Involuntary Movement Disorders

Front 1

What is ideomotor apraxia?

Back 1

1. Inability to initiate hand gestures and/or voluntary mime actions

Front 2

What is ideational/conceptual apraxia?

Back 2

1. Loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects in everyday life.

Front 3

What are the MCC movement disorders?

Back 3

1. Restless legs

2. Essential tremor

3. Parkinson's

Front 4

What are the ssx of Parkinson's?

Back 4

1. Bradykinesia

2. Resting tremor

3. Rigidity

4. Postural instability

Front 5

With what is a postural tremor associated?

Back 5

1. Essential tremor

Front 6

With what is an intention tremor associated?

Back 6

1. Cerebellar tremor

Front 7

What is the progression of the tremor in Parkinsons's?

Back 7

1. Asymmetric at first, then bilateral

2. "Pill rolling" in hand at rest only

3. May affect head, trunk, jaw, or lips

Front 8

Where is the pathology located in Parkinson's?

Back 8

1. Substantia nigra pars compacta

Front 9

What is the age of onset of essential tremor?

Back 9

1. Decades 2-6

Front 10

How do you tx essential tremor? How do the drugs work?

Back 10

1. Propranolol--- not in asthma

2. Primidone--- breaks down into phenobarbital

Front 11

What are the ssx of shaky leg syndrome?

Back 11

1. Tremor in legs that occurs suddenly when initially standing up or standing still

2. Feels unsteady and imbalanced

3. Abates with walking

Front 12

What is the tx of shaky leg syndrome?

Back 12

1. Klonopin

Front 13

What are the ssx of cerebellar tremor?

Back 13

1. Absent in first part of initiating a precise, projected movement

2. Increases as action continues

3. Interferes with skilled acts

Front 14

What test ponts to cerebellar tremor?

Back 14

1. Finger-nose-finger test

Front 15

Where is the pathology localized in cerebellar tremor?

Back 15

1. Lesions of lateral cerebellar nuclei or superior cerebellar peduncle

2. Ipsilateral to lesion

Front 16

How do you tx writing tremor?

Back 16

1. Anticholinergics-- artane, cogentin

Front 17

How do you dx a psychogenic tremor?

Back 17

1. Increases with attention and decreases with distractions

2. Clinical inconsistencies

Front 18

How do you tx a psychogenic tremor?

Back 18

1. Psychotherapy

Front 19

What disorders present with chorea?

Back 19

1. Huntington's

2. SLE

3. Hemiballism

Front 20

Where is the pathology localized in chorea?

Back 20

1. Subthalamic nucleus

Front 21

What are the ssx of athetosis?

Back 21

1. Slow, writhing, continuous, involuntary movements

Front 22

What is the MCC of syndrome of athetoid cerebral palsy?

Back 22

1. Injury to basal ganglia in prenatal, perinatal, or infancy period

Front 23

What is dystonia?

Back 23

1. Spontaneous, involuntary, sustained muscle contractions

2. Repetitive

3. Progress to abnormal postures

Front 24

What are the different types of dystonia?

Back 24

1. Blepharospasm

2. Spasmodic dystonia

3. Writers cramp

4. Spasmodic torticollis

Front 25

What are gests? In what disorder to they present?

Back 25

1. Voluntary movements in spasmodic toritcollis that are meant to control involuntary movement

Front 26

How do you tx focal dystonias?

Back 26

1. Botulinum toxin

Front 27

What are tremors?

Back 27

1. Involuntary oscillatory movements

Front 28

What is chorea?

Back 28

1. Abrupt movements of limb and facial muscles

Front 29

What is ballism?

Back 29

1. Violent, flailing movements

Front 30

What are tics?

Back 30

1. Sudden, rapid, nonrhythmic, stereotyped, involuntary movements

Front 31

What are the different types of tics? What does it mean if both are present?

Back 31

1. Simple or complex

2. Both- Tourette syndrome

Front 32

What is myoclonus?

Back 32

1. Single or repetitive

2. Abrupt, brief, lightning-like jerky, arrhythmic, synergic, involuntary contractions

Front 33

What is the mcc of myoclonus?

Back 33

1. Ischemia

Front 34

What is the MCC of dyskinesias?

Back 34

1. Antipsychotics

2. Peak-dose dyskinesias due to adverse effects of L-dopa in tx of Parkinson's

Front 35

What is akathisia?

Back 35

1. Inner restlessness

2. Inability to sit still or remain motionless

Front 36

What is tardive dyskinesia?

Back 36

1. Focal/segmental dystonia

2. MC: oromandibular dystonia--- lip smacking, tongue protrusion

Front 37

What is the MCC of hemiballismus?

Back 37

1. Hemorrhage into subthalamic nucleus

Front 38

What is asterixis?

Back 38

1. Inability to sustain normal muscle tone

2. Liver flap seen in hepatic encephalopathy

Front 39

What is the inheritance of Wilson's?

Back 39

1. AR

Front 40

When should you consider Wilson's?

Back 40

1. Young patient

2. Tremors, dystonias, choreoathetosis, or rigidity associated with psychiatric disease

3. Kayer-Fleschner ring