hyperkinetic movement disorders

Question 1

what is dytstonia

Answer 1

abnormal sustained, but not fixed posture of a body part due to involuntary muscle activation

Question 2

what is cause of dystonia

Answer 2

co-contraction of agonsists and antagonists

Question 3

what is general presentation of dystonia

Answer 3

mobile rather than fixed, often task specific

- can be tricked with sensory tricks

Question 4

what is dystonic tremor

Answer 4

typically jerky with ireegular frequency and amplitude

Question 5

what are 2 classifications of dystonia

Answer 5

axis 1 - clinical Sx

axis 2 - etiology

Question 6

what are axis 1 features (3)

Answer 6

1. distribution (focal, multifocal, segmental, general)
2. additional feat (task specific, paroxismal)
3. age of onset

Question 7

what are 2 axis 2 types

Answer 7

1. primary (idiopathic or genetic)

2. secondary (trauma, stroke, degenerative)

Question 8

what are primary idiopathic dystonias (3)

Answer 8

blepharospasm, torticolis, task specific (writes cramps

Question 9

what are genetic dystonias

Answer 9

young onset

DYT1 gene

Question 10

3 secondary, degenerative/metabolic dystonias

Answer 10

1. huntingtons
2. wilsons
3. PKAN

Question 11

what is wilsons

Answer 11

AR disoreder of gene mutation causing accumulation of Cu in brain and around eye

Question 12

what is essential question in dystonia

Answer 12

Is this a secondary dystonia?

Question 13

what is workup for dystonia (3)

Answer 13

1. MRI
2. gene testing depending on presentation
3. if DYt neg - Cu, trial of DOPA

Question 14

5 treatments of generalized dystonia

Answer 14

1. artane
2. baclofen
3. DA depletin agent
   L-dopa
4. DBS

Question 15

treatment for focal dystonia

Answer 15

botox

Question 16

what is defining feature of tourettes

Answer 16

chronic motor and vocal tics

Question 17

3 key questions to ask for tourettes

Answer 17

1. urge/ supressabilty of tic
2. comorbidities
3. familiy Hx

Question 18

what is neurodegenerative association with tics

Answer 18

Huntingtons

Question 19

treatment of tics

Answer 19

1. conidine
2. neuroleptics
3. tetrabenzene (DA depletions)
4. habit reversal

Question 20

what id diff between lupic movements and akathisia movements

Answer 20

in lupus they feel comfortable and don’t notice it

Question 21

what is presentation of huntingtons (4)

Answer 21

1. psych
2. chorea
3. gait
4. tics

Question 22

what is genetics of HD

Answer 22

CAG repeats