movement disorders Flashcards
(42 cards)
Direct and indirect pathways
D1(direct)= facilitates movement. D2 (indirect)= inhibits movements
Dopamines normal effect on direct/indirect pathways
Dopamine turns up direct pathway and turns down indirect pathway
What are hyperkinesias
moving too much: tremor, chorea, tics, dystonia
hypokinesias
not moving enough: Parkinsonism
Tremor- definition
rhythmic oscillatory movement produced by alternating or synchronous contraction of antagonist muscles
tremor- position when happens most
resting, action (intentional), postural (sustained)
tremor- frequency, characteristics
can be slow or fast, regular or jerky
Drugs that induce tremor
theophylline, bronchodilators, amphetamines, antidepressants, caffeine, cyclosporin, steroids, lithium, alcohol, amiodarone, valproate, neuroleptics, metaclopromide, reserpine, anti-nauseants
what is an essential tremor
benign/senile tremor. Postural tremor more common than kinetic. Most common in hands, followed by head
Other symptoms occuring with essential tremor
gait disorder, parkinsonism, dystonia, impaired smelling or hearing
How do essential tremors change with age
get slower and larger
Therapy of essential tremor
beta blockers (propranolol), primidone, topiramate, gabapentin, clonazepam, botulinum toxin, assisted devices
surgical options for essential tremor
thalamotomy, deep brain stimulation delivering stimulation to thalamus
Parkinsons symptoms
resting tremor, bradykinesia or akinesia, rigidity, gait freezing,
compare essential tremor with parkinsons
ET: kinetic, bilateral, disabling. Parkinsons: during rest, unilateral, not disabling, plus parkinsons signs
Parkinsons pharmacological treatment
Carbidopa/levidopa, dopamine agonists, anticholinergics, COMT-inhibitors, amantadine, and MAO-b inhibitors
What areas of the brain are targeted for deep brain stimulation in parkinsons
subthalamic nucleus, internal globus pallidus, Vim
Define tics
brief, intermittent movements or sounds. Sudden, abrupt, transient. Repetitive and coordinated. Vary in intensity, repeated at irregular intervals. May resemble gestures or normal behavior
Diagnostic criteria for tourette syndrome
Age of onset 1 yr
Tourette syndrome is associated with what other conditions
ADHD, OCD and poor impulse control
Is tourettes more common in females or males
males
Compare simple and complex tics in tourette syndrome
simple: grimacing, blinking, nose twitching lip pouting. Complex: hopping, clapping, touching, throwing, head banging
Tourette syndrome treatment
habit reversal therapy, treat OCD and ADHD
Chorea- definition
irregular, brief, dancing like, jerky. Randomly flit from one body part to another.