movement disorders

Question 1

where is wernickes area + what blood vessel supplies it

Answer 1

superior temporal gyrus - left MCA

Question 2

symptoms wenickes aphasia

Answer 2

receptive aphasia - sentences do not make sense and comprehension impaired

Question 3

where is brocas area + what blood vessel supplies it

Answer 3

inferior frontal gyrus - left MCA

Question 4

symptoms brocas aphasia

Answer 4

expressive aphasia - fluint is laboured and halting, comprehension normal

Question 5

area affected in conduction aphasia

Answer 5

arcuate fasculus (connects wernickes and brocas)

Question 6

symptoms conduction aphasia

Answer 6

speech is fluent but repetition poor, aware of errors, comprehension normal

Question 7

symptoms global aphasia

Answer 7

laboured and halting aphasia that does not make sense, comprehension impaired

Question 8

what is ataxia

Answer 8

problems with coordination, balance and speech - originate in cerbellum

Question 9

which part of cerebellar causes peripheral ataxia eg fnger nose

Answer 9

hemisphere

Question 10

which part of cerebellar causes gait ataxia

Answer 10

vermis

Question 11

inheritance friedreich’s ataxia + gene

Answer 11

recessive, GAA repeat on chromosome 9, does not demonstrate anticipation

Question 12

age of onset and symptoms friedreich’s ataxia (7)

Answer 12

10-15 // absent ankle jerk or plantars //cerebellar ataxia // optic atrophy //spinocerebellar tract degen // HCOM // DM // high arch palate

Question 13

ataxia telangiectasia inheritance

Answer 13

recessive, defect in ATM gene

Question 14

symptoms and onset ataxia telangiectasia i

Answer 14

age 1-5 // cerebellar ataxia // telangiectasia // IgA def –> chest infection // risk of malignancy

Question 15

what type of immunodeficiency is ataxia telangiectasia i

Answer 15

combined

Question 16

what are action/ postural tremors

Answer 16

worse with arms outsretched, absent at rest

Question 17

what can cause active tremours

Answer 17

anxiety, alcohol, withdrawal, benign essential tremor, thyrotoxicosis, drugs eg salbutamol, coffee

Question 18

what hz are active tremors

Answer 18

always below 13Hz

Question 19

inheritance benign essential tremor

Answer 19

autosomal dominant

Question 20

symtoms benign essential tremor

Answer 20

bilateral postural tremor (worse with out stretched hands) - most common head tremor

Question 21

what relieves benign essential tremor

Answer 21

alcohol and rest

Question 22

mx benign essenital tremor

Answer 22

beta blockers

Question 23

what can cause postural active tremors

Answer 23

anxiety, alcohol, withdrawal, benign essential tremor, thyrotoxicosis, drugs eg salbutamol, coffee

Question 24

what can cause intention tremors

Answer 24

worse with movement - cerebellar disease

Question 25

parkinsons tremor

Answer 25

resting - better with movement, pin-rolling, bradykinesia

Question 26

what is dystonia

Answer 26

involuntary, sustained muscle contractions that result in abnormal postures and twisting

Question 27

what is focal dystonia and examples

Answer 27

limited to one muscle group - cervical neck torticollis // eye blephospasm // jaw clenching (trismus)

Question 28

mx focal dystonia

Answer 28

botox injection

Question 29

what usually causes generalised dystonia

Answer 29

genetic autosomal dominant condition

Question 30

mx generalised dystonia

Answer 30

anticholergics eg procyclidine

Question 31

what drugs usually cause acute dystonia

Answer 31

metoclompramide, antiphysotics

Question 32

mx acute dystonia

Answer 32

anticholergics eg procyclidine

Question 33

what is chorea

Answer 33

non-rythymical, irregular, jerky movements randomly distributed eg facial grimacing, writhing of shoulder, rapid finger movement

Question 34

what can cause chorea

Answer 34

huntingtons, wilsons, sydenhams

Question 35

what inheritance and mutation is huntingtons

Answer 35

CAG expansion chromsome 4 - autosomal dominant // genetic anticipation

Question 36

pathology huntingtons

Answer 36

atrophy basal ganglia + caudate nucleus --> frontal and parietal atrophy

Question 37

when does huntingtons present and what is the triad

Answer 37

40s: emotional cognitive and motor disturbance

Question 38

early huntington symptoms

Answer 38

depression, clumsiness, chorea

Question 39

late huntington symptoms

Answer 39

chorea, dementia, dysphagia and aphasia

Question 40

mx huntingtons

Answer 40

tetrabenazine

Question 41

what is sydenhams chorea + what usually causes it

Answer 41

strep throat --> rheumatic fever --> chorea in children

Question 42

what is restless leg symptoms

Answer 42

uncontrollable urge to move leg, occur at night, worse at rest // parasthesia

Question 43

assoc with restless leg

Answer 43

FH // iron deficiency // uraemia // DM // pregnant

Question 44

invx restless leg

Answer 44

ferritin to exlude anaemia

Question 45

mx restless leg

Answer 45

walking, massage // 1 = dopamine agonist, 2 = benzos or gabapentin