Clinical Approach to Movement Disorders (Hon) Flashcards
Movement disorders are generally classified into what two types?
1) Bradykinetic
2) Hyperkinetic
What is the most common bradykinetic Disorders (aka Akinetic Rigid Syndromes)?
Parkinsonism
Idiopathic Parkinson’s Disease is caused by?
Depletion of dopamine in the nigrostriatal system which disrupts the balance of dopamine and acetylcholine
What are the cardinal features of Parkinson’s?
1) Resting tremor (often unilateral at first)
2) Cogwheel rigidity (increased resistance to passive movement)
4) Bradykinesia
What symptoms are seen with Progressive Supranuclear Palsy?
1) Bradykinesia
2) Rigidity
3) Loss of voluntary control of eye movements (especially vertical gaze)
What symptoms are seen with Multiple Systems Atrophy (Shy-Drager Syndrome)?
1) Bradykinesia
2) Rigidity
3) Pronounced autonomic dysfunction
What symptoms are seen with Cortical Basal (Ganglionic) Degeneration?
1) Bradykinesia
2) Rigidity
3) Cortical sensory loss, apraxia, myoclonus or aphasia
What hyperkinetic movement disorder is characterized as irregular, brief, “dancelike” movement?
Chorea
What hyperkinetic movement disorder is characterized as writhing, sinuous movements?
Athetosis
What hyperkinetic movement disorder is characterized as sustained muscle contractions that produce twisting and repetitive movements and abnormal postures?
Dystonia
What hyperkinetic movement disorder is characterized as large amplitude, flinging movement, usually from the proximal part of an extremity?
Ballism
What hyperkinetic movement disorder is characterized as brief, rapid, repetitive, seemingly purposeless stereotyped action that may involve single or multiple muscle groups?
Tic
Huntington’s Disease is characterized by what symptoms?
What is its inheritance pattern?
When do symptoms generally begin?
1) Chorea and dementia
2) AD
3) Age 30-50
Sydenham’s Chorea occurs mainly in what population?
It occurs as a complication from what previous infection?
It is characterized by what movements?
1) Pediatrics
2) Group A hemolytic strep
3) Unilateral chorea
What is characterized by dystonic movements and postures of anywhere in the body without other signs?
Idiopathic Torsion Dystonia
What is characterized by dystonic movements confined to one area of the body?
Focal Torsion Dystonia
What can be used to treat Idiopathic Torsion Dystonia?
What can be used to treat Focal Torsion Dystonia?
1) Low dose levodopa
2) BOTOX
Wilson’s disease is characterized by?
What is its inheritance pattern?
When does it usually present?
What clinical features are present?
1) Disorder of copper metabolism that produces neuro and hepatic dysfunction
2) AR
3) Childhood or young adulthood
4) Bradykinetic and hyperkinetic movements
What is characterized by chronic multiple motor and vocal tics with onset before the age of 21?
Gilles De La Tourette’s syndrome
What is the clinical presentation of essential tremor?
Postural or kinetic tremor of both hands and may involve the head or voice
What often decreases essential tremors temporarily?
Alcohol
