Matthew Coulson
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Movement Disorders lecture given in Week 3

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Matthew Coulson
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Movement Disorders

Question 1 of 22

1

Easy first question:

Hyperkinetic diseases:
Example:

Hypokinetic diseases:
Example:

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    Excessive/unwanted movement
    Tremor
    Lack of movement
    Parkinsonism

Explanation

Question 2 of 22

1

Match the Dyskinesia to its definition:
- Rhythmic sinusoidal oscillation of a body part
- An involuntary stereotyped movement or vocalisation (can occur singularly)
- Brief irregular purposeless movements which move from one body part to another
- Brief electric shock like jerks in groups of muscles
- Twisting and repetitive movements or an abnormal fixed posture in the affected body part

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    Dystonia
    Myoclonus
    Chorea
    Tic
    Tremor

Explanation

Question 3 of 22

1

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What is the most common form of dyskinesia?

Explanation

Question 4 of 22

1

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Resting tremor is a condition whereby a tremor occurs when muscles are at rest. This type of tremor typically affects the ( hands/fingers, feet/toes, legs, arms ) and is the tremor most commonly associated with ( Parkinson's, Huntington's, Wilson's ) disease

Explanation

Question 5 of 22

1

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Which type of tremor is the most common generally?
tremor

Explanation

Question 6 of 22

1

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Essential tremor is considered to be a type of ( postural, resting, kinetic ) tremor, which is a tremor that occur upon sustained muscle tone (e.g. holding arms out horizontally)

Explanation

Question 7 of 22

1

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Patients with an essential tremor are commonly misdiagnosed as having Parkinson's disease. This is not the case as essential tremor is considered to be a ( postural, resting, kinetic ) tremor whereas parkinson's features only ( resting, postural, kinetic ) tremors

Explanation

Question 8 of 22

1

Which of the following conditions is associated with a kinetic tremor? (tremor exacerbated by purposeful movements)

Select one of the following:

  • Wilson's Disease

  • Huntington's Disease

  • Parkinson's Disease

Explanation

Question 9 of 22

1

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Wilson's disease a genetic disorder in which builds up in the body, resulting in jaundice, vomiting and a kinetic tremor.

Explanation

Question 10 of 22

1

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Apart from a resting tremor typically in the hands, Parkinson's disease patients can also experience a ( Jaw, Head, Shoulder ) tremor

Explanation

Question 11 of 22

1

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In the approach to a patient with a tremor, why might you want to test a young patient (<45) for copper and caeruloplasmin?
To test for Disease

Explanation

Question 12 of 22

1

What are the two first line treatments for essential tremor?
(only prescribe one at a time)

Select one or more of the following:

  • Primidone

  • Propranolol

  • Atenolol

  • Gabapentin

  • Alpraxolam

  • Topiramate

Explanation

Question 13 of 22

1

Propranolol -
Primidone -

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    Anticonvulsant
    Antidepressant
    Antiemetic
    Beta Blocker
    ACE Inhibitor

Explanation

Question 14 of 22

1

Primary tic disorders almost always start in childhood - adult onset of tics is rare and almost always due to a secondary cause

Select one of the following:

  • True
  • False

Explanation

Question 15 of 22

1

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Disease is the most common inherited cause of Chorea

Explanation

Question 16 of 22

1

Medications for Chorea in Huntington's Disease:
- Antipsychotic medication
- Blocks Dopamine transport into synaptic vesicles in CNS

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    Tetrabenazine
    Haloperidol
    Primidone

Explanation

Question 17 of 22

1

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( Haloperidol, Tetrabenazine ) has side effects such as night sedation and weight gain which can be beneficial to Huntington's Disease patients.
( Tetrabenazine, Haloperidol ) does not have these side effects, however is more likely to cause depression.

Explanation

Question 18 of 22

1

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A 27 year old woman presents to her GP, describing that every so often at night as she is falling asleep she is suddenly awoken by a brief jerk and a feeling that she is falling. This woman is most likely suffering from jerks

Explanation

Question 19 of 22

1

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Hypnic jerks are often associated with a feeling of falling, and are categorised as a type of ( myoclonus, chorea, tic, dystonia )

Explanation

Question 20 of 22

1

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A 17 year old boy presents to his GP complaining of involuntary movements. This started around the age of 14 as brief twitches of his muscles in the mornings, but now consists of more forceful jerks occurring both in the mornings and before bed. He describes that the jerks are typically worse after he's been on a night out drinking alcohol, or when he is very tired.
What condition is he suffering from?

Explanation

Question 21 of 22

1

Juvenile Myoclonic Epilepsy (JME) is normally treated with which medication?

Select one of the following:

  • Sodium Valproate

  • Lamotrigine

  • Gabapentin

  • Phenytoin

Explanation

Question 22 of 22

1

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Hiccups are a form of ( myoclonus, tremor, chorea, tic, dystonia )

Explanation