Movement disorders

Question 1

What are the 2 categories of movement disorder?

Answer 1

Hyperkinetic

Hypokinetic

Question 2

What are examples of hyperkinetic conditions?

Answer 2

Chorea
Tics
Dystonia

Question 3

Does Parkinson’s disease fall into either of the movement disorder categories?

Answer 3

Not really, it is classed as a hypokinetic disorder but has features of both.

Remember TRAP.

Question 4

Which group of conditions is tremor a hallmark of?

Answer 4

Hyperkinetic conditions.

Question 5

Which group of conditions is akinesia a hallmark of?

Answer 5

Hypokinetic conditions.

Question 6

What are the 3 groupings of tremor?

Answer 6

Resting tremor
Postural tremor (upon standing)
Kinetic tremor (upon moving limb)

Question 7

What is an essential tremor?

Answer 7

Seen in hands when outstretched.

This runs in families and can be helped by alcohol consumption.

Question 8

Which part of the brain does a kinetic tremor arise from?

Answer 8

Cerebellum

Question 9

What is dystonia?

Answer 9

A movement disorder characterised by sustained or intermittent muscle contractions.

These can be repetitive movements or postures (can be both).

Question 10

Are dystonic movements worsened through voluntary action?

Answer 10

Yes

Question 11

What is the most common form of dystonia?

Answer 11

Cervical dystonia

Question 12

What can be used to help with dystonia?

Answer 12

Implement a sensory tic.

This may involve a voluntary movement to distract from dystonia (e.g. put hand in pocket whilst walking).

Question 13

What is chorea?

Answer 13

A brief, irregular, purposeless movement that can travel between different body parts (not limited to a single area being affected).

Question 14

What is the name of an extreme variant of chorea that involves the proximal joints?

Answer 14

Ballism

Question 15

Patients that appear constantly restless and fidgety are thought to have what?

Answer 15

Chorea

Question 16

What is chorea linked to?

Answer 16

Drugs
Huntington’s disease
Sydenham’s chorea

Question 17

In ballism, where is a lesion suspected?

Answer 17

The striatum/subthalamic nucleus

Question 18

What are tics?

Answer 18

Involuntary, repetitive, stereotyped movements/vocalisations.

Question 19

Can tics be suppressed?

Answer 19

Yes, only for a short period of time.

This causes great deals of anxiety for the patient.

Question 20

What can produce a flurry of tics?

Answer 20

Anxiety

Question 21

What are examples of motor tics?

Answer 21

Eye blinking
Head jerks
Arm/leg jerks

Question 22

What are examples of vocal tics?

Answer 22

Sniffing
Grunting
Snorting
Words/sentences

Question 23

At which point is a primary tic developed?

Answer 23

Childhood

Question 24

At which point is a secondary tic developed?

Answer 24

Adulthood

Question 25

What is the most common tic syndrome?

Answer 25

Gilles de la Tourettes

Question 26

What is Gilles de la Tourette syndrome?

Answer 26

A condition of persistent, multiple motor and vocal tics, often seen in childhood. It is usually associated with a psychiatric disturbance.

Question 27

What type of tremor is an essential tremor?

Answer 27

A postural tremor.

Question 28

How would you differentiate between a postural tremor and kinetic tremor?

Answer 28

A postural tremor does not worsen when approaching its target.

Question 29

What improves an essential tremor?

Answer 29

Alcohol

Question 30

Give other causes of a postural tremor?

Answer 30

Physiological | Hepatic encephalopathy

Question 31

What are fasciculations?

Answer 31

Fast, visible, fine, spontaneous twitches. They occur in healthy muscle and are precipitated by stress, caffeine or fatigue.

Question 32

What is myotonia?

Answer 32

Failure of the muscle to relax after use. A chloride channel disorder.

Question 33

What do fasciculations indicate?

Answer 33

Disease of a motor neuron.