Movement Disorders

Question 1

The job of the basal ganglia is to ____________.

Answer 1

coordinate and smooth out muscle movements

Question 2

Parkinson’s is a _________-kinesia.

Answer 2

hypo

Question 3

The most common movement disorder in adults is __________; in kids is __________.

Answer 3

restless leg syndrome; tics

Question 4

Again, essential tremor only occurs ___________.

Answer 4

with intention

Question 5

What structure is targeted in DBS for Parkinson’s?

Answer 5

The VIM (ventral intermediate nucleus of the thalamus)

Question 6

In order to have a diagnosis of tourettes, the symptoms need to be present prior to age _______.

Answer 6

16

Question 7

What two side effects must you ask every patient taking Parkinson’s medications?

Answer 7

Daytime sleepiness

Impulsivity (gambling, sexual indiscretion)

Question 8

Normally, dopamine turns up the __________ pathway and turns down the ___________ pathway, facilitating movement.

Answer 8

direct (D1); indirect (D2)

Question 9

Tremor, tics, chorea, and dystonia are examples of ________-kinesia.

Answer 9

hyper

Question 10

The mean age of onset for essential tremor is _____________.

Answer 10

45

Question 11

What are the two first-line medications for essential tremor?

Answer 11

Primidone and beta-blockers

Question 12

Tics in those with Tourette’s continue into adulthood in _______ percent of cases.

Answer 12

25

Question 13

How is Tourette’s treated?

Answer 13

Educate the family, patient, and school
Treat tics if life threatening (not sure with what)
Treat OCD and ADHD as you would otherwise
CBT

Question 14

What drugs can treat dystonia?

Answer 14

Anticholinergics
Botulinum
Muscle relaxants

Question 15

Exaggerated startle response is called _____________.

Answer 15

hyperekplexia

Question 16

Muscle fluttering that is insufficient to move a joint is called __________.

Answer 16

myokymia (eyelid fluttering)

Question 17

Bending down (in Parkinson’s) is called _________.

Answer 17

camptocormia

Question 18

Lack of facial expression in those with Parkinson’s is called __________.

Answer 18

hypomimia

Question 19

Postural instability is more typical of ___________. As is having the “___________” expression.

Answer 19

progressive supranuclear palsy; reptillian/scared

Question 20

Importantly, restless leg syndrome does not occur when the patient is _______________.

Answer 20

asleep; it is a disorder of resting wakefulness