Movement Disorders Overview

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Questions and Answers

What is the role of the neocortical areas in movement coordination?

  • Higher-order planning and learning. (correct)
  • Coordination and modulation of movements.
  • Final execution of motor commands.
  • Coordination of voluntary movements, balance, and motor learning.

Which brain structure is responsible for the modulation and coordination of movements?

  • Cerebellum
  • Pyramidal system
  • Basal Ganglia (correct)
  • Neocortical areas

What is the primary function of the cerebellum in movement coordination?

  • Controlling muscle strength and tone
  • Fine-tuning and coordinating complex movements (correct)
  • Planning and learning of new motor skills
  • Initiating and executing simple movements

Which of the following pathways in the basal ganglia promotes movement by inhibiting the thalamus?

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

Which disorder is characterized by degeneration of striatal neurons in the indirect pathway of the basal ganglia?

<p>Huntington's Disease (C)</p> Signup and view all the answers

What is the primary symptom of Parkinson's Disease related to the direct pathway?

<p>Bradykinesia</p> Signup and view all the answers

What does the loss of dopamine in the substantia nigra result in?

<p>Bradykinesia</p> Signup and view all the answers

Which statement is TRUE regarding the vestibulocerebellum?

<p>It is associated with balance and coordination of eye movements. (C)</p> Signup and view all the answers

Which of the following symptoms is a hallmark of cerebellar lesion, specifically in the spinocerebellum?

<p>Intention tremor (A), Gait ataxia (C)</p> Signup and view all the answers

Which of the following is a common cause of alcoholic cerebellar degeneration?

<p>Damage to Purkinje cells (D)</p> Signup and view all the answers

Flashcards

Basal Ganglia

Brain structures that coordinate and modulate movements.

Direct Pathway

Basal ganglia pathway that promotes movement by disinhibiting the thalamus.

Indirect Pathway

Basal ganglia pathway that suppresses movement by inhibiting the thalamus.

Parkinson's Disease

Movement disorder caused by dopamine neuron loss.

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Huntington's Disease

Movement disorder caused by indirect pathway neuron degeneration.

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Cerebellum

Brain region vital for coordinating voluntary movements.

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Vestibulocerebellum

Cerebellar region crucial for balance and eye movements.

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Spinocerebellum

Cerebellar area controlling gait and limb coordination.

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Cerebrocerebellum

Cerebellar region for fine motor control.

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Bradykinesia

Slowness of movement.

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Rigidity

Increased resistance to passive movement.

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Resting Tremor

Tremor appearing when limb is at rest.

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Postural Instability

Impaired balance and increased fall risk.

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Essential Tremor

Action/postural tremor, worsened by stress.

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Deep Brain Stimulation (DBS)

Surgical procedure for advanced Parkinson's.

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Gait Ataxia

Loss of coordination during walking.

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Intention Tremor

Increasing tremor amplitude as target approached.

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Dysdiadochokinesia

Inability to perform rapid alternating movements.

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Chorea

Rapid, jerky, involuntary movements.

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Dystonia

Sustained muscle contractions causing abnormal postures.

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Nystagmus

Involuntary, rhythmic eye movements.

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Myoclonus

Sudden, brief muscle jerks.

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Tics

Repetitive, stereotyped movements or vocalizations.

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Hyperkinesias

Excessive involuntary movements.

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Study Notes

Movement Disorders

  • Overview of movement coordination structures

    • Neocortical areas are responsible for higher-order planning and learning.
    • Basal ganglia (extrapyramidal system) coordinate and modulate movements.
    • Cerebellum coordinates voluntary movements, balance, and motor learning.
    • Pyramidal system executes motor commands.

  • Basal Ganglia and Movement Disorders

    • Direct pathway promotes movement by disinhibiting the thalamus.
      • Parkinson's disease: Loss of dopamine reduces activity, leading to bradykinesia.
    • Indirect pathway suppresses movement by inhibiting the thalamus.
      • Huntington's disease: Degeneration leads to hyperkinetic movements.

Cerebellar Anatomy and Associated Disorders

  • Functional Divisions
    • Vestibulocerebellum (flocculonodular lobe): Truncal ataxia, nystagmus.
    • Spinocerebellum (vermis and intermediate zones): Gait ataxia, intention tremor.
    • Cerebrocerebellum (lateral hemispheres): Dysdiadochokinesia, poor fine motor control.

Disorders Involving the Cerebellum

  • Alcoholic cerebellar degeneration: Truncal ataxia, dysarthria, gait ataxia.
  • Friedreich's ataxia: Gait ataxia, cardiomyopathy, diabetes.
  • Sensory ataxia: Impaired proprioception, positive Romberg sign.

Diagnostic and Examination Techniques

  • Gait and posture: Wide-based gait suggests cerebellar dysfunction.
  • Limb coordination: Dysmetria (finger-to-nose test); dysdiadochokinesia (rapid alternating movements).
  • Eye movements: Gaze-evoked nystagmus, saccadic overshoot.

Imaging and Laboratory Tests

  • Bloodwork: Vitamin deficiencies (e.g., B12, E), copper, and ceruloplasmin levels (Wilson's disease).
  • Neuroimaging: MRI, CT.
  • Electrodiagnostics: EMG/NCS.

Comprehensive Treatment Approaches

  • Parkinson's disease: Levodopa, dopamine agonists, MAO-B inhibitors, DBS.
  • Essential tremor: Propranolol, primidone, topiramate, gabapentin.
  • Huntington's disease: Supportive care, tetrabenazine, antipsychotics.
  • Wilson's disease: Copper chelation (penicillamine), zinc supplementation.
  • Friedreich's ataxia: Symptomatic management.
  • Cerebellar ataxias: Treat underlying cause, physical therapy, adaptive devices.

Summary Table

  • Structure: Basal ganglia, cerebellum, pyramidal system
  • Role in Movement: Modulates movement, coordinates movement, executes voluntary movement.
  • Associated Disorders: Parkinson's, Huntington's, alcoholic cerebellar degeneration, Wilson's disease.
  • Symptoms: Bradykinesia, rigidity, hyperkinesias, dysmetria, gait ataxia, intention tremor.
  • Parkinson's disease: Resting tremor, bradykinesia, rigidity.
  • Huntington's disease: Chorea, psychiatric symptoms, dementia.
  • Wilson's disease: Wing-beating tremor, dystonia, hepatic signs.

Cerebellum: Anatomy and Associated Disorders

  • Functional Divisions: Vestibulocerebellum, spinocerebellum, cerebrocerebellum.

Disorders Involving the Cerebellum

  • Alcoholic cerebellar degeneration, Friedreich's ataxia, sensory ataxia.

Diagnostic and Examination Techniques

  • Gait and posture.
  • Limb coordination.
  • Eye movements.

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Movement Disorders Study Guide PDF

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