Gait, Cerebellar Function, and Movement Disorders

Question 1

systems that provide coordination and postural control of gait

Answer 1

cerebellar and extrapyramidal systems

Question 2

can’t walk when asked

Answer 2

gait apraxia

Question 3

Romberg sign - issue with

Answer 3

proprioception - dorsal column or afferent sensory nerves

Question 4

proprioception/sensation is needed for walking when?

Answer 4

in dark

Question 5

broad based ataxic gait

Answer 5

posterior column lesion

Question 6

hemiplegic gait

Answer 6

circumducting (ipsi upper limb flexes at elbow too) - stroke patients

Question 7

tabetic gait

Answer 7

foot slap

Question 8

steppage gait

Answer 8

foot drop or weak dorsiflexion

Question 9

unilateral foot drop

Answer 9

peroneal n or L5 root lesion

Question 10

b/l foot drop

Answer 10

polyneuropathy, motor neuron dz, b/l L5 root lesions

Question 11

waddling gait

Answer 11

weakness of hip girdle muscles - myopathy

Question 12

scissors gait

Answer 12

UMN (CST) lesions like spastic paraparesis

Question 13

parkinsonian gait

Answer 13

slow and shuffling with festination (lean forward and inc speed)

Question 14

overshooting or undershooting target during cerebellar tests

Answer 14

dysmetria

Question 15

uncoordinated nonrhythmic sloppy hand movements instead of rapid/alternating

Answer 15

dysdiadochokinesia

Question 16

kinetic/action tremor due to issue where?

Answer 16

cerebellum issue

Question 17

imbalance between agonist and antagonist muscles

Answer 17

rebound phenomenon (ex: pull on dr’s arm but they let go and you can’t stop your arm from moving so you hit yourself)

Question 18

broken down syllables with unequal emphasis/force, jerky speech

Answer 18

cerebellar dysarthria

Question 19

multidirectional nystagmus seen w/

Answer 19

cerebellar dz, vestibular lesions, brainstem lesions

Question 20

atrophy of anterior-superior vermis - gait ataxia, truncal unsteadiness, lower limb dysmetria - seen with

Answer 20

alcoholic cerebellar degeneration

Question 21

autosomal recessive dz that starts in kids and worsens, cerebellum is affected

Answer 21

Friedrich’s ataxia - chromosome 9 trinucleotide repeats

Question 22

limb dysmetria, gait ataxia, dysarthria seen w/ lesion where

Answer 22

spinocerebellar lesion

Question 23

weakness and babinski sign seen w/ lesion where

Answer 23

CST lesion

Question 24

postural tremor seen with

Answer 24

familial essential tremor

Question 25

kinetic tremor seen with

Answer 25

cerebellar dz

Question 26

continuous slow writhing movements of distal limbs

Answer 26

athetosis

Question 27

dance-like irregular movements

Answer 27

choreoathetosis

Question 28

unilateral rapid violent flinging movements of proximal limb

Answer 28

hemiballismus

Question 29

hemiballismus due to lesion where?

Answer 29

contralateral subthalamic nuc (usually via ischemic infarct)

Question 30

continual sustained contraction of muscle leading to spasm (often painful)

Answer 30

dystonia

Question 31

stereotyped repetitive focal muscle contractions that appear semipurposeful

Answer 31

tics

Question 32

Tourette’s- gender and accompanying conditions

Answer 32

seen in boys

behavioral disorders/ADHD

Question 33

rapid shock-like lightning movements/jerks of limbs and trunk - typically bilateral

Answer 33

myoclonus

Question 34

myoclonus can be seen in which dz

Answer 34

Creutzfeldt-Jakob

Question 35

semi-rhythmic loss of postural control of hands and feet - tremor seen when extended - “flapping”

Answer 35

asterixis

Question 36

tx for resting tremor

Answer 36

anticholinergics or levodopa and DA agonists

Question 37

tx for essential tremor

Answer 37

beta blockers or barbituates

Question 38

tx for choreoathetosis

Answer 38

DA antagonist

Question 39

tx for hemiballismus

Answer 39

DA antagonist

Question 40

tx for tics

Answer 40

DA antagonist

Question 41

tx for dystonia

Answer 41

anticholinergics, benzos, botulinum toxin injections