CH04: Movement and Posture Flashcards
caudate nucleus + putamen
STRIATIUM
main receptive part of the basal ganglia
PUTAMEN
(2) output nuclei of the basal ganglia
MEDIAL PALLIDUM + PARS RETICULATA
sample of drug that can induce Parkinsonism
Phenotiazine
most pervasive role neurotransmitter but can act as excitatory or inhibitory
Dopamine
areas with richest dopamine
(1) Cell bodies of Pars Compacta (2) Termination fibers in Striatum
Location D1 and D2 receptors
STRIATIUM
Location D3 receptor
Nucleus accumbens
Location D4 receptor
Frontal cortex, limbic structures
Location D5 receptor
Hippocampus and limbic system
D1- like class
D1 and D5 subtypes
D2- like class
D2, D3, D4
Intermediate precursor of dopamine that crosses the blood-brain barrier
L- Dopa
Addition of this enzyme in the catabolism of Dopamine
dopadecarboxulase
Why add LDopa and CDopa
Minimize the systemic side effects
(T/F) Psychological stress and anxiety worsen the abnormal movements in the EPS
TRUE
tendency for the voluntary movement to adopt the frequency of a coexistent tremor
Entrainment
A gentle push on the sternum or tug on the shoulders may cause a fall or start a series of small corrective septs that the patient cannot control
Festination
Rhythmically interrupted, ratchet- like resistance
Cogwheel phenomenon
Unable to relax a group of muscles on request
Paratonia
Encompasses all the active movement phenomena that are a consequence of disease of the basal ganglia, implying an element of dystonia
Dyskinesia
Chorea and myoclonus differ in what aspect
Myoclonic jerks is much faster and may involve single muscles
Chorea after Streptococcal infection
Syndenham chorea
(2) Paraneoplastic chorea antibodies
anti- CRMP, anti- Hu
involuntary movements involve proximal limb muscles and are of wide range and flinging ni the nature
Hemiballismus
Term stems from Greek word “unfixed”
Athetosis
Idiopathic dystonia responding to extremely small doses of L- dopa
Segawa Disease
A characteristic, almost diagnostic, example of the acute drug- induced dystonias
Retrocolis
Give (3) drugs that can induce dystonias
L- Dopa, CCB, AEDs
Surgery in these structures yielded positive but unpredictable results in dystonia
Pallidum, ventrolateral thalamus
Numerous brief attacks of dystonia or CA provoked by sudden movement, startle, hyperventilation
Paroxysmal kinesigenic choreoathetosis
Treatment for paroxysmal kinesigenic choreothetosis
Phenytoin and Carbamazepine
Precipitated by ingestion of alcohol or coffee or fatuge
Second’ nonkinesigenic choreoathetosis
Treatment for nonkinesigenic choreoathetosis
Benzodiazepine
Third type of paroxysmal choreoathetosis precipitated by prolonged exercise
Mount- Reback type VARIANT
Treatment for Mount- Reback type VARIANT paroxysmal choreoathetosis
Acetazolamide
involuntary rhythmic oscillatory movement produced by alternating or irregularly synchronous contractions
Tremor
Tremor vs other involuntary movement distinguishing factor
Rhythmicity
Tremor vs myocolonus and asterixis
Oscillatory nature
Frequency of tremors
8- 13 Hz
Commonest type of tremor
Essential (Familial) Tremor
Essential tremor of non- alternate beat type can be supressed by this in 75% of cases
Alcohol
Antibody associated with tremor of polyneuropathy
Anti- MAG
coarse, rhythmic tremor with a frequency of 3-5 Hz characterized by bursts of activity that alternate between opposing muscle groups
Parkinsonian Tremor
ratchet- like interruption perceived by the examiner on passive movement of an extremity
Negro sign
sign when patient engages the opposite limb tracing circles in the air
Froment sign
constant frequency, variable amplitude
Parkinsonian Tremor
meperidine analogue that destroys neurons of the substantia niagri pars compacta (p. 96)
MPTP
wide- ranging, rhythmic 2- 5 Hz “wing beating tremor” (p. 97)
Rubral tremor
strong familial episodic trmor disorder of the chin and lower lip that begins in childhood and may worsen with age (p. 97)
Geniospasm
chromosome involved with the mutation that causes geniospasm
Chromosome 9
Tremor occuring during quiet standing and its cessation almsot immediately on walking (p. 97)
Orthostatic tremor
Loading the limb exaggerates this tremor (p. 98)
Psychogenic and tremor by polyneuropathy
arrhythmic lapses of sustained posture that allow gravity of the inherent elastocotu of muscles produce a sudden movement which the patient corrects (p. 99)
Asterixis
sharp wave, probably generated in the motor cortex, immediately preceding a period of EMG silence (p. 99)
Asterixis
rapid, shock-like contractions of group of muscles, irregular in rhythmn and amplitude (p. 99)
Myoclonus
myoclonus associated with atypical petit mal and akinetic seizure (p. 101)
Lennox- Gastaut Syndrome
stimulus sensitive (reflex) myoclonus autosomal recessive disease (p. 101)
Lafora- body disease
myoclonus disease asociated with loss of Purkinje cells but NO inclusion bodies (p. 101)
Baltic variety of myoclonic epilepsy
give (3) drugs taht can cuase myoclonus (p. 101)
Haloperidol, lithium, amphatemines
T/F Action myoclonus is almost always associated with cerebellar ataxia (p. 102)
TRUE
repeated stimuli may recruit a series of incremental myoclonic jerks that culminate in a generalized convulsion (p. 102)
Unverricht- Lundberg Syndrome
most common mutation in startle syndromes (p. 103)
1- subunit of GLRA1
act of flexing the neck and bringing hte arms close to teh torso decring the intensity of attackes of Startle syndromes (p. 103)
Vigevano maneuver
gene associated with generalized torsion dystonia (p. 104)
DYT-1 mutation
most frequent form of restricted dystonia (p. 104)
Torticolis
percent of tortiolis with oral, mandibular or hand dystonia (p. 106)
15%
percent of torticolis with blepharospasm (p. 106)
10%
percent of torticolis with no relief with Botox injection (p. 106)
10%
Blepharospasm with forceful opening of the jaw, retraction of the lips, spasms of the plastysma, protrusion of tongue (p. 107)
Meige syndrome
treatment for tardive dyskinesia (p. 109)
Reserpine and Tetrabenazine
main identifying features of tics and habit spasm (p. 109)
Stereotypy and irresistibility
inner feeling of restlessness, inability to sit still, compulsion to move about (p. 111)
Akithisia