Chorea and Ballismus in Neurology
24 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the typical age of onset for early onset focal dystonia?

  • 20 years
  • 30 years
  • 35 years
  • 26 years (correct)

What is the primary treatment for dystonia?

  • Medications
  • Botulinum toxin (correct)
  • Physical therapy
  • Surgery

What is the characteristic of UMN weakness?

  • Wasting of muscles
  • Reduced or absent reflexes
  • Increased tone (correct)
  • Reduced tone

What is the term for inflammation of the grey matter of the spinal cord?

<p>Poliomyelitis (C)</p> Signup and view all the answers

What is the term for the pattern of weakness that defines the type of muscular dystrophy?

<p>Pattern of weakness (B)</p> Signup and view all the answers

What is the primary cause of polio?

<p>Viral infection (A)</p> Signup and view all the answers

What is the term for acute inflammatory demyelinating polyneuropathy?

<p>AIDP (D)</p> Signup and view all the answers

What is the typical treatment for polio?

<p>Supportive care (A)</p> Signup and view all the answers

What is the characteristic of chorea in terms of movement?

<p>Irregular, rapid, non-stereotyped, and random (D)</p> Signup and view all the answers

What is the term for proximal chorea resulting in large amplitude movements?

<p>Ballismus (A)</p> Signup and view all the answers

Which of the following is a therapy for chorea?

<p>Butyrophenones such as haloperidol (C)</p> Signup and view all the answers

Which of the following is a type of chorea that usually occurs in childhood?

<p>Sydenham's chorea (C)</p> Signup and view all the answers

What is the result of dysfunction within the complex neuronal network that interconnects motor cortical areas and subcortical nuclei?

<p>Chorea (D)</p> Signup and view all the answers

What is the term for the involuntary sustained contraction of muscles or groups of muscles resulting in an abnormal posture?

<p>Dystonia (D)</p> Signup and view all the answers

What is the usual age of onset for Huntington's disease?

<p>Adolescence (B)</p> Signup and view all the answers

What is the associated condition with Sydenham's chorea?

<p>Rheumatic fever (C)</p> Signup and view all the answers

Which of the following is a characteristic of Parkinson's disease?

<p>Lewy body accumulation in areas of the body, including the CNS and outside the CNS (C)</p> Signup and view all the answers

What is a common symptom of cerebellar ataxia?

<p>Upper-limb dysmetria (C)</p> Signup and view all the answers

What is a possible treatment for ataxia in patients with multiple sclerosis?

<p>Deep brain stimulation (C)</p> Signup and view all the answers

What is a characteristic of Parkinson's disease diagnosis?

<p>Bradykinesia and at least one of the following: muscular rigidity, 4-6 Hz resting tremor, or postural instability (C)</p> Signup and view all the answers

What is a type of movement disorder?

<p>All of the above (D)</p> Signup and view all the answers

What is the meaning of the term 'ataxia'?

<p>Incoordination of movement (B)</p> Signup and view all the answers

What is a cause of epilepsy?

<p>All of the above (D)</p> Signup and view all the answers

What is a characteristic of cerebellar ataxia?

<p>Variability in amplitude (C)</p> Signup and view all the answers

Study Notes

Chorea/Ballismus

  • Chorea: irregular, rapid, non-stereotyped, random, involuntary movement
  • May manifest as fidgetiness or restlessness in children
  • Ballismus: proximal chorea resulting in large amplitude movements
  • Usually seen with lesion of the subthalamic nucleus, but can occur from lesions along all its afferent or efferent paths
  • Classified according to aetiology
  • Therapy relates to aetiology and symptomatic therapy usually with butoryphenones (e.g. haloperidol)

Neuroanatomy and Neurophysiology of Chorea

  • Chorea results from dysfunction within a complex neuronal network interconnecting motor cortical areas and the basal ganglia
  • Basal ganglia includes the caudate nucleus, putamen, external and internal segments of the globus pallidus (GPe and GPi), subthalamic nucleus, and substantia nigra

