movement disorders Flashcards
What is the definition of a tremor
rhythmical, involuntary and oscillatory movement of a body part (need all 3 descriptors)
What is rhythmical movement
regular and repetitive in timing
What type of tremor is always action based
essential tremor
What is the most common rest tremor
parkinsons
What type of disease starts with a “pill rolling” tremor
Parkinsons
What is an essential tremor
Bilateral, symmetric, persistent, and mostly seen in hands/arms
What is the cause of a functional tremor
usually from trauma or stressors and will not be picked up on an MRI or EEG
What type of tremor will not progress
essential
What can reduce an essential tremor
alcohol
what pt. history can help indicate an essential tremor
family hx of one
slow progressive nature
No other neuro signs
can control for short periods
What is the best way to diagnose an essential tremor
A spirograph
If a patient shows signs of Brady kinesia, what is this indicative of
parkinsons
What is the mainstay treatment for an essential tremor
propanolol or primidone
Which patients would you avoid propranolol with
Asthma
COPD
What is Wilsons disease
poor metabolization of copper
What are red flags against essential tremors
Bradykinesia
nystagmus
hemiparesis/weakness
hepatic dysfunction
What helps differentiate a functional tremor
distractibility
entertainment
may move around the body
sudden onset
mixed tremors
What is the cause of parkinsons
loss of dopamine neurons
presence of Lewey bodies
What is needed to confirm a parkinsons diagnosis
Bradykinesia and either
rigidity OR rest tremor
What signs rule out parkinsons
strictly lower limb involvement
early/severe dementia
cerebellar abnormalities
normal DaT imaging
What are red flags against parkinsons
Severe autonomic failure within the first 5 years
What early signs can be seen in someone who has NOT been diagnosed with parkinsons
constipation
loss of smell
mood disorders
acting out dreams/restless leg
What test will you preform during an exam for parkinsons
Romberg and tandem walk
pull test
extremity rigidity
finger taps
What is the first line treatment for parkinsons
exercise and monitoring of symptoms
