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21 Cards in this Set
- Front
- Back
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What major neuroologic disorder is associated with resting tremor?
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Parkinsons Disease. It is typically seen in relaxed position or when hands are not in motion.
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What are the three types of tremor?
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1. Resting
2, Kinetic (Action) 3. Postural |
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Discuss the pathophysiology of essential tremor.
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Most common movement disorder sporadic, familial (auto dominant). Monosymptomatic disored of postural and or kinetic tremor usually presenting in adolescence affeting upper extremities, head and voice. (4-12 Hz) Usually improving with alcohol.
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True/False. Wilsons dz involves various combinations of postural, kinetic and resting tremors.
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True. Outflow "rubral" tremor
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What tremor is usually associated with essential tremor?
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A bilateral postural tremor reproduced when you ask patient to extend arms.
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What therapies are frequenlt used to treat essential tremor.
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1. Anti-convulsant primodone....sedative effects can aid sleep dysrythmia
2. Beta-blockers. Specificallly propanolol and indorol. Side efx are typical of this drug class bradychardia, loss of consciousness, fatigue, depression and exacerbation of reactive asthma. |
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What drug can be admininstered to treat localized tremor?
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Botulinum toxin..can be induce loss of dexterity if used in hands.
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What is the neurological target of surgical ablation for the attenuation of tremor?
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Ventral intermediate nucleus in the thalamus. However, this procedure produces neurological sequlae such as changes in speech and swallowing.
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What is DBS? Discuss its clincal utilization.
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Deep Brain stimulation represent a reversible intervention for tremor. Consists of en elcetrode implanted into the thalamus VIN of the thalamus through which currrent is passed from four distal leads. Fucking expensive 25 thou!
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What is the most common seen in cerebellar dysfunciton?
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Intention tremors most commonly seen in Multiple Sclerosis.
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What is a rubral tremor?
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A combination of large amplitude intention, resting and postural tremors involving the posterior fossa of the cerebellum. The worst kind of tremor. Associated with MS, stroke and titubation.
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Discuss the most common etiology/presentation of hypotonia.
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A result of acute injury (cerebrovascular event/stroke) to the ipsilateral cerebellar hemisphere resulting in asymmetgry of posture so that the affected limb slumpsm impaired reflexes.
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What is the most common cause of abnormalaties in volitional movement?
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Cerebellar disease typically manifested by ataxia- impaired coordination, wide base unsteady gait, dysmetria- over or undershooting movt (heel to shin)
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True/False. Cerebellar disease are usually manifested as impairment in the speed of initiation and velocity of movement.
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False. Cerebellar disorders are primarily disorders in the CORRECTION of movement. Thus patients have trouble decelerating or accelerating movement resulting in past pointing and side to side jerky movements.
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Define the cerebellar gait and localize the lesion responsible for this pathology.
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Wide based stance to maintain station, stagger to the side opposite the lesion. Cerebellar gait is seen with lesion to the anterior vermis usually secondary to alcoholic cerbellar atrophy.
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What three types of tremor constitute the "cerebellar" tremor?
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1. Intetion Tremor (2-5 Hz)
2, Cerebellar outflow "rubral" tremor 3. Titubation |
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What is titubation?
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Postural tremor of head and axial structures (yes-yes) tremor associated with bilateral cerebellar lesions.
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What general signs of cerebellar dysfunction should a physician look for in patient hx or presentaiton?
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1. Abnormalities of volitional movt
2. Tremor 3. Disoreder gait and equilibrium 4. Hypotonia 5. Scanning dysarthria 6. Ocular Abnormalities |
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What ocular abnormalities are associated with cerebellar disease?
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1. Ocular myoclonus- spontaneous contraction of msl (non-purposeful movt)
2. saccadic (jerky pursuits) with overshoot 3. nystagmus |
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What is the function of the cerebellum?
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1. Control of muscle tone.
2. Coordination of skilled movt. 3, Control of posture and gait. |
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What is dysarthria?
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Disorder of speech due to dysfunction of muscles of articulation. Secondary to cerebellar dz.
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