Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med- Neuro > Movement Disorders Lecture > Flashcards

Movement Disorders Lecture Flashcards

(63 cards)

Start Studying
1
Q

Seen when there is NO muscle engagement/activity

(must hold up the pts affected body part to really determine)

A

Resting tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tremor that is produced by voluntary muscle contraction

A

Action tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tremor that is present during visually guided, target directed motion

ie..going to pick up a water bottle

A

Intention tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

“normal” finding
high frequency, low amplitude postural tremor
enhanced by hyper-adrenergic states

fine, fast tremor. low amplitude. worse with anxiety

A

Physiologic tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MC movement disorder wordwide

aka benign familial tremor

generally seen in elderly (60+)

A

Benign essential tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Insidious development, slow progression
95% start with postural distal arm tremor

*unilateral, progresses to bilateral
almost ALWAYS upper extremity!!!

A

Benign essential tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Elder pt, slow progression, upper extremity (starts unilateral, moves bilateral)

..think of?

A

Benign essential tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Worsens with:
Stress, fatigue, CNS stimulants, voluntary activity

Better with:
ETOH, beta blockers, rest

A

Benign essential tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment for benign essential tremor

contraindicated in asthma

SE: sedation, dizziness, nausea, mood changes

barbiurate, anticonvulsant

A

Primidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Do you use beta blockers to treat benign essential tremor?

A

YES.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What will the neurological exam look like in a benign essential tremor?

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Neurodegenerative disorder resulting from decreased dopaminergic transmission in basal ganglia

A

Parkinsons

(think dopamine when you hear Parkinsons)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

4 cardinal signs:

  1. tremor
  2. rigidity
  3. bradykinesia
  4. postural impairment
A

Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tremor is present in 85% of cases
“pill rolling” 4-6 Hz resting tremor
one limb or one side of body for months to years
spares head

A

Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rigid gait
Flat affect/facial expressions
Tremor with rest and action

A

Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Increased resistance to passive movements
“cogwheel rigidity”

NO weakness (5/5 in all extremities)
NO change in DTRs

A

Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bradykinesia (slowness of movements)
Effects voluntary movements and speech

*start hesitation..trouble taking that first step

A

Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Parksinson pts have difficulty with balance and gait

..at what point in the disease process do you see this?

A

later in disease course

(worrisome if seen early. normally this takes long time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is “festinating gait” referring to?

A

The way a Parkinson’s pt walks…

short fast steps, trying to keep up with center of gravity. shuffling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does turn “en bloc” refer to?

A

The way a Parkinson’s patient turns

freezing with direction change or when entering small space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

“mask like” face
decreased blinking
dementia 6x normal
micrographia
hypophonia
depression
akinesia

A

Parkinsons

(non specific, just other findings)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Peak onset 60 (35-85)
Course 10-25 years
Males>Females
Some genetic predisposition

A

Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Loss of melanin-containing, dopaminergic neurons in substantia nigra

Lewy bodies***- Pathological hallmark of PD when in basal ganglia (not specific)

A

Pathophysiology of Parkinsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

At the time Parkinsons symptoms appear, what levels might be depleted by 70%?

