14 - Basal Ganglia and Movement Disorders

Question 1

Parts of the basal ganglia

Answer 1

Caudate, putamen, globus pallidus, subthalamic nucleus, substantia nigra

Question 2

Parts of the striatum

Answer 2

Caudate and putamen

Question 3

Parts of the lenticular nucleus

Answer 3

Globus pallidus and putamen

Question 4

Characteristics of hypokinetic movement disorder

Answer 4

Akinesia, bradykinesia, rigidity, stooped posture, retropulsion (a form of postural instability), aprosody, masked facial appearance, small handwriting

Question 5

Characteristics of hyperkinetic movement disorder

Answer 5

Chorea (hemiballismus, athetosis, dyskinesia (dopamine dyskinesia, tardive dyskinesia)), tremor (parkinsonian, essential), tic, dystonia

Question 6

Different types of chorea and their differences

Answer 6

Hemiballismus - sudden, fling-like motion on one side
Athetosis - slow writhing movement of trunk and extremities
Dyskinesia - chorea due to iatrogenic conditions

Question 7

Different types of tremors

Answer 7

Parkinsonian tremor - 4-6 Hz, pronation/supination of forearm with “pill rolling tremor”
Essential tremor - 8 Hz, fine to medium amplitude, persists and worsens with purposeful movement, suppressed temporarily with alcohol (not motor basal ganglia system)

Question 8

Input nuclei of basal ganglia

Answer 8

Caudate (saccadic eye mvmt, cognitive function) and putamen (motor control)

Question 9

Output nuclei of basal ganglia

Answer 9

Internal segment of globus pallidus and SN pars reticulata

Question 10

Hypokinetic movement disorder lesion locations

Answer 10

SN pars compacta, globus pallidus, or putamen (excitatory)

Question 11

Hyperkinetic movement disorder - chorea lesion locations

Answer 11

STN or putamen (inhibitory)

Note: hemiballismus often has contralateral STN lesions

Question 12

Hyperkinetic movement disorder - dystonia lesion locations

Answer 12

Putamen