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Flashcards in Movement Disorders Deck (59)
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1

What is a tremor?`

Rhythmic sinusoidal oscillation of a body part

2

What are tics?

Involuntary stereotyped movements or vocalisations

3

What is chorea?

Brief irregular purposeless movements which flit and flow from one body part to another

4

What is myoclonus?

Brief electric-shock like jerks

5

What is dystonia?

Abnormal posture of the affected body part

6

How are tremors classified?

Position(rest, posture, movement), distribution, frequency, amplitude

7

What are some causes for a resting tremor?

Parkinson’s disease
Drug-induced parkinsonism
Psychogenic tremor

8

What are some causes for a postural tremor?

Essential tremor
Enhanced physiological tremor
Tremor associated with neuropathy

9

What are some causes for a kinetic tremor?

Cerebellar disease (demyelination, haemorrhage, degenerative, toxic)
Wilson's disease

10

What are some causes for a head tremor?

Dystonia
Cerebellar disease

11

What are some causes for a jaw tremor?

Dystonia
Parkinson's disease

12

What are some causes for a palatal tremor?

With ataxia
Symptomatic
Essential tremor

13

What investigations should be done in patients with tremor?

Possibly TFTs and in young patients (<45) copper and coeruloplasmin

14

What is a tremor associated with dystonia?

Tremor in a body part that is not dystonic but there is dystonia elsewhere

15

What is essential tremor?

Abnormal tremor in bilateral upper limbs with absence of neuro signs elsewhere.
Long duration
No rest tremor
+ve FHx
Alcohol responsive

16

What are the first line treatments for dystonic tremor?

Propanolol and primidone
Deep brain stimulation for severely affected patients

17

Which brain region is affected in dystonia?

Basal ganglia

18

What 3 main physiological abnormalities have been found in patients with dystonia?

Loss of reduction in reciprocal inhibition
Alterations in brain plasticity
Alterations in sensory function

19

What does the gene DYT1 cause?

Torsion Dystonia

20

Describe torsion dystonia

Starts before 28yo- usually childhood
Starts in a limb- usually legs
Progresses over 5-10y to become generalised/multifocal
Often +ve FHx, but gene not highly penetrant
Trunk and neck in minority, head/face very rare

21

What is the best option for cervical dystonia?

Botox A or B(both same effect, low dose has fewer side effects and works as well as high)

22

What is good at treating writer's cramp?

Botox

23

When is surgery required in cervical dystonia?

When botox is ineffective

24

What are some AI causes of chorea?

Anti-phospholipid syndrome
Bechet syndrome
Coeliac disease
Sydenham’s chorea
Hashimotos’ thyroiditis

25

What are some inherited/degenerative causes of chorea?

HD/HD-like syndromes
Wilson's disease
Neuroacanthocythosis
Benign hereditary chorea
Ataxia telangiectasia
Spinocerebellar ataxia Typ 17

26

What are some infectious causes of chorea?

HIV

27

What are some drug-based causes of chorea?

Dopamine-receptor blocking drugs, levodopa, stimulants, pill, anticonvulsants

28

What are some paroxysmal chorea causes of chorea?

PD

29

What are some metabolic causes of chorea?

Chorea gravidarum, glucose, thyroid, parathyroid, sodium, magnesium metabolism

30

What investigations should be carried out in chorea?

Possibly brain imaging
Bloods for acanthocytes
ds-DNA
antiphospholipid autoantibodies
Copper
Genetic testing for HD