A

Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Gold standard tx of Parkinsons?
Levodopa (converted to dopamine in the brain. dopamine itself cant cross BBB)
26
When do you start treating Parkinsons?
When **functional disability** starts \*medication benefit only works for a few years
27
What is a surgical tx option for Parkinsons?
Surgically implanted deep brain stimulation ## Footnote **blocks abnormal signals that cause PD symptoms**
28
Autosomal dominant neurodegenerative disorder **Classic triad: motor, cognitive and psychiatric symptoms** insidious onset, no cure age of onset: 30-50 Fatal in 15-20 years\*
Huntington's disease
29
Primary involuntary movement in Huntington's Disease "the dance"
Chorea
30
What is athetosis? (seen in Huntington's)
Proximal limb writhing
31
Involuntary, irregular, rapid, uncontrolled, excessive movement \*often not noticed by, nor disturbing to, the patient
Chorea
32
Abnormal eye movements Slow or uncoordinated fine motor control Dyarthria Dysphagia Gait disturbance Bradykinesia and rigidity late in course (as chorea peaks and wanes)
Huntington's
33
Psychiatric symptoms: Depression Mania OCD Apathy Anxiety
Huntington's disease
34
Cognitive symptoms: Dysfunction of executive functions Problems with plannig, judgement, emotion, regulation, learning, attention, etc. Cant follow instructions Temper outbursts Difficulty with spatial perception
Huntington's
35
**decreased** GABA **decreased** Ach **increased** dopamine
Huntingtons
36
Excessive number of "CAG" sequence repeats
Huntingtons
37
How do you treat Huntingtons?
Symptomatically (Neuroleptics, Benzos, Dopamine depleting agents)
38
MAJOR potential complication of Huntingtons?
Rhabdomyolysis (breakdown of muscle tissue that releases damaging protein into blood)
39
Inherited neurobehavioral disorder characterized by sudden involuntary, repetitive muscle movements and vocalizations
Tourette's
40
For a diagnosis of Tourette's... Tic episodes several times a day, almost every day, or periodically during period longer than....
1 year
41
Where does Tourette's start/originate?
Head and face (ie blinking, face twitch, head jerk, shrug, neck stretch, sniffing)
42
Meaningless repitition or imitation of movements \*seen in Tourette's patients
Echopraxia
43
Palilalia
repeating one’s own words
44
Repeating heard words-last words spoken by someone else
Echolalia
45
Coprolalia
the involuntary and repetitive use of obscene language
46
movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures or both **diagnosed in the young!**
Cerebral palsy
47
Non-traumatic fractures can occur due to extreme hyper flexion or hyper extension
Cerebral Palsy (CP)
48
"burning" sensation generally starts in distal extremities (MC feet) and moves proximally
Neuropathy
49
Hallmark= VERY painful with light touch Hypersensitive ## Footnote **pain out of proportion**
Neuropathy
50
Compression at the superior thoracic outlet resulting from excess pressure places on a neurovascular bundle passing between the anterior scalene and middle scalene muscles
Thoracis outlet syndrome
51
Positive Adson's sign Costoclavicular movement seen in...
Thoracis Outlet Syndrome
52
Intermittent, progressive chronic disorder involving aberrant firing of trigeminal nerve- **usually 2nd and 3rd branches** Unilateral lancing paroxysmal facial pain
Trigeminal neuralgia
53
Triggers= **light touch!!** but NOT firm pressure
Neuropathy
54
What will a neuro exam look like in trigeminal neuralgia?
NORMAL! except for illicit pain with light touch
55
Drug class for treatment of trigeminal neuralgia?
Anti-convulsants
56
Highest risk location of shingles?
Trigeminal (especially ophthalmic division..**can cause blindess**) Brachial plexus
57
A term applied to a number of genetic disorders that produce progressive degeneration and necrosis of skeletal muscle fibers and eventual replacement with fat and connective tissue
Muscular dystrophy
58
Does muscular dystrophy involve the nervous system?
NO..disease of muscle tissue!
59
A disorder of the neuromuscular junction that affects impulse transmission between the motor neuron and the innervated muscle cell
Myasthenia Gravis
60
An acute life threatening polyneuropathy **rapid progressive limb weakness and LOSS of tendon reflexes** MC cause of acute, flaccid paralysis in developed countries
Guillain-Barre syndrome
61
An acute onset immune-mediated demyelinating neurpathy **progressive ascending muscle weakness of limbs, producing a symmetric flaccid paralysis** Symptoms: parasthesia and numbness, often accompany the loss of motor function
Guillain-Barre syndrome
62
What is the Myerson Sign and what disorder is it seen in?
Sustained eye blinking in response to taping above nasal bridge ## Footnote **seen in Parkinson's**
63
Can you tx trigeminal neuralgia with Carbamazepine?
YES

Clin Med- Neuro (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions