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Movement: Common Movement Pitfalls
Terms in this set (19)
presence of nystagmus, illusory movement of the environment (moving up, down, sideways)
Sudden onset of ataxia, nystagmus, anterograde amnesia with projectile vomitting
Upbeat nystagmus can be seen in what disorders? Usually present on primary gaze, may suppress or convert to downbeat nystagmus on convergence
1. Wernicke's encephalopathy
2. paramedian lesions in the medulla
3. lesion in pons and midbrain
4. arsenic poisoning
Where are the targgets of Wernicke's encepahloapthy on MRI?
1. mammillary bodies
2. dorsal midbrain
3. periaqueductal region
What is on pathology of Wernicke's?
symmetric demyelination, petechial hemorrhages, and gliosis of midline gray matter areas (cerebral aqueduct)
Mammillary bodies are affected in 75% of cases,
dorsomedial thalamus, hypothalamus, vestibular nuclei and superior cerebellar vermis in over 50% of patients
What is the only allowed UMN sign in stiff person syndrome?
hyperreflexia. If spasticity -> suggests concurrent corticospinal tract involvement
What frequency is suggestive of orthostatic tremor?
High frequency 14-16 Hz
How can you diagnosis orthostatic myclonus?
EMG showing random, non-rhythmic bursts of EMG activity ranging from 50-130 ms in duration
In what neurodegnerative diseases do orthostatic myoclonus develop?
PD, MSA, DLB, Alzheimer's disease, cerebral amyloid angiopathy
What are the tau-opathies?
Pick's disease, PSP, CBD, MSA
What is hemimasticatory spasm?
rare movement disorder characterized by isolated and sustained muscle contraction of masticatory muscles due to hyperexcitability of the motor branch of the trigeminal nerve
What are causes of hemimasticatory spasms?
2. pontine infarctions affecting the trigeminal nucleus
3. progressive facial hemiatrophy
4. localized scleroderma
What are the two fundamental components of FXTAS?
tremor, cognitive impairment
can also cause generalized atrophy
If you have a PD patient with orofacial dystonia, what should you think?
Diagnosis is wrong, suggests MSA
What is benign hereditary chorea?
mutation in TITF1 gene on chromosome 14q with autosomal dominant chorea. early history of congenital hypothyroidism and respiratory distress is supportive of diagnosis
What is the tremor of CBD?
high frequency resting and postural tremor that is assymetric
CBS associate with AD is more likely to be associated with tremor or myoclonus?
What is more in keeping with a metabolic, iatrogenic, and enhanced physiologic tremor?
low amplitude, high frequency
What is the hallmark of drug induced tremor?
small amplitutde, high-frequency, postural and kinetic tremor, symmetric
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