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Clin Med III Disease Key Notes > Movement Disorders (Exam #4) > Flashcards

Movement Disorders (Exam #4) Flashcards

1
Q

What type of movement is state of restlessness, “can’t sit still”?

A

Akathisia

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2
Q

What type of movement is inability to coordinate movements of trunk/limbs?

A

Ataxia

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3
Q

What type of movement is involuntary writhing limb movements?

A

Athetosis

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4
Q

What type of movement is flailing, involuntary limb movements?

A

Ballism (ballistic movements)

  • Ex. https://www.youtube.com/watch?v=ci6Rp4Sv9ao
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5
Q

What type of movement is quick, involuntary, dance-like movements?

A

Chorea

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6
Q

What type of movement is involuntary movements, chorea-like or tic-like?

A

Dyskinesia

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7
Q

What type of movement is abnormal muscle tone with sustained posture?

A

Dystonia

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8
Q

What type of movement is involuntary, spasmodic, jerky movements?

A

Myoclonus

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9
Q

What type of movement is habitual, semi-voluntary, spasmodic, quick, brief movements?

A

Tics

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10
Q

What type of movement is involuntary, rhythmic, repetitive movement?

A

Tremor

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11
Q

What is the general progression of Idiopathic Parkinson’s Disease (IPD) (hint: 2 steps)?

A
  1. Sxs-free honeymoon for ~3 years

2. Motor comp. after 5-7 years

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12
Q

What are the four cardinal features of Idiopathic Parkinson’s Disease (IPD)?

A
  • Rest tremor
  • Rigidity
  • Akinesia-Bradykinesia
  • Postural Instability (late)
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13
Q

What condition presents with resting tremor, rigidity, akinesia/bradykinesia, postural instability?

A

Idiopathic Parkinson’s Disease (IPD)

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14
Q

What condition involves apraxia of gait (“feet glued to floor”), cognitive impairment, urinary incontinence, rigidity?

A

Normal Pressure Hydrocephalus (NPH)

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15
Q

What condition involves symmetric sxs, mild akathisia; NO resting tremor?

A

Drug-Induced Parkinsonism

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16
Q

What condition involves gait disturbance; UMN sxs (spasticity, hyperreflexia)?

A

Vascular Disease

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17
Q

What condition involves cognitive disorder; limb apraxia, unilateral limb rigidity?

A

Corticobasal Degeneration (CBS)

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18
Q

What condition involves supranuclear gaze palsy, early falls, poor L-Dopa response?

A

Progressive Supranuclear Palsy (PSP)

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19
Q

What condition involves prominent autonomic sxs early, poor L-Dopa response, stridor, NO resting tremor?

A

Multi-System Atrophy (MSA)

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20
Q

What condition involves hallucinations, cognitive disorder, fewer autonomic sxs

A

Dementia with Lewy Bodies (DLB)

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21
Q

What is the general dx test used for PD?

A

MRI of brain

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22
Q

What condition presents with “hot cross bun” sign on MRI?

A

Multi-System Atrophy (MSA)

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23
Q

What condition presents with “hummingbird” sign on MRI?

A

Progressive Supranuclear Palsy (PSP)

24
Q

What condition presents with enlarged ventricles on MRI?

A

Normal Pressure Hydrocephalus (NPH)

25
Q

What condition should always be ruled out in any patient <50 years with movement disorder?

A

R/O Wilson’s Disease

26
Q

In addition to MRI, what other test should be ordered in a patient with cognitive sxs?

A

Neuropsychometric testing

27
Q

In addition to MRI, what other test should be ordered in a patient with tremor?

A

Thyroid studies

28
Q

In addition to MRI, what other test should be ordered in a patient with suspected PD?

A

Vitamin D levels

29
Q

In addition to MRI, what other test should be ordered in a patient with dysphagia?

A

Swallow study

30
Q

In addition to MRI, what other test should be ordered in a patient with voice change?

