Movement disorders [6] Flashcards

1
Q

What is responsible for unconscious motor control, smoothness of movements, coordination btwn diff muscle groups, muscle tone?

A

Basal ganglia

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2
Q

Key NT of the extrapyrimidal system. responsible for motor control

A

DA

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3
Q

Tremor

A

rhythmic oscillatory movement produced by alternating or synchronous contraction of antagonist muscles

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4
Q

Essential tremor

A

tremor with posture and action (circle drawing)

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5
Q

Antihypertensive med to treat tourettes if its bothersome

A

clonidine

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6
Q

Dystonia

A

cocontraction of muscle agonist + antagonist

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7
Q

Red flags for DDX of Parkinsonium

A

rapid progression
early onset dementia
confusions.hallucinations
early onset of motor instability

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8
Q

Prognosis of parkinsonium syndromes

A

7-10 years

worst than PD

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9
Q

PD vs ET (essential tremors)

  • at rest
  • action
A

PD:
- increased tremor at rest

ET
- Increased tremor with action

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10
Q

PD vs ET (essential tremors)

  • with mental concentration
  • with walking
A

PD:

  • increased tremor with mental concentration
  • increased tremor with walking

ET:

  • decreased
  • decreased
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11
Q

Symmetry of limb tremor

PD vs Et

A

PD:
- Assymetric

ET:
- symmetric

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12
Q

Most common movement disorders

A
  1. restless leg syndrome
  2. ET
  3. PD
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13
Q

Lewy body diseases

- PD vs Diffuse Lewy body disease

A

PD: movement disorder

DLBD: dementing disease

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14
Q

Substantia nigra damage (parkinsonism)

A
  • PD
  • Mult sys atrophy
  • PSP
  • Picks
  • corticobasal deg. disability
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15
Q

Extrapyrimidal signs

A

abnormal movement, posture, muscular tone

NOT paresis or sensory loss

  1. basal ganglia disorder
  2. cerebellar disorder
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16
Q

basal ganglia disorder

- extrapyramidal signs

A

Resting tremor

Hypokinetic

  • rigidity
  • bradykinesia

Hyperkinetic

  • chorea
  • athetosis
  • akathisia
17
Q

cerebellar disorder

- extrapyramidal signs

A
  1. Synergy (ataxia)
    - Dysmetria (FNF test)
    - dysdiadochokinesia
    - decomp of movement
  2. Dysequilibrium
  3. hypotonia
  4. ACTION tremor (unlike basal gang)
  5. Nystagmus
18
Q

pronator drift

-injury is seen in

A

eyes closed, arm out, palm up

seen in pyramidal tract dysfxn (contralat)
parietal lobe dysfxn (contralat)
parietal lobe dysfxn (ips)

19
Q

hemiparetic gait

-injury is seen in

A

unilateral UMN injury (hemispheric stroke)

- ips motor error

20
Q

Diplegic gate

-injury is seen in

A

bilateral periventricular lesions (cerebral palsy)

21
Q

Unilateral Neuropathic gate

-injury is seen in

A

(foot drop (weakness of foot dorsiflex) )

peroneal nerve palsy
L5 radiculopathy

22
Q

Bilateral Neuropathic gate

-injury is seen in

A

ALS
Charcot
uncontrolled diabetes

(foot drop (weakness of foot dorsiflex) )

23
Q

Myopathic gait

-injury is seen in

A

“trendelenburg sign*”

Muscular dystrophy

24
Q

Sensory gait

-injury is seen in

A

“stomping gait”
dorsal column disorders
- B12
- tabes dorsalis

uncontrolled diabetes

25
Clinical features of dementing diseases
1. impaired memory 2. impaired behavior, planning, judgement, emotional control 3. impaired language
26
Clinical features of movement disorders
1. choreiform movement disorders 2. Parkinsonium features 3. ataxia
27
Tauopathies - what do taus usually do?
Alz PSP CBD (FTLD, Picks) - binds to and stabilizes microtubules (hyperphos and aggreg is toxic)
28
PSP Tau acculm in
at least 3 Substantia nigra Pallidum subthal. nuc Pons
29
Onset of HD age
40s Progressive atrophy of neostriatum (ant caudate+dorsal putamen)\ - loss of medium spiney neurons
30
Freidreich's Ataxia
b4 20 years old GAA (TNR) AR Ch 9 Loss of neurons in DRG - loss of periphery sensory fibers