Dystonias & Involuntary Movements

Question 1

What is Motor Neurone Disease?

Answer 1

Neurodegenerative condition affecting the brain and spinal cord. Leads to progressive muscle weakness - muscle cramps, loss of dexterity.

Question 2

What’s the most common form of Motor Neurone Disease?

Answer 2

Amyotrophic lateral sclerosis (ALS)

Question 3

1st, 2nd and alternative treatment for muscular symptoms?

Answer 3

All unlicensed use.
1st Qunine
2nd Baclofen

then
Tizanidine
Dantrolene sodium
Gabapentin

Question 4

What should be used for saliva problems?

Answer 4

Antimuscarinics e.g Glycopyrronium bromide (unlicensed)

Question 5

What is mainly used to treat Huntington’s chorea (neurological disorder characterised by jerky movements)

Answer 5

Tetrebenazine

Question 6

Dose and Drug class of Tetrebenazine?

Answer 6

Monoamine depleting drug

Movement disorder 25mg TDS then increased if needed 25mg every 3-4 days. Max 200mg daily.

Elderly started on a lower dose.

Tardive dyskinesia:
12.5 daily dose increased according to response

Question 7

Tetrebenazine can cause QT interval prolongation. True or False

Answer 7

True

Question 8

What is the drug class and dose of Promazine hydrochloride

Answer 8

1st gen anti-psychotic

Short term adjunct management of psychomotor agitation:

100-200 mg QDS

Agitation and restleness in elderly:
25-50 mg QDS

Question 9

What class is Botulinum toxin type A?

Answer 9

Muscle relaxant > Peripherally acting neurotoxins (botulinum toxins)

Question 10

What can Botulinum toxin type A be used for?

Answer 10

Specialist use only
Focal spasticity (including hand and wrist disability associated with stroke)
Prophylaxis of headaches in adults with chronic migraine

More but not relevant i guess