Chorea: Disease

  • Huntington's disease: AD, 10/100000, Chr 4, codes for huntingtin, neurotoxic gain of function, may have psychiatric or movement disorder, associated with caudate atrophy, depression is common
  • Sydenham's chorea: usually in childhood, major criterion for rheumatic fever, increased Group A beta hemolytic streptococcus titer, usually remits within 15 weeks but can recur, treat symptomatically with haloperidol and provide prophylaxis for rheumatic fever

Dystonia

  • Dystonia: involuntary sustained contraction of muscles or groups of muscles resulting in an abnormal posture
  • Can be caused by trauma, altered blood supply, altered blood content, metabolic abnormal brain chemistry, acidosis, hypoglycemia, hypoxia, electrolyte abnormalities, toxins

Threats to the System

  • Ischemia
  • Tumours in the brain or spinal cord
  • Metabolic abnormal brain chemistry
  • Acidosis, hypoglycemia, hypoxia
  • Electrolyte abnormalities
  • Toxins
  • Abnormal circuits resulting in epilepsy, movement disorders, psychosis
  • Neurodegenerative disease

Parkinson's Disease

  • Neurodegenerative disease characterized by Lewy body accumulation in areas of the body resulting in dysfunction
  • Recent data suggest that abnormality also occurs outside the CNS (e.g. the myenteric plexus)
  • Classical degeneration in Substantia nigra pars compacta

Diagnosis of Parkinsonism

  • Bradykinesia and at least one of the following:
    • Muscular rigidity
    • 4-6 Hz resting tremor
    • Postural instability not caused by primary visual, vestibular, cerebellar or proprioceptive dysfunction

Cerebellar Ataxia

  • Characterized by an incoordination of movement and unsteadiness due to cerebellar dysfunction
  • Clinical examination reveals:
    • Gait disorder with imbalance, staggering
    • Difficulties with tandem walking
    • Upper-limb and lower-limb dysmetria, dysdiadochokinesia
    • Hypotonia, cerebellar dysarthria, and saccadic ocular pursuit

Ataxia: Management

  • If etiology found, treat
  • Otherwise, symptomatic therapy:
    • Difficult to treat
    • Physical measures such as walkers, weights, etc.
    • In MS patients, DBS has some benefit

UMN and LMN

  • UMN:
    • Weakness
    • No wasting
    • Increased tone (spastic)
    • Brisk reflexes
    • Extensor plantar responses
  • LMN:
    • Weakness
    • Reduced tone
    • Reduced or absent reflexes
    • Wasting of muscles

UMN & LMN Causes

  • UMN:
    • Brain lesions (stroke, tumour, haemorrhage, demyelination, ADEM)
    • Spine (fracture with spine impression, tumour, demyelination, viral myelitis, B12 deficiency)
  • LMN:
    • AHC (polio, SMA, AVM)
    • Root (disc disease, arachnoiditis, AIDP, CIDP)
    • Plexopathies
    • Peripheral neuropathy
    • Myopathies
    • Myoneural junction (myasthenia gravis)

Muscular Dystrophies

  • Many causes of muscular dystrophy
  • Pattern of weakness defines type
  • Examples:
    • Duchenne's muscular dystrophy (dystrophinopathy)
    • Limb girdle muscular dystrophy (many types)
    • Congenital myopathy (many types)
    • Myotonic dystrophies (dystrophia myotonica, schwartz Jampel)
  • Most are genetically determined
  • Therapy usually supportive: OT, physiotherapy

Infections

  • Polio
  • GBS (AIDP)
  • Abscess
  • Meningitis
  • Encephalitis

Polio

  • Poliomyelitis is inflammation of the grey matter usually of the spinal cord where the AHC resides
  • Caused by polio or other viruses (CMV, herpes, entero-viruses)
  • Characterized by LMN features and no sensory abnormality
  • Therapy supportive

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Description

This quiz covers the definitions and characteristics of chorea and ballismus, including their causes, symptoms, and treatment options. Test your knowledge of these neurological movement disorders.

More Like This

Neurological Disorders Quiz
5 questions
Desórdenes Motores Neurologicos
12 questions

Desórdenes Motores Neurologicos

SelfSufficientDarmstadtium avatar
SelfSufficientDarmstadtium
Neurología Lancet: Distrofia de la mano
20 questions
Use Quizgecko on...
Browser
Browser