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Flashcards in Movement disorders Deck (21)
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1
Q

What causes parkinson’s disease?

A

Degeneration of dopaminergic neurons in the substantia nigra pars compacta

2
Q

What are the major clinical features of Parkinson’s?

A

Pin rolling tremor which is worse at rest

Rigidity and increased tone

Bradkinisia (slow to initiate movement and monotonous hypophoic speech)

Shuffling gait

3
Q

What are some of the non-motor symptoms of Parkinson’s?

A

Sleep disorders

Hallucinations

Dementia

Depression

4
Q

What is the neurohistological hallmark of parkinson’s disease?

A

Lewy Bodies

5
Q

What is important to consider in terms of medications when treating GI problems in Parkinson’s disease?

A

Metoclopromide is contraindicated as it is a dopamine antagonist and therefore exacerbates symptoms

Domperidone can be used instead because it doesn’t cross the BBB

6
Q

What drug can be used for symptomatic management of Parkinson’s disease?

What are its main side effects?

A

Levodopa

Dyskinisia 
Postural hypotension 
Cardiac arrhythmias 
Red discolouration of urine on standing 
Drug resistance
7
Q

?How should psychosis in parkinson’s disease be treated

A

Quetiapine

NB drugs like haloperidol are contraindicated because they cause EPSE, one of which is parkinsonism

8
Q

What are the causes of postural tremors, which are absent on rest but present with maintained posture?

A

Benign essential tremor

Neuropathy

B agonist tremor

Anxiety

Thyrotoxicosis

9
Q

What are the causes of kinetic/ intention tremors?

A

Cerebellar disease

Wilson’s disease

10
Q

Describe essential tremor

A

Autosomal dominant condition affecting both upper limbs

tremor is postural (worse if arms are outstretched)

Improves with alcohol and rest

11
Q

What is the treatment for essential tremor?

A

Propanolol

12
Q

Describe Gilles De La Tourette Syndrome

A

Autosomal dominant inheritance

Multiple motor tics and one or more vocal tics must be present

Age of onset <18

Affects males more than females

13
Q

What is the name of the condition which presents with chorea and is due to previous rheumatic fever?

A

Sydenham’s

14
Q

What drugs can be given as symptomatic treatment for chorea?

A

Terabenazine and dopamine receptor blocking drugs

15
Q

What drugs can be given as symptomatic treatment for Tourettes?

A

Clonidine and tetrabenazine

16
Q

What are the genetics of Huntington’s disease?

A

Autosomal dominant

CAG triplet repeat affecting the huntingtin gene on chromosome 4

Genetic anticipation

17
Q

What is myoclonus?

A

Brief activation of a group of muscles leading to a jerk of the affected body part

18
Q

What is negative myoclonus? Give an example

A

Negative myoclonus is caused by a temporary cessation of muscle activity

E.g asterisks (liver flap) in patients with liver failure

19
Q

Describe juvenile myoclonic epilepsy

A

Myoclonic jerks and generalised seizures with onset in the teenage years

Alcohol and sleep deprivation are common triggers

Symptoms tend to be worse in the mornings

Sodium valproate can be used as treatment, an AED is usually required long-term

20
Q

What is dystonia?

A

Involuntary muscle spasms leads to sustained abnormal posture of a body part

21
Q

Describe primary young onset dystonias

A

Onset in late childhood/ early teens

Autosomal dominant inheritance

Typically limb onset with spreads of symptoms over a couple of years