Movement Disorders Flashcards
What is the difference between rigidity + spasticity
Spasticity is velocity-dependent
tone increases the faster you move it
What is apraxia
Loss of movement planning
- Limb apraxia: fronto-parietal cortex
- Gait apraxia: Frontal lobe + Frontal White matter
What is myoclonus
A brief jerk
- associated with cortex
- associated with late stage dementia
What is Dystonia
Sustained, abnormal tone + posture of a group of muscles
What are the core symptoms of Parkinson’s disease
- Rigidity
- Tremor
- Bradykinesia
- Postural instability
Presents assymetrically
What are the non-core features of Parkinson’s disease
- Hypomimia
- Micrographia
- Loss of arm swing
- Festination (shuffling gait)
- Cogwheel rigidity
How do you diagnose Parkinson’s disease
Clinical diagnosis
What is the management of PD
Changes as disease progresses
- L. Dopa + Carbidopa
- Dopamine agonists (Cabergoline)
- Deep brain stimulation
What are some of the characteristic side effects of anti-PD drugs
- ‘On-off’ effect: sudden freezing + unfreezing
What is drug-induced Parkinsonism
Parkinsonian signs caused by drugs
- e.g. neuroleptics, CCBs, lithium, antiemetics
- Symmetrical onset
- Symptoms resolve upon drug withdrawal
What is Vascular Parkinsonism
Parkinsonism caused by vascular pathology
- Rare
- Stuttering evolution
- Marked sparing of upper limbs
- Changes shown on MRI
- CVD risk factors present
What are the classifications of Dystonia
Primary Dystonia
- No evidence of pathology
- Presentation: old (focal), young (generalised)
Secondary Dystonia
- Due to underlying pathology
Name two causes of secondary dystonia
- Wilson’s disease
- Drug-induced
Clinical features of dystonia
Can often be ‘aborted’ by specific sensory stimulation
- ‘sensory tricks’
Can be focal or generalised
- Focal: e.g. writers cramp, torticollis
- Generalised: e.g. generalised torsion dystonia
Can present as a tremor
Management of dystonia
Botox injections
- last for ~3 months
