Abnormal Movements (Exam 1) Flashcards
What are the 2 types of classifications for movement disorders?
hypokinetic or hyperkinetic
What does hypokinetic mean?
-purposeful, voluntary decreased movement
-slow movement, aka bradykinesia
-rigidity
What 2 diseases are commonly associated hypokinetic movement?
parkinson’s disease and MS
What does hyperkinetic mean?
-overactivity of basal ganglia results in increased involuntary movement
-can result in: tremors, myoclonus, dystonia, chorea, or tics
What is an example of a tremor disease that has hyperkinetic movement?
parkinsons disease
What is an example of a myoclonus condition that has hyperkinetic movement?
restless leg syndrome
What does myoclonus mean?
sudden, brief, and involuntary muscle contractions or jerks that a person cannot control
What does dystonia mean?
muscles contract abnormally
What is an example of a dystonia disease that has hyperkinetic movement?
wilson’s disease
What are some examples of chorea?
-huntington’s disease
-hemiballismus
-athetosis
What is an example of a tics disorder that has hyperkinetic movement?
tourette’s syndrome
What is the most common movement disorder?
tremors
What are tremors?
-involuntary rhythmic oscillating muscle movement
-non-life threatening
-tremors stop during deep sleep
-tremors increase with emotional stress
-may be neurological (stroke, TBI, drugs, neurodegenerative diseases) or idiopathic
What are the 3 types of tremors?
1) resting tremor
2) action tremor
3) essential tremor
What is a resting tremor?
-muscles are relaxed
-hands, arms, and legs may shake at rest
-may go away when patient engages muscles
Which tremor is the opposite of a resting tremor?
action tremor
What are action tremors?
-occurs during voluntary movement (ex: flexion and extension of wrist or grabbing a cup)
-intention tremors (sub-class of action tremors) occur during visually guided movement toward a target
-seen with MS or cerebellar disease/dysfunction
What is the most common type of tremor?
essential tremors
What are essential tremors?
-typically bilateral head tremor (shaking head yes or no)
-severity depends
-can happen at any age but most common at 40-50 y/o
-50% of it is genetic (autosomal dominant) and the other 50% is idiopathic
What is athetosis?
-slow, writhing movements
-typically affects hands and feet
-holding limbs together causes flowing movement of trunk
-can present dystonia-like features in fingers
-often occurs with chorea as choreoathetosis
-seen with huntington’s disease and cerebral palsy
What is chorea?
-abnormal movement and gait
-rapid, random, involuntary, jerky movements
-affects entire body (most noticeable in the hands and limbs)
-movements move from muscle to muscle (appears dance like)
-often occurs with athetosis as choreoathetosis
-seen in huntington’s disease and (unilateral) hemiballismus
What is dystonia?
-involuntary muscle contraction “super muscle spasm”
-fixed/repetitive twisting contracture
-can distort body part position and limit function
-can be mild or severe pain
-seen in Parkinson’s disease, Wilson’s disease, MS, cerebral palsy, stroke, and torticollis
What is muscular rigidity?
-stiffness or inflexibility
-abnormally tight muscles
-increased muscle tone while at rest
-increased resistance to passive stretch
-underlying condition that leads to bradykinesia and/or dystonia
What is hemiballismus?
-type of unilateral chorea (one arm or leg)
-involuntary violent, flinging of one extremity
-movements are wider and more intense than chorea
-flinging =ballistic
-typically self resolving several days to 6 weeks
-antipsychotic drugs help
What is the most common cause of hemiballismus?
lacunar infarct of subthalamic nucleus (note: symptoms are on the opposite side of infarct)
What is a lacunar infarct/stroke?
-an ischemic stroke of the deeper structures of the brain
-caused by blockage of blood flow through the deep penetrating arteries that supply the basal ganglia
-blockage is due to atherosclerosis-> tissue death-> creates cavities called lacunes
-can be asymptomatic
-most common cause is high blood pressure
What is the most common cause of lacunar infarct?
high BP
What is myoclonus?
-sudden involuntary jerking of a muscle or muscles
-non-suppressible
-sometimes have shock like sensation preceding twitch
-ex: hiccups or restless leg syndrome
What is restless leg syndrome?
-sensorimotor disorder
-nocturnal myoclonus
-usually accompanied by paresthesias and sometimes pain in the upper or lower extremities
What are tics?
-rapid, repetitive movements like a twitch
-no pain or paresthesia
-uncontrollable urge to do the movement
-will feel a brief relief after doing them
-tics can be suppressed only for brief periods and with conscious effort
What is tourette’s syndrome?
-condition of the NS
-causes involuntary tics
-2 types of tics: motor and vocal
-begins around age 5-18 y/o
-may become chronic or dissipate in adulthood
What are some examples of motor tics for tourette’s syndrome?
-rapid blinking
-shrugging shoulders
-jerking arm
What are some examples of vocal tics for tourette’s syndrome?
-humming
-clearing throat
-yelling
-shouting swear words (coprolalia)
-constantly repeating the words of other people (echolalia)
How is tourette’s syndrome diagnosed?
clinical only! If patient has both motor and vocal tics that last at least a year
Tourette’s syndrome often occurs with what disorders?
ADHD and OCD
