Hypo and hyperkinetic movements Flashcards
Parkinsonism is classified based on Bradykinesia and one of ….
(RTP)
- Rigidity
- Tremor
- Postural instability
To diagnose parkinson’s disease you need at least 3 criteria
- Asymmetric onset
- Excellent response to Levodopa
- Rest tremor
If a patient has history of incontinence, orthostatic hypertension, stridor, neck droop (anterocollis), high pitched quavering speech ….
They have MSA - multi system atrophy
What is an imaging feature of MSA?
Hypointense Putamen (MSA-P) Hot cross bun sign (MSA-C)
If a patient has postural instability, symmetric bradykinesia, bulbar symptoms - difficulty swallowing, axial rigidity and gaze palsy - what do they have?
Progressive supranuclear palsy - PSP
What is an imaging feature of PSP?
Hummingbird sign - midbrain atrophy
If a patient forgets to use a limb, ailing limb phenomenon,
Cortical Basal ganglionic degeneration
Secondary Parkinsonism can be due to
Drugs (antipyschotics, lithium, MPTP)
Multiple infarcts, head injury
red flags for diagnosing PD
- Falls
- Incontinence MSA
- Alien limb or apraxia (CBD)
- early or prominent dementia
- midline bulbar signs
- cerebellar signs
- PSP
Define DYSTONIA and how can it be improved?
- Sustained (but not FIXED) posture - Involuntary muscle activity
- Caused by co-contraction of antagonist and agonist muscles
Sensory tricks can improve
Dystonia can be - (describe distribution)
and treated by..
- Focal, multifocal
- Segmental
- Generalized
L-DOPA
Difference between primary (idiopathic) or genetic dystonias
Primary ones are task-specific
Genetic ones start in foot (60% have a DYT1 mutation)
Secondary ones (Wilson’s), tardive,
Treatments for Dystonia
- Anticholinergic - artane
- Baclofen
- Tetrabenazine
- Ldopa
- DBS
if it’s focal or segmental - botox
tic disorders are treated by
D2 receptor antagonists Antiadrenergics other dopamine block - Neuroleptics botox SSRIs for OCD
In HD which basal nucleus is atrophied?
Caudate
