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2nd year > Dyskinesia > Flashcards

Dyskinesia Flashcards

1
Q

dyskinesia

A

rhythmic sinusoidal movements - tremors
jerks
muscle spasms

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2
Q

tremors

A

many causes
lots of categories
can be drug induced

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3
Q

drug induced tremors

A

tetrabenazine

anticancer drugs

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4
Q

diagnosis of tremors

A 
parkinson's 
essential tremor - benign 
hyperthyroidism
dystonic tremor 
orthostatic 
functional
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5
Q

which are primary tremors?

A

parkinson’s

essential tremor

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6
Q

secondary tremors?

A

drug induced

hyperthyroidism

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7
Q

what is a dystonic tremor?

A

involuntary muscle contractions resulting in postural abnormalities

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8
Q

What is an orthostatic tremor?

A

Standing tremor in legs
Not present when lying down or when walking
Helicopter sound on auscultation of legs

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9
Q

What is a functional tremor?

A

No cause identified

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10
Q

Imaging of tremors

A

Unlikely to appear on scan

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11
Q

Treatments for tremors

A 
Reassurance 
Limited number of effective drugs
Devices
Deep brain stimulation
New drugs and procedures
Avoid precipitants
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12
Q

Drugs used for tremors

A

Propranolol

Primidone

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13
Q

Precipitants of tremors

A

Lithium

Anticonvulsants

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14
Q

Treatment of orthostatic tremor

A 
Propranolol
Clonazepam
Gabapentin 
Reassurance 
Tripod seat for queues
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15
Q

New tremor therapies

A

MRI focused ultrasound thalamtomy
Induce lesion using ultrasound waves to burn a whole into thalamus
1 off treatment

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16
Q

Cervical dystonia

A

Muscle spasm in the neck

Usually a late diagnosis

17
Q

Correction of cervical dystonia

A

Geste antagoniste - sensory trick to return to normal position

18
Q

Treatment for cervical dystonia

A 
Artane/ trihexylphenidyl 
Baclofen
Clonazepam
Valium
Tetrabenazine
L dopa
Amantadine 
Dopamine agonists 
Anti-epileptics
Best = Botox injection
Deep brain stimulation
19
Q

Tics

A

Linked to Tourette’s syndrome

20
Q

Features of tics

A

Can be suppressed for a small amount of time
Coprolalia
Copropraxia

21
Q

Coprolalia

A

Abusive or rude language

22
Q

Copropraxia

A

Inappropriate movements and actions

23
Q

Types of tics/ what happens

A 
Movements - motor
Sounds - phonic
Sudden
Rapid
Recurrent
Non-rhythmic
Non-voluntary
Can be preceded by an urge 
Affected by behavioural states
Repetitive
Focal
Sniffs
Grunts
Coughs
Vocal utterances
24
Q

Suppression of tics

A

Can be done voluntarily for a very short period of time but this is mentally and physically draining

25
Q

Causes of tics

A

Tourette’s syndrome is main cause
Genetic
Many other causes
Drug induced - methylphenidate

26
Q

What are the clinical features of Tourette’s syndrome?

A 
Depression
Tics
OCD
Anxiety
ADHD
Autism
Gifted and skilled
Learning difficulties
27
Q

Treatment and management of Tourette’s syndrome

A 
Psycho education
Suppression techniques
Mental health support
Diversion tactics
Tourette’s service
Psychologists
Avoid drug treatments 
Behavioural treatment 
Pharmacological treatment when advanced 
Deep brain stimulation
28
Q

What are the pharmacological treatments of Tourette’s syndrome?

A 
Dopamine receptors antagonists
Monoamine depleters
Dopamine receptors agonists
Alpha 2 agonists
Benzodiazepines
Anticonvulsants
Nicotine
Cannabinoids
29
Q

Problems with treating tics

A

Treatments for tics can worsen the other Tourette’s symptoms and vice versa

30
Q

Deep brain stimulation for tics

A

Targets basal ganglia
Adverse effects = dysarthria, parathesia, haemorrhage, infection
Very expensive

31
Q

What is chorea?

A

Fidgety
Cannot stay still
Huntington’s is the most common cause

32
Q

tic attack/ storm

A 
occurs in tourettes syndrome 
lots of tics occurring at once 
similar to seizure 
aware of surroundings
can last from minutes to hours 
causes tiredness
33
Q

potential tourettes treatments

A 
botox - downregulates motor feedback loop
psychological treatments 
talking therapies
diazepam
gas and air - nitrous oxide 
aripiprazole - antipsychotic 
topiramate 
deep brain stimulation
tetrabenazine
34
Q

topiramate

A

anticonvulsant
beneficial for tics
less psychologcail side effects

2nd year (48 decks)

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