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Neurology > Gait and movement disorders > Flashcards

Gait and movement disorders Flashcards

1
Q

What is spasticity?

A

Continuous contraction of muscles with or without weakness.

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2
Q

How does spasticity affect walking?

A

Stiff and jerky walking
Catch toes on the ground
Short pace and narrow base
Clonus – involuntary extensor rhythmic leg jerking
Stiff, weak leg is circumducted and drags.

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3
Q

How does Parkinson’s affect gait?

A

Shuffling gait- short rapid steps
Diminished arm swinging
Difficulties turning

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4
Q

Why do people with Parkinson’s shuffle?

A

Rigidity in both flexors and extensors

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5
Q

What is a Cerebellar ataxia gait?

A

Broad based gait

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6
Q

Why does cerebellar ataxia cause a broad based gait?

A

Due to unsteadiness

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7
Q

What are some features of a cerebellar ataxic/broad based gait?

A

Veer to affected side

Fall backwards or sideways

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8
Q

What kind of gait does sensory ataxia give?

A

Stamping gait

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9
Q

What causes a sensory ataxia/stamping gait?

A

Sensory loss leaving loss of proprioception.

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10
Q

Describe a stamping gait

A

Broad based
High stepping
Stamping down.

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11
Q

What can make a stamping gait worse?

A

Removing visual input

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12
Q

How can you test for a stamping gait?

A

Romberg’s test

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13
Q

Describe Romberg’s test

A

Stand up with arms by side and close eyes.

Lose balance when do so is positive.

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14
Q

What kind of gait does a lower limb weakness give?

A

Slapping or waddling depending on affected area.

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15
Q

What causes a slapping gait?

A

Distal limb weakness

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16
Q

What can cause distal limb weakness?

A

Peroneal nerve palsy

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17
Q

What can cause a waddling gait?

A

Proximal limb weakness- pelvis is poorly supported by each leg

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18
Q

What can cause proximal limb weakness?

A

Polymyositis

Muscular dystrophy

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19
Q

What is gait apraxia?

A

Disorganised walking

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20
Q

Damage to which part of the brain causes gait apraxia?

A

Frontal lobe

21
Q

Give some features of gait apraxia

A

Shuffling gait

Undue hesitancy

22
Q

What does gait apraxia often occur with?

A

Urinary incontinence

Dementia

23
Q

What two categories can movement disorders be split into?

A

Akinetic-rigid syndromes

Dyskinesias

24
Q

Describe akinetic-rigid syndromes

A

Increased tone and slow movement

25
Q

Describe dyskinesias

A

Additional and uncontrolled movements

26
Q

Give an example of an akinetic-rigid syndrome

A

Wilson’s disease

27
Q

What causes Wilson’s disease?

A

Copper deposits in basal ganglia, cornea and liver.

28
Q

What can WIlson’s disease cause in the eyes?

A

Kayser-Fleischer rings

29
Q

How do you treat Wilson’s disease?

A

Copper chelators

30
Q

Give some examples of dyskinesias

A

Benign essential tremor
Chorea
Myoclonus
Dystonias

31
Q

What is a benign essential tremor?

A

5-8Hz tremor generally in the upper limb.

Generally occurs when holding something like a spoon or pen

32
Q

What can a benign essential tremor be confused with?

A

Parkinson’s

33
Q

What can help a benign essential tremor?

A

Small amounts of alcohol

BB

34
Q

What can make tremors worse?

A

Sympathomimetics (i.e. Salbutamol)

35
Q

What is chorea?

A

Jerky, quasi-purposive, explosive fidgety movements

36
Q

Give some examples of chorea

A 
Huntington's disease
Drugs
Thyrotoxicosis
SLE
Sydenham’s chorea (St Vitus’ dance)
37
Q

What is Sydenham’s chorea (St Vitus’ dance)?

A

Transient post infection chorea in children

38
Q

What drugs can cause chorea?

A

Oral contraceptive
Levodopa
Phenytoin
Alcohol

39
Q

What is myoclonus?

A

Sudden jerk of one muscle or muscle group

40
Q

What conditions can myoclonus be associated with?

A

Benign essential myoclonus
Epilepsy
Encephalopathy

41
Q

What is benign essential myoclonus?

A

Nocturnal myoclonus as dropping off to sleep- non-pathological.

42
Q

Is myoclonus a major feature of epilepsy?

A

Yes it can be. Very classical

43
Q

What can help for myoclonus in epilepsy?

A

Na Valporate

44
Q

What are dystonias?

A

Movement caused by prolonged muscular contraction – part of the body is thrown into spasm.

45
Q

What are some examples of dystonias?

A

Primary torsion dystonia
Dopamine-responsive dystonia
Spasmodic torticollis
Writer’s cramp

46
Q

What is primary torsion dystonia?

A

Dystonia affecting gait and posture spreading to all parts of the body over one to four decades

47
Q

What is dopamine-responsive dystonia?

A

Lower limb dystonia that is almost completely abolished by small doses of levodopa

48
Q

What are spasmodic torticollis?

A

Dystonic spasms gradually develop around the neck, usually in the third to fifth decade that cause the head to turn or to be drawn backwards or forwards.

49
Q

What is writer’s cramp?

A

Inability to perform a previously highly developed repetitive skilled movement (e.g. Writing)

Neurology (30 decks)

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