Week Wrap Up

Question 1

Early, severe dysautonomia points to…

Answer 1

MSA

Question 2

What does early cognitive impairment, early hallucinations, and fluctuating level of consciousness point to?

Answer 2

Dementia with lewy bpdies

Question 3

Eye movement abnormalities point to…

Answer 3

PSP

Question 4

4 issues with dysautonomia

Answer 4

Detrusor hyperactivity
Orthostatic hypotension
Erectile dysfunction
Constipation

Question 5

3 medications that cause parkinsonism

Answer 5

Neuroleptics
Metoclopramide
Prochlorperazine

Question 6

Multiple system atropy

Answer 6

Subtypes: parkinsonian, cerebellar, autonomic
Severe dysautonomia
Symmetrical symptoms
Poor response to levodopa
Cerebellar, pyramidal, and extrapyramidal features

Question 7

Progressive supranuclear palsy

Answer 7

Typically no tremor
Vertical gaze palsy (saccadic > pursuit), progresses to ophthalmoplegia
Early falls
Facial dystonia

Question 8

Corticobasal syndrome

Answer 8

Very asymmetrical parkinsonism
Myoclonus, dystonia of affected limb
Cortical sensory loss (agraphesthesia, asterognosis)
Alien limb phenomenon

Question 9

Dementia with lewy bodies

Answer 9

Early cognitive impairment
Visual hallucinations
Fluctuating level of awareness

Question 10

Wilson disease

Answer 10

Rare autosomal recessive disorder of Cu metabolism
Treatable with copper chelation or liver transplant
Can cause any type of movement disorder
Classic presentations: postural tremor most prominent with arms in wing-beating position, generalized dystonia, neuropsychiatric symptoms
Screen for in all people under 50 with a new movement disorder

Question 11

Hemiballism commonly localizes to…

Answer 11

The subthalamic nucleus

Question 12

How to treat generalized dystonia

Answer 12

DBS is treatment of choice

Otherwise: artane, baclofen, clonazepam

Question 13

Where does the
1. SCA
2. AICA
3. PICA 
supply?

Answer 13

1. Superior cerebellum
2. Lateral pons and small region of the anterior cerebellum
3. Inferior cerebellum and lateral medulla