movement disorders

Question 1

what is the treatment for essential tremor?

Answer 1

propanolol

Question 2

unilateral, resting tremor of asymmetrical onset is a diagnosis of which condition?

Answer 2

IPD

Question 3

what is the confirmatory test for IPD?

Answer 3

positive response to levodopa

Question 4

what is the pattern of PSP?

Answer 4

1. loss of vertical eye movement
2. pseudobulbar palsy
   (dysarthria, dysphagia, tongue weakness, emotional lability)
3. dementia
4. bradykinesia / falls

Question 5

what is the management of PSP?

Answer 5

none, Poor response to L dopa

Question 6

what is the pattern of MSA?

Answer 6

1. autonomic features
2. cerebellar features

Question 7

where is the lesion causing intention tremor?

when is it seen?

Answer 7

lesion in ipsilatetal cerebellar hemisphere

appears when at the limit of intended movement

Question 8

what is the key factor to remember when treating MSA?

Answer 8

L dopa -> worsens sx

Question 9

how does one categorize myoclonus?

Answer 9

sudden onset, rapid, jerks

Question 10

when is myoclonus often seen?

Answer 10

brain injury with oxygen starvation
encephalitis

Question 11

is treatment for myoclonus?

Answer 11

Rx includes: sodium valproate, clonazepam, levetiracetam,

Question 12

How does one categorize Hemiballismus?

Answer 12

violent, uncontrolled, and continuous movements of one arm or leg. ‘flinging’

usually last <8weeks

Question 13

treatment for hemibalism?

Answer 13

antidopaminergic drugs, benzodiazepines,
anti-epileptics,
intrathecal baclofen, and tetrabenazine

Question 14

hemibalism: where is the lesion ?

Answer 14

damage to sub thalamic nucleus of LOSS - movements are on contralateral side to lesion

Question 15

how does one categorise choreaform movements?

Answer 15

continuous flow of small jerky movements from one limb to another. ‘dancing’

Question 16

causes of causes choreaform movements

Answer 16

huntingtons disease,
SLE,
drug induced.
wilsons disease.

Question 17

where is the lesion that causes choreaform movements?

Answer 17

chorea: damage to the caudate nucleus

Question 18

describe the genetics of Huntingtons

Answer 18

CAG repeat disorder of expansion
- chromosome 4

Question 19

Huntingtons, what is the pattern of sx:

Answer 19

psychiatric disturbance -> movements / chorea -> cognitive decline /dementia.

Question 20

huntingitns Rx

Answer 20

AEDS

Question 21

what are the genetics of wilsons disease?

Answer 21

defective atp7b gene on chromosone 13.

leading to copper deposition in eye liver + BG

Question 22

Wilsons disease pattern of sx:

Answer 22

psychosis -> movement ->liver cirrhosis-> fanconi syndome (defective proximal convoluted tubule function = glycosuria / osteomalacia (as ca and phos not resorbed) / RTA ty 2 (caused by failure to resorb bicarb ))

Question 23

what is the test for diagnosis and treatment in wilsons?

Answer 23

diagnosis: low ceruloplasmin

rx with penacillamine