Movement Disorders

Question 1

How we be best define the problem in Parkinson’s?

Answer 1

Loss of dopamine neurons in substantia nigra leading to hypo movement

Question 2

Explain the pathway by way of neurons for movement and how that is affected by Parkinson’s?

Answer 2

Dopamine is released to inhibit GABA which are defaulted to inhibit movement. So when we have low dopamine we are not inhabited gaba and gaba is free to inhibit movement.

Question 3

Explain the process of stopping movement by way of neurons?

Answer 3

Ach neurons stimulate GABA to inhibit movement.

Question 4

4 classic symptoms of Parkinson’s

Answer 4

Bradykinesia
Cogwheel rigidity
Resting tremor
Shuffling gait

Question 5

When would you use benzotropine for Parkinson’s?

Answer 5

Young person with mild dz who just have a tremor

Question 6

If pt. Is less than 70 and functional and has Parkinson’s, what is the best treatment?

Answer 6

Dopamine agonists

Ropinerole or pramipexole

Question 7

Pt is over 70 and dysfunctional, how to treat their Parkinson’s?

Answer 7

L dopa and carbidopa

Question 8

What can we add to L dopa when it becomes less effective over time?

Answer 8

MAO inhibitors and COMT inhibitors

Question 9

Definition of chorea?

What dx to think about?

Answer 9

Purposeless ballistic movements

Huntington’s