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21 Cards in this Set

  • Front
  • Back
What major neuroologic disorder is associated with resting tremor?
Parkinsons Disease. It is typically seen in relaxed position or when hands are not in motion.
What are the three types of tremor?
1. Resting
2, Kinetic (Action)
3. Postural
Discuss the pathophysiology of essential tremor.
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.
True/False. Wilsons dz involves various combinations of postural, kinetic and resting tremors.
True. Outflow "rubral" tremor
What tremor is usually associated with essential tremor?
A bilateral postural tremor reproduced when you ask patient to extend arms.
What therapies are frequenlt used to treat essential tremor.
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.
What drug can be admininstered to treat localized tremor?
Botulinum toxin..can be induce loss of dexterity if used in hands.
What is the neurological target of surgical ablation for the attenuation of tremor?
Ventral intermediate nucleus in the thalamus. However, this procedure produces neurological sequlae such as changes in speech and swallowing.
What is DBS? Discuss its clincal utilization.
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!
What is the most common seen in cerebellar dysfunciton?
Intention tremors most commonly seen in Multiple Sclerosis.
What is a rubral tremor?
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.
Discuss the most common etiology/presentation of hypotonia.
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.
What is the most common cause of abnormalaties in volitional movement?
Cerebellar disease typically manifested by ataxia- impaired coordination, wide base unsteady gait, dysmetria- over or undershooting movt (heel to shin)
True/False. Cerebellar disease are usually manifested as impairment in the speed of initiation and velocity of movement.
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.
Define the cerebellar gait and localize the lesion responsible for this pathology.
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.
What three types of tremor constitute the "cerebellar" tremor?
1. Intetion Tremor (2-5 Hz)
2, Cerebellar outflow "rubral" tremor
3. Titubation
What is titubation?
Postural tremor of head and axial structures (yes-yes) tremor associated with bilateral cerebellar lesions.
What general signs of cerebellar dysfunction should a physician look for in patient hx or presentaiton?
1. Abnormalities of volitional movt
2. Tremor
3. Disoreder gait and equilibrium
4. Hypotonia
5. Scanning dysarthria
6. Ocular Abnormalities
What ocular abnormalities are associated with cerebellar disease?
1. Ocular myoclonus- spontaneous contraction of msl (non-purposeful movt)
2. saccadic (jerky pursuits) with overshoot
3. nystagmus
What is the function of the cerebellum?
1. Control of muscle tone.
2. Coordination of skilled movt.
3, Control of posture and gait.
What is dysarthria?
Disorder of speech due to dysfunction of muscles of articulation. Secondary to cerebellar dz.