10: Movement Disorders- Dodge Flashcards
rhythmic, oscillating movement of body part
tremor
clumsiness, instability, imbalance or lack or coordination with voluntary movements
ataxia
movements appear disjointed, unsteady giat, falls
involuntary muscle spasms
dystonia
can be generalized or focal (writer’s cramp, torticollis)
repetitive, purposeless, involuntary movements
tardive dyskinesia
grmacing, lip-smaking, rapid arm/leg movements
prolonged exposure to antipsychotics, neuroleptics
impaired ability of rapid alternating movements
dysdiadochokinesia
non-repetitive jerking movements of limbs, face or truk
chorea
most common tremor disorder
essential tremor : involuntary rhythmic, oscillatory movements
kinetic (tremor with movement of body part) or postural (tremor when body part held against gravity)
risk factors for essential tremor
lead, beta-carboline alkaloids
D3 receptor gene variant possibly associated with familial essential tremor
diagnosis of essential tremor
rule out other disorders that may mimic essential tremor
check thyroid function, ceruloplasmin (to exclude Wilson’s disease especially in pt less than 40 yo)
if caused by disease process… NOT an essential tremor
DD for tremor
hyperthyroidism PD Enhanced physiologic tremor Wilson's Disease (dysfunction of copper with deposition) Medications
what medications might cause a tremor?
amiodarone
beta agonists
lithium
theophylline (Asthmatics)
treatment for tremor (symptom management)
***propranolol (beta blocker)
primidone (GABA effect)
Todd’s syndrome (alice in wonderland syndrome)
characterized by migraines in children that cause micro/macropsia, teleopsia (far away), pelopsia (close)
pathophysiology of PD
loss of dopaminergic neurons in sunstantia nigra
neurons die and degenerate
imbalance in DA:Ach in striatum –> improper signalling pathway for cortical motor commands
possibly related to alpha-synuclein; defective degradation leads to increased alpha-synuclein in nigrostriatal neurons
what is MPTP?
precursor to MPP+ (neurotoxin that destroys dopaminergic receptors in substantia nigra)
