic Disorders

Question 1

Tics are sudden, stereotyped movements or sounds which occur at irregular intervals. Are tics suppressible?

Answer 1

• yes

Typically associated with premonitory (unpleasant) urge

Question 2

Tics are sudden, stereotyped movements or sounds which occur at irregular intervals. Which of the following are common presentations of tics?

1 - simple-blinking
2 - coughing/throat clear
3 - shouting
4 - complex-jumping/twirling
5 - all of the above

Answer 2

5 - all of the above

Question 3

Are tics worse with anxiety/fatigue?

Answer 3

• yes

Question 4

Can tics be reduced?

Answer 4

• yes

Distraction techniques are often used

Question 5

Which neurotransmitted are tics commonly associated with?

1 - glutamate
2 - GABA
3 - dopamine
4 - serotonin

Answer 5

3 - dopamine

Typically in the basal ganglia

Question 6

Gilles de la Tourette’s Syndrome is a common form of tics. At what age does this typically present?

1 - <3
2 - <7
3 - <15
4 - <20

Answer 6

2 - <7

Can occur in adolescence

Question 7

Gilles de la Tourette’s Syndrome is a common form of tics. Is this more common in boys or girls?

Answer 7

• boys

4 x more likely
Also linked to ADHD, OCD and anxiety

Question 8

Gilles de la Tourette’s Syndrome is a common form of tics. Which 2 of the following are the most common presentations?

1 - resting tremor
2 - throat clearing/coughing
3 - cranial nerves (eyes mostly)
4 - vocal noises

Answer 8

3 - cranial nerves (eyes mostly)
4 - vocal noises

Question 9

How is Gilles de la Tourette’s Syndrome typically treated?

1 - CBT/neuropsychiatry
2 - antileptics
3 - dopamine antagonists
4 - anticholinesterases

Answer 9

1 - CBT/neuropsychiatry

Question 10

Chorea is a rapid, irregular, involuntary, dance-like movements that flow randomly from one body region to another, including oral, facial, and appendicular muscles. Which of the following is an example of chorea?

1 - Huntingtons disease
2 - Bulbar palsy
3 - Gallium Barres Syndrome
4 -All of the above

Answer 10

1 - Huntingtons disease

Inherited autosomal-dominant illness

Causes atrophy caudate nucleus, putamen and globus pallidus and a degree of cerebral atrophy

Question 11

Huntingtons disease is a form of chorea is a rapid, irregular, involuntary, dance-like movements that flow randomly from one body region to another, including oral, facial, and appendicular muscles. In Huntingtons disease, which of the following features are common?

1 - behavioural disorders
2 - dementia
3 - psychiatric dysfunction
4 - neurological dysfunction
5 - all of the above

Answer 11

5 - all of the above

Question 12

Which part of the brain do chorea disorders typically affect?

1 - cerebellum
2 - occipital lobe
3 - basal ganglia
4 - primary somatosensory cortex

Answer 12

3 - basal ganglia

Question 13

Which of the following would NOT typically cause chorea?

1 - Vascular
2 - Sydenham’s or rheumatic chorea
3 - Trauma
4 - Systemic lupus erythematosus
5 - Auto-immune encephalitis
6 - Toxoplasmosis (HIV)

Answer 13

3 - Trauma

Question 14

Dystonia is defined as abnormal twisting posture that can often affect axial, facial and truncal regions. Are these associated with jerky tremor?

Answer 14

• can be

Not always though

Question 15

Although the exact pathophysiology of dystonia is not completely understood, abnormal activity in which areas of the brain has NOTbeen shown?

1 - somatosensory cortex
2 - motor cortex
3 - supplementary motor areas
4 - cerebellum
5 - basal ganglia

Answer 15

1 - somatosensory cortex

Question 16

Which neurotransmitter has dystonia been linked with?

1 - glutamate
2 - GABA
3 - dopamine
4 - serotonin

Answer 16

3 - dopamine

Dystonia has been linked with a blockage of dopamine receptors in basal ganglia

Some dystonia disorders have been shown to be responsive to levodopa

Question 17

All of the following can cause dystonia, but which is the most common?

1 - Stroke
2 - Brain Injury
3 - Encephalitis
4 - Parkinson’s disease
5 - Huntington’s disease
6 - Medication induced-antipsychotics

Answer 17

1 - Stroke

Essentially brain hypoxia