Movement Disorder

Question 1

tremors

Answer 1

Involuntary, rhythmic, oscillatory movements

Question 2

Resting tremor

Answer 2

Tremors observable at rest and may or may not disappear with movement, may increase with mental stress. Example is pill rolling tremor with Parkinson’s

Question 3

Postural tremor

Answer 3

Tremors are observable during a voluntary contraction to maintain a posture, examples include rapid tremor associated with hyperthyroidism, fatigue or anxiety, and benign essential tremor

Question 4

Intention or kinetic tremor

Answer 4

Tremors absent at rest but observable with activity and typically increase as the target approaches. Likely indicate lesion of cerebellum or its efferent pathways and are typically seen with MS

Question 5

Tics

Answer 5

Sudden, brief, repetitive coordinated movements usually occurring at irregular intervals. Can be simple or complex, ranging from myoclonic jerks to jumping movements that may include sounds. Tourette’s syndrome

Question 6

Chorea

Answer 6

Hyperkinesia that presents with brief, irregular contractions that are rapid but not to the degree of myoclonic jerks. Typically secondary to damage of caudate nucleus, chorea often equated to fidgeting. Ballism is a form that includes choreic jerks of large amplitude. Huntingtons disease

Question 7

Dystonia

Answer 7

Syndrome of sustained muscle contractions that cause twisting, abnormal postures and repetitive movements. Presentations can include sustained contraction of agonist and antagonist muscles, repeatedly persisting within the same muscle group, voluntary movements that create involuntary movement secondary to overflow, torsion spasms that are continual, patterned and twisting, etc. Parkinson’s, cp, encephalitis

Question 8

Athetosis

Answer 8

Slow, twisting and writhing movements that are large in amplitude. Primarily seen in face, tongue, trunk, and extremities. When brief, merge with chorea, when sustained, merge with Dystonia, typically associated with spasticity. Cp. basal ganglia

Question 9

Akinesia

Answer 9

Inability to initiate movement

Question 10

Asthenia

Answer 10

Generalized weakness, typically secondary to Cerebellar pathology

Question 11

Ataxia

Answer 11

Inability to perform coordinated movements

Question 12

Bradykinesia

Answer 12

Slow movement

Question 13

Clasp knife response

Answer 13

Form of resistance at hypertonic joint. Greatest resistance at initiation of range that lessons with movement throughout the range

Question 14

Clonus

Answer 14

Characteristic of upper motor neuron lesion

Involuntary alternating spasmodic contraction of a muscle precipitated by quick stretch reflex

Question 15

Cogwheel rigidity

Answer 15

Resistance to movement has phasic quality. Parkinson’s

Question 16

Dysdiadochokinesia

Answer 16

Inability to perform rapid alternating movements

Question 17

Dysmetria

Answer 17

Inability to control range of movement and force of muscular activity

Question 18

Fasciculation

Answer 18

Muscular twitch caused by random discharge of lower motor neuron and its muscle fibers. Suggests lmn disease but can be benign

Question 19

Hemiballism

Answer 19

Involuntary and violent movement of a large body part

Question 20

Kinesthesia

Answer 20

Ability to perceive direction and extent of movement of a joint or body part

Question 21

Lead pipe rigidity

Answer 21

Form of rigidity where uniform and constant resistance to range of motion. Often associated with basal ganglia

Question 22

Rigidity

Answer 22

State of severe hypertonicity where sustained muscle contraction does not allow for any movement at a specified joint