Movement Disorders Flashcards
what artery mainly supplies the Basal ganglia?
MCA
what part of the basal ganglia is adjacent to the lateral ventricleS?
caudate nucleus
what is adjacent to the caudate nucleus on lateral side?
internal capsule
what is lateral to the internal capsule?
globus pallidus
what is lateral to the globus pallidus that is part of the basal ganglia
putamen
D1 is of the direct pathway in the BG and leads to excitatory or inhibitory synapses?
excitatory dopamine synapses
D2 is of the indirect pathway and leads to excitatory or inhibitory synapses in the BG?
inhibits the indirect pathway to increase movement
what portion of the BG forms dopamine?
pars compacta of the substantia nigra
in addition to GABA and dopamine, what other Nt is involved in the striatum of the BG?
cholinergic neurons
what is the effect of the chilinergic neurons in the BG?
opposite of dopamine…excite indirect pathway and inhibit direct pathway…limit movement
what are the two types of hypokinesia to know?
bradykinesia and rigidity
what is bradykinesia?
slow movement
what is akinesia?
no movement at all
what is rigidity?
stiffness and resistance to movement
what is the type of rigidity seen in parkinsons?
cogwheel rigidity
what is parkinsons disease an issue with?
substantia nigra destroyed
what does substantia nigra destruction lead to?
more inhibition of the thalamus and movement than excitation
what are the four motor features of parkinsons?
tremor
rigidity
bradykinesia
postural instability
what are the non motor symptoms of parkinsons?
depression
dementia
constipation
orthostatic hypotension
what accumulates in parkinsons and where does it accumulate?
alpha synuclein accumulates in neuronal cell bodies
how does alpha synuclein appear in neuronal cell bodies in parkinsons?
round lamellated eosinophilic cytoplasmic inclusions
what are the round lamellated eosinophilic cytoplasmic inclusions called in parkinsons?
Lewy bodies
what is chorea?
irregular random semi directed smooth movements
what is athetosis?
continuous writhing movements
what is ballismus?
sudden vigorous forceful movements involving a whole limb
what is dystonia?
sustained contraction of opposing muscle groups causing abnormal posture and twisting
what is myoclonus?
sudden brief shock like movements
what are the three types of tremors?
cerebellar
physiologic
essential
when does cerebellar tremor occur/
at end of purposeful moevemtns
what is an essential tremor?
postural and intention tremor
where does essential tremor occur usually?
arms and head
what is rx for essential tremo?
beta blockers and mysoline
what relieves essential tremor?
booze
when does parkinsons tremor occur?
at rest
are essential tremors symmetric?
yes
are parkinsons tremors symmetric?
no
what is rx for dystonia?
botulinum toxin
what is chorea a common feature of?
huntingtons
what drugs can cause chorea?
antipsychotics…tardive dyskinesia
what is an infection that leads to chorea?
streptococcal infection
name systemic disease that can have chorea?
lupus `
what stage in life can lead to chorea?
pregnancy…chorea gravidarum
what is inheritance of huntingtons
AD
what is genetic change in huntingtons
CAG trinucleotide expansion
what is affected in the brain in huntingtons ?
atrophy of caudate nucleus
with atrophy of caudate in huntingtons what else happens?
dilation of lateral ventricles
when does huntingtons onset?
4th-5th decade of life
tics are often part of what triad?
tics, OCD ADHD
tourettes has what in diagnosis?
multiple motor tics and one vocal tic
where is lesion in hemiballismus?
subthalamic nuclei
what is cause of lesion in subthalamic nuclei that leads to hemiballismus?
vascular
