Lecture 15: Movement Disorders Flashcards
What kind of tremor do patients with Parkinson’s Disease initially present with?
Unilateral resting tremor - “pill-rolling” quality
*TRAPS
T = tremor at rest
R = rigidity
A = akinesia and bradykinesia
P = postural instability
S = shufflng gait
Although findings are similar to PD, what distinguishes Progressive Supranuclear Palsy (PSP)?
Loss of voluntary control of eye movements (especially VERTICAL gaze)
Although findings are similar to PD, what distinguishes Multiple Systems Atrophy (MSA)?
Pronounced autonomic dysfunction
Although findings are similar to PD, what distinguishes Cortical Basal Degeneration (CBD)?
- Cortical and ganglionic dysf.
- May see cortical sensory loss, apraxia, myoclonus or aphasia
Sustained muscle contraction that produce twisting and repetitive movements and abnormal postures; often stuck in torticollis, defines what?
Dystonia
Chorea vs. Athetosis?
- Chorea = irregular, brief, “dancelike movements;” may be incorporated into puposeful movements
- Athetosis = writhing (snake-like), sinous movements (often occur in combo w/ chorea)
Who is most often affected by Sydenham’s Chorea?
Why does it occur?
Characterized by?
- Mainly children/adolescents as complication of previous strep infection
- Unilateral choreiform movements
What is the treatment of choice for someone with Focal Torsion Dystonia?
BOTOX
Wilson’s disease is a disorder of ________ metabolism that produces ______ and _______ dysfunction
Wilson disease is a disorder of copper metabolism that produces neurologic and HEPATIC dysfunction
Who is most often affected by Wilson’s Disease?
Children and young adults
Which disease have both bradykinetic and hyperkinetic movements?
Wilson’s Disease
What is the clinical presentation of Essential Tremor (aka Benign Familial Tremor)?
How does it progress?
- Postural or kinetic tremor (induced by movement) of both hands and may involve head or voice
- Can begin in early adulthood, and usually progresses slowly over years to decades
Drug induced Parkinson’s will present with what kind of finding different from idiopathic?
Bilateral tremor/findings
Which movement disorder is characterized by hypophonia (soft voice), masked facies, decreased frequency of eye blink, and a Myerson’s sign?
Idiopathic Parkinson’s Disease (the classic/most common)
Which disease is characterized by unexplained periods of markedly increased confusion that last days to week and closely mimic delirium?
Lewy Body Disease