Movement Disorders

Question 1

Hemiballismus

Answer 1

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

Characteristic Lesion: Contralateral subthalamic nucleus (e.g. lacunar stroke)

Notes: “Half-of-body ballistic”. Contralateral lesion.

Question 2

Chorea

Answer 2

Presentation: Sudden, jerky, purposeless movements

Characteristic Lesion: Basal ganglia (e.g., Huntington’s)

Notes: Chorea = dancing.

Question 3

Athetosis

Answer 3

Presentation: Slow, writhing movements; especially seen in fingers

Characteristic Lesion: Basal ganglia (e.g., Huntington’s)

Notes: Writhing, snake-like movement.

Question 4

Myoclonus

Answer 4

Presentation: Sudden, brief, uncontrolled muscle contraction

Characteristic Lesion:

Notes: Jerks; hiccups; common in metabolic abnormalities such as renal and liver failure.

Question 5

Dystonia

Answer 5

Presentation: Sustained, involuntary muscle contractions

Characteristic Lesion:

Notes: Writer’s cramp; blepharospasm (sustained eyelid twitch).

Question 6

Essential tremor (postural tremor)

Answer 6

Presentation: Action tremor; exacerbated by holding posture/limb position

Characteristic Lesion:

Notes: Genetic predisposition. Patients often self-medicated with EtOH, which decreases tremor amplitude. Treatment: Beta-blockers, primidone.

Question 7

Resting tremor

Answer 7

Presentation: Uncontrolled movement of distal appendages (most noticeable in hands); tremor alleviated by intentional movement

Characteristic Lesion: Parkinson’s disease

Notes: Occurs at rest; “pill-rolling tremor” of Parkinson’s disease.

Question 8

Intention tremor

Answer 8

Presentation: Slow, zigzag motion when pointing/extending toward a target

Characteristic Lesion: Cerebellar dysfunction

Notes: