Flashcards in Neuro E Movement Disorders Deck (30):
1
Rate limiting step in DA creation
Tyrosine hydroxylase (Tyrosine -> L-Dopa)
(1st step)
2
Rate limiting step in Parkinsons patient who you give L-Dopa
Dopa decarboxylase (L-Dopa -> Dopamine)
3
Chorea
-Dance
-Irregular
4
Sydenham's Chorea
Secondary to Group A Strep infection
-Shows with carditis, arthritis, rheumatic fever
5
Sydenham's Chorea Dx
Tx
Antistreptolysin antibody titer
Antibacterial and Antipsychotics
6
Huntington's Disease Triad
Anatomy
Chorea, Dementia, Psychiatric D/O
Destruction of Caudate and Putamen
7
Huntington's genetics
Chromosome 4 CAG repeat (>36)
Anticipation
8
Huntington's Tx
Tetrabenazine, Antipsychotics (only for chorea)
9
Hemiballismus - Anatomy
-Features
-Tx
-Lesion to contralateral subthalamic nucleus
-Unilateral wild limb jerking
-Antipsychotics
10
Intention Tremor drug causes
Alcohol, Anticonvulsants, Sedatives
(Cerebellum)
11
Postural (physiologic) Tremor drug causes
Physiologic causes
Lithium, Bronchodilators, Theophylline, Alcohol withdrawal
Hyperthyroidism, Anxiety
12
Spasticity v Rigidity problem location
Corticospinal v Basal Ganglia
13
Cogwheel rigidity
Parkinsonian
Tremor on top of Rigidity (BG)
14
Lewy Body protein
Alpha Synuclein
15
Parkinsons Tx
symptom based (bradykinesia)
-L-Dopa - Carbodopa (peripheral blocker)
-Anticholinergics
-Amantadine (antiviral)
MAO B inhibitor
16
NT from Frontal Lobe to Basal Ganglia (excitatory)
Acetylcholine
17
Parkinsons drug Tx theory
Give direct agents first, DA later. This delays "on/off" phenomenon
18
Direct Dopamine Agonists
Ropinirole
Pramipexole
19
Anticholinergics
Benztropine
Trihexyphenidyl
20
Surgical Tx of Parkinsons
DBS of Thalamus and Globus Pallidus
21
Restless Leg Syndrome drug Tx
DA agonist
Iron supplementation
Sedatives
22
RLS anatomy
Reticular Formation
23
Parkinsonism drug causes
Antipsychotics
24
"Parkinson's Plus" Syndrome
Parkinsons-like, but different clinical presentation and different L-Dopa response
25
Parkinson's Plus Syndromes (3)
-Progressive Supranuclear Palsy
-Multiple System Atrophy
-Diffuse Lewy Body Dementia
26
Dystonia
Slow twisting of body, fixed posturing
27
Torticollis
Cervical dystonia, often with arm held in hyperpronated position
28
Blepharospasm
Forced closure of eyelids for period of time, often with facial grimacing
29
Writer's cramp
Dystonic posture of hand & forearm when pen is held
30