Movement Disorders

Question 1

Name three movement disorders

Answer 1

Parkinson’s disease

Huntington’s chorea

Hemiballismus

Question 2

What causes Parkinson’s disease

Answer 2

Parkinson’s disease is caused by degeneration of dopaminergic neurones in the substantia nigra pars compacta (SNc)

This means there is a loss of dopamine driven facilitation of movements via both direct and indirect pathways

Question 3

Name some signs and symptoms of Parkinson’s disease

Answer 3

Tremor - pill-rolling tremor

Rigidity - hypertonia. May have Cogwheeling

Bradykinesia - may manifest as hypophonia, micrographia, mask-like facies, shuffling gait

Depression

Dementia - can progress to dementia

Question 4

What is Huntington’s chorea

Answer 4

Autosomal dominant, progressive disorder

Has onset around 40/50

Early stages associated with loss of inhibitory projections from striatum to globus pallidus external leading to hyperkinetic features

Question 5

Name some features of Huntington’s chorea

Answer 5

Chorea

Dystonia - due to overactivity in agonist and antagonist muscle circuits and loss of coordination between them leading to odd postures

Loss of coordination

Cognitive decline and behavioural disturbances

Question 6

What is hemiballismus

Answer 6

Hemiballismus is damage to subthalamic nucleus which normally inhibits the internal globus pallidus

This causes increased movement and patient will have unilateral explosive movements