Movement disorders

Question 1

1 hypokinetic movement dis

Answer 1

parkinsonism

Question 2

4 hyperkinetic

Answer 2

1. dystonia
2. choreal/ballism
3. tics
4. myoclonus

Question 3

what is function of direct pathway

Answer 3

release of intended movement

Question 4

what is function of indirect pathway

Answer 4

supression of competing motor programs

Question 5

what is occilatory model of BG

Answer 5

occilatory activity of brain stuctures vary in predictable way with activity, goal directed behav

Question 6

what is def. pf parkinsonISM

Answer 6

bradykinesia and one of: rigidity, tremor, postural instability

Question 7

what is prevalence of parkinson disorders

Answer 7

P. disease - 80%

atypical - 20%

Question 8

3 non motor aspects of P.

Answer 8

1. sleep dist.
2. fatigue
3. psych

Question 9

what is park rigidity

Answer 9

increased resitance to passive movement

- cogwheel and lead pipe

Question 10

what is freezing

Answer 10

sudden motor blocks - common cause of falls, especiallly in tight spaces

Question 11

what is park speech

Answer 11

monotone, slurred, but understandable speech

Question 12

what is Park disease def

Answer 12

at least 3 of:
assymetric onset
persistent assymetry affecting sidfe of onset
excellent response to L DOPA
L dopa induce chorea
resting tremmor
progression
clinical course over 10 years

Question 13

what is PD pathology

Answer 13

progressive loss of pigmented dopaminergic neruons in sub nigra

Question 14

where may PD begin?

Answer 14

in the PNS with neruons in the gut being affected

Question 15

what is multiple systems atrophy

Answer 15

combo of Sx affecting motor, cerebellar, autonomic

Question 16

subtypes of MSA

Answer 16

park, cerbellar

Question 17

Sx of MSA

Answer 17

1. auto dysfunction - othrostatic hypotension
2. rigidity
3. post instability
4. cerebellar dysfunction
5. stridor
6. speech is high pitch and quivering

Question 18

2 MRI signs of MSA

Answer 18

1. putamen hypointensity

2. hot cross but on pons

Question 19

what are Sx of progressive supranuclear palsy

Answer 19

1. post. instability
2. symmetric
3. bulbar Sx
4. axial rigidity

Question 20

what is cortical basal ganglia degeneration

Answer 20

limb curls up on you - forget it’s there, alien limb

Question 21

3 potential causes of secondary Park

Answer 21

1. post-encephalatic
2. drug/toxins
3. multiple infarcts

Question 22

red flags for Park other than PD

Answer 22

1. early falls
2. orthostatic hypotension or falls
3. apraxia, alien limb
4. early hallucinations
5. early or prominent dementia