Involuntary Movement Disorders

Question 1

What is involuntary movement defined as?

Answer 1

A movement that the person does not start or stop at the person’s own command or with an observer’s command

Question 2

What are common forms of hypokinesia?

Answer 2

1. Apraxia
2. Rigidity
3. Bradykinesia

Question 3

What are common forms of hyperkinesia?

Answer 3

1. Ataxia
2. Athetosis
3. Chorea
4. Tremors
5. dysmetria
6. Dystopia

Question 4

How does athetosis present?

Answer 4

Slow, twisting, and writhing movements that are LARGE amplitude

Question 5

Where are athetoid movements primarily seen?

Answer 5

Face, tongue, trunk and extremities

Question 6

When the movements are brief, the merge with __________ (choreathetosis), and when SUSTAINED, they merge with ________, and is typically associated with spasticity

Answer 6

Chorea; Dystonia

Question 7

Athetosis is a common finding in what pathologies?

Answer 7

Several forms of CP secondary to basal ganglia pathology

Question 8

How does chorea present?

Answer 8

Brief, Irregular contractions that are rapid, but not to the degree of myoclonic jerks.

Question 9

What is chorea typically secondary to?

Answer 9

Damage of the CAUDATE nucleus

Question 10

What is chorea often equated to?

Answer 10

“Fidgeting”

Question 11

________ is a form of chorea that includes choreic jerks of large amplitude.

Answer 11

Ballism

Question 12

What does Ballism produce?

Answer 12

Produces failing movements of the limbs

Question 13

What is ballism typically secondary to?

Answer 13

Secondary To damage of the Subthalamic nucleus

Question 14

What is an example of a disease that presents with chorea?

Answer 14

Huntington’s Disease

Question 15

What is dystonia?

Answer 15

Syndrome of sustained muscle contraction that frequently cause twisting, abnormal postures, and repetitive movements

Question 16

What are common diagnoses that may include dystonia?

Answer 16

PD, CP, and encephalitis

Question 17

What are tics?

Answer 17

Sudden, brief, repetitive, coordinated movements that will usually occur at irregular intervals

Question 18

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

Answer 18

True

Question 19

What is an example of a pathology that presents with tics?

Answer 19

Tourette syndrome

Question 20

Describe Tremors.

Answer 20

Involuntary, rhythmic, oscillatory movements taht are typically classified into 3 groups:

1. Resting
2. Postural
3. Intention (kinetic)

Question 21

What are resting tremors?

Answer 21

Observable at rest and may or may not disappear with movment; may increase with mental stress

Question 22

What is an example of a resting tremor?

Answer 22

Pill-rolling in PD

Question 23

What are postural tremors?

Answer 23

Observable during a voluntary contraction to maintain a posture

Question 24

What is an example of a postural tremor?

Answer 24

Include the rapid tremor associated with hyperthyroidism, fatigue or anxiety, and benign essential tremor

Question 25

What is an intention (kinetic) tremor?

Answer 25

Absent at rest, but observable with activity and typically increase as the target approaches.

Question 26

What do intention tremors typically indicate?

Answer 26

Cerebellum or its efferent (motor) pathways and are typically seen with MS

Question 27

Akinesia

Answer 27

The inability to initiate movement; commonly seen in PD

Question 28

Asthenia

Answer 28

Generalized weakness, typically secondary to cerebellar pathology

Question 29

Ataxia

Answer 29

The inability to perform coordinated movements

Question 30

Athetosis

Answer 30

A condition that presents with involuntary movements combined with instability in posture

Peripheral movements occur without central stability

Question 31

Bradykinesia

Answer 31

Movement that is very slow

Question 32

Chorea

Answer 32

Movements that are sudden, random, and involuntary

Question 33

Clasp-Knife response

Answer 33

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

Question 34

Clonus

Answer 34

A characteristic of an UMN lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex

Question 35

Cogwheel Rigidity

Answer 35

A form of rigidity where resistance to movement has a physic quality to it; often seen with PD

Question 36

Disdiadochokinesia

Answer 36

The inability to perfomr rapidly alternating movements

Question 37

Dysmetria

Answer 37

The inability to control the ROM and the force of muscular activity

Question 38

Dystonia

Answer 38

Closely related to athetosis, however, there is larger axial muscle involvement rather than appendicular

Question 39

Fasciculation

Answer 39

A muscular twitch that is caused by random discharge of LM and its muscle fibers; suggest LMN disease, however can be bending

Question 40

Hemiballism

Answer 40

An involuntary and violent movement of a large body part

Question 41

Kinesthesia

Answer 41

The ability to perceive the direction and extent of movement of a joint or body part

Question 42

Lead pipe rigidity

Answer 42

A form of rigidity where there is uniform and constant resistance to ROM often associated with lesion of the basal ganglia

Question 43

Rigidity

Answer 43

A state of sever hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint

Question 44

Tremor

Answer 44

Involuntary, rhythmic, oscillatory movements secondary to a basal ganglia lesion. There are various classifications secondary to specific etiology