Movement disorders intro Flashcards
common features of disordered movement
impaired postural refelxes that would normally contribute to balance - diminished or slowed movement(hypokinesia/bradykinesia) - excessive involuntary movements (hyperkinesia) -uncoordinated or unsteady movements (ataxia)
Physiological(nonpathological tremor)
refelcts low-amplitude oscillatory movement of a , bodily region
Resting tremor
common in parkinsons, wanes during voluntary movement of the affected body part, a BASAL GANLIAR dysfunction secondary to mesencephalic degeneration is integral to parkinson’s disease.
Intention (kinetic) termor
arises with voluntary movement particularly as the affected body part approaches a target in space (commonly cerebellar lesions yield this)
Chorea
brief, purposeless, irregular jerky movements of body parts,(often from Basal gangliar disease. -voluntary movements may be affected as abnormal choreic movements are superimposed. -successive choreic movements resembles dancing. -HALLMARK of Huntington disease and sydenham disease.
athetosis
continuous slow writhing body parts, (Often Basal Gangliar) may be seen in athetoid cerebral palsy -can accompany hemiplagia(gate is superimposed.
Ballismus
flinging or rotary movements, causal lesions often involve the subthalamus which contributes to basal gangliar function - is expressed unilaterallly with manifestations expressed contralateral to the injury
Lower motor neurons can present hypokinetic disorders presents as
flaccid paralysis
hypokinesia is asssociated with
upper motor neurons
hypokinesia yields
elevated muscular tone and hyperreflexia
dysfunctions involving modulatory and regulator circuits can also produce
hypokinesia
sensory and motor systems cooperate to
mantian equilibirum
posture is immediately linked to
muscel tone which can be adversely affected by a broad array of lesions
aberrations of posturecan
reflect tonically increased or decreased muscle tone.
damage to modulatory centers can
destabilize muscle tone yielding spontaneous and uncontrolled movements.
Decorticat posture suggests
a cereberal lesion affecting the corcio spinal system with sparing of motor centers of the brain stem. including the red nucleus
station is sensitive to
damage to conscious and unconscious sensory systems and motor systems.
ability of patient to stnad steady with feet together may deteriorate when
the eyes are close and the visual system isn’t able to compensate for nervous deficits.
postural tremor
apparent only when a particular posture is maintained may reflect basal gangliar dysfunction
Prakinson disease
-akinesia/bradykinesia, -facial masking -muscular rigidity -loss of postural refelxes -parkinsonian gait -loss of habituiation to glabellar stimulation -speech is quiet, hoarse and monotonous with accelerated bursts
stages of parkinson
- unilateral 2. bilateral but with preserves postural reflexes, 3. bilateral with loss of postural refelxes 4. severe disability with some movement 5. Akinesia
Prodrome
hyposomia, autonomic disturbances and REM sleep disorder. reflects degeneration in olfactory and cuadal bulbar centers
Cogwhell rigidity
recurrent stepwise release and return of resistance to passive movement
lead pipe rigidity
resistance that is sustained throught a range of passive movement.
glabellar reflex involves
noxious stimulation between the eyes to elicit bilateral blinking, normally blinks weaken with repeated stimulation
Dystonia
muscle spasms or sustained abnormal postures involving trunk and limbs -post are partial or segmental.
spasmodic torticollis
a specific dystonia involving the neck, they contract involuntarily and may become hypertrophic.
Tic Syndromes
irregularly occuring sterotyped movements that are usually transient and uncoordinated.
tourette syndrome.
multifocal tics, ADHD, vocal tic.
Tardive dyskinesia
patients exposed to antipsychotic. oral movements, doesn’t necessarly abate with drug withdrawal
Dopa induced dyskinesia
often arises during treatment of parkinson disease with precursor to dopamine. -choreic movemnts, facial dystonias
drug induced parkinsonism.
suppresion of dopaminergic transmission. may dissipate within weeks
