Hyperkinetic Movement Disorders

Info

🌱 來自: Huppert’s Notes

Hyperkinetic Movement Disorders🚧 施工中

Hyperkinetic Movement Disorders

Tremor

•   Essential tremor: Postural and action tremor that usually starts in the hands/arms and spreads to the head, voice, and legs; often improves with alcohol intake. Treatment: Propranolol or primidone

•   Dystonic: Concomitant contraction of agonist and antagonist muscles causing abnormal postures; can be associated with tremor

•   Parkinsonian: Resting > postural tremor

•   Cerebellar: Appendicular ataxia when cerebellar hemispheres are involved; intention tremor (higher amplitude tremor when getting closer to target)

•   Physiologic: Low amplitude not visible under normal conditions, more obvious with drugs/caffeine

Other hyperkinesias

•   Chorea: Involuntary continual, irregular “dance-like” movements. Etiologies include genetic diseases (e.g., Wilson’s disease, Huntington’s), drug-induced (especially neuroleptics, cocaine), metabolic (e.g., HHS, hyperthyroidism), infectious (e.g., HIV, viral encephalitis), autoimmune (e.g., Sydenham chorea), nutritional (e.g., thiamine deficiency)

•   Restless leg syndrome (RLS): Typically nocturnal discomfort in the legs that is partially or totally relieved by movement. Screen for iron deficiency, uremia, anemia, and neuropathies and treat the underlying condition if present. Treatment: Dopamine agonists (e.g., pramipexole, ropinirole, rotigotine patch)

•   Tics: Irresistible, repetitive, purposeless, temporarily suppressible movements with urge to complete and relief after completing the movements