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Neurology > 2: Movement Disorders > Flashcards

2: Movement Disorders Flashcards

1
Q

What is a movement disorder

A

Syndrome caused by excess or paucity of automatic or voluntary movements

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2
Q

What are 3 common movement disorders

A
  • Essential tremor
  • PD
  • Restless leg syndrome
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3
Q

What are the 4 types of movement

A
  1. Automatic
  2. Voluntary
  3. Semi-voluntary
  4. Involuntary
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4
Q

What is automatic behaviours

A

Learned motor behaviours performed without conscious effort

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5
Q

Give an example of automatic behaviour

A

Walking to a familiar place

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6
Q

What is voluntary behaviour

A

Behaviour performed in response to an external stimulus

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7
Q

What is semi voluntary movement

A

Behaviour performed in response to an internal stimulus

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8
Q

Give two examples of semi voluntary movement disorders

A
  • Tic

- Restless leg syndrome

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9
Q

What are involuntary movements

A

Movements that cannot be surpassed

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10
Q

Give 4 examples of non-supressable movement disorders

A
  • Tremor
  • Myoclonus
  • Chorea
  • Dystonia
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11
Q

How is normal control of movement divided

A

Central

Peripheral

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12
Q

What are central components of movement

A
  • Motor cortical areas

- Basal ganglia

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13
Q

What are peripheral components of movement

A
  • Motor neurone junction
  • Muscle
  • Spinal Cord
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14
Q

What pathways exist in the basal ganglia

A

Direct and Indirect

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15
Q

Explain effect of dopamine on direct pathway

A

Direct pathway contains D1-receptors. Hence is excited by dopamine release from corticostriatal neutrons

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16
Q

Explain effect of dopamine on indirect pathway

A

Direct pathway contains D2-receptors. Hence is inhibited by dopamine release from corticostriatal neurons

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17
Q

What is the role of direct pathway

A

Increases voluntary movement

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18
Q

Explain direct pathway

A
  • Corticostriatal neurons stimulate external pallidum
  • External palladium inhibits internal pallidum
  • This prevents internal pallidum form inhibiting thalamus
  • Excites thalamus and movement
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19
Q

Explain indirect pathway

A

Inhibits movement

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20
Q

Explain indirect pathway

A
  • Corticostriatal neurons inhibit external pallidum (D2 receptors)
  • This disinhibits sub thalamic nucleus
  • Subthalamic nucleus stimulates the internal pallidum
  • Internal pallidum inhibits thalamus, inhibiting movement
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21
Q

What are the two types of movement disorders

A

Hyperkinetic

Hypokinetic

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22
Q

What are 7 hyperkinetic movement disorders

A
  • Dystonia
  • Tremor
  • Tic
  • Myoclonus
  • Akathisia
  • Athetosis
  • Chorea
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23
Q

What are 5 hypo kinetic movement disorders

A
  • Cataplexy
  • Bradykinesia
  • Rigidity
  • Catatonia
  • Holding Tic
24
Q

Define tremor

A

Regular, rhythmic, repetitive movements that affects one or more body parts

25
Q

Define dystonia

A

Sustained twisting repetitive movements with prolonged abnormal posture involving groups of muscles

26
Q

Define chorea

A

Involuntary, Irregular, Purposeless, unsustained movement that flow from one body part to another

27
Q

Define myoclonus

A

Brief electric shock like movements arising from nervous system

28
Q

What is positive myoclonus

A

Contraction agonist then antagonistic muscle groups

29
Q

What is negative myoclonus

A

Transient interruption in tonic muscle tone (asterixis)

30
Q

What is a Tic

A

Repetitive stereotyped behaviour that is difficult to control

31
Q

What is akathisia

A

Inner restlessness

32
Q

What is cataplexy

A

Transient loss in muscle tone due to strong emotion

33
Q

Define a tremor

A

Rythmic involuntary movement of one or more body parts

34
Q

What is the most common cause of tremor

A

Essential tremor

35
Q

What is the inheritance pattern of essential tremor

A

Autosomal dominant

36
Q

How does essential tremor present

A
  • Postural tremor - worse with arms outstretched

- Head tremor

37
Q

What improves essential tremor

A

Alcohol

Rest

38
Q

What is stereotype for essential tremor patient

A

Young patient with sudden-onset tremor

39
Q

How is essential tremor managed first line

A

Propanolol

40
Q

What is an alternative to propranolol for managing essential tremor

A

Primidone

41
Q

What tremor is present in Parkinson’s disease

A

Pill Rolling

42
Q

What type of tremor is pill rolling tremor

A

Resting

43
Q

What tremor is present in cerebellar lesion

A

Intention tremor

44
Q

Give 4 organic causes of tremor

A
  • Thyrotoxicosis
  • CO2 retention
  • Hepatic encephalopathy
  • Anxiety
45
Q

How are tremors broadly divided

A
  • Action

- Resting

46
Q

Are resting tremors or action tremors more common

A

Action tremors

47
Q

What disorder is most commonly associated with resting tremor

A

Parkinson’s disease

48
Q

What is restless leg syndrome

A

Spontaneous continuous lower limb movement that may be associated with parasthesia

49
Q

In which gender is restless leg syndrome more common

A

Female

50
Q

How can aetiology of restless leg syndrome be divided

A

Primary

Secondary

51
Q

What are secondary causes of restless leg syndrome

A
  • IDA
  • DM
  • ESRD
  • Inflammatory: Coeliac, IBD
  • Neuorlogical: anti-depressants
52
Q

What are 4 risk factors for restless leg syndrome

A
  • Pregnant
  • IDA
  • FH
  • DM
  • Uraemia
53
Q

What type of movement disorder is restless leg syndrome and why

A

Akathisia = inner restlessness causes a desire to move leg.

Symptoms start at night and then progress to day-time

54
Q

When are symptoms of restless leg syndrome worse

A

At rest

55
Q

What investigations are ordered in restless leg syndrome

A

EMG
NCS
FBC - to exclue IDA

56
Q

How can restless leg syndrome be managed

A

Stretching and walking

Dopamine agonists

Neurology (26 decks)

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