Flashcards in Movement Disorders Deck (59)
What is a tremor?`
Rhythmic sinusoidal oscillation of a body part
What are tics?
Involuntary stereotyped movements or vocalisations
What is chorea?
Brief irregular purposeless movements which flit and flow from one body part to another
What is myoclonus?
Brief electric-shock like jerks
What is dystonia?
Abnormal posture of the affected body part
How are tremors classified?
Position(rest, posture, movement), distribution, frequency, amplitude
What are some causes for a resting tremor?
What are some causes for a postural tremor?
Enhanced physiological tremor
Tremor associated with neuropathy
What are some causes for a kinetic tremor?
Cerebellar disease (demyelination, haemorrhage, degenerative, toxic)
What are some causes for a head tremor?
What are some causes for a jaw tremor?
What are some causes for a palatal tremor?
What investigations should be done in patients with tremor?
Possibly TFTs and in young patients (<45) copper and coeruloplasmin
What is a tremor associated with dystonia?
Tremor in a body part that is not dystonic but there is dystonia elsewhere
What is essential tremor?
Abnormal tremor in bilateral upper limbs with absence of neuro signs elsewhere.
No rest tremor
What are the first line treatments for dystonic tremor?
Propanolol and primidone
Deep brain stimulation for severely affected patients
Which brain region is affected in dystonia?
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
What does the gene DYT1 cause?
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
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)
What is good at treating writer's cramp?
When is surgery required in cervical dystonia?
When botox is ineffective
What are some AI causes of chorea?
What are some inherited/degenerative causes of chorea?
Benign hereditary chorea
Spinocerebellar ataxia Typ 17
What are some infectious causes of chorea?
What are some drug-based causes of chorea?
Dopamine-receptor blocking drugs, levodopa, stimulants, pill, anticonvulsants
What are some paroxysmal chorea causes of chorea?
What are some metabolic causes of chorea?
Chorea gravidarum, glucose, thyroid, parathyroid, sodium, magnesium metabolism