Clinical Approach to Movement Disorders (Hon)

Question 1

Movement disorders are generally classified into what two types?

Answer 1

1) Bradykinetic

2) Hyperkinetic

Question 2

What is the most common bradykinetic Disorders (aka Akinetic Rigid Syndromes)?

Answer 2

Parkinsonism

Question 3

Idiopathic Parkinson’s Disease is caused by?

Answer 3

Depletion of dopamine in the nigrostriatal system which disrupts the balance of dopamine and acetylcholine

Question 4

What are the cardinal features of Parkinson’s?

Answer 4

1) Resting tremor (often unilateral at first)
2) Cogwheel rigidity (increased resistance to passive movement)
4) Bradykinesia

Question 5

What symptoms are seen with Progressive Supranuclear Palsy?

Answer 5

1) Bradykinesia
2) Rigidity
3) Loss of voluntary control of eye movements (especially vertical gaze)

Question 6

What symptoms are seen with Multiple Systems Atrophy (Shy-Drager Syndrome)?

Answer 6

1) Bradykinesia
2) Rigidity
3) Pronounced autonomic dysfunction

Question 7

What symptoms are seen with Cortical Basal (Ganglionic) Degeneration?

Answer 7

1) Bradykinesia
2) Rigidity
3) Cortical sensory loss, apraxia, myoclonus or aphasia

Question 8

What hyperkinetic movement disorder is characterized as irregular, brief, “dancelike” movement?

Answer 8

Chorea

Question 9

What hyperkinetic movement disorder is characterized as writhing, sinuous movements?

Answer 9

Athetosis

Question 10

What hyperkinetic movement disorder is characterized as sustained muscle contractions that produce twisting and repetitive movements and abnormal postures?

Answer 10

Dystonia

Question 11

What hyperkinetic movement disorder is characterized as large amplitude, flinging movement, usually from the proximal part of an extremity?

Answer 11

Ballism

Question 12

What hyperkinetic movement disorder is characterized as brief, rapid, repetitive, seemingly purposeless stereotyped action that may involve single or multiple muscle groups?

Answer 12

Tic

Question 13

Huntington’s Disease is characterized by what symptoms?

What is its inheritance pattern?

When do symptoms generally begin?

Answer 13

1) Chorea and dementia
2) AD
3) Age 30-50

Question 14

Sydenham’s Chorea occurs mainly in what population?

It occurs as a complication from what previous infection?

It is characterized by what movements?

Answer 14

1) Pediatrics
2) Group A hemolytic strep
3) Unilateral chorea

Question 15

What is characterized by dystonic movements and postures of anywhere in the body without other signs?

Answer 15

Idiopathic Torsion Dystonia

Question 16

What is characterized by dystonic movements confined to one area of the body?

Answer 16

Focal Torsion Dystonia

Question 17

What can be used to treat Idiopathic Torsion Dystonia?

What can be used to treat Focal Torsion Dystonia?

Answer 17

1) Low dose levodopa

2) BOTOX

Question 18

Wilson’s disease is characterized by?

What is its inheritance pattern?

When does it usually present?

What clinical features are present?

Answer 18

1) Disorder of copper metabolism that produces neuro and hepatic dysfunction
2) AR
3) Childhood or young adulthood
4) Bradykinetic and hyperkinetic movements

Question 19

What is characterized by chronic multiple motor and vocal tics with onset before the age of 21?

Answer 19

Gilles De La Tourette’s syndrome

Question 20

What is the clinical presentation of essential tremor?

Answer 20

Postural or kinetic tremor of both hands and may involve the head or voice

Question 21

What often decreases essential tremors temporarily?

Answer 21

Alcohol