Movement Disorders Flashcards
What are 3 categories of abnormal movements and some examples of each
Impaired voluntary movements: incoordination, impaired motor planning
Presence of involuntary movements: tremor, chorea, dystonia, tics
Abnormal muscle tonw: spasticity, rigidity
Parkinson’s disease epidemiology, pathophys
1 million affected in US, Parkinson belt in upper midwest, *MC in men than women
Occurs d/t lewy bodies affecting the substantia nigra in the midbrain
Parkinson’s disease clinical, diagnosis, tx
*S/s: resting tremor, bradykinesia, rigidity, posture/balance changes, insidious onset, unilateral
Dgx: No dgx tests. based on H and P and if they respond to Parkinson meds
tx: Levodopa for sx, deep brain stim, no cure
What does deep brain stim do to the brain
electrodes are placed in the subthalamic nucleus and only helps to improve motor functions affected by PD
What are some nonmotor sx of PD
constipation, REM sleep disturbances, cognition problems, increased risk of melanoma
What do most people with PD die of
pulmonary infection, UTI, pulmonary embolism, complications from falls/fractures
Restless leg syndrome epidem, pathophy
MC “movement disorder”, variable age of onset, idiopathic or secondary RLS, *affects females more than males
Occurs d/t dopaminergic dysfunction
Restless leg syndrome clincal, dgx, tx
sleep disturbances, needing to get up and move
Dgx: check for underlying ds (anemia, folic acid deficiency, renal disease)
tx: avoid triggers, improve sleep habits, dopamine agonists (bromocriptine), maybe benzodiazepines or opiods
Essential tremor clinical, dgx, tx
S/s: Bilateral, postural or kinetic tremor NOT present at rest
Dgx: clinical/family hx, H and P, check for hyperthyroid, Archimedes spiral test
Tx: no tx, lifestyle changes, Beta blockers, thalamic stim surgery
dystonia definition
neurologic movement disorder, sustained muscle contractions; can be primary or secondary
spasticity def, clinical, tx
increased muscle tone, hyperexcitable relexes, sharp jerk like movements
S/s: abnormal relexes (+ Babinski), muscle overactivity, muscle shortening, motor weakness
tx: baclofen, tizanidine, PT, denervation by botulinum toxin
Ataxia def, dgx, tx
dysmetria of eye movements, nystagmus, dysarthria, incoordination, gait ataxia
Dgx: r/o EtOH, Brain MRI, paraneoplastic check,
Tx: no meds, supportive, assistive devices
Huntington’s epidem, pathophys
Family hx, autosomal dominant genetic disorder, MC in caucasians, *affects males and females equally
Occurs d/t degenerating cells developing intranuclear inclusions of abnormal huntington protein and the brain can’t clear it
Huntington’s sx, dgx, and tx
S/s:chorea, involuntary movements, later dystonia, cognitive disorders (can’t learn new things, takes longer to process things but can still recognize faces, do math, etc)
Dgx: Luria 3 step test, H and P, gene test
Tx: only tx sx (neuroepileptics, tetrabenazine), not cureable, PT/OT, nutrition
