Yocom 2 Flashcards
What are hyperkinetic movements?
Myoclonus (fast) Dystonia (sustained) Chroea (twisting) Tics (repetitive) Ballism (failing) Athetosis (slow writhing) Tremor (oscillation)
What are hypokinetic movements?
Akinesia (power loss)
Bradykinesia (slow)
What 3 features are unique to dystonia?
Task specificity, Geste antagoniste, state function
What is task-specific dystonia often confused for?
Focal dystonia
What are the tree key factors to diagnosing dystonia?
Age of onset, distribution in body, other neurological disturbances
When is the normal age of onset for dystonia?
Before 26
What is primary dystonia?
Dystonia is isolated w/ no other symptoms (neurological)
What is secondary dystonia?
Due to a drug/toxin
What is the treatment of choice for focal dystonia?
Botox injection
What are the drugs used for dystonia (ABC)?
Artane, Baclofen, Clonazepam
What is a kinetic tremor?
Tremor with movement
Which is the most common tremor seen in adults?
Essential Tremor
What exacerbates the essential tremor?
Stress, exercise, fatigue, caffeine, meds
What makes the essential tremor better?
Relaxation and alcohol
What is the first line treatment for essential tremor?
Primidone or propanolol
What is the most common primary tic disorder?
Tourette Syndrome
What are some secondary cause of tics?
Neurodevelopmental, acute brain lesions, post-infection, neurodegenerative, meds
What is the treatment for tourettes?
Alpha 2 agonists, clonidine and guanfacine
What types of motion and clinical features would be seen in Huntington’s?
Chorae, bradykinesia, dystonia, irritability, mania, depression, lack of self-control, dysphagia, strained loud voice, hostile outbursts
What are some early signs of huntington’s cognitive decline?
Forgetfulness, difficulty maintaining attention/focus and multitasking
What are the genetic features of huntington’s?
Autosomal dominant, CAG repeat
What is Wilsons disease (hepatolenticular degeneration)?
Mutations resulting in elevated levels of copper in the body
What are the principle problems in Wilson’s disease?
Reduced copper excretion due to mutated ATP7B
Impairs formation of ceruoloplasmin
What occurs if there is a build up of copper?
It’s toxic so oxidative damage occurs; screws up liver and basal ganglia, causes cerebral atrophy
What are the signs and symptoms of Wilsons?
Progressive neurodegenerative that starts 11-25 y/o
Liver signs proceed neurological ones
Mood changes, depression, psychosis
What are the physical neurological signs of Wilsons?
Dystonia and tremor (wing beat), rigidity, Kayser-Fleisher ring
What MRI sign would you see in Wilsons?
Giant panda sign
What is the treatment for Wilsons?
Initial phase: Pencillamine
Maintenance phase: Zinc acetate (prevents Cu GI absorption)
Liver transplant
What are the cardinal features of Parkinson’s?
Tremor at rest/postural, bradykinesia, rigidity
What proteins can be linked to Parkinson’s?
a-synnuclein, parkin, UCH-L1
What is the first step to diagnose Parkinson’s?
Bradykinesia + Rigity OR Tremor at rest OR Postural instability
What is step 2 to diagnose Parkinson’s?
Exclusion of other things that may show similar signs
What is step 3 to diagnose Parkinson’s?
Support features
Unilateral onset, rest tremor, levodopa responsiveness
What dec the risk of getting Parkinson’s?
Caffeine, cigarettes
What are some drug therapies to use for Parkinson’s?
Monoamines oxidase B inhibitors (Selegiline, Rasagiline) with levodopa
Amantadine
Who cannot take anticholinergic drugs for Parkinson’s?
Elderly (over 65)
What are the surgical procedures done to treat Parkinson’s?
Deep brain stimulation, creation of lesions Thalamic surgeries (tremor), Pallidal/subthalamic (global effect)
