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Neurology Board Review > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

What presents with unilateral resting tremor, cogwheel rigidity, bradykinesia, and hypomimia?

A

Parkinson’s disease

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2
Q

What symptoms can present years before classic PD symptoms appear?

A

REM sleep behavior disorder, constipation, and anosmia

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3
Q

Psychiatric co-morbidity in PD

A

Major depression

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4
Q

Diagnosis criteria for PD with dementia (Parkinsons +)

A

PD for at least 1 year before the onset of dementia symptoms

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5
Q

Gene mutation present in 10% of familial PD and 5% of sporadic PD

A

LRRK2 mutations (autosomal dominant)
Most common in North African Arabs

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6
Q

Parkinson’s pathologic findings

A

Alpha-synuclein inclusions/Lewy bodies primarily within the substantia nigra and locus coeruleus

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7
Q

How are dopamine transporter (DAT-SPECT) scans used for PD?

A

Measures the availability of striatal dopamine

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8
Q

How are PET scans for 11F or 11C dopa used for PD?

A

Measure dopa decarboxylase activity while PET scans for 11C DTBZ assess vesicular monoamine transporter-2 activity

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9
Q

α-synucleinopathies

A

Parkinson disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB)

Marked clinically by parkinsonism and pathologically by deposition of α-

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10
Q

Gold standard for PD diagnosis

A

Post-mortem pathology
Atrophy of dopaminergic cells in the substantia nigra and accumulation of α-synuclein in Lewy bodies and neurites in the brain

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11
Q

What drugs can cause drug induced parkinsonism?

A

Antipsychotics
* chlorpromazine, prochlorperazine, risperidone, clozapine, etc.
Antiemetics (metoclopramide)
Lithium
SSRIs
Valproic acid
Phenytoin

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12
Q

Is drug induced parkinsonism always resolved with medication resolution?

A

Usually but not always

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13
Q

Symptoms of restless leg syndrome

A

Uncomfortable sensation in the legs and irresistible urge to move legs, worse at night/periods of rest and relieved by movement

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14
Q

What are the tauopathies?

A

Progressive Supranuclear Palsy
Corticobasal Degeneration
Frontotemporal with Parkinson linked to chromosome 17

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15
Q

Symptoms of PSP

A

Parkinsonism (asymmetric limb rigidity)
Behavioral changes
Early falls
Vertical gaze palsy
Impaired smooth oculomotor pursuit

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16
Q

PSP imaging findings

A

Atrophy of the midbrain tegmentum, corpus callosum, and anterior cingulate gyrus
Known as hummingbird or penguin sign

17
Q

PSP pathology

A

Globose neurofibrillary tangles in the brainstem and ganglia. Tufted astrocytes

18
Q

What drugs can cause chorea (aka tardive dyskinesia?

A

Dopamine blocking agents - metoclopramide

19
Q

Treatment for tardive dyskinesia:

A

Vesicular monoamine transporter 2 (VMAT2) inhibitors: valbenazine and deutetrabenazine

20
Q

Characteristics of physiologic tremor

A

Low frequency, high amplitude tremor that involves the hands: no other associated disorder
Can be worsened by sympathetic activity: drinking coffee, SSRIs

21
Q

What medication increase physiologic tremor

A

Adrenergic agonists
Lithium
Tricyclics
Levodopa
Nicotine
Xanthines
Antidepressants
Corticosteroids
VPA
Bromides

22
Q

Frequency of a PD tremor:

A

4-6 Hz, low amplitude

23
Q

Characteristics of spinocerebellar ataxia type 1:

A

Starts around 30-40 yo
Progressive cerebellar ataxia
Dysarthria
Bulbar dysfunction

24
Q

Mode of inheritance for spinocerebellar ataxias:

A

Autosomal dominant

25
Q

Characteristics of spinocerebellar ataxia type 7:

A

Similar to type 1 with seizures, myoclonus and retinal degeneration
Presents in teenagers/young adults

26
Q

Dentatorubral pallidoluysian atrophy (DRPLA) is caused by:

A

CAG trinucleotide repeat expansion of the polyglutamine receptor on atrophin-1 gene on chromosome 12p

27
Q

MRI findings for Dentatorubral pallidoluysian atrophy (DRPLA)

A

Cerebellar and brainstem atrophy, calcification of the basal ganglia and leukodystrophic changes

28
Q

What are the pathologic characteristics of corticobasal degeneration?

A

Widespread neurodegeneration and deposits of hyperphosphoralated tau in neurons, glia, astrocytic plaques and corticobasal inclusions

29
Q

Classic presentation of corticobasilar degeneration:

A

Asymmetric rigidity
Dystonia
Ideomotor apraxia

30
Q

Neuroimaging findings for corticobasal degeneration:

A

Asymmetric frontoparietal atrophy

Neurology Board Review (16 decks)

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