Dyskinesia and dystonia

Question 1

Define dyskinesia

Answer 1

Abnormal involuntary movements

Question 2

List examples of dyskinesia

Answer 2

Tremor
Tics
Tardive disorders
Chorea
Myoclonus

Question 3

Types of tremor

Answer 3

Intention - worse at end of purposeful movement

Rest - abolished on voluntary movement

Question 4

Causes of types of tremor

Answer 4

Intention - cerebellar lesion

Rest - Parkinsonism

Question 5

Describe chorea and its causes

Answer 5

Non-rhythmic, jerky, purposeless movements

Feature of Huntington’s disease

Question 6

Where can myoclonus arise from

Answer 6

Cerebral cortex
Brainstem
Spinal cord

Question 7

Describe myoclonus

Answer 7

Sudden involuntary jerks

Question 8

Cause of tardive syndromes

Answer 8

Chronic exposure to dopamine antagonists (antipsychotics and antiemetics)

Question 9

Features of tardive dyskinesia

Answer 9

Lip smacking
Repetitive chewing
Rapid eye blinking
Tongue protrusion
Grimacing

Question 10

Features of tardive dystonia

Answer 10

Opisthotonos (back arching)
Retrocollis (neck extension)
Twisting movements

Question 11

Treatment for tardive dyskinesia

Answer 11

Gradually reduce dopamine antagonists
If indicated for psychosis, replace with atypical antipsychotics as less EPSE
(Tardive dyskinesia may be irreversible)

Question 12

Define dystonia

Answer 12

Prolonged muscle contraction resulting in abnormal posture and/or repetitive movements

Question 13

Cause of acute dystonia

Answer 13

Starting dopamine antagonists, especially metoclopramide and antipsychotics

Question 14

Treatment for acute dystonia

Answer 14

Anticholinergics

Question 15

Describe oculogyric crisis

Answer 15

Eyes are drawn up

Question 16

Describe oromandibular crisis

Answer 16

Trismus (lockjaw)

Question 17

What is torticollis and what condition is it seen in

Answer 17

Head is pulled to one side

In acute dystonia