Parkinson's and Movement Disorders Flashcards Preview

Y3 Neurology > Parkinson's and Movement Disorders > Flashcards

Flashcards in Parkinson's and Movement Disorders Deck (42)
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1
Q

what are the two main groups of movement disorders?

A

hypokinetic - too little movement i.e. parkinson’s

hyperkinetic - too much movement i.e. tics

2
Q

what mnemonic can be used to remember the main presentation of parkinsonism and what does this stand for?

A

TRAP

tremor
rigidity
akinesia/bradykinesia
postural disturbances

3
Q

what postural disturbances can be seen in parkinsonism?

A

flexed posture

postural instability

4
Q

what is rigidity?

A

increased muscle tone

felt by passive movements

5
Q

what are the two types of rigidity?

A

lead pipe = consistent throughout the movement

cogwheel = has a superimposed tremor

6
Q

how is rigidity distinguished from spasticity?

A

felt throughout the whole range of movement

no increase with higher mobilising speed

7
Q

what type of motor neurone lesion is associated with spasticity?

A

upper motor neuron lesions

8
Q

what is a positive froment’s maneouvre?

A

rigidity increases in the examined body segment by voluntary movement of other body parts

9
Q

how do you test for akinesia or bradykinesia?

A

ask the patient to perform rapid repetitive and alternating movements such as finger/toe tapping, opening and closing the fist + pronating and supinating the wrist

10
Q

why do patients with parkinsonism have stooped posture?

A

impaired postural reflexes

11
Q

what is camptocormia?

A

postural impairment where patients have extreme anterior truncal flexion

seen in parkinsonism

12
Q

describe the gait associated with parkinsonism

A

slow
narrow base
short, shuffling steps

13
Q

what is the hallmark of the gait impairment in parkinsonism and how can this be visualised?

A

freezing

seen on turning, may also have start hesitation

14
Q

what can be used to test for postural instability in parkinsonism?

A

pull test

stand behind the patient, hold their shoulders and pull them backwards

15
Q

what is a tremor?

A

a rhythmic sinusoidal oscillation of a body part

16
Q

when does a rest tremor occur?

A

when the affected body part is at rest

17
Q

when does a postural tremor occur?

A

when the arms are outstretched

18
Q

when does a kinetic tremor occur?

A

during the movement of a body part

19
Q

describe the appearance of a physiological tremor

A

symmetrical
fast
small amplitude

20
Q

name two liver conditions associated with a postural tremor

A

wilson’s disease

hepatic encephalopathy

21
Q

what is dystonia?

A

a movement disorder characterised by sustained/intermittent muscle contractions causing abnormal movements, postures or both

22
Q

what are dystonic movements like?

A

patterned
twisting
may be tremulous

23
Q

what can initiate dystonia?

A

voluntary movement

24
Q

name some possible causes of chorea

A

drugs
basal ganglia lesions
anti phospholipid syndrome
huntington’s

25
Q

what is ballism?

A

extreme variant of chorea

26
Q

how does ballism present?

A

large amplitude flinging movements usually affecting proximal joints

usually in a hemi-body distribution

27
Q

what does ballism suggest?

A

a contralateral lesion typically involving the striatum of the subthalamic nucleus

28
Q

what is myoclonus?

A

brief electric shock like jerks

29
Q

what are two common, normal forms of myoclonus?

A

hiccups

hypnic jerks when falling asleep

30
Q

what causes myoclonus?

A

brief activation of a group of muscles

31
Q

what causes negative myoclonus?

A

temporary cessation of muscle activity

32
Q

name an example of negative myoclonus

A

asterixis (aka liver flap) in patients with liver failure

33
Q

what are tics?

A

involuntary, repetitive movements or vocalisations

34
Q

when do tics tend to start?

A

almost always in childhood

35
Q

what i sthe most common type of postural tremor?

A

essential tremor

36
Q

what is the inheritance pattern of essential tremor that runs in families?

A

autosomal dominant

high penetrance

37
Q

what can make an essential tremor better?

A

alcohol intake

38
Q

what is a histological hallmark of parkinson’s?

A

lewy bodies

39
Q

what are the motor symptoms of parkinson’s?

A

tremor
rigidity
akinesia/bradykinesia
postural instability

(TRAP)

40
Q

what non motor symptoms can be seen in parkinson’s?

A
sleep disorders 
hallucinations
GI problems 
depression 
dementia 
anosmia
41
Q

what are the essential features for a diagnosis of parkinson’s?

A

bradykinesia and 1+ of:

  • resting tremor
  • rigidity
  • postural instability
42
Q

who is more likely to get parkinson’s - males or females?

A

males