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Motor Disorders Flashcards

1
Q

What is Huntington’s disease?

A

A neurodegenerative disorder involving affective, cognitive, and motor symptoms.

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2
Q

What gene is responsible for Huntington’s disease?

A

A mutated version of the huntingtin (HTT) gene on chromosome 4.

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3
Q

What does it mean that the HTT gene is autosomal dominant?

A

Offspring of a person with this gene have a 50% chance of inheriting the disease.

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4
Q

Which areas of the brain are affected by Huntington’s disease?

A

Caudate nucleus, putamen, cerebral cortex, cerebellum, and thalamus.

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5
Q

What neuroimaging findings are associated with Huntington’s disease?

A

Glucose hypometabolism and atrophy in the caudate nucleus and putamen.

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6
Q

What neurotransmitters are associated with Huntington’s disease?

A

GABA, dopamine, and glutamate.

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7
Q

At what age do symptoms of Huntington’s disease most often appear?

A

Between 30 and 50 years of age.

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8
Q

What is the typical life expectancy following the onset of symptoms in Huntington’s disease?

A

10 to 30 years.

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9
Q

What are the early affective symptoms of Huntington’s disease?

A

Depression and mood swings.

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10
Q

What cognitive symptoms are associated with Huntington’s disease?

A

Short-term memory loss and impaired concentration and judgment.

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11
Q

What is the primary motor symptom of Huntington’s disease?

A

Chorea, involving irregular, uncontrollable jerky or writhing movements.

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12
Q

What severe motor symptoms occur in the later stages of Huntington’s disease?

A

Rigidity and bradykinesia, trouble walking, speaking, and swallowing.

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13
Q

What criteria may a person with advanced Huntington’s disease meet?

A

Criteria for mild or major neurocognitive disorder.

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14
Q

Is there a cure for Huntington’s disease?

A

No, there is no cure.

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15
Q

What are the goals of treatment for Huntington’s disease?

A

To relieve symptoms and improve quality of life.

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16
Q

What is Parkinson’s disease?

A

A neurodegenerative disorder that produces prominent motor symptoms due to a combination of genetic and environmental factors.

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17
Q

What causes the motor symptoms in Parkinson’s disease?

A

Degeneration of dopamine-producing cells in the substantia nigra, reducing dopamine levels in areas of the basal ganglia.

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18
Q

What role does excessive glutamate activity play in Parkinson’s disease?

A

It is implicated in the progression of the disease.

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19
Q

How do low levels of acetylcholine (ACh) affect individuals with Parkinson’s disease?

A

They contribute to impairments in gait, balance, and cognitive decline.

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20
Q

What non-motor symptoms are associated with low levels of norepinephrine in Parkinson’s disease?

A

Depression, cognitive deficits, sleep disturbances, and other non-motor symptoms.

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21
Q

What genetic variant is linked to an increased risk for neurocognitive disorders in Parkinson’s disease?

A

Variants of the ApoE gene.

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22
Q

List the primary motor symptoms of Parkinson’s disease.

A
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23
Q

What is a resting tremor in Parkinson’s disease?

A

A tremor that occurs when muscles are at rest, beginning in the hands and including ‘pill rolling’.

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24
Q

What is postural instability?

A

Impaired balance and coordination.

