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Flashcards in Movement Disorders Deck (38)
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1

Movement disorders due to damage/disease of _______.

basal ganglia

2

Possible causes of movement disorders

AGE, environmental toxins, genetic d/o, metabolic d/o, anti-psychotics, Parkinson's, stroke

3

ataxia

lack of coordination often producing jerky movements; due to cerebellum or basal ganglia

4

dystonia

long lasting spasmodic muscle contraction - slow, sustained, unusual postures

5

Intention tremor caused by _______ damage and resting tremor caused by ________.

cerebellum
basal ganglia

6

myoclonus

sudden, brief, shock-like contraction

7

chorea

irregularly timed, non-repetitive, dance-like movements in random distribution, (fidgeting, exaggerated gestures)

8

athetosis

slower type of chorea; writhing nature and usually distal extremities

9

Functional movements disorders

abnormal movements NOT due to neuro disease, inconsistent PE

10

Sydenham's chorea

chorea in children due to rheumatic fever; "St. Vitus' dance"

11

essential tremor

never stops; kinetic or resting
bilateral
resolves with relaxation
improves with mild alcohol

12

How to treat essential tremor?

Symptomatic tx: BB, antieptileptic, antidepressant

13

Pathophysiology of Parkinson's

death/damage to cells of basal ganglia in substantia nigra that release dopamine

Inadequate dopamine inhibits motor regions of cerebral cortex

14

Tremor of Parkinson's

resting tremor
"pill rolling"
unilateral early in disease
resolves with voluntary movement

15

Main symptoms of Parkinson's

Resting tremor
Bradykinesis
Rigidity (cogwheeling, lead pipe)
Shuffling gait w/ forward bending torso
Mask like face

16

How does essential tremor differ from Parkinson's?

Normal gait/balance
No bradykinesis
No rigidity
No masked face
Bilateral tremor (Parkinson's unilat early in dz)

17

What is the earliest sign of Parkinson's?

fine motor skills (then decreased mental status, then tremor)

18

Mainstay tx of Parkinsons

Levodopa
Dopamine agonists

19

What is the problem of Parkinsons therapy?

too much dopamine leads to hallucinations and schizophrenia; must assess risks vs benefits

20

What symptoms of Parkinson's are not improved with Levodopa?

sleep disturbances, supranuclear palsy, depression, fatigue, constipation

21

Highest RF of Parkinson's

age

22

When is CT/MRI ordered for suspected Parkinson's?

if ONE inconsistent finding. may be tumor, hydrocephalus, etc.

23

Typical patient with Tourette's syndrome

Male < 15 yo

24

Psych features of Tourette's syndrome

obsessions, compulsive behaviors, impulsivity, rage attacks, involuntary cursing

25

When are Tourette's symptoms suppressed?

when stared at. if want to see best detected out of corner of eye

26

Chronic progressive chorea is called ________.

Huntington's Dz

27

Age of Huntington's disease?

30-40 yo

28

How is Huntington's diagnosed?

genetic probe since inherited autosomal dominant disease (100% specificity)

29

Huntington's tx largely psychiatric?

high risk of suicide

30

Huntington's sx

chorea, psych problems, dementia