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Neuro Module > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

Movement disorders due to damage/disease of _______.

A

basal ganglia

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2
Q

Possible causes of movement disorders

A

AGE, environmental toxins, genetic d/o, metabolic d/o, anti-psychotics, Parkinson’s, stroke

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3
Q

ataxia

A

lack of coordination often producing jerky movements; due to cerebellum or basal ganglia

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4
Q

dystonia

A

long lasting spasmodic muscle contraction - slow, sustained, unusual postures

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5
Q

Intention tremor caused by _______ damage and resting tremor caused by ________.

A

cerebellum

basal ganglia

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6
Q

myoclonus

A

sudden, brief, shock-like contraction

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7
Q

chorea

A

irregularly timed, non-repetitive, dance-like movements in random distribution, (fidgeting, exaggerated gestures)

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8
Q

athetosis

A

slower type of chorea; writhing nature and usually distal extremities

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9
Q

Functional movements disorders

A

abnormal movements NOT due to neuro disease, inconsistent PE

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10
Q

Sydenham’s chorea

A

chorea in children due to rheumatic fever; “St. Vitus’ dance”

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11
Q

essential tremor

A

never stops; kinetic or resting
bilateral
resolves with relaxation
improves with mild alcohol

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12
Q

How to treat essential tremor?

A

Symptomatic tx: BB, antieptileptic, antidepressant

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13
Q

Pathophysiology of Parkinson’s

A

death/damage to cells of basal ganglia in substantia nigra that release dopamine

Inadequate dopamine inhibits motor regions of cerebral cortex

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14
Q

Tremor of Parkinson’s

A

resting tremor
“pill rolling”
unilateral early in disease
resolves with voluntary movement

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15
Q

Main symptoms of Parkinson’s

A 
Resting tremor
Bradykinesis
Rigidity (cogwheeling, lead pipe)
Shuffling gait w/ forward bending torso
Mask like face
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16
Q

How does essential tremor differ from Parkinson’s?

A 
Normal gait/balance
No bradykinesis
No rigidity
No masked face
Bilateral tremor (Parkinson's unilat early in dz)
17
Q

What is the earliest sign of Parkinson’s?

A

fine motor skills (then decreased mental status, then tremor)

18
Q

Mainstay tx of Parkinsons

A

Levodopa

Dopamine agonists

19
Q

What is the problem of Parkinsons therapy?

A

too much dopamine leads to hallucinations and schizophrenia; must assess risks vs benefits

20
Q

What symptoms of Parkinson’s are not improved with Levodopa?

A

sleep disturbances, supranuclear palsy, depression, fatigue, constipation

21
Q

Highest RF of Parkinson’s

A

age

22
Q

When is CT/MRI ordered for suspected Parkinson’s?

A

if ONE inconsistent finding. may be tumor, hydrocephalus, etc.

23
Q

Typical patient with Tourette’s syndrome

A

Male < 15 yo

24
Q

Psych features of Tourette’s syndrome

A

obsessions, compulsive behaviors, impulsivity, rage attacks, involuntary cursing

25
Q

When are Tourette’s symptoms suppressed?

A

when stared at. if want to see best detected out of corner of eye

26
Q

Chronic progressive chorea is called ________.

A

Huntington’s Dz

27
Q

Age of Huntington’s disease?

A

30-40 yo

28
Q

How is Huntington’s diagnosed?

A

genetic probe since inherited autosomal dominant disease (100% specificity)

29
Q

Huntington’s tx largely psychiatric?

A

high risk of suicide

30
Q

Huntington’s sx

A

chorea, psych problems, dementia

31
Q

Life expectancy of Huntington’s

A

15-20 yrs

32
Q

signs/sx of restless leg syndrome

A

paresthesias, dysesthesias that are worse at night, usually legs but can be arms

33
Q

4 diagnostic criteria

A
  1. urge to move legs
  2. urge worse at night
  3. sensations unpleasant, not painful
  4. sensations gone when up and walking, but then recur
34
Q

Which lab should be ordered in RLS work up?

A

check serum ferritin for commonly associated iron deficiency anemia

35
Q

RLS neuro exam findings

A

normal

36
Q

RLS management

A

Lifestyle changes: no caffeine, alcohol, tobacco; exercise; regular sleep patterns; hot back before bed

Meds not needed or prn: dopaminergic agents, benzos, gabapentin, anti-convulsants, opioids

37
Q

Who is most likely to get Tardive Dyskinesia? Why?

A

Patients with schizophrenia, bipolar, elderly

likely on long term potent anti-psychotic meds

38
Q

Main location of movement issues in Tardive Dyskinesia?

A

facial muscles - grimacing, tongue protrusions, lip smacking, blinking, etc.

Neuro Module (13 decks)

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