Basal Ganglia Pathology

Question 1

Akinesia

Answer 1

In ability ot initiate movment and is seen in the late stages of PD

Associated with assumption and maintenance of fixed postures (freezing episodes)

Tremendous amount of effort is required to perform even the simplest motor activites

Question 2

Athetosis

Answer 2

Slow, Involunatry, writhing, twisting, “wormlike” movements; frequently greater involved in distal UEs

Also referred to as athetoid movements

Pure athetosis is uncommon and typically present with spasticity, tonic spasms, or chorea

Question 3

Bradykinesia

Answer 3

Decreased amplitude and velocity of voluntary movements

May be demonstrated in a variety of ways such as: decreased arm swings; slow, shuffling gait, difficulty initiation or changing direction; lack of facial expression; or difficulty stopping a movement once begun

Question 4

Chorea

Answer 4

Characterized by involuntary, rapid, irregular, and jerky movements involving multiple joints.

Choreiform movements demonstrate irregular timing, are most apparent in the UE and cannot be voluntarily inhibited; associated with Huntington’s disease

Question 5

Hemiballismus

Answer 5

Large-amplitude sudden violent, flailing motions of the arm and leg of one side of the body

Primary involvement is in the axial Nd proximal musculature of the limb

Hemiballismus results from a lesion of the contralateral subthalamic nucleus

Question 6

Hyperkinesis

Answer 6

Abnormally increased muscle activity or movement

Question 7

Hypokinesia

Answer 7

Decreased motor response especially to a specific stimulus

Question 8

Rigidity

Answer 8

Increase in muscle tone causing greater resitance to passive movement

Tends to be more pronounced in the flexor muscles of the turnk and extremities causing activity limitations in such areas as: dressing, transfers, speech, eating, and postural control

Two kinds: lead-pipe rigidity and cog-wheel rigidity

Question 9

Leadpipe rigidity

Answer 9

Uniform, constant resistance felt b the PT as the extremity is moved through a ROM

Question 10

Cog-wheel rigidity

Answer 10

Considered a combination of the lead-pipe type with tremor. Characterized b a series of brief relaxations or “catches” as the extremity is passively moved

Question 11

Resting Tremor

Answer 11

Typically disappear or decrease with purposeful movements, but may increase with emotional stress.

Question 12

Where are tremors associated with basal ganglia lesions (eg PD) are frequently noted?

Answer 12

Distal UE in the form of “pill rolling” (looks as if a pill is being rolled bt two fingers and the thumb)