Movement disorders

Question 1

Parkinson

Answer 1

1) Degenerative disorder of DNA associated with Lewy bodies (composed of alpha synuclein), which leads to
2) Loss of dopaminergic neuron in substantia nigra pars compacta

Your body becomes a TRAP
Tremer at rest (pill rolling tremor)
cogwheel Rigidity
Akinesia (or bradykinesia)
Postural instability

“Lewis Park” Some korean dude you dont like bc hes got no dope

Question 2

Hungtington

Answer 2

Autosomal dominant CAG repeat (expansion= anticipiation)
Chorea, aggression, depression, and dementia
(sometimes mistaken for substance abuse)

Neuronal death via NMDA-R binding and glutamate toxicity.
Atrophy of striatal nuclei (main inhibitors of movement) can be seen on imaging.

“CAG”
Caudate loss
ACh (low)
GABA (low)

Question 3

Hemiballismus

Answer 3

Sudden, wild flailing of 1 arm +/- ipsilateral leg

Lesion: CONTRAlateral subtahalmic nucleus (lacunae stroke)

Question 4

Chorea

Answer 4

Sudden, jerky, purposeless movement

Lesion: basal ganglia (Huntington)

Chorea=dancing

Question 5

Athetosis

Answer 5

Slow, writhing movements: especially seen in fingers

Lesions: basal ganglia (huntington)

Writhing, snake-like movement
“Huntington beach infested with snakes!”

Question 6

Myoclonus

Answer 6

Sudden, brief uncontrolled muscle contraction

Jerks; hiccpus; common in metabolic abnormalities such as renal and liver failures

“Muscular hiCcup”

Question 7

Dystonia

Answer 7

Sustained, involuntary muscle contraction

Writer’s cramp; blepharospasm (sustained eyelid twitch)

Question 8

Essential tremor (postural tremor)

Answer 8

Action tremor; exacerbated by holding postures/limb positions

Genetic predispositions. Patients often self-mediated with EtOH, which decreases tremor amplitude

Treatment: beta blocker and primidone

Question 9

Resting tremor

Answer 9

Uncontrolled movement of distal appendages (most noticeable in hands)
Tremor alleviated by intentional movement

Lesion: Parkinson
Occurs at rest: pill-rolling tremor of Parkinson’s disease
“Don’t tremor; rest in parking lot”

Question 10

Intentional tremor

Answer 10

Slow, zigwag motion when pointing extending toward a target

Lesion: cerebellar dysfunction.