Movement disorders intro

Question 1

common features of disordered movement

Answer 1

impaired postural refelxes that would normally contribute to balance - diminished or slowed movement(hypokinesia/bradykinesia) - excessive involuntary movements (hyperkinesia) -uncoordinated or unsteady movements (ataxia)

Question 2

Physiological(nonpathological tremor)

Answer 2

refelcts low-amplitude oscillatory movement of a , bodily region

Question 3

Resting tremor

Answer 3

common in parkinsons, wanes during voluntary movement of the affected body part, a BASAL GANLIAR dysfunction secondary to mesencephalic degeneration is integral to parkinson’s disease.

Question 4

Intention (kinetic) termor

Answer 4

arises with voluntary movement particularly as the affected body part approaches a target in space (commonly cerebellar lesions yield this)

Question 5

Chorea

Answer 5

brief, purposeless, irregular jerky movements of body parts,(often from Basal gangliar disease. -voluntary movements may be affected as abnormal choreic movements are superimposed. -successive choreic movements resembles dancing. -HALLMARK of Huntington disease and sydenham disease.

Question 6

athetosis

Answer 6

continuous slow writhing body parts, (Often Basal Gangliar) may be seen in athetoid cerebral palsy -can accompany hemiplagia(gate is superimposed.

Question 7

Ballismus

Answer 7

flinging or rotary movements, causal lesions often involve the subthalamus which contributes to basal gangliar function - is expressed unilaterallly with manifestations expressed contralateral to the injury

Question 8

Lower motor neurons can present hypokinetic disorders presents as

Answer 8

flaccid paralysis

Question 9

hypokinesia is asssociated with

Answer 9

upper motor neurons

Question 10

hypokinesia yields

Answer 10

elevated muscular tone and hyperreflexia

Question 11

dysfunctions involving modulatory and regulator circuits can also produce

Answer 11

hypokinesia

Question 12

sensory and motor systems cooperate to

Answer 12

mantian equilibirum

Question 13

posture is immediately linked to

Answer 13

muscel tone which can be adversely affected by a broad array of lesions

Question 14

aberrations of posturecan

Answer 14

reflect tonically increased or decreased muscle tone.

Question 15

damage to modulatory centers can

Answer 15

destabilize muscle tone yielding spontaneous and uncontrolled movements.

Question 16

Decorticat posture suggests

Answer 16

a cereberal lesion affecting the corcio spinal system with sparing of motor centers of the brain stem. including the red nucleus

Question 17

station is sensitive to

Answer 17

damage to conscious and unconscious sensory systems and motor systems.

Question 18

ability of patient to stnad steady with feet together may deteriorate when

Answer 18

the eyes are close and the visual system isn’t able to compensate for nervous deficits.

Question 19

postural tremor

Answer 19

apparent only when a particular posture is maintained may reflect basal gangliar dysfunction

Question 20

Prakinson disease

Answer 20

-akinesia/bradykinesia, -facial masking -muscular rigidity -loss of postural refelxes -parkinsonian gait -loss of habituiation to glabellar stimulation -speech is quiet, hoarse and monotonous with accelerated bursts

Question 21

stages of parkinson

Answer 21

1. unilateral 2. bilateral but with preserves postural reflexes, 3. bilateral with loss of postural refelxes 4. severe disability with some movement 5. Akinesia

Question 22

Prodrome

Answer 22

hyposomia, autonomic disturbances and REM sleep disorder. reflects degeneration in olfactory and cuadal bulbar centers

Question 23

Cogwhell rigidity

Answer 23

recurrent stepwise release and return of resistance to passive movement

Question 24

lead pipe rigidity

Answer 24

resistance that is sustained throught a range of passive movement.

Question 25

glabellar reflex involves

Answer 25

noxious stimulation between the eyes to elicit bilateral blinking, normally blinks weaken with repeated stimulation

Question 26

Dystonia

Answer 26

muscle spasms or sustained abnormal postures involving trunk and limbs -post are partial or segmental.

Question 27

spasmodic torticollis

Answer 27

a specific dystonia involving the neck, they contract involuntarily and may become hypertrophic.

Question 28

Tic Syndromes

Answer 28

irregularly occuring sterotyped movements that are usually transient and uncoordinated.

Question 29

tourette syndrome.

Answer 29

multifocal tics, ADHD, vocal tic.

Question 30

Tardive dyskinesia

Answer 30

patients exposed to antipsychotic. oral movements, doesn't necessarly abate with drug withdrawal

Question 31

Dopa induced dyskinesia

Answer 31

often arises during treatment of parkinson disease with precursor to dopamine. -choreic movemnts, facial dystonias

Question 32

drug induced parkinsonism.

Answer 32

suppresion of dopaminergic transmission. may dissipate within weeks