Movement Disorders (Hon)

Question 1

What are the 5 Akinetic Rigid Syndrome discussed in lecture?

Answer 1

AKA Bradykinetic (slow and stiff)
1. Parkinson’s Disease
2. Progressive Supranuclear Palsy (PSP)
3. Multiple Systems Atrophy (MSA)
4. Cortical Basal Degeneration (CBD)
5. Lewy body Disease

Question 2

Pathophysiology of Idiopathic Parkinson’s Disease

Answer 2

depletion of dopamine in the nigrostriatal system; disrupts the balance of dopamine and acetylcholine (decreased inhibitor of the inhibitor (GABA) doesn’t allow for movement to occur)

Question 3

What are the 3 cardinal features of Parkinson’s disease?

Answer 3

Tremor - resting tremor “pill-rolling”
Rigidity - increased resistance “cogwheel”
Bradykinesia -slowness of movement and difficulty initiating movement

Question 4

Myerson’s sign

Answer 4

repetitive tapping on the forehead leads to sustained blink response - if present then, can indicate Parkinson’s disease

Question 5

Progressive Supranuclear Palsy (PSP)

Answer 5

a Akinetic Rigid Syndrome; patients are slow and stiff; there will also be loss of voluntary control of eye movements (especially the vertical gaze)

Question 6

Loss of vertical gaze is seen in which akinetic rigid syndrome?

Answer 6

Progressive Supranuclear Palsy (PSP)

Question 7

Multiple Systems Atrophy (MSA)

Answer 7

AKA Shy-Drager Syndrome
a Akinetic Rigid Syndrome; PRONOUNCED autonomic dysfunction will be observed

Question 8

Cortical Basal Degeneration (CBD)

Answer 8

a Akinetic Rigid Syndrome
characterized by both cortical and basal ganglionic dysfunction; may also see cortical sensory loss, apraxia, myoclonus or aphasia

Question 9

Anti-Parkinsonian treatment

Answer 9

Dopamine agonists (Bromocriptine)
Levodopa
COMT inhibitors
Anticholinergics
Deep Brain Stimulation

Question 10

In which akinetic rigid syndrome will you see PRONOUNCED autonomic dysfunction early and dramatically in the disease?

Answer 10

Multiple Systems Atrophy (MSA)

Question 11

Chorea

Answer 11

irregular, brief “dance-like” movements

Question 12

Athetosis

Answer 12

writhing, sinuous movements (often occur in combination with chorea)

Question 13

Dystonia

Answer 13

sustained muscle contractions that produce twisting and repetitive movements and abnormal postures

Question 14

Ballism

Answer 14

large amplitude, flinging movement; usually from the proximal extremities (hips and shoulders)

Question 15

Tic

Answer 15

brief, rapid, repetitive, seemingly purposeless stereotyped action that may involve single or multiple muscle groups

Question 16

What are the two chorea type disorders discussed in lecture?

Answer 16

1. Huntington’s Disease
2. Sydenham’s Chorea