Podcast
Questions and Answers
Which feature is primarily associated with Bradykinesia in Parkinson's disease?
Which feature is primarily associated with Bradykinesia in Parkinson's disease?
What is the most common initial feature observed in patients with Parkinson's disease?
What is the most common initial feature observed in patients with Parkinson's disease?
Which condition is characterized by stiffness in the muscles due to lesions in the basal ganglia?
Which condition is characterized by stiffness in the muscles due to lesions in the basal ganglia?
Which of these features is not typically associated with Parkinson's disease?
Which of these features is not typically associated with Parkinson's disease?
Signup and view all the answers
What type of movement disorder is characterized by a lesion in the pyramidal tract resulting in increased muscle tone?
What type of movement disorder is characterized by a lesion in the pyramidal tract resulting in increased muscle tone?
Signup and view all the answers
Which symptoms are considered 'red flags' suggesting a diagnosis other than Parkinson's disease?
Which symptoms are considered 'red flags' suggesting a diagnosis other than Parkinson's disease?
Signup and view all the answers
What characterizes resting tremor in the context of Parkinson's disease?
What characterizes resting tremor in the context of Parkinson's disease?
Signup and view all the answers
What is a distinctive feature of kinetic tremor as observed during clinical examination?
What is a distinctive feature of kinetic tremor as observed during clinical examination?
Signup and view all the answers
What differentiates spasticity from rigidity in Parkinson's disease?
What differentiates spasticity from rigidity in Parkinson's disease?
Signup and view all the answers
What is indicated by the term 'alien limb phenomenon' within the context of Parkinson's disease?
What is indicated by the term 'alien limb phenomenon' within the context of Parkinson's disease?
Signup and view all the answers
Study Notes
Movement Disorders - General Overview
- Pyramidal tract initiates movement, weakness results from dysfunction
- Extrapyramidal tract coordinates/modifies movement, disorders from basal ganglia problems
- Basal ganglia: group of nuclei deep in the brain; includes caudate nucleus, putamen, subthalamic nuclei, globus pallidus (external/internal), substantia nigra (compacta/reticulate)
- Involved in movement of trunk, extremities, extra-ocular muscles, cognition, and emotion.
- Sometimes includes cerebral cortex
Parkinsonism
- Syndrome of clinical features, mainly caused by Parkinson's disease
- Cardinal features: (1) bradykinesia—main feature, (2) resting tremor—most common initial feature, (3) postural instability—recurrent falls, clinically diagnosed by a pull test, (4) rigidity.
Parkinson's Disease
- Progressive neurodegenerative disease, affecting 100-200 per 100,000 people over 40, common age onset in 60s
- Loss of dopaminergic neurons in substantia nigra pars compacta
- Early onset if presents before 50
- Levodopa-induced dyskinesias (combination of chorea and dystonia) develop over time with higher doses
Clinical Presentation
- Bradykinesia, often with resting tremor
Red Flags Suggesting Diagnosis Other Than Parkinson's
- Early dementia
- Early postural instability
- Early hallucinations/psychosis (low doses)
- Ocular signs (impaired vertical gaze)
- Pyramidal tract signs not explained by prior stroke or spinal cord issues
- Early autonomic symptoms
- Prominent motor apraxia
- Alien limb phenomenon
- Truncal symptoms more than appendicular symptoms
- Marked symmetry early in disease
Tremor
- Most common movement disorder, involuntary rhythmic oscillation
- Resting, action, postural, kinetic
- Position-specific, task-specific
- Essential and Parkinsonian tremor have different characteristics
Essential Tremor
- Isolated tremor syndrome, bilateral upper limb action tremor (postural and kinetic)
- At least 3 years, with/without in other locations (head, voice).
- Improves with alcohol, not parkinsonism
- AD, with absence of neurological signs
Dystonia
- Movement disorder-sustained/intermittent muscle contractions
- Abnormal, often repetitive movements/postures, sometimes tremulous
- Often initiated or worsened by voluntary muscle action
- Sensory trick often accompanies
- Stereotyped
Chorea
- Non-goal-directed, rapid movements involving multiple body parts
- Random, erratic amplitude with high individual variability
- Not suppressed by volition
- Neurological conditions like Huntington's disease and drugs such as levodopa cause this
Myoclonus
- Briefest hyperkinetic movement
- Shock-like movements, positive/negative myoclonus
- Sudden muscle contractions or pauses in tone
- Can be spontaneously occurring or during movement
- May be provoked by external stimuli like touch or sound
Tics
- Unwanted, non-goal-directed, discrete muscle movements, repetitive, patterned, inter/intra-individual variability
- Severity can range
- Associated with premonitory sensory phenomena; sometimes suppressed by volition
- Motor or phonic types, simple or complex movement
Tourette's Syndrome
- Neuropsychiatric disorder, motor/phonic tics, diagnosed before age 18.
- Often associated with ADHD and OCD
Wilson's Disease
- Young-onset movement disorder, AR
- Impaired intracellular copper transporter function causing copper accumulation in liver, brain, cornea
- Clinical features: liver, neurologic, psychiatric—may present with any movement disorder.
- Diagnosis: Reduced serum ceruloplasmin with/without Kayser-Fleischer rings.
Sydenham Chorea
- Acute rheumatic fever
- Most common form of acquired chorea in children (5-13 years old)
- Onset 1-8 months after infection (Group A beta-hemolytic streptococcus)
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the key concepts of movement disorders with a focus on Parkinson's disease. Participants will learn about the anatomy of the pyramidal and extrapyramidal tracts, the role of the basal ganglia, and the hallmark features of Parkinsonism. Ideal for students studying neurology or related fields.
