11 Movement disorders Flashcards
when does Parkinson’s disease usually occur?
late 50’s to 60’s
what is the prevalence of Parkinson’s?
200 out of 100,000 people
what are some common signs of Parkinson’s disease?
resting tremor Bradykinesia Rigidity in movement Loss of reflexes fatigue depression
what causes Parkinsons?
loss of dopaminergic neurons in the SNC
loss of cholinergic neurons in the cortex leads to?
Cognitive deficits
loss of cholinergic neurons in the brain stem leads to ?
postural loss
Attention deficits
loss of serotonergic neurons in the brain stem leads to?
Signal to noise deficits
Why not just give dopamine to the parkinsons patients?
dopamine does not cross the blood brain barrier?
why not just give L-Dopa?
although it can cross the blood brain barrier, its half life it too short to be very affective.
So how would you treat Parkinson’s?
1) L-Dopa attached to a decarboxylase inhibitor
2) fetal tissue transplantation
3) Gene therapy
4) High stimulation of subthalmic nuclei and GPi to “jam” them up preventing inhibition.
What is chorea?
a rapid non stereotypic movement that flows from one area of the body to another.
what is BALLISM?
chorea that severely affects the proximal extremities.
what is it called when chorea/ballism affects only one side of the body?
Hemiballism or Hemichorea
what is the pathology behind hemiballism?
sub thalamic nuclei or neurons
what are some common characteristics of huntingtons disease?
1) generalized chorea
2) triple repeat
3) autosomal dominant
4) late onset
5) dementia
what is the pathology affecting huntingtons disease?
Degeneration of the MSN neurons projecting to the GPe
What is dystonia?
twisting and slow abnormal movements of the body.
What is the most common reason (defect) that causes dystonia?
defects in the putamen
Idiopathic torsion dystonia (DYT1) can be characterized by what?
1) autosomal dominant
2) Defective DYT1 gene
3) low penetrance
4) no clear structural abnormality in CNS
5) begins in childhood
If a patient has the DYT1 gene mutation, when will this first present itself? where will it present?
DYT1 mutations present early in life and usually begin in the lower limbs and progressively move to whole body.
If you block the dopaminergic neurons what happens?
parkinson like symptoms
What is tardive dyskinesia?
a movement disorder caused by dopamine blockage resulting in involuntary tongue and mouth movements.
what is Akathisia?
a movement disorder caused by dopamine blockage resulting in the desire to keep in motion. (fidgeting, marching in place, speaking incessantly)
