Parkinsons

Question 1

Characteristics of hypokinetic motor diseases

Answer 1

• expressionless
• low-tone facial appearance
• diminished activity initiations
• slowed execution of motions
• rigidity
• may have resting tremor

Question 2

Hypothyroidism and hypokinesia

Answer 2

Thyroid gland cannpt make enough T3 and T4 hormones

Changes in facial tone are seen in hypothyroidism

General s/s

• brittle skin, hair, nails
• cold, low mood, energy
• water retention, hoarse, puff face and feet
• slowed heart rate

Question 3

Progressive supranuclear palsy and hypokinesia

Answer 3

Progressive deterioration of brainstem, c cortex, cerebellum and basal ganglia

Onset 40+ years

Features:

• slowing of vertical saccacdes
• postural instability (^ falls)
• symmetric akinesia
• abnormal neck posture (retrocollis)
• early dysphagia and dysarthria
• cognitive impairment

Question 4

Parkinsons disease and hypokinesia

Answer 4

2nd mc neurodegenerative ds after alzheimer’s
-onset 58-62 years

Disease triad

• bradykinesia
• rigidity
• resting tremor

Signs

• expressionless
• long latency responses
• reduced arm swing (checked at side)
• small font when writing
• slow speech
• drooling
• en-bloc turning
• fatigue

Question 5

Multiple system atrophy (MSA)

Answer 5

Multiple brain systems are involved and degenerating at the same time
-extrapyramidal (coordination), pyramidal (motor control), cerebellar and autonomic

Patients are clinically classified accoridng to the predominant affecvt

• motor presentation
• parkisonian subtype
• autonomic failure contributed to urinary difficulty

Question 6

Lacunar state and hypokinesia

Answer 6

Subcortical infarcts that occur with blockage of a single perforating artewry

When symptomatic:

• pure motor hemiparesis (MC)
• ataxic hemiparesis (2nd MC(
• pur sensory
• sensorimotor

Question 7

Characteristics of hyperkinetic motor diseases

Answer 7

• dystonia
• athetosis (slow involuntary writhing movements of head/neck, hands, tongue)
• chorea (involuntary irregular movements)
• dyskinesia
• tics
• tremor
• myoclonus

Question 8

Huntington’s disease and hyperkinesia

Answer 8

Genetically programmed degeneration that cuases unctontrolled movements, loss of intellectural faculties, and emotional disturbance

Early s/s

• mood swings
• depression
• irritabiltiy
• trouble driving
• trouble learning new things
• trouble remembering facts or making deciisions

Progresses to: concentration difficulties and issues feeding and swallowing

Question 9

Tardive dyskinesia

Answer 9

Commonly occurs after prolonged exposure to neuroleptic agents (e.g. psycholgical meds)

Characteristics: repetitive, involuntary, purposeless movements, e.g.:

• grimacing, tongue protrusion, lip smacking, puckering and pursuing, rapid eye blinking
• rapid movmeents of arms and legs
• involuntary movmenets of fingers

Question 10

Ballismus

Answer 10

Involuntary jerking and flinging of proximal muscles

Can occur with strokes, trauma, MS and subthalamic lesions

“Ballismus” = ballistic

Dystonia

Question 11

Dystonia

Answer 11

Abnormal tone anywhere with impaired movements

Can occur with Meige’s syndrome, spasmatic torticollic, tardive dystonia, and hypocalcemia

Question 12

Tic

Answer 12

Brief twitchy fast, involuntary movemnts

Stereotypical, repetitive and chronic

Question 13

Tremor

Answer 13

Repeittive regular oscillatory movement

Irregular contraction of opposing muscles

Usually involuntary

Question 14

Myoclonus

Answer 14

the sudden, involuntary jerking of a muscle or group of muscles

Question 15

Chorea

Answer 15

sudden, rapid, jerky, purposeless movement involving limbs, trunk, or face

Question 16

Athetosis

Answer 16

bizarre, slow, twisting, writhing movement, resembling a snake or worm

Question 17

Tourette syndrome

Answer 17

Dysfunction with direct/indirect circuits between subcortical regions, thalamus, basal ganglia, and frontal cortex