A

SLP eval

31
Q

In addition to MRI, what other test should be ordered in a patient with MIXED tremor?

A

SPECT/DaTSCAN

32
Q

What medication is prescribed for tx of ALL PD patients?

A

Carbidopa/Levodopa (Sinemet)

33
Q

What is a long-term AE of Carbidopa/Levodopa (Sinemet)?

A

Motor fluctuations

34
Q

What class of medications might be considered in a PD patient that is <70 years?

A

DA Agonists

  • Pramipexole
  • Ropinirole
  • Rotigotine
35
Q

If surgery is warranted for the tx of PD, what surgery is typically considered?

Under what two conditions would this be considered?

A

Deep Brain Stimulation (DBS)

  • Severe disability
  • Motor fluctuations (NO cognitive)
36
Q

What two body parts are often affected by an Essential Tremor (ET)?

A
  • UEs

- Head/chin

37
Q

What improves an Essential Tremor (ET)? What exacerbates it?

A
  • Improves with EtOH

- Worse with caffeine

38
Q

What are the three possible med tx for Essential Tremor (ET)?

A
  • Propranolol
  • Primidone
  • Gabapentin
39
Q

What condition involves abnormal sensations with urge to move legs at rest? What time of day are sxs often worst?

A

Restless Leg Syndrome (RLS)

- Sxs worse at night

40
Q

What class of medications are used to tx Restless Leg Syndrome (RLS)? What other med tx may be considered?

A

DA Agonists

- Also, Fe replacement

41
Q

What condition involves the sxs TRIAD of motor, cognitive and psychiatric? What are three examples of motor dysfunction?

A

Huntington’s Disease (HD)

- Motor = chorea, dystonia, bradykinesia

42
Q

What is the TRIAD associated with Huntington’s Disease (HD)?

A
  • Motor dysfunction
  • Cognitive dysfunction
  • Psych dysfunction
43
Q

What are the three classes of drugs used to tx Huntington’s Disease (HD)?

A
  • Anti-DA drugs
  • Benzos
  • Anti-depressants
44
Q

What med is used to tx General Tics? What other two classes of drugs might be considered?

A

Clonidine

  • Neuroleptics
  • Benzos
45
Q

How do you dx Tourette’s Syndrome (3)?

A 
- 2+ motor tics
AND
- 1+ phonic tics for 1+ years
AND
- Onset before age 18 years
46
Q

What are the two types of Primary Dystonia? Describe each.

A
  • General

- Focal

47
Q

What is the age onset and etiology of General Primary Dystonia?

A
  • Childhood onset

- Idiopathic

48
Q

What is the recommended tx for General Primary Dystonia?

A

BOTOX (@Megan @Paige)

49
Q

What is the most common etiology of Hemifacial Spasm (HFS)?

A

CN VII compression

50
Q

What condition involves involuntary, intermittent spasms of half of face?

What part of the face is often initially affected?

A 
Hemifacial Spasm (HFS)
- Periorbital muscles initially
51
Q

How is Hemifacial Spasm (HFS) diagnosed (2)?

A
  • Clinical

- MRI (check for compression of CN VII)

52
Q

What is the recommended tx for Hemifacial Spasm (HFS)?

A

BOTOX (@Megan @Paige)

53
Q

What group of conditions often involves tremor, dystonia and myoclonus?

A

Functional/Psychogenic Movement Disorders

54
Q

What three sxs often present with Functional/Psychogenic Movement Disorders?

A
  • Tremor
  • Dystonia
  • Myoclonus
55
Q

What group of conditions often involves abrupt onset, bizarre movements, exaggerated efforts, suggestible/trainable, inconsistent?

A

Functional/Psychogenic Movement Disorders

56
Q

What is the recommended tx for Functional/Psychogenic Movement Disorders?

A

Multidisciplinary approach

- Psychiatry, psychology (CBT), PT, OT, ST

Clin Med III Disease Key Notes (18 decks)

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