Positive neurological diagnosis Flashcards
fnd misdiagnoses
parkinsons
frontal lobe seizure
stiff person syndrome
myoclonus dystonia
lambert eaton syndrome
thalamic stroke
limb shaking TIA
what are the levels of certainty for fmd
documented (remittance with suggestion)
clinically established plus other features (inconsistent over time and incongruent with clinical condition)
clinically established minus other features
lab supported definite (electrophysiology)
clues in the hx to suggest a functional movement disorder
abrupt maximal onset
static course
spontaneous remission
paroxysmal symptoms
psychiatric comorbidities
secondary gain
trauma related risk factors
psychological stressors
multiple somatizations
broad clues in the general examination suggestive of a functional movement disorder
movement inconsistencies
incongruous movement
suggestibility
effort
self inflicted injury
delayed and excessive startle response
verbal gibberish/ stuttering speech
false weakness
nonatomic sensory loss or spread of movement
disproportionality
which movement inconsistencies suggest fmd
variability over time (frequency, amplitude, direction/ distribution of movement)
distractibility reduces or resolves movement
attention increases movement
selective disability
entrainment
which movement incongruencies (how is the movement different to the organic disorder) suggest fmd
mixed movement disorders
paroxysmal attacks
precipitated paroxysms
what are functional gait disorder symptoms
monoplegic dragging gait at the hip
fluctuation of impairment
excessive slowness of movement
excessive hesitation
psychogenic romberg test (balance lost when eyes closed non neurological cause)
walkiing on ice pattern
uneconomic postures
sudden knee buckling
external or internal hip rotation
ankle inversion or eversion
describe the test
hoover’s sign
weakness fo hip extension that returns to normal with contralateral hip flexion against resistance
describe the test
tremor entrainment
tremor that either stops of entrains to an externally cued varying repetitive finger-thumb opposition rhythm
The test is also positive when the individual cannot copy movements
describe the test
gait “pretend your dominant leg is weak”
patterns shown include circumducting, dragging, walking on ice
describe the test
tuning fork
vibrating tuning fork placed on each side of the forehead. aysmmetry is thought to be a functional sign frontal bone is one piece so vibration should be the same
limb shaking transient ischaemic attacks are associated with which type of damage
internal carotid atery occlusion
