Movement Disorders

Question 1

Movement disorders broken down into

Answer 1

bradykinetic

hyperkinetic

Question 2

Brady kinetic/ akinetic movement disorders

Answer 2

Parkinsonism, PSP, MSA, CBD

Question 3

Hyperkinetic movement disorders

Answer 3

Corea - huntingons, syndehams
Dystonia - Idopathic torsion dystonia, focal dystonia, wilson’s disease, Tic disorders, Gilles de la tourette’s syndrome, essential tremor

Question 4

parkinsons is caused by

Answer 4

a depetion of dopamine in the nigrostriatal system. disrupting balance of dopamine and acetylcholine
lack of dopamine, with increased Ach

Question 5

Cardinal features of parkinsons

Answer 5

tremor, rigidity, bradykinesia

Question 6

what’s the first symptom of parkinsons

Answer 6

tremor

Question 7

Other features of parkinsons

Answer 7

postural instability, quiet voice, hypomimia, decreased frequency of eyeblink, myerson’s sign, gait disturbance, may not swing arms. dysautonomia, dementia.

Question 8

Other akinetic rigid syndromes are similar to parkinsons but they lack a

Answer 8

tremor

Question 9

PSP

Answer 9

bradykinesia and rigidity

loss of voluntary control of eye movements, esp vertical gaze

Question 10

Multiple systems atrophy

Answer 10

bradykinesia and rigidity

PRONOUNCED autonomic dysfunction

Question 11

Cortical basilar degeneration

Answer 11

bradykinesia and ridgidity
cortical and basal ganglionic dysfunction. may present with alien limb
may also see cortical sensory loss, apraxia, myoclonus or aphasia

Question 12

Anti parkinsonian tratment

Answer 12

dopamine agonists, 
levadopa
COMT inhibitors 
anticholinergics
MAOB inhibitorys 
Amantadine
surgery

Question 13

Huntingtons

Answer 13

chorea, dementia caused by inherited trinucleotide repeat.
autosomal dominant inheritance.
begins afe 30-50.
no known prevention or cure

Question 14

Syndeham’s choria

Answer 14

children and adolescents, as complication of an infection

UL choreiform movements. may also see behavioral changes

Question 15

idiopathic torsion dystonia.

Answer 15

dystonic movements and postures without other signs.
torticolis, blepharospasm, oromandibular dystonia, arm held in hyperpronation wit wrist flexed and fingers extended. lege may be held in extension, with pronation and inversion of foot.
hace multiple of these

Question 16

tx for idopathic torsion dystonia

Answer 16

diff pts respond to different things

low dose levadopa, anticholinergics, benzos, neurleptic drugs, baclofen, carbamazepine

Question 17

Focal torsion dystonia

Answer 17

dystonia confined to FOCAL area. Do not have multiple.

Tx = BOTOX

Question 18

Wilson’s disease

Answer 18

young person with weird movemtn and weird behavior. .

Question 19

wilsons affects what organs

Answer 19

brain and liver

Question 20

what ion in wilsons

Answer 20

copper

Question 21

wilson’s has bot ___ and ___ features

Answer 21

bradykinetic and hyperkinetic

Question 22

eye sign in wilsons

Answer 22

kayser fleishcer ring on eye exam

Question 23

tx of wilsons

Answer 23

restriction of dietary copper, penicillamine (copper chelating agent)

Question 24

Tic Disorders

Answer 24

motor or vocal tics.

Gilles de la tourettes is more common in males, most cases are sporadic

Question 25

treatment of tourettes

Answer 25

clonidine, haldol, phnothiazines

Question 26

essential tremor

Answer 26

postural or kinetic tremor of both hands and may involve the head or voice. can begin in early adult hood, ut often not until later in life. progresses slowly over years to decades, MUCH SLOWER PROGRESSION THAN PARKINSONS. usu does not result in significant disability, but social embarrassment is common. EtOH can decrease tremor temporarily.

Question 27

Essential tremor tx

Answer 27

Beta blockers, primidone, benzos, topirimate.