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Neurology > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

Define hypokinetic

A

decreased/absence of movement

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2
Q

Define hyperkinetic

A

increased amount of movement

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3
Q

etiology of parkinson’s

A

degeneration and loss of pigmented dopamine neurons of the substantia nigra regions of the brain

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4
Q

mean age of onset of parkinson’s

A

55

prevalence increases sharply after the age of 50 and peaks around about 75

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5
Q

strongest predictor of increased risk of PD

A

age

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6
Q

Parkinson’s disease: presentation (TRAP)

A

T: tremor (pill rolling)
R: rigidity (cogwheel/lead pipe)
A: akinesia/bradykinesia
P: postural (instability, retropulsion)

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7
Q

Parkinson’s disease: common clinical presentation

A

forward head tilt
resting tremor
bradykinesia
>55y/o

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8
Q

Common imaging results for Parkinson’s disease

A

CT is normal
MRI may have slight degeneration of substantia nigra
SPECT/PET may show reduced dopamine transporter density (less dopamine things)

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9
Q

pharmacologic treatment for Parkinson’s

A
  • levodopa
  • dopamine agonists
  • MAOI’s
  • anticholinergic
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10
Q

Non-pharmacologic treatments for Parkinson’s

A
  • PT
  • Tx comorbid conditions
  • Caregiver support
  • Deep brain stimulation
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11
Q

pathophys for Huntington’s

A

causes cells in specific parts of the brain to degenerate: caudate, putamne, cerebral cortex

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12
Q

Function of caudate and putamen that is affected in Huntington’s

A

These brain locations have functions that project pathways into different parts of the brain and help to control body movement, emotions, thinking, behavior, and perception of the world.

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13
Q

Genetic component of Huntington’s

A

genetic disorder caused by faulty gene on chromosome 4

Autosomal dominant disorder

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14
Q

Primary ages of Huntington’s

A

30-45

early as 5 and late as 70s

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15
Q

Common clinical presentation of Huntington’s patients

A 
nervous twitching
hyperactivity
clumsy
problems performing ADL's
forgetful, worsening memory
irritable, impulsive
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16
Q

Essential tremor characteristics

A
  • tremor reduced with EtOH ingestion
  • tremor of hands/forearms (not a resting tremor)
  • isolated head tremor (constantly saying yes or constantly saying no)
  • usually have a FHx (family hx)
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17
Q

Tourette’s common presentation

A

child between 6 & 11
performs obscene gestures they cannot control
feel impulsed to perform tic and feel better when they have completed the tic

18
Q

pharmacological treatments for Tourettes

A

antidopinergics: haloperiodol, pimozide, aripiprazole

19
Q

Cerebral palsy

A

permanent, nonprogressive motor dysfunction due to abnormalities of the developing fetal/infantile brain resulting from a variety of causes

20
Q

cerebral palsy is MC in what type of infants

A

premature!

21
Q

myasthenia gravis defintion

A

fluctuating weakness, exacerbated by exertion, fatigue, and improved at rest

22
Q

maysthenia gravis common presentation

A 
droopy eyelids
double vision
slurred speech
facial weakness
head drop
23
Q

myasthenia gravis patho

A

autoimmune disorder of postsynpatic NMJ characterized by fluctuating weakness involving variable combinations of ocular, bulbar, limb, and respiratory muscles

autoABs against acetylcholine receptors

24
Q

myasthenia gravis treatment

A

immunomodulatory: IV immunoglobulin; plasma exchange
immunotherapy: pernisone

25
Q

Multiple sclerosis

A

autoimmune inflammatory demyelinating disease of idiopathic origin

associated with axon degeneration of white matter of brain, optic nerve, and spinal cord

26
Q

multiple sclerosis presentation

A

uhthoff’s phenomenon: temporary worsening of MS symptoms with heat

L’hermitte’s sign: flexion of neck causes lightning-shock type pain radiating from spine down leg

trigeminal neuralgia

optic neuritis (unilateral eye pain worse with EOM)

marcus-gunn pupil: during swinging flashlight test, the affected eye does not dilate/constrict as much as it’s supposed to so the eyes do not have symmetrical dilation/constriction
AKA relative afferent pupil defect (RAPD)

27
Q

multiple sclerosis diagnostics

A

MRI with gadolinium:

  • shows white matter plaques - “open ring sign”
  • can also see “Dawson’s fingers” of active inflammation and breakdown of the blood brain barrier

LP shows increased IgG oligoclonal bands in the CSF

28
Q

treatment for multiple sclerosis: acute

A
  • IV corticosteriods (solumedrol)

- plasmapheresis if not responsive

29
Q

treatment for multiple sclerosis: chornic

A

beta interferon

injectable glatiramer acetate to decrease number/severity of relapses

30
Q

ALS is a disease of…

A

upper and lower motor neurons

31
Q

ALS upper motor neuron symptoms

A

spasiticity
hyperreflexia
pathological reflexes

32
Q

ALS lower motor neuron symptoms

A

weakness
atrophy
hyporeflexia
fasciculations

33
Q

ALS presentation

A

loss of ability to initiate and control motor movements

SPARES: sensation, urinary sphincter, and voluntary eye movements

34
Q

ALS treatment

A

riluzole to slow progression
baclofen for spasticity
benzos for anxiety/depression

35
Q

neurofibromatosis 1

A

MC tumor seen in NF1 - peripheral nerve sheat tumor with malignant transformation in less than 10% of patients

36
Q

neurofibromatosis 1 presentation

A

optic glioma (pilocytic astrocytoma - MC tumor)

cafe au lait

freckling of axilla/groin

learning disorders

37
Q

neurofibromatosis 2

A

autosomal dominant that results in bilateral vestibular schwannomas

38
Q

tuberous sclerosis

A

inherited neurocutanoeous disorder that is characterized by pleomorphic features involving many organ systems - brain, eyes, heart, lung, liver, kidney, skin

39
Q

presentation of tuberous sclerosis

A

most have epilepsy, ash-leaf macules, shagreen patches

1/2 or more have cognitive deficits/learning disabilites

commonly have autism, behavioral problems

40
Q

con-hippel lindau disease

A

inherited autosomal dominant syndrome manifested by a variety of benign/malignant tumors

MC manifestation: menangioblastomas - have mass effects

also gives renal cell carcinomas, pheochromocytomas

Neurology (12 decks)

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