Basal Ganglia Dysfunctions Flashcards
What symptom will always be present with a basal ganglia dysfunction?
what symptoms will never be seen with basal ganglia dysfunction?
disorder of movement either Hyperkinetic or Hypokinetic
Upper motor paralysis or Lower motor paralysis, no muscle weakness as well
what is the most common hyperkinetic basal ganglia dysfunction?
what is the most common hypokinetic basal ganglia dysfunction?
Huntington’s Disease
Parkinson’s Disease
What symptoms will you expect to see in Huntington’s disease?
What symptoms willyou expect to see in Parkinson’s Disease?
Chorea, Athetosis, Dystonia and Ballismus
Bradykinesia, Rigidity, Resting tremo
what is chorea?
what is athetosis?
what is dystonia?
what is ballismus?
rapid jerky involuntary movement
continued involuntary movement
locking muscles in a position
involuntary flinging of limbs
What is the cause of developing Huntington’s Disease?
why do we see the symptoms in this disease?
how do we categorize the symptoms seen in Huntington’s Disease?
loss of the ENK neurons of the striatum/neostriatum
Because the loss of ENK neurons allows the Globus Pallidus lateral to keep throwing GABA to the subthalamic nucleus…the globus pallidus medial does not get stimulated, the thalamus keeps active the cortex
Hyperkinetic
what is the genetic basis of Huntington’s Disease?
What symptom can precede the motor symptoms?
What change can be expected to be seen in an MRI or CT Scan of the brain in a patient with Huntington’s Disease? Why?
CAG trinucleotide repeat
dementia
enlarged ventricles due to degeneration of caudate nucleus
How do we categorize the symptoms seen in Ballismus?
what causes ballismus to happen?
What are the symptom seen in Ballismus?
they are hyperkinetic
Stroke induced damage to the subthalamic nucleus
involuntary flinging of contralateral limbs (arms and legs could be affected)
When does Sydenham’s Chorea happen?
what ages are susceptible to this disease?
what are the symptom’s seen?
after following a viral infection, in particular Rheumatic Fever
ages 5-15
milkmaids grasp (rhythmic squeezing when the patient attempts to grab something), choreic hand, darting tongue and PRONATOR SIGN
At what age does Parkinson’s Disease start?
What causes the symptoms to be seen in Parkinson’s Disease?
What can be seen in microscopy to identify Parkinson’s?
how do we categorize parkinson’s disease symptoms?
what are parkinson’s disease symptoms?
40-70
loss of neuromelanin due to loss of substantia negra
Lewy bodies
hypokinetic
resting tremor, bradykinesia
what are the 2 types of Parkinson’s Disease?
which of the 2 types of Parkinson’s Disease is called Primary Parkinson’s?
What may cause secondary Parkinson’s Disease?
1) idiopathic
2) non-idiopathic
the idiopathic type
1) MPTP = drug that destroys substantia negra
2) head trauma
3) viral infections = Encephalitis Lethargica
4) Toxins = Manganese, CO
what are the 3 types of treatment for Parkinson’s Disease?
1) Dopamine replacement: use of L-Dopa
• Ex: Sinemet = L-Dopa Carbidopa used to lower degradation in order to lower side effects
2) Surgery: because patient develops side effects to medication
Pallidotomy: lesion to Globus Pallidus medial (less GABA release)
Thalidotomy: damaging part of thalamus to make it less active
3) Deep Brain Stimulation: use of bilateral electrodes
- In Thalamus = reduces essential and resting tremor
- In Subthalamus = reuces tremor
- In Globus Pallidus = reduce drug induced side effects in patients with pallidotomy
What basal ganglia structure is damaged in Tourette’s Syndrome?
what do we see in Tourette’s?
what do we call extreme Tourette’s?
how is it treated?
Globus Pallidus
multiple motor tics and 1 verbal tic
(copralalia, echolalia, palilalia)
Deuce Bigalow
goes away with age
Damage to what basal ganglia will cause dystonia?
when do we have early onset dystonia?
when do we have late onset dystonia?
what symptoms does dystonia have?
where do the symptoms being?
lentiform nucleus
before 28 y/o
after 28 y/o
locking muscles in position with twisting movement
localized in the foot or leg
what is Wilson’s Disease?
What are the symptoms of Wilson’s Disease?
In what part of the brian will the accumulation occur in wilson’s disease?
Copper accumulation in Liver, eyes, brain, kidneys due to a enzyme deficiency
fatigue, hepatitis, cirrhosis, behavioral changes, hypo or hyperkinetic movements, infertility, arrhytmias, Kayser-Fleischer rings
Copper accumulates in the lentiform nuclei
what are the 3 types of cerebral palsy?
what gets damaged in each?
- spastic = corticospinal (motor cortex)
- ataxic = cerebellum
- athetoid or dyskinetic = basal ganglia damage
