Flashcards in Movement Disorders Deck (38)
Movement disorders due to damage/disease of _______.
Possible causes of movement disorders
AGE, environmental toxins, genetic d/o, metabolic d/o, anti-psychotics, Parkinson's, stroke
lack of coordination often producing jerky movements; due to cerebellum or basal ganglia
long lasting spasmodic muscle contraction - slow, sustained, unusual postures
Intention tremor caused by _______ damage and resting tremor caused by ________.
sudden, brief, shock-like contraction
irregularly timed, non-repetitive, dance-like movements in random distribution, (fidgeting, exaggerated gestures)
slower type of chorea; writhing nature and usually distal extremities
Functional movements disorders
abnormal movements NOT due to neuro disease, inconsistent PE
chorea in children due to rheumatic fever; "St. Vitus' dance"
never stops; kinetic or resting
resolves with relaxation
improves with mild alcohol
How to treat essential tremor?
Symptomatic tx: BB, antieptileptic, antidepressant
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
Tremor of Parkinson's
unilateral early in disease
resolves with voluntary movement
Main symptoms of Parkinson's
Rigidity (cogwheeling, lead pipe)
Shuffling gait w/ forward bending torso
Mask like face
How does essential tremor differ from Parkinson's?
No masked face
Bilateral tremor (Parkinson's unilat early in dz)
What is the earliest sign of Parkinson's?
fine motor skills (then decreased mental status, then tremor)
Mainstay tx of Parkinsons
What is the problem of Parkinsons therapy?
too much dopamine leads to hallucinations and schizophrenia; must assess risks vs benefits
What symptoms of Parkinson's are not improved with Levodopa?
sleep disturbances, supranuclear palsy, depression, fatigue, constipation
Highest RF of Parkinson's
When is CT/MRI ordered for suspected Parkinson's?
if ONE inconsistent finding. may be tumor, hydrocephalus, etc.
Typical patient with Tourette's syndrome
Male < 15 yo
Psych features of Tourette's syndrome
obsessions, compulsive behaviors, impulsivity, rage attacks, involuntary cursing
When are Tourette's symptoms suppressed?
when stared at. if want to see best detected out of corner of eye
Chronic progressive chorea is called ________.
Age of Huntington's disease?
How is Huntington's diagnosed?
genetic probe since inherited autosomal dominant disease (100% specificity)
Huntington's tx largely psychiatric?
high risk of suicide