Movement Disorders Flashcards
Supplement with 3MB Neurology same name
What do the letters TRAP stand for in akinetic-rigid syndrome?
Tremor
Rigidity
Akinesia/bradykinesia
Postural disturbances
What is the difference between lead pipe and cogwheel rigidity?
Lead pipe is increased muscle tone in passive movement alone whereas cogwheel rigidity is increased tone and resting tremor so “clicks” when passively moved
What is a positive Froment’s maneuver?
When patient moves other body part voluntarility the rigidity increases in the examined part
How do you test for akinesia/bradykinesia?
- rapid repetitive and alternate movements e.g. tap toes, pronation/supination of wrist
- shoulder shrug or arm swing
- speed and amplitude are slow and small
How does postural and gait impairment present?
- stooped posture, maybe camptocormia (really leaning forward)
- slow, short, shuffling steps when walking
- freezing when walking
- festination: walk with feet “glued to floor”
How do you test for postural instability?
pull test
List 7 types of hyperkinetic/dyskinetic disorders.
- Tremor
- dystonia
- athetosis
- chorea
- ballism
- myoclonus
- tics
What is a postural tremor?
Occurs when the arms are outstretched
What often worsens or initiates dystonia?
voluntary action
Lesions on what part of the brain can cause chorea?
Basal ganglia
What is ballism?
a type of chorea usually involving a proximal joint with large flinging movements
Hemiballism/hemichorea suggests there is a lesion of what part of the brain?
Contralateral lesion of striatum of subthalamic nucleus
What is negative myoclonus?
Temporary cessation of muscle activity e.g. liver flap
Around what age do tis almost always start?
Childhood
What autonomic functions can be disrupted in movement disorders? (2)
- orthostatic hypotension
- incontinence
