Movement disorders Flashcards
What are the 2 categories of movement disorder?
Hyperkinetic
Hypokinetic
What are examples of hyperkinetic conditions?
Chorea
Tics
Dystonia
Does Parkinson’s disease fall into either of the movement disorder categories?
Not really, it is classed as a hypokinetic disorder but has features of both.
Remember TRAP.
Which group of conditions is tremor a hallmark of?
Hyperkinetic conditions.
Which group of conditions is akinesia a hallmark of?
Hypokinetic conditions.
What are the 3 groupings of tremor?
Resting tremor Postural tremor (upon standing) Kinetic tremor (upon moving limb)
What is an essential tremor?
Seen in hands when outstretched.
This runs in families and can be helped by alcohol consumption.
Which part of the brain does a kinetic tremor arise from?
Cerebellum
What is dystonia?
A movement disorder characterised by sustained or intermittent muscle contractions.
These can be repetitive movements or postures (can be both).
Are dystonic movements worsened through voluntary action?
Yes
What is the most common form of dystonia?
Cervical dystonia
What can be used to help with dystonia?
Implement a sensory tic.
This may involve a voluntary movement to distract from dystonia (e.g. put hand in pocket whilst walking).
What is chorea?
A brief, irregular, purposeless movement that can travel between different body parts (not limited to a single area being affected).
What is the name of an extreme variant of chorea that involves the proximal joints?
Ballism
Patients that appear constantly restless and fidgety are thought to have what?
Chorea
What is chorea linked to?
Drugs
Huntington’s disease
Sydenham’s chorea
In ballism, where is a lesion suspected?
The striatum/subthalamic nucleus
What are tics?
Involuntary, repetitive, stereotyped movements/vocalisations.
Can tics be suppressed?
Yes, only for a short period of time.
This causes great deals of anxiety for the patient.
What can produce a flurry of tics?
Anxiety
What are examples of motor tics?
Eye blinking
Head jerks
Arm/leg jerks
What are examples of vocal tics?
Sniffing
Grunting
Snorting
Words/sentences
At which point is a primary tic developed?
Childhood
At which point is a secondary tic developed?
Adulthood
What is the most common tic syndrome?
Gilles de la Tourettes
What is Gilles de la Tourette syndrome?
A condition of persistent, multiple motor and vocal tics, often seen in childhood.
It is usually associated with a psychiatric disturbance.
What type of tremor is an essential tremor?
A postural tremor.
How would you differentiate between a postural tremor and kinetic tremor?
A postural tremor does not worsen when approaching its target.
What improves an essential tremor?
Alcohol
Give other causes of a postural tremor?
Physiological
Hepatic encephalopathy
What are fasciculations?
Fast, visible, fine, spontaneous twitches.
They occur in healthy muscle and are precipitated by stress, caffeine or fatigue.
What is myotonia?
Failure of the muscle to relax after use.
A chloride channel disorder.
What do fasciculations indicate?
Disease of a motor neuron.
