Movement Disorders: Introduction

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Questions and Answers

Which medication is often used to manage tics by slowing down sudden movements?

Clonazepam (correct)

Sertraline

Lithium

Fluoxetine

What type of movements are characteristic of Tourette's Syndrome?

Shuffling gait

Abrupt, stereotypical movements (correct)

Sustained muscle contractions

Random jerking movements

Which feature is commonly associated with Parkinson's disease along with a shuffling gait?

Involuntary vocalization

Resting tremor (correct)

Uncontrolled muscle spasms

Dystonic posturing

What type of involuntary movements is associated with Huntington's disease?

Abrupt onset of irregular movements Signup and view all the answers

Which condition is best described by sustained muscle contractions, repetitive twisting, and abnormal posturing?

Secondary dystonia Signup and view all the answers

What is the primary treatment goal for managing tics?

Slowing down movements and reducing frequency Signup and view all the answers

What is the Kayser-Fleischer Ring an indicator of?

Wilson's Disease Signup and view all the answers

Which of the following is a cause of secondary dystonia?

Neurodegenerative diseases Signup and view all the answers

What type of dystonia affects only specific body parts?

Focal Dystonia Signup and view all the answers

What characterizes myoclonus compared to dystonia?

Abrupt and brief muscle contractions Signup and view all the answers

Which of the following conditions can induce chorea-like movements?

Thyrotoxicosis Signup and view all the answers

What distinguishes focal dystonia from segmental dystonia?

Focal dystonia targets specific body parts. Signup and view all the answers

Which type of brain injury can cause myoclonus?

Hypoxic brain injury Signup and view all the answers

What is the main pathophysiological problem leading to dystonia?

Dysfunction in the basal ganglia Signup and view all the answers

What type of movement disorder is characterized by involuntary abrupt, irregular movements of the body?

Chorea Signup and view all the answers

Which condition is associated with chorea due to basal ganglia damage?

Huntington's Disease Signup and view all the answers

Which type of tremor is typically seen at rest, particularly in conditions like Parkinson's disease?

Resting tremor Signup and view all the answers

What can be inferred if a patient exhibits both hypokinetic and hyperkinetic symptoms?

They are likely suffering from a condition like Parkinson's disease. Signup and view all the answers

Which of the following best describes hyperkinetic movement disorders?

Includes uncontrollable bursts of movement. Signup and view all the answers

In what way is the classification of movement disorders critical?

It guides accurate diagnosis and management. Signup and view all the answers

What is a common cause of chorea related to copper metabolism?

Wilson's Disease Signup and view all the answers

Which statement is true regarding action tremors?

They can suggest cerebellar injury or lesion. Signup and view all the answers

Study Notes

Overview of Movement Disorders

Classified as hyperkinetic (excessive movement) or hypokinetic (reduced movement).
Hyperkinetic disorders: include tremors, chorea, dystonia, myoclonus, tics, and stereotypical movements.
Patients can show mixed symptoms from both categories, exemplified by Parkinson's disease presenting with shuffling gait (hypokinetic) and resting tremors (hyperkinetic).
Classification is essential for accurate diagnosis and management.

Tremors

Classified based on behavior patterns and observation during specific actions.
Types:
- Resting tremors: prevalent in conditions like Parkinson's disease.
- Action tremors: associated with cerebellar lesions, found in essential tremors.
Differential diagnosis relies heavily on identifying the tremor type for effective management.

Hyperkinetic Movement Disorders

Chorea

Characterized by involuntary, abrupt, and irregular body movements.
Pathophysiology involves basal ganglia damage, disrupting motor control.
Associated Conditions:
- Huntington's Disease: caused by CAG repeat expansion affecting basal ganglia.
- Wilson's Disease: copper metabolism disorder, leads to chorea with Kayser-Fleischer ring around the iris.
- Drug-induced chorea: often consequence of neuroleptics or dopaminergic medications.
- Toxic exposures: ethanol and carbon monoxide can result in chorea-like movements.
- Thyrotoxicosis: hyperthyroidism can also induce similar movements.
- Immunological disorders: SLE and post-streptococcal conditions related to chorea development.

Dystonia

Defined by sustained muscle contractions resulting in repetitive twisting or abnormal postures.
Pathophysiology involves basal ganglia dysfunction disrupting motor commands.
Types:
- Focal Dystonia: affects a specific area (e.g., blepharospasms, spasmodic dysphonia).
- Segmental Dystonia: impacts adjacent regions.
- Generalized Dystonia: affects multiple areas throughout the body.
Causes:
- Idiopathic Dystonia: no identifiable cause, includes torsion dystonia linked to genetics.
- Secondary Dystonia: stems from cerebral issues, neurodegeneration, hypoxic injury, and drug-related causes.

Myoclonus

Sudden, lightning-like muscle contractions, typically brief and abrupt.
Quick like dystonia but characterized by distinct muscle contractions.
Causes range from physiological factors and epilepsy to metabolic disorders and brain trauma.
Management often includes benzodiazepines (e.g., clonazepam) and antiepileptics (e.g., valproate) to reduce the frequency and intensity of movements.

Tics

Abrupt, coordinated, repetitive movements or sounds.
Suppression of tics can lead to anxiety, commonly observed in Tourette’s syndrome.
Coprolalia refers to involuntary swearing or inappropriate remarks in some patients with Tourette's.
Management strategies focus on behavioral therapies and medications, depending on severity.

Clinical Considerations

A 75-year-old with a shuffling gait may also exhibit resting tremors, indicating a possible diagnosis of Parkinson's disease.
Huntington disease is identified by abrupt onset chorea, characterized by irregular movements flowing unpredictably through the body.
Wilson disease may present as sustained muscle contractions and abnormal posturing, typically classified as hyperkinetic secondary dystonia.

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Description

This quiz introduces the classification of movement disorders, focusing on hyperkinetic and hypokinetic types. It covers examples like tremors, dystonia, and Parkinson's disease, helping students understand the distinctions between these disorder categories.