Involuntary movement/movement disorders

Question 1

Athetosis

Answer 1

Presents with slow, twisting, and writhing movements that are large and amplitude.

Primarily seen in the face, tongue, trunk, and extremities.

Brief movements, merge with Chorea
When movements sustained, they are merged with dystonia and typically associated with spasticity

Common finding in several forms of cerebral palsy secondary to basal ganglia pathology

Question 2

Chorea

Answer 2

Form of hyperkinesia

Presents with brief, irregular contractions that are rabbit, but not to the degree of myoclonic jerks.

Typically secondary to damage of the caudate nucleus; often equated to fidgeting

Ballism is a form of chorea

Huntington’s example of chorea

Question 3

Chorea—ballism

Answer 3

Choreic Jerks of large amplitude

Produces flailing movement of the limbs and typically secondary to damage of the subthalamic nucleus

Question 4

Dystonia

Answer 4

a syndrome of sustained muscle contractions that frequently causes twisting, abnormal contractions, and repetitive movement.

All muscles can be affected in the involuntary movement are often accentuated during volitional movement/intentional, and with progression, can produce overflow.

Presentations varies as multiple times and etiology surrounding dystonia.

Etiologies range from genetic or acquired to environmental or secondary effect of medications.

Presentations can include sustained contractions of agonist and antagonist muscles; repeatedly persisting within the same muscle group; voluntary movements that create involuntary movement secondary to overflow; torsion spasms that are continual, patterned and twisting.

Common diagnoses are Parkinson’s disease, cerebral palsy, and encephalitis

Question 5

Tics

Answer 5

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

Simple and complex tics that vary from myoclonic jerks to jumping movements, may include vocalization and repetition of other sounds.

Tourette syndrome example of patho

Question 6

Tremors

Answer 6

Involuntary, rhythmic, oscillatory movements that are typically classified into three groupings:

Resting, postural, intention (kinetic)

Question 7

Resting tremors

Answer 7

Observable and rest and may or may not disappear with Movement; may increase with mental stress.

Pill rolling trimmer associated Parkinson’s disease

Question 8

Postural tremor

Answer 8

Observable during a voluntary contraction to maintain a posture.

Examples include rapid tremor associated with hyperthyroidism, fatigue or anxiety, and benign essential tumor

Question 9

Intention (kinetic) tremor

Answer 9

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

These tremors likely indicate a lesion of the cerebellum or its efferent pathways and are typically seen with multiple sclerosis