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25
Define rigidity as a symptom of Parkinson's disease.
Rigidity in the limbs and trunk.
26
What is bradykinesia?
Slowed voluntary movement causing a slow shuffling gait and decreased eye blinking.
27
What is akinesia?
An inability to move one's muscles voluntarily or in response to a command.
28
What are some non-motor symptoms of Parkinson's disease?
Gastrointestinal problems, sleep disturbances, pain, loss of smell, anxiety, and depression.
29
What percentage of people with Parkinson's disease experience depression?
Up to 50%.
30
In what percentage of Parkinson's cases do depressive symptoms precede motor symptoms?
About 20%.
31
What cognitive disorders can develop in people with Parkinson's disease?
Mild or major neurocognitive disorder.
32
What is the primary treatment for alleviating symptoms of Parkinson’s disease?
Levodopa ## Footnote Levodopa is generally considered the first-line medication for Parkinson’s disease.
33
How does levodopa exert its beneficial effects?
It is converted to dopamine in the brain ## Footnote This conversion helps to alleviate symptoms like bradykinesia.
34
What symptoms is levodopa most effective in treating?
Bradykinesia, muscle rigidity, and tremor ## Footnote Bradykinesia refers to slowness of movement.
35
What are dopamine agonists?
Medications that mimic dopamine at receptor sites ## Footnote They serve as alternatives to levodopa.
36
What are the advantages of using dopamine agonists over levodopa?
They may delay disease progression and have fewer long-term side effects ## Footnote Side effects include dystonia, myoclonus, and other dyskinesias.
37
What is deep brain stimulation (DBS)?
A surgical treatment that reduces motor symptoms by implanting electrodes ## Footnote It delivers electrical impulses to specific brain areas.
38
When is deep brain stimulation considered for a Parkinson’s patient?
When motor symptoms are not adequately controlled by medication ## Footnote It significantly impairs the patient's quality of life.
39
What does the pulse generator in DBS do?
Sends electrical impulses to target areas in the brain ## Footnote This alters brain activity in those areas.
40
True or False: Dopamine agonists are only used for Parkinson’s disease.
False ## Footnote They are also used for conditions like restless leg syndrome and neuroleptic malignant syndrome.
41
What conditions can deep brain stimulation (DBS) treat besides Parkinson’s disease?
Essential tremor, dystonia, refractory epilepsy, refractory OCD, and others ## Footnote DBS is used for various neurological conditions.
42
What is a seizure?
A seizure is a transient physical or behavioral alteration that results from abnormal electrical activity in the brain. ## Footnote Definition based on Story, 2022, p. 472.
43
What are the two main types of seizures?
Focal onset seizures and generalized onset seizures. ## Footnote These categories help classify seizures based on their onset.
44
What distinguishes provoked seizures from unprovoked seizures?
Provoked seizures have a known cause, while unprovoked seizures occur without a known cause. ## Footnote Examples of provoked seizures include traumatic brain injury and alcohol withdrawal.
45
When is epilepsy diagnosed?
When seizures are recurrent and unprovoked. ## Footnote This indicates a chronic condition requiring further management.
46
What are focal onset seizures?
Focal onset seizures begin in a localized area in one cerebral hemisphere and affect one side of the body. ## Footnote They may spread to other parts of the brain.
47
What are focal onset aware seizures?
Focal onset aware seizures (simple partial seizures) do not affect consciousness. ## Footnote These are one type of focal onset seizure.
48
What are focal onset impaired awareness seizures?
Focal onset impaired awareness seizures (complex partial seizures) cause a change in consciousness and may begin with an aura. ## Footnote Auras can manifest as various sensory experiences.
49
What symptoms can occur with focal seizures?
Symptoms depend on their location and may include: * Changes in consciousness * Autonomic symptoms * Automatisms * Trouble speaking and impaired comprehension. ## Footnote These symptoms vary widely based on the affected brain area.
50
What are common characteristics of temporal lobe seizures?
They may begin with an aura, with symptoms such as: * Strange taste or odor * Rising sensation in the stomach * Sudden intense fear or emotion * Déjà vu or jamais vu. ## Footnote Temporal lobe seizures are the most common type of focal onset seizure.
51
What autonomic symptoms may accompany temporal lobe seizures?
Characteristics include: * Sweating * Dilated pupils * Tachycardia. ## Footnote These reflect the body's autonomic response during seizures.
