Involuntary Movement/Movement Disorders

Question 1

Athetosis

Answer 1

Slow twisting and writhing movements that are large in amplitude
Primarily seen in the face, tongue, trunk, and extremities
Typically associated with spasticity
Instability of posture – peripheral movements occur without central stability
Common in cerebral palsy secondary to basal ganglia pathology

Question 2

Chorea

Answer 2

Brief, irregular contractions that are rapid
Typically secondary to damage of the caudate nucleus
Ballism is a form of chorea that includes jerks of large amplitude, usually due to damage of the subthalamic nucleus.
Huntington’s presents with chorea

Question 3

Dystonia

Answer 3

Sustained muscle contractions that causes twisting, abnormal postures, and repetitive movements
Often accentuated during volitional movement
Can be genetic or acquired due to environmental or secondary effect from medications
Common conditions that present with dystonia include Parkinson’s disease, cerebral palsy, and encephalitis

Question 4

Tics

Answer 4

Sudden, brief, repetitive coordinated movements that usually occur at irregular intervals
Can include myoclonic jerks or vocalization
Tourette’s presents with tics

Question 5

Tremors

Answer 5

Involuntary, rhythmic, oscillatory movements often due to basal ganglia lesion
Classified into 3 groups:
1) Resting: tremors at rest and may or may not disappear with movement. May increase with mental stress.
2) Postural: tremors during voluntary contraction to maintain a posture.
3) Intention (kinetic): tremors are absent at rest and observable with activity and typically increase as the target approaches. Likely indicate lesion of the cerebellum or its efferent pathways and typically seen with MS.

Question 6

Asthenia

Answer 6

Generalized weakness typically due to cerebellar pathology

Question 7

Clasp-knife response

Answer 7

Form of resistance during range of motion where greatest resistance is at initiation of range and lessons with movement throughout range

Question 8

Dysmetria

Answer 8

Inability to control range of a movement and the force of muscular activity