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NEURO MOD > Movement D/o > Flashcards

Movement D/o Flashcards

1
Q

Cerebellar d/o signs & causes

A

Signs: ataxia, dysarthria, dysdiadochokinesia, dysmetria
traumatic brain injury, stroke, MS, toxin exposure

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2
Q

Pyramidal tract d/o signs & causes

A

signs: weakness, paralysis, loss of dexterity
MS, malignancies, autoimmune diseases, infection, stroke, spinal cord injury

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3
Q

extrapyramidal tract d/o signs & causes

A

signs: involuntary movement, postural abnormalities
Parkinsons, huntingtons

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4
Q

Essential tremor

A

bilateral action tremor mostly in hands/arms
gets better with alcohol and worse with anxiety, excitement
women tend to have head/voice tremor

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5
Q

Essential tremor pathogenesis

A

abnormal activity in cerebellothalaocortical circuitry
autosomal dominant

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6
Q

how do you evaluate essential tremors

A

get labs for calcium & thyroid levels
get labs to rule out Wilson’s disease
only do imaging if w/ focal deficit or suspect stroke, etc.

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7
Q

First line tx for essential tremors

A

Beta blocker– propanolol
– not for asthma, heart failure, DM 1

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8
Q

2nd line for essential tremors

A

anticonvulsants—
primidone– not for porphyria
topiramate
gabapentin

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9
Q

Tx Classes for essential tremors

A
  1. beta blockers
  2. anticonvulsants
  3. BZD
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10
Q

3rd line for essential tremors

A

BZD– clonazepam, alprazolam

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11
Q

4 Non-medication tx for essential tremors

A

OT
assistive devices
deep brain stimulation
MRI guided US

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12
Q

pathogenesis of restless legs

A

iron deficiency!
dopaminergic deficiency, thalamic issue, peripheral pathology

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13
Q

restless legs evaluation

A

check iron levels
review meds for antihistamines, antipsychotics, antidepressants

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14
Q

restless legs treatment

A
  1. iron supplement
  2. replace offending meds
  3. dopamine agonists (pramipexole, ropinirole)
  4. Levodopa
  5. gabapentin
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15
Q

parkinsons risk factors

A

vitamin D deficiency
pesticide exposure
rural living/ag work
exposure to heavy metals, well water
age & genetics

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16
Q

parkinsons pathophysiology

A

no dopamine in substantia nigra causing communication disruption btwn basal ganglia and motor cortex

17
Q

features of parkinson’s

A

TRAP— tremor (pill rolling), rigid (cog wheeling), akinesia, postural instability

18
Q

non motor sx of parkinson’s

A

olfactory dysfx
fatigue
REM sleep d/o
cognitive changes
psychosis
mood d/o
autonomic sx— hypotension, constipation, urinary sx, sexual dysfx

19
Q

parkinson’s diagnosis

A

bradykinesia is required! plus tremor or rigidity
supportive— benefit from dopaminergic meds, unilateral sx at onset, olfactory loss, levodopa induced dyskinesia
mostly diagnosed in 60s

20
Q

imaging for parkinson’s

A

DAT scan to see density of dopamine neurons

21
Q

Parkinson’s medication

A

C SALAD
COMT inhibitors
Selegiline (MAO-B inhibitors)
Anticholinergics
Levodopa
Amantadine
Dopamine agonist

22
Q

Gold standard med for Parkinson’s disease

A

Levodopa

23
Q

Class of meds that must be taken w/ Levodopa & what it addresses

A

COMT inhibitors for motor fluctuations

24
Q

signs that it is NOT idiopathic parkinson’s

A

rapid progression of gait sx needing wheelchair <5yrs
bulbar dys (dysphonia,-phagia-arthria) w/in 5 yrs
bilateral parkinsonism

25
Q

differential diagnosis for parkinson’s

A

drug induced parkinsonism
vascular parkinsonism
normal pressure hydrocephalus
wilsons disease
toxin exposure
parkinson plus

26
Q

Parkinson’s Plus syndromes

A

look like parkinson’s initially but then it rapidly progresses
Progressive Supranuclear Palsy & Multiple System Atrophy

27
Q

Progressive Supranuclear Palsy

A

early onset of postural instability, lot of falls in first year
vertical gaze palsy
frontal lobe dysfx
death 6-9 yrs after diagnosis

28
Q

Multiple system Atrophy

A

postural abnormalities
dysphagia
cognitively OK
death at 6-10 years after but care dependent at about 4 yrs

29
Q

Huntington’s disease

A

changes in caudate, putamen, globus pallidus, temporal & frontal lobes
diagnosed when we see chorea (dance like movements)
starts as clumsiness and fidgeting then becomes classic choreifrom movements
slow saccadic eye movement
cognitive and personality changes
slurred speech, difficulty swallowing, wt loss
high CAG repeats

NEURO MOD (8 decks)

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