52
What triggers temporal lobe seizures?
Causes include: * Genetic factors * Traumatic brain injury * Brain tumors and infections * Cerebrovascular accidents * Psychological stress. ## Footnote Psychological stress is a frequent trigger for these seizures.
53
What are frontal lobe seizures?
The second-most common type of focal onset seizure, often occurring during sleep and lasting less than 30 seconds. ## Footnote Symptoms include repetitive movements, abnormal body posturing, explosive screams or laughter, trouble speaking, and autonomic symptoms.
54
What symptoms are associated with frontal lobe seizures?
* Kicking * Rocking * Bicycle pedaling * Abnormal body posturing (e.g., fencing posture) * Explosive screams or laughter * Trouble speaking with intact comprehension * Autonomic symptoms ## Footnote These symptoms can manifest during the seizure episode.
55
What are parietal lobe seizures characterized by?
* Tingling * Numbness * Pain * Other abnormal sensations * Feelings of movement (e.g., floating) * Distortions in body image ## Footnote Distortions may include feelings that a body part is enlarged, shrunken, or absent.
56
What sensations are involved in parietal lobe seizures?
Tingling, numbness, pain, feelings of movement, and distortions in body image. ## Footnote Examples of distortions include feeling that a body part is enlarged, shrunken, or absent.
57
What are the characteristics of occipital lobe seizures?
* Rapid eye blinking * Eyelid flutter * Involuntary eye movements * Flashing or stationary bright lights * Multi-colored circular patterns * Simple visual hallucinations * Partial blindness or impaired visual acuity ## Footnote These symptoms may vary in severity and presentation.
58
Fill in the blank: Occipital lobe seizures are characterized by _______.
rapid eye blinking, eyelid flutter, and involuntary eye movements.
59
True or False: Frontal lobe seizures can last more than 30 seconds.
False ## Footnote Frontal lobe seizures typically last less than 30 seconds.
60
What are generalized onset seizures?
Generalized onset seizures affect both hemispheres and include generalized onset motor seizures and generalized onset non-motor seizures.
61
What are generalized onset motor seizures also known as?
Tonic-clonic seizures and grand mal seizures.
62
What is the tonic phase of generalized onset motor seizures characterized by?
A stiffening of muscles in the face and limbs.
63
What occurs during the clonic phase of generalized onset motor seizures?
Jerky rhythmic movements in the arms and legs.
64
What may a person experience after regaining consciousness from a generalized onset motor seizure?
Depression, confusion, or fatigue; may have no memory of the seizure.
65
What are generalized onset non-motor seizures also known as?
Absence seizures and petit mal seizures.
66
What characterizes generalized onset non-motor seizures?
A very brief loss of consciousness with a blank stare, possibly accompanied by rapid blinking.
67
Fill in the blank: Generalized onset motor seizures include _______ and _______.
tonic-clonic seizures, grand mal seizures.
68
True or False: Generalized onset seizures affect only one hemisphere of the brain.
False.
69
What is a common postictal state after a generalized onset motor seizure?
Depression, confusion, fatigue.
70
What is the definition of status epilepticus (SE)?
A single seizure that continues for 5 minutes or more or recurrent seizures without a return to consciousness between them ## Footnote Definitions of SE may vary, but this is the most common description.
71
What are the two main types of status epilepticus?
* Generalized convulsive SE * Non-convulsive SE
72
What characterizes generalized convulsive status epilepticus?
Loss of consciousness and tonic-clonic seizures ## Footnote Tonic-clonic seizures involve both tonic (stiffening) and clonic (jerking) phases.
73
What characterizes non-convulsive status epilepticus?
Seizure activity apparent on EEG without prominent motor symptoms, possibly involving altered consciousness, delusions, hallucinations, automatisms, and aphasia.
74
What are some causes of status epilepticus?
* Head trauma * CNS infections * Cerebrovascular accidents * Drug toxicity * Autoimmune disorders * Non-compliance with seizure medications
75
True or False: Status epilepticus is considered a medical emergency.
True
76
What is the first-line treatment for status epilepticus?
Benzodiazepines ## Footnote These medications are typically used due to their rapid efficacy in controlling seizures.
77
What additional treatments may be used if benzodiazepines are ineffective?
Anti-seizure medications ## Footnote These medications are also used for maintenance treatment to prevent recurrence.

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