Movement Disorders

Question 1

Hemiballismus: presentation

Answer 1

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

“Half of body ballistic”

Question 2

Hemiballismus: characteristic lesion

Answer 2

Contralateral STN (lacunar stroke)

Question 3

Chorea: presentation

Answer 3

sudden, jerky, purposeless movements

chorea = dancing

Question 4

Chorea: characteristic lesion

Answer 4

Basal ganglia (Huntington dx)

Question 5

Athetosis: presentation

Answer 5

slow, writhing movements; especially seen in fingers

Question 6

Athetosis: characteristic lesion

Answer 6

Basal ganglia (Huntington dx)

Question 7

Myoclonus: presentation

Answer 7

sudden, brief, uncontrolled muscle contraction

Question 8

Myoclonus: examples

Answer 8

jerks; hiccups; common in metabolic abnormalities such as renal and liver failure

Question 9

Dystonia: presentation

Answer 9

sustained, involuntary muscle contractions

Question 10

Dystonia: examples

Answer 10

writer’s cramp; blepharospasm (sustained eyelid twitch)

Question 11

Essential tremor (postural tremor): presentation

Answer 11

action tremor; EXACERBATED by holding posture/limb position

Question 12

Essential tremor: treatment

Answer 12

Beta-blockers, Primidone (anticonvulsant)

Question 13

Essential tremor: notes

Answer 13

Genetic predisposition

Patients often self-medicated with EtOH, which decrease tremor amplitude

Question 14

Resting tremor: presentation

Answer 14

Uncontrolled movement of distal appendages (most noticeably in hands)
Tremor ALLEVIATED by intentional movement

Question 15

Resting tremor: lesion

Answer 15

Parkinson dx

Question 16

Resting tremor: example

Answer 16

“pill-rolling tremor” of Parkinson dx; occurs at rest

Question 17

Intention tremor: presentation

Answer 17

slow, zigzag motion when pointing/extending toward a target

Question 18

Intention tremor: lesion

Answer 18

cerebellar dysfunction