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 is Chorea
Hyperkinetic movement disorder
Irregular, brief, “dancelike” movement
What is Athetosis?
hyperkinetic movement disorder is characterized as writhing, sinuous movements?
What is Dystonia?
Hyperkinetic movement disorder
Sustained muscle contraction that produce twisting and repetitive movements and abnormal postures?
What is Ballism?
Hyperkinetic movement
Large Amplitude, Flinging movement, usually from proximal part of extremity
What is a Tic?
Hyperkinetic movement disorder
Brief, rapid, repetitive action involving single or multiple muscle group
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?
What is the treatment?
1) Pediatrics
2) Group A hemolytic strep
3) Unilateral chorea
4) Bedrest and antibiotics
What is Idiopathic Torsion Dystonia?
What kind of clinical findings?
Dystonic movements and postures of anywhere is the body without other signs
- Torticollis (Neck twisted to one side)
- Blepharospasm (Spontaneous involuntary forced closure of eyes)
- Oromandibular dystonia (spasm of mouth muscles)
What is Focal Torsion Dystonia
-What are the treatments?
Dystonic movements confined to one area of the body
Botox
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?
What is used to Dx
What is the treatment?
1) Disorder of copper metabolism that produces neuro and hepatic dysfunction
2) AR
3) Childhood or young adulthood
4) Bradykinetic and hyperkinetic movements
5) History, Increased Cu excretion, decreased serum ceruloplasm, Kayser-Fleischer ring
5) Penicillamine (Cu chelating agent) + Restrict dietary Cu
What is Gilles De La Tourette’s syndrome characterized by?
Chronic multiple motor and vocal tics with onset before the age of 21
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 the tremor temporarily?
Alcohol
