Movements disroders

Question 1

Movement disorders - types

Answer 1

1. athetosis 2. chorea 3, Dystonia 4. Essential tremor
2. Hmiballismus 6. intention tremor 7. Myoclonus
3. Resting tremor

Question 2

Athetosis - presentation

Answer 2

slow, writhing (snake-like) movements, especially seen in fingers

Question 3

Athetosis - characteristic lesions

Answer 3

Basal ganglia (Huntington)

Question 4

Athetosis - especially seen in (area)

Answer 4

fingers

Question 5

Chorea - presentation / chorema means (as a world)

Answer 5

sudden, jerky purposeless movements

chorea –> dancing

Question 6

chorea - characteristic lesion

Answer 6

Basal ganglia (Huntington)

Question 7

dystonia - presentation

Answer 7

sustained involuntary muscle contraction

Question 8

dystonia - examples

Answer 8

Writer’s cramp

blepharospam (sustained eyelid twitch)

Question 9

Essential tremor - presentation

Answer 9

high frequency tremor with sustained posture (eg outstretched arms), worsened with movement or when anxious

Question 10

Essential tremor - worsened when

Answer 10

with movement or when anxious

Question 11

Essential tremor - treatment

Answer 11

1. β-blockers (nonselective –> eg. propranolol)
2. primidone
3. patients often self medicate with EtOH

Question 12

Essential tremor IS OFTEN

Answer 12

familiar

Question 13

hemiballismus - presentation

Answer 13

sudden, wild flailing of 1 arm +/- ispilateral leg

Question 14

hemiballismus - characteristic lesion

Answer 14

contralateral subthalamic nucleus (eg. lacunar stroke)

Question 15

intention tremor - presentation

Answer 15

slow, zigzag motion when pointing extending toward a target

Question 16

intention tremor - characteristic lesion

Answer 16

cerebellar dysfunction

Question 17

Myoclonus - presentation

Answer 17

sudden brief uncontrolled muscle contraction

- hiccups are common

Question 18

Myoclonus - common in

Answer 18

metabolic abnormalities such as liver or renal failure

Question 19

Resting tremor - presentation

Answer 19

uncontrolled movement of distal appendages (most noticeable in hands) (pill rolling tremor)
tremor alleviated by intentional movement

Question 20

Resting tremor - alleviated by

Answer 20

intentional movement

Question 21

Resting tremor - seen in

Answer 21

Parkinson

Question 22

Huntington - types of movement disorders

Answer 22

1. athetosis

2. chorea

Question 23

essential vs intention tremor (speed)

Answer 23

essential - high frequency

intention –> slow

Question 24

pill rolling tremor

Answer 24

Resting tremor

Question 25

essential vs resting (on movement)

Answer 25

essential –> worsened on movement (and resting –> alleviated by intentional movement

Question 26

familiar movement disorder

Answer 26

essential tremor

Question 27

movement disorder with cerebellar dysfunction

Answer 27

intention tremor

Question 28

movement disorder with hiccups

Answer 28

myoclonus

Question 29

movement disorder - patients often self mediated with EtOH

Answer 29

essential tremor

Question 30

movement disorder - writer’s cramp

Answer 30

dystonia

Question 31

Hemiballismus course - course

Answer 31

Recovers spontaneously over months

Question 32

2 causes of chorea

Answer 32

1. Huntington

2. Sydenham chorea

Question 33

Asterixis?

Answer 33

Jerking of outstretched hands, worse with wrist extended (incoordination between flexors and extensors)