Lecture 7 motor Flashcards
If a person is experiencing motor problems, what could possibly be the location of dysfunction?
Muscle, alpha motor neuron, spinal cord, cortex (PPC, PFC, PMC), basal ganglia, cerebellum
What are the symptoms of apraxia?
literally means without action but not paralysed
can’t imitate or perform actions in response to vocal instruction
What are the types of apraxia?
limb, oral (speech or muscle), constructional and apraxic agraphia
limb apraxia - a disorder of motor planning in the absense of impaired muscle control that affects voluntary positioning and sequencing of muscle movements of the limbs
oral apraxia - a child (typically a late talker) is unable to coordinate or initiate movement of their jaw, lips and tongue
constructional apraxia - inability to build, assemble or draw objects
apraxic agraphia - impairment in written lanugage production associated with disruption of the motor system
What is the cause of apraxia
parietal lobe lesions
limb - left frontal and parietal lesions
constructional - right parietal lobe lesions
What is the treatment of apraxia
physical/occupaitonal/speech therapy
What are the symptoms of ataxia
‘without coordination’
poor coordination, speech changes, unsteady walking/stumbling, swallowing difficulty
What are the causes of ataxia
cerebellar damage due to
alcohol abuse, strokes, tumors, multiple sclerosis, hereditary forms (eg. frederick’s), viruses (eg. chicken pox)
What are the treatment options for ataxia?
treatment/management
treating underlying cuase where possible
viral may reverse spontaneously
physical/speech/occupational therapy
devices to aid mobility when untreatable
What are the symptoms of parkinson’s disease?
muscle tremors, slow movements, rigidity
cognitive difficulties, memory loss, depression
loss of olfaction (early warning sign!)
What are the causes of ataxia
cerebellar (cerebellum, not cerebral!!!) damage due to
alcohol abuse, strokes, tumors, multiple sclerosis, hereditary forms (eg. frederick’s), viruses (eg. chicken pox)
Why russian music is the best for study today
it’s got the exotic vibe, cheerful and a little bit depressing
Describe the direct pathway and indirect pathyway
direct - cortex excites striatum, striatum inhibits globus pallidus internal and substantia nigra, thus reduce their inhibitory control on thalamus, thus thalamus runs crazy (pls review i’m not sure)
indirect pathway - cortex excites striatum inhibits globus pallidus external, releasing the inhititory effect, thus increasing the activity in subthalamic nucleus, subthalamic nucleus excites global pallidus and substantia nigra, which inhibits thalamus, reducing or stopping or do something to the movement?
What are some of the tricks to get over a specific feature of parkinson’s
Freezing gait - involuntary inability to move at unpredictable time because of what (does the thalamus ony control certain movement?)
tricks to avoid
marching, stepping with rhythmic music
stepping over an imiginary line in front of them
What are the treatment or management of parkinson’s disease
behavioural (exercise)
carbidopa-levodopa/dopamine agonists
mao-b inibitors (inhibits breakdown of dopamine)
deep brain stimulation (advanced disease)
What is the percentage of population that is asymptomatic when infected by polio?
Who are the most vulnerable
90-95%
most polio suffers are children under 6 months
however, post polio syndrome possible
What are the symptoms of polio
flu like symptoms - full recovery
non-paralytic (1%) - headache, pain, fever, vomiting, and irritability. full recovery
paralytic (0.5%) - muscle weakness/paralysis. some recover, some not at all
post-polio syndrome (25-50%) - weakness years after infection
What is the cause of polio
viral infection spread through faeces-mouth
paralytic polio - virus attacks the spinal alpha motor neurons
What ar ethe treatment options for polio
NONE
focus on prevention via vaccination
booster vaccination recommonded if travelling to active areas (afghan, pakistan, nigerai)
What are the symptoms of myasthenia gravis
muscle weakness and fatigue, usually starting with head muscles (eyelids)
What are the causes of myasthenia gravis
bodies’ own immune system creates antibodies that bind to the ach receptor
What are the treatment options for myasthenia gravis
immunosuppressant to slow down antibody production
ach inhibitor to increase the time ach is present in neuromuscular junction (you mean reuptake?)
What is anarchic hand
Alien hand syndrome is a rare disorder of involuntary, yet purposeful, hand movement
What is the cause of anarchic hand
commonly caused by anterior cerebral artery strokes, midline tumors, and neurodegenerative ilnesses
frontal varient - groping movement: SMC, prefrontal cortex, corpus callosum involvement
posterior varient - levitating hand, withdrawal. PPC, thalamic, occipital lobe damage
What are the symptoms of tourette syndrome
tics - rapic, repetitive and involuntary muscle movement and vocalisations
Give examples of simple and complex tics
Simple - motor - eye link, head jerk, nose twitch, shrugging
vocal - grunts, sniffs, throad clearing, barking noise
complex
motor - jumping, twirling, pulling at clothes
vocal - words or phrases, corprolalia (involuntary swearing), echoalia (repeating other people’s words), palilalia (repeating one’s own words)
What are the causes of tourett syndrome
unclear but
abnormal activity in the cortico-basal ganglia loops
genetics assumed
What are the possible treatment options for tourette syndrome
mild - nothing
comorbid condition
problematic - haloperiodol, pimozide (both antipsychotic) deep brain stimulation
What are the disorders often associated with tourette syndrome
adhd, ocd, anxiety
What is psychogenic movement disorders
abnormal movements not attributable to an organic neurologic disorder
psychologically mediated (conversion disorder)
What are the problems associated with diagnosing someone with psychogenic movement disorder
Many patients lack clear psychological distress and don’t velieve there is a psychological caue of abnormality
How to treat psychogenic movement disoder
CBT
Map the following disorder to the location of dysfunction
apraxia, parkinson’s disease, ataxia, polio, myasenthia gravis
apraxia - cortex
parkinson’s - substantia nigra
ataxia - cerebellum
polio - spinal cord
myasenthia gravis - muscle (local muscles, not in the cns!!!)
