Movement Disorders

Question 0

Chorea

Answer 0

Sudden, jerky, purposeless movements

Basal ganglia

Chorea means dancing

Question 1

Hemiballismus

Answer 1

Sudden wild flailing of 1 arm plus or minus the ipsilateral leg.

Contralateral subthalamic nucleus.

Contralateral lesion

Question 2

Athetosis

Answer 2

Slow, writhing movements, especially seen in the fingers

Basal ganglia (eg Huntington’s)

Writhing, snake-like movement

Question 3

Myoclonus

Answer 3

Sudden, brief uncontrolled muscle contraction

Jerks, hiccoughs, common in metabolic abnormalities such as renal and liver failure

Question 4

Dystonia

Answer 4

Sustained, involuntary muscle contractions.

Writer’s cramp

Question 5

Blepharospasm

Answer 5

Sustained eyelid twitch - an example of dystonia

Question 6

Essential tremor / postural tremor

Answer 6

Action tremor, exacerbated by holding posture or limb position.

Genetic predisposition. Patients often self-medicated with EtOH, which decreases tremor amplitude. Treatment includes beta blockers and primadone (an anti-convulsant that breaks down into phenobarbital and phenylethylmalonamide)

Question 7

Resting tremor

Answer 7

Uncontrolled movement of distal appendages - most noticeable in the hands - tremor alleviated by intentional movement.

Parkinson’s disease/ basal ganglia.

Occurs at rest - pill-rolling tremor.

Question 8

Intention tremor

Answer 8

Slow, zigzag motion when pointing or extending toward a target.

Cerebellar dysfunction.