0904 - Movement Disorders Flashcards
What is Parkinsonism? What are the cardinal features?
Most common movement disorder. Chronic, idiopathic neurodegenerative disease characterised by extrapyramidal motor symptoms and non-motor symptoms.
4 cardinal features - Resting tremor, rigidity/stiffness, bradykinesia, postural instability.
What are some non-motor symptoms of Parkinson’s Disease?
Anosmia, depression, dementia, psychosis, pain, constipation, fatigue, sleep disturbance.
What is the pathophysiology of Parkinson’s disease?
Destruction of dopaminergic neurons in the substantia nigra (pars compacta), brainstem, olfactory tract and GIT. Only become symptomatic after 60-80% loss. Lewy bodies present, but role is completely unknown at this stage.
What is the composition of Lewy bodies?
Alpha Synuclein and ubiquitin.
What are some PD mimics
Secondary parkinsonism - Vascular, drugs, normal pressure hydrocephalus, subdural haematoma, repeated head trauma.
Primary neurodegenerative disorder - Dementia with Lewy bodies, corticobasal degeneration, progressive supranuclear palsy, multiple system atrophy.
What is a tremor? What are the 5 broad potential causes?
Involuntary rhythmic, repetitive, oscillatory movement of a body part caused by alternate contraction of agonist and antagonist muscle groups.
Causes - Idiopathic, Degenerative, Metabolic, Drugs, Emotion
What are the three primary types of tremor and a common cause of each?
Resting tremor - Parkinsons
Postural/action tremor (when limb maintained in position) - Essential tremor
Intention tremor - Cerebellar pathology/MS/Midbrain pathology
What are the three types of hyperkinesis that may be present in Huntington’s Disease?
Chorea - Rapid, distal, dance-like
Athetosis - Slower, Writhing, random
Ballism - Proximal, large-amplitude, ‘flinging’.
What is the pathophysiology of Huntington’s Disease?
Autosomal dominant, progressive neurodegenerative disorder characterised by choreiform movements, psychiatric symptoms and dementia. Caused by CAG repeats in huntingtin gene, somehow resulting in caudate atrophy.
What is dystonia?
Movement disorder characterised by sustained or intermittent muscle contractions causing abnormal, repetitive movements, postures or both. Movements are often patterned and twisting - and it is made worse by voluntary action.
How does botulinum toxin work?
Blocks release of ACh, leading to chemical denervation.
