Movement Disorders Flashcards
(30 cards)
What are the 5 most common diseases in neurology?
Migraine Stroke Epilepsy Dementia Parkinson’s disease
What are quality-adjusted life years (QALY)?
1 QALY is one year lived in perfect health
What are disability-adjusted life years (DALY)?
1 DALY is one year lost due to ill-health
What is motor neurone disease?
Amyotrophic lateral sclerosis (ALS) - degeneration of UMNs and LMNs. Muscular atrophy, facial paralysis, progressive
What is multiple sclerosis (MS)?
Autoimmune disease that attacks myelin and causes symptoms of UMN and LMN syndromes
What is stroke?
Acute onset of neurological defects due to disturbance in blood supply to brain.
What are the symptoms of stroke?
FAST: Facial weakness Arm weakness Speech difficulty Time to call 999
What are the 2 different types of stroke?
Haemorrhagic (15%)
Ischemic (85%)
What is a lacunar infarction?
Occlusion of small penetrating arteries that supply deep brain structures
What is the most common type of stroke?
Middle cerebral artery territorial infarction - contralateral hemiplegia and hemisensory loss
How would you diagnose a stroke?
Neurological assessment followed by neuroimaging (CT to detect haemorrhage)
How would you treat a haemorrhage stroke?
Pain management and surgery to repair origin of bleed
How would you treat an ischemic stroke?
Thrombolysis with Alteplase within 3hrs. Thrombectomy with retriever devices within 6hrs
What is penumbra regarding a stroke?
Potentially salvageable tissue
What blood flow defines cells as irreversibly damaged?
<12mL/100g/min
What is the sequence of events after stroke to cell death?
Failure of ion pumps, depolarisation and swelling Excessive glutamate release Peri-infarct depolarisations Inflammatory invasion Apoptosis
What is Parkinson’s Disease? What is the cause?
Neurodegeneration of the extrapyramidal system. Dopamine loss interferes with nigrostriatal pathway leading to inability to perform normal motor function
What are triplet repeats?
Triplet repetitiveness in genome that have varied lengths
What is the consequence of longer triplet repeats?
Neuromuscular and neurodegenerative disorders. Longer repeats = more severe disease
What is Huntingdon disease?
Progressive neurodegenerative disorder causing motor dysfunction (affects striatum and rest of brain).
What is the cause of Huntingdon disease?
Expansion of a CAG trinucleotide repeat in exon 1 of the huntingtin (HTT) gene. Expansion leads to longer huntingtin protein being translated which is cut into toxic fragments that accumulate in neurons.
When does Huntingdon disease present?
First symptoms ~35-50 years of age (~5-10% before 20 years)
What is Myotonic Dystrophy type 1?
Expansion of a CTG trinucleotide repeat in the 3’UTR of DMPK gene. Repeats transcribed into mRNA and accumulate in nucleus, trapping essential cellular RNA-binding proteins
What is Fragile X syndrome?
Expansion of CHG trinucleotide repeat in 5’UTR of FMR1 gene on X chromosome. Large DNA expansion hypermethylated and FMR1 expression silenced, reducing FMR1 protein
