L7 - When brain body interactions fail Flashcards
What is apraxia?
Difficulty imagining or imitating an action in response to a vocal instruction. (purposeful, learnt sequences of action eg. unlocking a door w/ a key)
Muscles are completely functional.
4 TYPES : limb, oral, constructional and apraxic apraphia (writing)
Cause - Parietal lobe lesion
Treatment - physical/occupational/speech therapy
What causes apraxia?
Parietal lobe lesion!
Limb - left frontal and parietal lesions
Constructional - right parietal lobe lesions
What is Ataxia?
Poor coordination, speech changes, unsteady walking, swallowing difficulties (general uncoordination).
due to cerebellar damage.
eg. stroke, tumour, alcohol abuse
treatment - treat underlying cause when possible, physical, speech and occupational therapy.
viral causes will resolve on their own
What characterises parkinson’s disease?
- Muscle tremors, slow movements, rigidity
- Cognitive difficulties, memory loss and depression
- Olfactory deficits
due to death of dopaminergic neurons in substantia nigra, affecting the basal ganglia
genetic and environmental contributors
What are the two pathways in the basal ganglia?
Direct pathway - excitatory
Indirect - inhibitory - controls vigour of movement
What’s freezing gait?
Involuntary inability to move and unpredictable times.
tricks to avoid - marching w/ rhythmic music, stepping over an imaginary line
Treatment of Parkinsons?
- behavioural - exercise
- Carbidopa/levodopa - dopamine agonists - decreases effiveness over time
- MAO - B inhibitors
- Deep brain stimulation for advanced disease - can also make medication start working again
What is polio
Viral disease that is not symptomatic in 90-95% of people.
Symptoms - flu and recovery. paralysis in some. Some people people don’t recover.
Cause - viral infection spread through faeces-mouth
treatment - none, focus on vaccination for prevention
What is myasthenia Gravis
Symptoms - muscle weakness, fatigue
Cause - Bodies own immune system creates antibodies that bind to ACh receptor
Treatment - immunosuppresants to slow antibody production, and acetylcholinesterase inhibitors to increase the time that Ach is present in neuromusc junction
What is Anarchic Hand?
Alien Hand Syndrome
- rare disorder of involuntary, yet purposeful hand movements
Cause - anterior cerebral artery strokes, midline tutmours and neurodegenerative illnesses.
FRONTAL VARIANT - GROPING MOVEMENTS - SMC, PFC, Corpus callosum involvement
POSTERIOR VARIANT - LEVITATING HAND, withdrawl, PPC, Thalamic and Occipital lobe damage.
What is Tourette Syndrome?
Symptoms - Tics: rapid, repetitve and involuntary muscle movements and vocalisations.
Simple:
- motor: eye blind, head jerk, nose twitch
- vocal: grunts, sniffs, throat clearing, barking
Complex:
- motor: jumping, twirling, pulling at clothes
- vocal: words/phrases, echolalia, palilalia
What causes tourette and what is treatment?
Cause:
unclear. ..
- abnormal plasticity in basal ganglia, motor cortex and brainstem
- dopamine, serotonin and NA may be involved
- genetic involvement
treatment:
- nothing if mild
- problematic - haloperidol etc
- comorbid conditions are ADHD, OCD and anxiety
What are psychogenic movement disorders?
Abnormal movements or absense of normal movement, usually repeititve movements.
which have no organic neurologic disorder/basis
considered to be psychological, but there is a lack of psychological distress in patients
CBT helps.
