Hyperkinetic Movement Disorder Flashcards
What is a tremor?
A rhythmic sinusoidal oscillation of a body part. Usually due to alternate activation of agonist and antagonist muscles.
What is a tic?
Involuntary stereotyped movements or vocalisations
What is chorea?
Brief irregular purposeless movements which flit and flow from one body part to another. Patients appear constantly restless or fidgety.
What is myoclonus?
Brief electric-shock like jerks
What is dystonia?
Involuntary muscle spasm which leads to abnormal posture of the affected body part
What is a postural tremor?
When the tremor occurs during when holding a position against gravity e.g. an outstretched arm
Name causes of a resting tremor?
Parkinson’s disease
Drug-induced parkinsonism
Psychogenic tremor
What is a kinetic tremor?
Tremor that occurs during movement of a body part.
What is an intention tremor?
The tremor is exaggerated when the limb is directed towards a particular target.
What pathology is usually behind a kinetic tremor?
Cerebellar disease (demyelination, haemorrhage, degenerative, toxic) Wilson's
What are the core criteria for essential tremor?
Bilateral action tremor of the hands and forearms
Absence of other neuro signs
May have isolated head tremor with no signs of dystonia
What are the secondary criteria for essential tremor?
Long duration (>3yrs)
Positive FH
Beneficial response to alcohol
What are the first line treatments for essential tremor?
Propanolol
Primidone
Diagnostic criteria for Gilles de la Tourette Syndrome (TS)
Both multiple motor tics and one or more vocal tics
Tics occur many times a day, nearly every day, or intermittently for more than 1 year with no longer than 3 months interval of tic-freeness
Age of onset
What is the treatment for Gilles de la Tourette syndrome (TS)?
Symptomatic treatment: clonidine, tetrabenazine
Cognitive Behavioural Therapy
What factors can relieve tics?
sleep
deep absorption in activity
What factors can exacerbate tics?
Stress/anxiety
Fatigue
Self consciousness
What drugs are used to treat juvenile myoclonic epilepsy
Sodium valproate and levetiracetam
Carbamazepine can aggravate the epilepsy syndrome
AED Treatment is longterm
