Movement Disorders Flashcards
Movement disorders broken down into
bradykinetic
hyperkinetic
Brady kinetic/ akinetic movement disorders
Parkinsonism, PSP, MSA, CBD
Hyperkinetic movement disorders
Corea - huntingons, syndehams
Dystonia - Idopathic torsion dystonia, focal dystonia, wilson’s disease, Tic disorders, Gilles de la tourette’s syndrome, essential tremor
parkinsons is caused by
a depetion of dopamine in the nigrostriatal system. disrupting balance of dopamine and acetylcholine
lack of dopamine, with increased Ach
Cardinal features of parkinsons
tremor, rigidity, bradykinesia
what’s the first symptom of parkinsons
tremor
Other features of parkinsons
postural instability, quiet voice, hypomimia, decreased frequency of eyeblink, myerson’s sign, gait disturbance, may not swing arms. dysautonomia, dementia.
Other akinetic rigid syndromes are similar to parkinsons but they lack a
tremor
PSP
bradykinesia and rigidity
loss of voluntary control of eye movements, esp vertical gaze
Multiple systems atrophy
bradykinesia and rigidity
PRONOUNCED autonomic dysfunction
Cortical basilar degeneration
bradykinesia and ridgidity
cortical and basal ganglionic dysfunction. may present with alien limb
may also see cortical sensory loss, apraxia, myoclonus or aphasia
Anti parkinsonian tratment
dopamine agonists, levadopa COMT inhibitors anticholinergics MAOB inhibitorys Amantadine surgery
Huntingtons
chorea, dementia caused by inherited trinucleotide repeat.
autosomal dominant inheritance.
begins afe 30-50.
no known prevention or cure
Syndeham’s choria
children and adolescents, as complication of an infection
UL choreiform movements. may also see behavioral changes
idiopathic torsion dystonia.
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
tx for idopathic torsion dystonia
diff pts respond to different things
low dose levadopa, anticholinergics, benzos, neurleptic drugs, baclofen, carbamazepine
Focal torsion dystonia
dystonia confined to FOCAL area. Do not have multiple.
Tx = BOTOX
Wilson’s disease
young person with weird movemtn and weird behavior. .
wilsons affects what organs
brain and liver
what ion in wilsons
copper
wilson’s has bot ___ and ___ features
bradykinetic and hyperkinetic
eye sign in wilsons
kayser fleishcer ring on eye exam
tx of wilsons
restriction of dietary copper, penicillamine (copper chelating agent)
Tic Disorders
motor or vocal tics.
Gilles de la tourettes is more common in males, most cases are sporadic
treatment of tourettes
clonidine, haldol, phnothiazines
essential tremor
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.
Essential tremor tx
Beta blockers, primidone, benzos, topirimate.
