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Questions and Answers
Which of the following symptoms is associated with Unilateral plastic rigidity with rest tremor?
Which of the following symptoms is associated with Unilateral plastic rigidity with rest tremor?
- Presence of tremor
- Increased reflexes
- Intention tremor
- Unilateral involvement of substantia nigra (correct)
Which anatomical structure is primarily affected in hemiballismus?
Which anatomical structure is primarily affected in hemiballismus?
- Caudate nucleus
- Subthalamic nucleus (correct)
- Inferior olive
- Cerebellum
What is a characteristic feature of chorea?
What is a characteristic feature of chorea?
- Consistent tremor
- Muscle atrophy
- Rigidity of the limbs
- Excessive movements with no clear purpose (correct)
In which condition would you typically find correlative bilateral degeneration of the putamen?
In which condition would you typically find correlative bilateral degeneration of the putamen?
What is the primary clinical correlation to excessive movements and rigidity in the context of Huntington chorea?
What is the primary clinical correlation to excessive movements and rigidity in the context of Huntington chorea?
Which statement best describes the relationship between the anatomical lesions and movement disorders?
Which statement best describes the relationship between the anatomical lesions and movement disorders?
In the context of extrapyramidal syndromes, which of the following is a typical feature of dystonia?
In the context of extrapyramidal syndromes, which of the following is a typical feature of dystonia?
What is observed in the clinical evaluation of reflexes in patients with chronic chorea?
What is observed in the clinical evaluation of reflexes in patients with chronic chorea?
When considering intention tremor, which statement is accurate?
When considering intention tremor, which statement is accurate?
Which statement correctly describes features of Wilson disease?
Which statement correctly describes features of Wilson disease?
What is the primary function of the basal ganglia in relation to the corticospinal system?
What is the primary function of the basal ganglia in relation to the corticospinal system?
Which of the following symptoms is characteristic of a Hypokinetic Basal Ganglionic Syndrome?
Which of the following symptoms is characteristic of a Hypokinetic Basal Ganglionic Syndrome?
How does the degeneration of the striatum affect motor control in Huntington's Disease?
How does the degeneration of the striatum affect motor control in Huntington's Disease?
What is a common feature of Hyperkinetic Basal Ganglionic Syndromes?
What is a common feature of Hyperkinetic Basal Ganglionic Syndromes?
What role does the subthalamic nucleus play in regard to the globus pallidus?
What role does the subthalamic nucleus play in regard to the globus pallidus?
Which of the following statements about tremors is true?
Which of the following statements about tremors is true?
In which type of motor syndrome would you most likely find rigidity as a primary symptom?
In which type of motor syndrome would you most likely find rigidity as a primary symptom?
Which pathway is primarily involved in the inhibition of the globus pallidus internal segment?
Which pathway is primarily involved in the inhibition of the globus pallidus internal segment?
Which pathway's activity is diminished in Parkinson's disease, contributing to hypokinetic movements?
Which pathway's activity is diminished in Parkinson's disease, contributing to hypokinetic movements?
What anatomical structure is primarily affected in cases of Huntington's chorea?
What anatomical structure is primarily affected in cases of Huntington's chorea?
Which structure is associated with lesions leading to hemiballismus?
Which structure is associated with lesions leading to hemiballismus?
In Parkinson's disease, loss of cells in which location is demonstrated to correlate with the disease's symptoms?
In Parkinson's disease, loss of cells in which location is demonstrated to correlate with the disease's symptoms?
Which of the following tremors is specifically related to intention and coordination?
Which of the following tremors is specifically related to intention and coordination?
What is the primary characteristic of dystonia?
What is the primary characteristic of dystonia?
Which type of dopamine receptor is primarily involved in modulating motor control within basal ganglia circuitry?
Which type of dopamine receptor is primarily involved in modulating motor control within basal ganglia circuitry?
Which anatomical location is NOT associated with chronic chorea of the Huntington type?
Which anatomical location is NOT associated with chronic chorea of the Huntington type?
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Study Notes
Overview of Motor Syndromes
- Basal ganglia and cerebellum interact with and modulate the corticospinal system, influencing posture and movement.
- The distinction between pyramidal (corticospinal) and extrapyramidal systems is essential for identifying various motor syndromes.
Huntington Disease and Corticospinal Syndrome
- Hyperkinetic syndrome characterized by loss of voluntary movements (paralysis or paresis) and spasticity.
- Involves degeneration of the striatum and impacts the direct pathway, leading to net inhibition of the globus pallidus.
Hypokinetic Basal Ganglionic Syndrome
- Symptoms include bradykinesia (slowness of movement) and rigidity (altered muscle tone).
- Tremors may occur without paralysis, associated with reduced inhibition from the striatum and increased inhibitory activity from the globus pallidus externa.
Chorea and Dystonia
- Chorea entails excessive involuntary movements, while dystonia involves sustained muscle contractions and abnormal postures.
- Both conditions relate to dysfunction in the basal ganglia circuitry, notably striatal connections.
Clinicopathologic Studies
- Observations correlate hemiballismus with lesions in the subthalamic nucleus, emphasizing the role of this area in motor control.
- Cell loss in the substantia nigra is central to Parkinson's disease, severely affecting movement regulation.
Cerebellar Syndrome
- Characterized by incoordination, intention tremor, and hypotonia, indicating dysfunction within cerebellar regions.
- Symptoms often arise from lesions in the ipsilateral cerebellar hemisphere or its connecting pathways.
Extrapyramidal vs. Corticospinal Syndromes
- Corticospinal Syndromes: Manifesting features include spasticity and increased reflexes, particularly in flexor muscles.
- Extrapyramidal Syndromes: Often show rigidity, involuntary movements, and absence of specific reflexes, with generalized hypertonus.
Wilson Disease
- First described by Wilson in 1912 as hepatolenticular degeneration, associated with putaminal degeneration.
- Clinicopathologic findings support its classification as an extrapyramidal disorder linked to basal ganglia dysfunction.
Key Cytopathological Links
- Chronic chorea in Huntington's is linked to degeneration of the caudate nucleus and putamen.
- Observations indicate that motor disorders may result from lesions in varying anatomical sites, reflecting the complex nature of motor control.
Concept Checkpoint
- The interrelations between the described anatomical loci and movement disorders highlight that no single locus is exclusively responsible for any movement disorder.
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