Movement Disorders Flashcards
What is a tremor?
Involuntary rhythmic oscillatory movement of a body part, usually due to reciprocal antagonistic muscle groups
Resting tremors are minimal during activity. True/False?
True
Action tremors incorporate which tremors and are always below what frequency?
Always below 13Hz
Postural, kinetic or intention tremors
Which tremor is associated with Parkinson’s disease?
Resting tremor
Intention tremors occur during voluntary movement and can be signs of which brain region dysfunction?
Cerebellar disorder
Give examples of causes of physiological tremors
Stress
Anxiety
Stimulants
Postural changes
A cerebellar tremor usually occurs unilaterally. True/False?
True
Which tremor is more associated with family history - resting or essential/postural?
Essential/postural tremor
What is dystonia?
Involuntary sustained muscle contraction in a body part leading to abnormal posture
Can lead to twisting, intermittent spasms and repetitive movement
Dystonias can be generalised or focal/segmental. What is the main treatment for each?
Generalised dystonia: anticholinergic, muscle relaxants
Focal/segmental: botox injection
List some diseases associated with secondary dystonias
Wilson’s disease
Multiple sclerosis
Parkinson’s disease
Cerebral palsy
What is chorea?
Non-rhythmic jerky purposeless movement, akin to fidgetiness, usually generalised but may be confined
List inherited causes of choreas
Huntington disease
Wilson’s disease
Spinocerebellar ataxia
Neuroacanthocytosis
List autoimmune causes of chorea
SLE Anti-phospholipid syndrome Behcet disease Coeliac disease Hashimoto thyroiditis Sydenham's chorea
Which drugs can provide symptomatic relief for choreas?
Tetrabenazine
Dopamine blockers
What are tics?
Non-rhythmic stereotypical rapid movements that provide relief after doing them
Give examples of tics
Eye blinking
Clearing throat
Arm swinging
Shouting/singing out loud
What is the main primary tics disorder?
Tourette’s syndrome
What is myoclonus?
Brief, shock-like muscle contraction
Spasticity is related to an UMN/LMN disorder of which motor tract?
UMN
Pyramidal tract
Give examples of hyperkinetic movement disorders
Dystonia Tics Myoclonus Chorea Tremor
Hyperkinetic movement disorders are associated with which motor tract and which are of the brain?
Extra-pyramidal tract
Basal ganglia
Give examples of hypokinetic movement disorders
Rigidity
Bradykinesia
(parkinsonism, parkinson’s disease)
Hypokinetic movement disorders are associated with which motor tract and which area of the brain?
Extra-pyramidal tract
Basal ganglia
What is bradykinesia?
Slowness of movement
Ataxia is associated with a lesion in which area of the brain?
Cerebellum
What is the function of the basal ganglia?
Collection of gray matter nuclei with important connections to other parts of the brain - involved in movement and coordination
How does the basal ganglia control movement?
Circulatory control with excitatory and inhibitory signals
List structures of the basal ganglia
Caudate nucleus Putamen Globus pallidus Subthalamic nucleus Substantia niagra
Which tremor would be elicited by eating or carrying plates?
Postural tremor
Holding hands out
What cerebellar test would you use to check for intention tremor?
Finger-nose test
What class of drug is typically used to treat postural tremors?
B blockers
Outline the management of tic disorders
CBT
Clonidine/ tetrabenazine
Tic disorders are most common in..
Teenagers
Males
A primary movement disorder is assocaited with no underlying cause. True/False?
True
Secondary = underlying cause
List the 4 main causes of movement disorders
Primary/ idiopathic
Secondary
Heredo-degenerative (late onset, progressive)
Psychogenic e.g. depression
List the clinical features of functional weakness
No wasting Normal tone Normal reflexes Erratic power Non-anatomical loss
What is Sydenham’s chorea?
Widespread chorea due to rheumatic fever
Typically occurs in young females
