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Clin Med III - Neuro > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

Define tremor

A

Fine stereotyped oscillation

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2
Q

Define chorea

A

Medium speed complicated moves

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3
Q

Define athetosis

A

Slow complicated movements

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4
Q

Define ballism

A

Fast complicated movements (violent flinging of limbs)

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5
Q

Define tics

A

Jerk like very brief repetitive movements

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6
Q

Is glutamate excitatory or inhibitory?

A

Excitatory

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7
Q

Is dopamine excitatory or inhibitory?

A

Either excitatory to D1 receptors or inhibitory to D2 receptors

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8
Q

Is GABA excitatory or inhibitory?

A

Inhibitory

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9
Q

Principle defect in Parkinson’s disease?

A

Loss of dopamine in substantia nigra of basal ganglia

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10
Q

Basic features of Parkinson’s disease

A
  1. Rigidity
  2. Tremor at rest (3-5 Hz pill rolling)
  3. Bradykinesia
  4. Loss of postural reflexes
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11
Q

How does Parkinson’s generally present early on?

A

Begins in one limb and spreads asymmetrically

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12
Q

What are the most diagnostic features of PD?

A

Rigidity and bradykinesia

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13
Q

Is it ok to delay treatment of PD?

A

Yes - meds are symptomatic not neuroprotective

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14
Q

What is the most effective medication option for PD?

A

Carbidopa/Levodopa (Sinemet)

-Replaces presynaptic dopamine

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15
Q

Which dopamine agonists are post-synaptic?

A
  • Ropinirole (Requip)
  • Pramipaxole (Mirapex)
  • Pergolide (Ergot family)
  • Bromocryptine (Ergot family)
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16
Q

Define parakinesia

A

Cover up movement to make a choreiform movement look purposeful

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17
Q

Describe Huntington’s disease

A

Autosomal dominant neurodegenerative disease with chorea, dementia, personality disorder

18
Q

Main traits of Huntington’s disease

A
  1. Chorea
  2. Dementia
  3. Personality disorder
19
Q

Genetic feature of Huntington’s

A

CAG trinucleotide repeat (which makes longer than normal proteins)

20
Q

What is the MC movement disorder?

A

Tremor

21
Q

Types of tremor

A
  • Resting (as in Parkinson’s, 3-5 Hz)
  • Intention/Kinetic
  • Essential (8-11 Hz, worse w/caffeine, better w/ETOH, bilateral)
22
Q

Define tremor

A

Rhythmic involuntary movement

23
Q

Features of Tardive Dyskinesia

A
  • Repetitive purposeless movements often of the face (but can be on trunk or limbs)
  • Tongue rolling, lip smacking
24
Q

Etiology of Tardive Dyskinesia

A

Usually iatrogenic - prolonged use of dopamine blockers (psych pts, diabetics w/gastroparesis)

25
Q

Is tardive dyskinesia hypo or hyperkinetic?

A

Hyperkinetic

26
Q

Define myoclonus

A
  • Hyperkinetic disorder

- Involuntary sudden shocklike muscle jerks

27
Q

Etiology of myoclonus

A

Usually CNS insult - anoxic/ischemic/alcoholics

28
Q

Define restless leg syndrome

A
  • Neuro movement disorder of the limbs often a/w sleep

- Mostly mild symptoms and do not need treatment

29
Q

Diagnosis of RLS

A

4 core symptoms:

  • Urge to move legs bc of irritating sensation
  • Worse at rest
  • Relief w/movement
  • Worse at night
30
Q

Treatment of primary RLS

A
  • Dopamine agonists (pramipexole, ropinirole)
  • Benzos
  • Anticonvulsants
31
Q

Treatment of secondary RLS

A

Correct underlying disorder (anemia, TSH, B12, DM)

32
Q

Define ataxia

A

Inability to coordinate muscle activity during voluntary movement

33
Q

Pathophys of ataxia

A
  • Degeneration of cerebellum

- Disease or damage to spinal cord and/or peripheral nerves

34
Q

What does a positive Romberg indicate in relation to ataxia?

A

Ataxia is sensory in nature

35
Q

Pure cerebellar lesions cause ____

A

Hyporeflexia

36
Q

Any disturbance of sensory or motor function will cause ____

A

Ataxia

37
Q

Mid-line cerebellar lesions cause ______

A

Gait and trunk instability

38
Q

Lateral cerebellar lesions show (ipsilateral/contralateral?) to the pathology

A

Ipsilateral

39
Q

What clinical sign is seen with cerebellar lesions (sometimes as the major physical feature)?

A

Nystagmus

40
Q

What is the MC cause of ataxia in older age groups (acute/non traumatic/non toxic etiology)?

A

Wallenberg stroke

41
Q

Describe Wallenberg stroke

A

Lateral medullary syndrome

  • Ipsilateral ataxia
  • Horner’s
  • Pharynx dysfunction
  • MOTOR AND COGNITIVE INTACT

Clin Med III - Neuro (11 decks)

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