Term
| What are some major limitations of clinical localization for involuntary movement conditions? |
|
Definition
1) Pathology can be from many areas, with multi-focal lesions
2) Direct/Indirect pathway is insufficient
3) Lesion: Manifestation link is imperfect |
|
|
Term
| What are the 3 major types of involuntary movements? |
|
Definition
1) Dystonia (Sustained contraction in BG with abnormal DA signaling)
2) Tremor (Rythmic oscillation)
3) Jerking (Myoclonus, Chorea, Tic) |
|
|
Term
Link each of the following Tremor patterns with their likely lesion sites.
1) Resting
2) Palatal
3) Intention |
|
Definition
1) Substantia Nigra (PD)
2) Central Tegmental Tract
3) Cerebellum + Efferent projections (Dentate?) |
|
|
Term
| What is a "sensory trick" as it relates to Dystonia? |
|
Definition
Dystonias are abnormal, sustained muscle contractions (probably in BG and relating to DA signaling).
Sometimes, something as simple of "touching one's cheek" is able to "distract" the system. |
|
|
Term
| How can you distinguish between the 3 types of Involuntary "Jerking movements"? |
|
Definition
1) Length of movement
- Chorea > Myoclonus ("burst")
2) Suppression
- Tic (well)
- Chorea (partial)
- Myoclonus (not) |
|
|
Term
A patient presents with involuntary movements in their left hand and wrist that appear to "flow from joint to joint."
When you ask them to stick out their tung, they can only hold it for a short period of time.
When you pull against their arm flexers, they are clearly hypotonic.
Whats going on? |
|
Definition
Chorea (Distal distribution, motor impersistence and hypotonia are all characteristic)
Violent Proximal Form is "Hemiballismus." |
|
|
Term
| Why does Chorea develop early in patients with Huntington's? |
|
Definition
| Early degeneration of Striatal neurons in the indirect BG tract promote these brief, low-amplitude distal movements. |
|
|
Term
A patient presents with brief "shock-like" involuntary movements that they cannot suppress.
What are these called? |
|
Definition
| Myoclonus (short duration without control) |
|
|
Term
| What happens to Myoclonus when a patient is sleeping? |
|
Definition
Depends on distribution!
1) Spinal will persist
2) Cortical will go away |
|
|
