Movement Disorders
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Introduction
Types of Movement Disorders
Basal ganglia and cerebellum, which control automatic and voluntary
Hyperkinetic Disorders
The four questions to ask are:
Is it rhythmic? yes - tremor
Is it supressible? yes - tic, stereotypy
Is it sustained? - yes, dystonia
Is it stereotyped? yes - myoclonus, hemiballism
Non-rhythmic, non, suppressible, non sustained, non-sterotyped - chorea, athetosis, akethesia, tardive dyskinesia
tic
A suppressible, dysrhythmic movement disorder.
There is some urgency to move prior to movement, which relieves them.
Tics can be seen with Tourette's syndrome, which appears before the age of 18.
stereotypy
Stereotypy is a suppressible, dysrhythmic movement disorder. Unlike tics, there is no urgency to move.
Stereortypy is associated with mental retardation or mental health conditions.
tardive (delayed) dyskinesia
- can appear up to a year
- commonly caused by neuroleptics
athetosis
- slow, writhing movements of the extremities
chorea
- jerky, random movements of the limbs and orofacial structures
- dance-like, as m ovements flow form one part to another
- seen in Huntington's Disease
akethesia
- sense of restlessness and need to move
- common manifestation is 'restless legs syndrome'
Hypokinetic Disorders
often seen in Parkinson's Disease
bradykinesia
freezing
rigidity
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis. To get students thinking.
Causes and Risk Factors
Pathophysiology
Signs and Symptoms
- history
- physical exam
History
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Treatments
- dopamine blockers, ie tetrabenazine, reserpine; antipsychotics
- GABAergic drugs, ie benzodiazepines
- anticholinergics for dystonia
Consequences and Course
The Case of...
Case #2 - a small story wrapping it all up and asking about esp management.
Additional Resources
Topic Development
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