Movement disorders

Question 1

name the 5 common Hyperkinesias (moving too much)

Answer 1

• Tremor
• Tics
• Chorea
• Dystonia
• Myoclonus

Question 2

what is the definition of Tremor

Answer 2

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

Question 3

what is the prevalence of Essential Tremor (ET)

Answer 3

0.4 to 4%

• Up to 14% of persons over 65

Question 4

what is Essential Tremor (ET) also called

Answer 4

‘Benign, familial tremor’

‘Senile tremor’

Question 5

Essential Tremor (ET) can be a Postural and kinetic tremor that Affect which parts of the body?

Answer 5

Hands, arms
Head,
Voice

Question 6

what are the main Pharmacological Therapy for ET

Answer 6

• Beta-blockers (Propranolol)
• Primidone (Mysoline)
• Topiramate (Topamax)
• Gabapentin (Neurontin)
• Clonazepam (Klonopin)

Question 7

what are non-pharmacological Treatments for ET?

Answer 7

• Botulinum toxin
– head tremor
– hand tremor

• Assisted devices
– Weighted utensils
– Non-cut gloves
– Tremor-cancellation spoon

Question 8

what are the Surgical Treatments for ET?

Answer 8

Thalamotomy

Deep Brain Stimulation

Question 9

what are the diagnostic criteria for Tourette’s syndrome

Answer 9

– Age of onset <16 years
– Motor & Vocal tics
– Last > 1 year

Question 10

what is Tourette syndrome associated with

Answer 10

• ADHD
• OCD
• Poor impulse control

Question 11

what are 5 common medications for Tourette Syndrome

Answer 11

– Anti-psychotics (pimozide)
– Dopamine depleting agents (tetrabenazine)
– Botulinum toxin injections (focal tics)
– Alpha-adrenergic agonists (clonidine, guanfacine)
– Anti-epileptics (topiramate)

Question 12

what is the definition of chorea

Answer 12

Irregular, brief, dancing like, jerky movement

Randomly flit from one body part to another

Question 13

what is the definition of Dystonia

Answer 13

Co-contraction of agonist and antagonist

muscles causing twisting, abnormal postures

Question 14

what is Cervical dystonia Spasmodic torticollis?

Answer 14

unilateral hypertrophy of sternocleidomastoid muscle, rotation of neck contralateral side

Question 15

what is the primary etiology of primary dystonia?

Answer 15

DYT 1 – Protein Torsin

Question 16

what is Blepharospasm

Answer 16

excessive eye blinking, often triggered by bright light s and wind

Question 17

what are the treatments for dystonia

Answer 17

• Medications
   – Anticholinergic (Artane, Cogentin)
   – Muscle relaxants (Baclofen)
   – Benzos
• Botulinum Toxin injections

Question 18

what is Akathisia

Answer 18

unpleasant sensation of inner
restlessness => inability to sit still or
remain motionless

Question 19

what is Hyperekplexia

Answer 19

exaggerated startle

Question 20

what is Myokymia

Answer 20

• localized quivering of a few
  muscles bundles within a muscle, but which
  are insufficient to move a joint (eyelid)

Question 21

what is Stereotypy?

Answer 21

repetitive or ritualistic movement, posture or utterance. (autism,schizophrenia)

Question 22

what are the main motor symptoms of parkinson’s disease

Answer 22

Bradykinesia or akinesia
Resting tremor
Rigidity
Postural instability

Question 23

Progressive supranuclear palsy (PSP) occurs at ______

characterized by ________, with a “Reptilian” or scared look.

Answer 23

> 50,

Impaired eye movements (Downgaze !)