Movement Disorders Flashcards
Examples of hyperkinetic movements
Chorea, hemiballismus, athetosis, myoclonus, choreoathetosis
What are chorea movements
Brief irregular fleeting jerky / fidgety involuntary movements
What are hemiballismus movements
Unilateral violent rapid and involuntary movements
What are athetosis movements
slow, sinuous, writing involuntary movements (combination of dystonia and chorea)
What are dystonic movements
Sustained involuntary contractions of opposing muscle groups producing abnormal posture
Common causes of Parkinsonism
Idiopathic, drug induced, neurodegenerative disorders, lower-body parkinsonism, genetic disorders, toxic or metabolic disease, hydrocephalus
Drugs which can cause Parkinsonism
neuroleptics, antiemetics, antipsychotics (dopamine antagonists)
Genetic disorders which can cause Parkinsonism
Wilsons disease, Spino-cerebellar ataxia, Huntingtons disease
Neurodegenerative causes of Parkinsonism
Multiple systems atrophy, progressive supranuclear palsy, corticobasal degeneration syndrome
What is multiple systems atrophy
Progressive akinetic-rigid syndrome with early prominent autonomic failure with cerebellar and UMN symptoms
Sympatoms of multiple systems atrophy
Early gait instability and postural hypotension, and occasionally sleep-disordered breathing with inspiratory stridor, coat hanger pain and preserved cognition
What is supranuclear palsy
Progressive akinetic-rigid syndrome with prominent eye signs and bradyphrenia
Supranuclear gaze palsy
inability to generate voluntary saccadic eye movements, often associated photophobia and bledpharospasm
Symptoms of supranuclear gaze palsy
Early gait instability and falls, later frontal dementia, and prominent eye signs
Types of dystonia
Generalised or focal
Common causes of dystonia
Drugs (neuroleptics), Parkinsons, genetic (Wilsons, primary DYT1 dystonia), idiopathic - mainly focal dystonias
Treatment of dystonias
Drugs such as trihexyphenidyl, local botulinum toxin, DBS
Different types of tremor
Benign essential / postural tremor, dystonic tremor, enhanced physiological tremor, parkinsonian rest tremor, cerebellar tremor, neuropathic tremor, tremor secondary to MS, primary orthostatic
Treatment of benign essential / postural tremor
Beta blockers, primidone
What type of tremor is cerebellar tremor
Intention type
Causes of chorea
Huntington’s, benign hereditary chorea, idiopathic ‘senule’ chorea, endocrine causes, autoimmune causes, drug causes and lacunar infarct
Drug causes of chorea
Neuroleptics, levadopa, COCP, stimulants
Treatment of chorea
Treat underlying cause/adjust medication, neuroleptics, tetrabenezine
Causes of acute or subacute ataxia
Acute alcohol intoxification, infarct, haemorrhage, primary or secondary neoplasm, MS, meningitis/encephalitis, paraneoplatic syndrome, Wernicke’s encephalopathy, drugs (phenytoin/lamotrigine intoxification)
Causes of chronic ataxia
Alcoholic degeneration, idiopathic degeneration, MS, low-grade tumour, hypothyroidism, Prion disease, hereditary
