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Neurology > Movement disorders > Flashcards

Movement disorders Flashcards

1
Q

Hypokinetic movement disorders

A

Bradykinesia; PD

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2
Q

Hyperkinetic disorder

A 
Dyskinesia; 
tremor
tics
chorea
myoclonus
dystonia
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3
Q

What is a tremor?

A

Rhythmic sinusoidal oscillation of a body part

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4
Q

What are the different classifications of a tremor?

A

Rest; occurs when body at rest (5Hz)
Postural; occurs when the arms are outstretched
Kinetic; occurs during movement of a body part

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5
Q

What is an essential tremor?

A 
Seen in hands at 5Hz when hold arms outstretched 
Continues through moto execution 
Familial 
Slow progression 
Ameliorated by alcohol intake
Asymmetric
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6
Q

Describe a physiological tremor

A

Symmetrical
Fast
Small amplitude

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7
Q

Describe a wilson’s disease tremor

A

Early stage postural

Wing beating

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8
Q

Describe a hepatic encephalopathy tremor

A

Asterixis

Repetitive drops of extended hands

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9
Q

What is chorea?

A

Brief irregular purposeless movement that flit and flow from one body part to another
Constantly restless or fidgety
Often generalised but can be focal

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10
Q

What can cause chorea?

A 
Drugs/ OCP 
Basal ganglia lesions
Sydenham's chorea
Antiphospholipid syndrome
HD 
Neurocanathocytosis
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11
Q

What is myoclonus?

A

Brief electric shock like jerks
Hiccups o hypnic jerks are common and normal forms of myoclonus
Arises from cortex, subcortical structures, spinal cord or nerve root and plexus

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12
Q

What is a tic?

A

Unvoluntary repetitive, stereotyped movements of vocalizations
They can be suppressed but there will be a growing feeling of anxiety and discomfort during tic suppression and when allowed to relax there will be a flurry of tics

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13
Q

What is a motor tic?

A

Eye blinking
Head jerks
Arm/leg jerks
Complex sequence

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14
Q

What is a vocal tic?

A

Sniffing
Grunting
Snorting

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15
Q

What is gilles de la tourette syndrome?

A

Typically onset of persistent multiple motor and vocal tics, often with assoc psych disturbance (ADHA, OCD, copropraxia, coprolalia)

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16
Q

What is dystonia?

A

Movement disorder characterized by sustained or intermittent muscle contractions causing abnormal often repetitive movements or posture
Tend to be patterned, twisting and may be tremulous
Often initiated o worsened by voluntary action and assoc with overflow muscle activation

17
Q

Motor sy of PD

A

Tremor
Bradykinesia
Rigidity
Postural and gait impairement

18
Q

Non motor sy of PD

A 
Depression
Dementia
Constipation 
Anosmia
Parasomnias
19
Q

What tremor is assoc with PD?

A

Pill rolling

3-6 Hz

20
Q

Tx for dementia in PD?

A

Acetylcholinesterase inhibitor; rivastigmine

21
Q

Tx for depression in PD?

A

Dopamine agonist
SSRI
Tricyclic

22
Q

Tx for REM sleep behavior disorder in PS?

A

Benz; clonazepam

Hormone; melatonin

23
Q

Tx for constipation in PD?

A

Osmotic laxative

24
Q

Tx for GI motility in PD?

A

Domperidone

25
Q

Tx for orthostatic hypotension in PD?

A

Domperidone

Fludrocortisone

26
Q

Tx for sialorrhoea in PD?

A

Atronic drops
Glycopyrrolate
Botulism

27
Q

Tx for fatigue in PD?

A

Modanifil

28
Q

What encomapsses bradykinesia?

A

Slowness of movement with progressive loss of amplitude or speed during rapid alternating movements
Hypomimia
Hypophonia
Micrographia

29
Q

Which rigidity is felt in PD?

A

Cog wheel
Lead pipe
Positive froment’s maneouvre

30
Q

How is posture and gait affected in PD?

A 
Stooped 
Impaired postural reflexes 
Gait; slow, shuffling
Decreased arm swing
Slow turning
Freezing
Festination 
Pull test
31
Q

Red flags in PD?

A 
Absence of asymmetry 
Severe axial or lower limb 
Frequent falls 
Fast disease progression
Eye movement; supranuclear palsy, dysmetric or slow saccades 
Tics, myoclonus or choea
Pyramidal or cerebellar dysfunction 
Bulbar or pseudobulbar features 
Parietal assoc sensory disturbances
Apraxia
32
Q

What is vascular parkinsonism?

A

Affects lower limbs
Rest tremor uncommon
Other neurological signs; spasticity, hemiparesis, pseudobulbar palsy
Poor levodopa response

33
Q

What is drug induces parkinsonism?

A

Symmetrical
Coarse postural tremor
Emergence of symptoms after drug exposure, and subsequent improvement after drug withdrawal

34
Q

What is the triad of symptoms in multi system atrophy?

A

Dysautonomia
Cerebellar features
Parkinsonism

35
Q

What is progressive supranuclear palsy?

A 
Symmetric akinetic rigid syndrome with predominantly axial involvement
Gait and balance impairment 
Vertical gaze supranuclear palsy
Pseudobulbar symptoms
Retrocollis
Continuous frontalis action 
NO response to levodopa
36
Q

How is psychosis in PD managed?

A

Clozapine; beware of idiosyncratic adverse drug reactions and agranulocytosis

Neurology (48 decks)

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