Headaches and General movement disorders Flashcards
What is the presentation of:
Akathisia
Restless and intense urge to move
What is the presentation of:
Asterixis
Extension of wrists causes “flapping” motion
What is the presentation of:
Athetosis
Slow, snake-like, writhing movements; especially seen in the fingers
What is the presentation of:
Chorea
Sudden, jerky, purposeless movements
What is the presentation of:
Dystonia
Sustained involuntary muscle contractions
What is the presentation of:
Essential Tremor
High-frequency tremor with sustained posture (eg. outstreched arms) worsened with movement or when anxious
What is the presentation of:
Hemiballismus
Sudden, wild flailing of 1 arm +/- ipsilateral leg
What is the presentation of:
Intention tremor
Slow zigzag motion when pointing/extending toward a target
What is the presentation of:
Myoclonus
sudden brief uncontrolled muscle contraction
What is the presentation of:
Resting Tremor
Uncontrolled movement of distal appendages (most noticable in hands); tremor alleviated by intentional movement
What is the presentation of:
Restless leg syndrome
Worse at rest/nighttime
A lesion of the basal ganglia would give you what type of movement disorders?
Athetosis
Chorea
in what conditions would you see akathisia
Can be seen with neuroleptic use or as a side effect of parkinson treatment
In what conditions would you see asterixis
Hepatic encephalopathy
Wilsons disease
Other metabolic derangements
In what conditions would you se Chorea
Huntingtons disease
Acute rheumatic fever
What are conditions associated with dystonia
Writers cramp
Blepharospasm: (closure of eyelids)
Torticollis: abnormal head or neck contract
What conditions are associated with Essential tremmor
Usually a familial condition
How would familial essential tremor present and how would you treat it
Pts usually self medicate with alcohol to dec tremor amplitude
Treat with nonselective beta blockers (propranolol) or primidone
In what conditions is myoclonus common
metabolic abnormalities such as renal and liver failure
What conditions are associated with resting tremor
Parkinsons (pill rolling tremor)
What conditions are associated with RLS and how would you treat it
associated with iron deficiency and CKD
Treat with dopamine agonists (pramipexole or ropinirole)
What lesion would cause:
Hemiballismus
Contralateral subthalamic nucleus (lacunar stroke)
What lesion would cause:
Intention tremor
Cerebellar dysfunction
What lesion would cause:
Resting tremor
Substantia nigra (parkinsons)
What is the duration of:
Cluster Headache
15min - 3 hours; repetitive
Describe the presentation of:
Cluster Headache
Unilateral Awful Periorbital pain W/ Lacrimation and rhinorrhea May present with Horner syndrome (more common in males)
What is the treatment for:
Cluster Headache
Acute: sumatriptan and 100% o2
Proph: Verapamil
What is the duration of:
Tension Headache
> 30 min (typically 4-6 hours); constant
Describe the presentation of:
Tension Headache
BILATERAL
Steady “Band like” pain
No Photophobia, phonophobia, or aura
What is the treatment for:
Tension Headache
Analgesics, NSAIDs, Acetaminophen
Amitriptyline for chronic pain
What is the duration of:
Migraine Headache
4-72 hours
Describe the presentation of:
Migraine Headache
Unilateral Pulsating pain Nausea, photophobia, or phonophobia May present with "aura" (due to irritation of CN V, meninges, or bv: release of substance P, calcitonin gene related peptide, and vasoactive peptides)
What is the treatment for:
Migraine Headache
Acute: NSAIDs, triptans, dihydroergotamine
Proph: lifestyle changes, b blockers, amitriptyline, topiramate, valproate
What is the duration of:
Trigeminal Neuralgia
seconds to minutes (episodes generally increase in intensity and frequency over time)
Describe the presentation of:
Trigeminal Neuralgia
Unilateral
repetitive shooting pain in the distribution of CN V
triggered by chewing, talking, or touching certian parts of the face
What is the treatment for:
Trigeminal Neuralgia
Carbamazepine
Other then the listed headaches, what other things should be considered with “worst headache of my life presentation”
Subarachnoid hemorrhage Meningitis Hydrocephalus Neoplasia Giant Cell (temporal) arteritis
