Hyperkinetic Movement Disorders Flashcards

Question

what are examples of simple motor tics?

Answer 1

one discrete movement) – eye blinking, head jerking, shoulder shrugging

Answer 2

(involve a cluster of movements and appear coordinated) – pulling at clothes, touching objects, touching people, echopraxia, copropraxia

Answer 3

(single unarticulated sounds) – throat clearing sniffing or grunting

Answer 4

(stereotyped words or phrases) – echolalia, palilalia, coprolalia

Answer 5

Simple transient tics of childhood Chronic tics of childhood Gilles de la Tourette’s syndrome Adult onset Tourettism

Answer 6

Huntington’s disease, Wilson’s disease, Neuroacanthocythosis, Neuronal brain iron accumulation syndrome, Rett’s syndromes, Lesch-Nyhan syndrome

Answer 7

Down syndrome and other chromosomal abnormalities, Fragile X syndrome, Autism, non-specific mental retardation

Answer 8

Post-encephalopathy, Basal ganglia lesions (usually caudate nucleus)

Answer 9

Sydenham’s chorea, PANDAS

Answer 10

Carbon monoxide poisoning, cocaine, amphetamines, anticonvulsants

Answer 11

Autosomal dominant inheritance

Answer 12

Both multiple motor tics and one or more vocal tics must be present The tics must 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 < 18 Exclusion of obvious secondary causes

Answer 13

``` Symptomatic treatment (clonidine, tetrabenazine) CBT ```

Answer 14

brief irregular purposeless movements that flit and flow from one body part to another. generalised or local

Answer 15

``` Huntington’s disease and HD-like syndromes Wilson’s disease Neuroacanthocythosis Benign hereditary chorea Ataxia telangiectasia Spinocerebellar ataxia Typ 17 ```

Answer 16

``` SLE APS Bechet syndrome Coeliac disease Sydenham’s chorea Hashimotos ```

Answer 17

Dopamine-receptor blocking drugs, levodopa, stimulants, oral contraceptive pill, anticonvulsants

Answer 18

Parkinson’s disease

Answer 19

Chorea gravidarum, glucose, thyroid, parathyroid, sodium, magnesium metabolism

Answer 20

terabenazine or dopamine receptor blocking drugs.

Answer 21

Brief electric-shock like jerks

Answer 22

a temporary cessation of muscle activity e.g. liver flap

Answer 23

Activation from the cortex, subcortical structures, spinal cord, or nerve root and plexus. Imbalance of neurotransmitters controlling communication of feedback loops in motor pathways - serotonin, GABA

Answer 24

``` Hypnic jerks, hiccup Benign infantile myoclonus with feeding / sleep Essential myoclonus Myoclonus dystonia Cortical tremor ```

Answer 25

``` Benign myoclonic epilepsy of infancy Juvenile myoclonic epilepsy Early infantile myoclonic encephalopathy West’s syndrome Lennox-Gastaut syndrome Epilepsia partialis continua ```

Answer 26

```  Lafora body disease  Unverricht-Lindborg disease  Neuronal ceroid lipofuscinosis  Sialidosis  Myoclonic epilepsy with ragged red fibres  Dentatorubropallidoluysian atrophy ```

Answer 27

```  With encephalopathy  Liver failure  Renal failure  Drug intoxication (alcohol, lithium)  Toxins (lead)  Post hypoxia  Progressive encephalomyelitis with rigidity ```

Answer 28

o involuntary muscle spasm which leads to sustained abnormal postures of the affected body part.

Answer 29

abnormal posture is not fixed, and slow writhing movements can occur Often improved by sensory trick Dystonic tremor is jerky, variable in amplitude, and worsened by particular position or task

Answer 30

Age of Onset Distribution Etiology

Answer 31

Early-onset (<26) | Late-onset (>26)

Answer 32

``` Focal - single body region Segmental - contiguous body region Hemibody - Ipsilateral arm and leg Multifocal - > 2 non-contiguous body parts Generalized - entire body ```

Answer 33

``` Primary Dystonia plus syndromes Secondary Heredodengerative Paroxysmal Psychogenic ```

Answer 34

dystonia +/- tremor are the only symptom and sign

Answer 35

other signs may occur, but there is no secondary cause and no neurodegeneration

Answer 36

clear secondary cause is present; e.g. brain injury, drug exposure

Answer 37

in the context of wider neurodegenerative process

Answer 38

episodic attacks of dystonia, often no clinical signs between attacks

Answer 39

abnormal head posture, head tremor, head pain

Answer 40

increased blink rate, forced eye closure, difficulty opening eyes

Answer 41

haw clenching (bruxism), jaw in opening position, lateral jaw shift

Answer 42

Adductor - voice breaks and strain Abductor - breathy voice Mixed - both

Answer 43

Action dystonia's affecting writing, playing an instrument, handling tools

Answer 44

movements of shoulders, back, or abdomen