Involuntary Movement Disorders Flashcards
What is involuntary movement defined as?
A movement that the person does not start or stop at the person’s own command or with an observer’s command
What are common forms of hypokinesia?
- Apraxia
- Rigidity
- Bradykinesia
What are common forms of hyperkinesia?
- Ataxia
- Athetosis
- Chorea
- Tremors
- dysmetria
- Dystopia
How does athetosis present?
Slow, twisting, and writhing movements that are LARGE amplitude
Where are athetoid movements primarily seen?
Face, tongue, trunk and extremities
When the movements are brief, the merge with __________ (choreathetosis), and when SUSTAINED, they merge with ________, and is typically associated with spasticity
Chorea; Dystonia
Athetosis is a common finding in what pathologies?
Several forms of CP secondary to basal ganglia pathology
How does chorea present?
Brief, Irregular contractions that are rapid, but not to the degree of myoclonic jerks.
What is chorea typically secondary to?
Damage of the CAUDATE nucleus
What is chorea often equated to?
“Fidgeting”
________ is a form of chorea that includes choreic jerks of large amplitude.
Ballism
What does Ballism produce?
Produces failing movements of the limbs
What is ballism typically secondary to?
Secondary To damage of the Subthalamic nucleus
What is an example of a disease that presents with chorea?
Huntington’s Disease
What is dystonia?
Syndrome of sustained muscle contraction that frequently cause twisting, abnormal postures, and repetitive movements
What are common diagnoses that may include dystonia?
PD, CP, and encephalitis
What are tics?
Sudden, brief, repetitive, coordinated movements that will usually occur at irregular intervals
T or F: There are simple and complex tics that vary from myoclonic jerks to jumping movements that may include focalization and repetition of other sounds
True
What is an example of a pathology that presents with tics?
Tourette syndrome
Describe Tremors.
Involuntary, rhythmic, oscillatory movements taht are typically classified into 3 groups:
- Resting
- Postural
- Intention (kinetic)
What are resting tremors?
Observable at rest and may or may not disappear with movment; may increase with mental stress
What is an example of a resting tremor?
Pill-rolling in PD
What are postural tremors?
Observable during a voluntary contraction to maintain a posture
What is an example of a postural tremor?
Include the rapid tremor associated with hyperthyroidism, fatigue or anxiety, and benign essential tremor
What is an intention (kinetic) tremor?
Absent at rest, but observable with activity and typically increase as the target approaches.
What do intention tremors typically indicate?
Cerebellum or its efferent (motor) pathways and are typically seen with MS
Akinesia
The inability to initiate movement; commonly seen in PD
Asthenia
Generalized weakness, typically secondary to cerebellar pathology
Ataxia
The inability to perform coordinated movements
Athetosis
A condition that presents with involuntary movements combined with instability in posture
Peripheral movements occur without central stability
Bradykinesia
Movement that is very slow
Chorea
Movements that are sudden, random, and involuntary
Clasp-Knife response
A form of resistance seen during ROM of a hypertonic joint where there is greatest resistance at the invitation of range that lessens with movement through the ROM
Clonus
A characteristic of an UMN lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
Cogwheel Rigidity
A form of rigidity where resistance to movement has a physic quality to it; often seen with PD
Disdiadochokinesia
The inability to perfomr rapidly alternating movements
Dysmetria
The inability to control the ROM and the force of muscular activity
Dystonia
Closely related to athetosis, however, there is larger axial muscle involvement rather than appendicular
Fasciculation
A muscular twitch that is caused by random discharge of LM and its muscle fibers; suggest LMN disease, however can be bending
Hemiballism
An involuntary and violent movement of a large body part
Kinesthesia
The ability to perceive the direction and extent of movement of a joint or body part
Lead pipe rigidity
A form of rigidity where there is uniform and constant resistance to ROM often associated with lesion of the basal ganglia
Rigidity
A state of sever hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint
Tremor
Involuntary, rhythmic, oscillatory movements secondary to a basal ganglia lesion. There are various classifications secondary to specific etiology
