Movement disorders

Question 1

What are the 2 main types of movement disorder?

Answer 1

Pyramidal movement disorders
Extra-pyramidal movement disorders

Question 2

What are the 2 main signs of pyramidal movement disorder?

Answer 2

Spasticity
Pyramidal weakness

Question 3

What are the 2 types of extra-pyramidal movement disorder?

Answer 3

Hyperkinetic
Hypokinetic

Question 4

What are some signs of hyperkinetic movement disorders?

Answer 4

• Dystonia
• Tics
• Myoclonus
• Chorea
• Tremor

Question 5

What is a sign of hypokinetic movement disorders?

Answer 5

Parkinsonism

Question 6

What is vascular parkinsonism?

Answer 6

A contentious form of movement disorder predominantly affecting the lower limbs, with signs of vascular lesions in the brain and rarely a resting tremor

Question 7

What causes drug-induced parkinsonism?

Answer 7

Any drug that blocks the action of dopamine

Question 8

What are some drugs that can cause drug-induced Parkinsonism?

Answer 8

• Metoclopramide (Anti-emetic)
• Neuroleptic drugs

Question 9

What is essential tremor?

Answer 9

An autosomal dominant tremor disorder causing a symmetric, high-frequency tremor, responsive to alcohol

Question 10

What is multiple system atrophy?

Answer 10

A progressive neurodegenerative disorder characterised by a combination of symptoms that affect both the CNS and autonomic nervous system

Question 11

What is the triad of symptoms in multiple system atrophy?

Answer 11

• Dysautonomia
• Cerebellar features
• Parkinsonism

Question 12

What are some non-triad symptoms of multiple system atrophy?

Answer 12

• Severe dysarthria
• Dysphonia
• Marked antecollis
• Inspiratory sighing
• Orofacial dystonia

Question 13

What are some MRI features of multiple system atrophy?

Answer 13

Cerebellar and pontine atrophy (“hot cross bun” sign, or hyperintense rim surrounding the putamen in T2-weighted sequences)

Question 14

What is progressive supra-nuclear palsy?

Answer 14

A symmetric, akinetic-rigid syndrome with predominantly axial involvement

Question 15

What is the presentation of progressive supra-nuclear palsy?

Answer 15

Gait and balance impairment
Vertical gaze palsy
Pseudobulbar syndromes
Retrocollis
Continuous activity of the frontalis muscle with eyes wide open

Question 16

What is corticobasal syndrome (CBS)?

Answer 16

A rare, progressive neurodegenerative disorder characterised by a combination of motor, cognitive, and sensory deficits

Question 17

What are some motor symptoms of CBS?

Answer 17

• Asymmetric rigidity
• Akinesia (lack of movement)
• Dystonia
• Alien limb phenomenon (Limb behaves as if it has a will of its own)

Question 18

What are some cognitive symptoms of CBS?

Answer 18

• Executive dysfunction
• Apraxia (inability to perform tasks despite understanding them and having the physical ability to perform them)
• Language disturbances.

Question 19

What are some sensory symptoms of CBS?

Answer 19

Tactile and proprioceptive deficits, leading to impaired perception of touch and limb position