11 Movement disorders

Question 1

when does Parkinson’s disease usually occur?

Answer 1

late 50’s to 60’s

Question 2

what is the prevalence of Parkinson’s?

Answer 2

200 out of 100,000 people

Question 3

what are some common signs of Parkinson’s disease?

Answer 3

resting tremor
Bradykinesia
Rigidity in movement
Loss of reflexes
fatigue
depression

Question 4

what causes Parkinsons?

Answer 4

loss of dopaminergic neurons in the SNC

Question 5

loss of cholinergic neurons in the cortex leads to?

Answer 5

Cognitive deficits

Question 6

loss of cholinergic neurons in the brain stem leads to ?

Answer 6

postural loss

Attention deficits

Question 7

loss of serotonergic neurons in the brain stem leads to?

Answer 7

Signal to noise deficits

Question 8

Why not just give dopamine to the parkinsons patients?

Answer 8

dopamine does not cross the blood brain barrier?

Question 9

why not just give L-Dopa?

Answer 9

although it can cross the blood brain barrier, its half life it too short to be very affective.

Question 10

So how would you treat Parkinson’s?

Answer 10

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.

Question 11

What is chorea?

Answer 11

a rapid non stereotypic movement that flows from one area of the body to another.

Question 12

what is BALLISM?

Answer 12

chorea that severely affects the proximal extremities.

Question 13

what is it called when chorea/ballism affects only one side of the body?

Answer 13

Hemiballism or Hemichorea

Question 14

what is the pathology behind hemiballism?

Answer 14

sub thalamic nuclei or neurons

Question 15

what are some common characteristics of huntingtons disease?

Answer 15

1) generalized chorea
2) triple repeat
3) autosomal dominant
4) late onset
5) dementia

Question 16

what is the pathology affecting huntingtons disease?

Answer 16

Degeneration of the MSN neurons projecting to the GPe

Question 17

What is dystonia?

Answer 17

twisting and slow abnormal movements of the body.

Question 18

What is the most common reason (defect) that causes dystonia?

Answer 18

defects in the putamen

Question 19

Idiopathic torsion dystonia (DYT1) can be characterized by what?

Answer 19

1) autosomal dominant
2) Defective DYT1 gene
3) low penetrance
4) no clear structural abnormality in CNS
5) begins in childhood

Question 20

If a patient has the DYT1 gene mutation, when will this first present itself? where will it present?

Answer 20

DYT1 mutations present early in life and usually begin in the lower limbs and progressively move to whole body.

Question 21

If you block the dopaminergic neurons what happens?

Answer 21

parkinson like symptoms

Question 22

What is tardive dyskinesia?

Answer 22

a movement disorder caused by dopamine blockage resulting in involuntary tongue and mouth movements.

Question 23

what is Akathisia?

Answer 23

a movement disorder caused by dopamine blockage resulting in the desire to keep in motion. (fidgeting, marching in place, speaking incessantly)