Disorders of Movement Workshop

Question 1

Neurological examination

Answer 1

• Think where is the lesion and what is the lesion - pattern recognition
• SYstem speficic
• Is it UMN or LMN syndrome
• Assessment of balance/ coordination
• Asessment of tremor/parkinsonism

Basic:

• Insepction
• Congition
• Gait
• Tone
• Power
• Reflexes
• Coordination
• (Sensation)

Question 2

UMN vs LMN

Answer 2

UMN eg, in multiple sclerosis

• Tone increased
• Pattern of muscle weakness
• Brisk reflexes
• Upgoing plantar reflexes
• Clonus
• Nb Pattern of sensory loss, eg sensory level
• Gait

LMN eg, peripheral neuropathy

• Tone normal/ reduced
• Pattern of muscle weaknes
• sReduced/absent reflexes
• Downgoing plantars
• Wasting
• Nb pattern of sensory loss eg acral
• Gait

Question 3

Focus on systems…

Answer 3

• Extrapyramidal vs pyramidal
• Temor
• Rigidity
• Bradykinesia
• Postural instability
• Balance (neurological)
• Cerebellar or sensory ataxia

Question 4

Movement disorder caused by cerebella dysfunction

Answer 4

• Impairs motor function of the body ipsilateal to the lesion
• Most apparant on movement not at rest
• No numbness/paralysis
• Ataxia - defect in force/range/direction/rate of movement
• Move more consciously than normla
• Past pointing - overshoot touching object with finger
• Intention tremor - more tremor of hand towards a target
• Dysdiadochokinesis - difficult repetitive supin/pronation
• Scanning speech/ decomposition of movement.