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BR 3rd Ed > Ch 12 - Movement Disorders > Flashcards

Ch 12 - Movement Disorders Flashcards

1
Q

What is an essential tremor?

A

Posture-maintaining tremor associated with sustained muscle contraction or stress

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2
Q

What is an intention tremor?

A

Tremor at end of purposeful movement

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3
Q

What is Parkinson’s Disease?

A

d/o of basal ganglia d/t loss of cells in substantia nigra and locus coeruleus where dopamine produced
Degeneration of nigrostriatal pathway results in ↓ dopamine in corpus striatum

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4
Q

What are signs of Parkinson’s Disease?

A
  • Resting tremor (“pill-rolling”) 3-5 Hz
  • Bradykinesia
  • Cogwheel rigidity
  • Masked facies
  • Lead pipe rigidity
  • Postural instability
  • Freezing
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5
Q

What is the general goal of treatment in Parkinson’s Disease?

A
  1. ↑ dopamine action

2. ↓ cholinergic effect

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6
Q

What are ergot derivatives?

A

Dopamine agonist agents produce symptomatic benefit by direct stim of dopamine receptors – Bromocriptine
– Pergolide (Permax®)

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7
Q

What are non-ergot derivatives?

A

– Ropinirole (Requip®)

– Pramipexole (Mirapex®)

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8
Q

What is the MOA of amantadine?

A

Antiviral agent

Potentiates the release of endogenous dopamine

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9
Q

What are anticholinergic agents used for in Parkinson’s?

A

Relieve tremor

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10
Q

What does a unilateral Thalamotomy do?

A

Relieve contralateral tremor

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11
Q

What does a unilateral pallidotomy do?

A

Permanent ablation of a portion of the globus pallidus

Improve dyskinesias, stiffness, and freezing

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12
Q

What does subthalamic nucleus DBS do?

A

Improves bradykinesia, rigidity and tremor
Reduces parkinson’s medications by 1/2
MC surgical procedure for PD

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13
Q

What does thalamic DBS do?

A

Reduces tremor on contralateral side
Worsens bradykinesia, rigidity and gait
Limited use

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14
Q

What does pallidal DBS do?

A

Controls all cardinal symptoms of PD

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15
Q

What should swallow evaluation be done for in PD?

A

Evaluate for oropharyngeal dysphagia

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16
Q

What can cause drug-induces parkinsonism?

A 
Neuroleptic agents (haloperidol)
Metoclopramide (Reglan®)
Reserpine
Amiodarone
Lithium
17
Q

What is Dementia pugilistica?

A

Parkinsonism associated with repeated trauma to the head

18
Q

What are Parkinson-plus syndromes?

A

– Progressive supranuclear palsy: Vertical gaze palsy

– Multisystem Atrophy-Parkinsonian Type (MSA-P)

19
Q

What is Progressive supranuclear palsy?

A

Vertical gaze palsy: patient cannot look down

Parkinsonian features with bradykinesia and rigidity (axial)&raquo_space; tremor

20
Q

What is the Most common among parkinsonism-plus syndromes?

A

Progressive supranuclear palsy

21
Q

What are types of Multisystem Atrophy-Parkinsonian Type (MSA-P)?

A

■Shy-Drager syndrome
■ Olivopontocerebellar atrophy
■ Striatonigral degeneration

22
Q

What is Shy-Drager syndrome?

A

Parkinsonian features with dysautonomia (autonomic dysfunction)

23
Q

What is Olivopontocerebellar atrophy?

A

Parkinsonian features with ataxia and dysarthria

24
Q

What is Striatonigral degeneration?

A

Parkinsonian features with dystonia (anterocollis); tremor uncommon

25
Q

What is Huntington’s disease?

A

ABN movements (chorea) d/t heightened sensitivity of striatal dopamine receptors

26
Q

What is the cause of Huntington’s disease?

A

AD
Trinucleotide CAG repeat on Chr 4p16.3
Huntington ABN gene accumulates in the brain

27
Q

What is the triad of Huntington’s disease?

A
  1. Chorea/choreathetosis
  2. Dementia and personality d/o
  3. Family hx
28
Q

What is the cause of death Huntington’s disease?

A

Aspiration PNA 15-20 years after diagnosis

29
Q

What is the goal of treatment of Huntington’s disease?

A

Dec Dopamine action

30
Q

What are characteristics of Ataxia-Telangiectasia?

A

Progressive ataxia in early childhood
Oculocutaneous telangiectasia
High incidence of neoplasia

31
Q

What differentiates early-onset cerebellar ataxia with Friedreich’s ataxia?

A

Presence of DTR

No DTR’s in Friedreich’s

32
Q

What is the MC form of inherited MR?

A

Fragile-X syndrome

BR 3rd Ed (92 decks)

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