Abnormal Movements (Exam 1)

Question 1

What are the 2 types of classifications for movement disorders?

Answer 1

hypokinetic or hyperkinetic

Question 2

What does hypokinetic mean?

Answer 2

-purposeful, voluntary decreased movement
-slow movement, aka bradykinesia
-rigidity

Question 3

What 2 diseases are commonly associated hypokinetic movement?

Answer 3

parkinson’s disease and MS

Question 4

What does hyperkinetic mean?

Answer 4

-overactivity of basal ganglia results in increased involuntary movement
-can result in: tremors, myoclonus, dystonia, chorea, or tics

Question 5

What is an example of a tremor disease that has hyperkinetic movement?

Answer 5

parkinsons disease

Question 6

What is an example of a myoclonus condition that has hyperkinetic movement?

Answer 6

restless leg syndrome

Question 7

What does myoclonus mean?

Answer 7

sudden, brief, and involuntary muscle contractions or jerks that a person cannot control

Question 8

What does dystonia mean?

Answer 8

muscles contract abnormally

Question 9

What is an example of a dystonia disease that has hyperkinetic movement?

Answer 9

wilson’s disease

Question 10

What are some examples of chorea?

Answer 10

-huntington’s disease
-hemiballismus
-athetosis

Question 11

What is an example of a tics disorder that has hyperkinetic movement?

Answer 11

tourette’s syndrome

Question 12

What is the most common movement disorder?

Answer 12

tremors

Question 13

What are tremors?

Answer 13

-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

Question 14

What are the 3 types of tremors?

Answer 14

1) resting tremor
2) action tremor
3) essential tremor

Question 15

What is a resting tremor?

Answer 15

-muscles are relaxed
-hands, arms, and legs may shake at rest
-may go away when patient engages muscles

Question 16

Which tremor is the opposite of a resting tremor?

Answer 16

action tremor

Question 17

What are action tremors?

Answer 17

-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

Question 18

What is the most common type of tremor?

Answer 18

essential tremors

Question 19

What are essential tremors?

Answer 19

-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

Question 20

What is athetosis?

Answer 20

-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

Question 21

What is chorea?

Answer 21

-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

Question 22

What is dystonia?

Answer 22

-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

Question 23

What is muscular rigidity?

Answer 23

-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

Question 24

What is hemiballismus?

Answer 24

-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

Question 25

What is the most common cause of hemiballismus?

Answer 25

lacunar infarct of subthalamic nucleus (note: symptoms are on the opposite side of infarct)

Question 26

What is a lacunar infarct/stroke?

Answer 26

-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

Question 27

What is the most common cause of lacunar infarct?

Answer 27

high BP

Question 28

What is myoclonus?

Answer 28

-sudden involuntary jerking of a muscle or muscles
-non-suppressible
-sometimes have shock like sensation preceding twitch
-ex: hiccups or restless leg syndrome

Question 29

What is restless leg syndrome?

Answer 29

-sensorimotor disorder
-nocturnal myoclonus
-usually accompanied by paresthesias and sometimes pain in the upper or lower extremities

Question 30

What are tics?

Answer 30

-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

Question 31

What is tourette’s syndrome?

Answer 31

-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

Question 32

What are some examples of motor tics for tourette’s syndrome?

Answer 32

-rapid blinking
-shrugging shoulders
-jerking arm

Question 33

What are some examples of vocal tics for tourette’s syndrome?

Answer 33

-humming
-clearing throat
-yelling
-shouting swear words (coprolalia)
-constantly repeating the words of other people (echolalia)

Question 34

How is tourette’s syndrome diagnosed?

Answer 34

clinical only! If patient has both motor and vocal tics that last at least a year

Question 35

Tourette’s syndrome often occurs with what disorders?

Answer 35

ADHD and OCD