Movement Dsdrs
Key feature of normal pressure hydrocephalus parkinsonism
apraxia of gait (magnetic gait)
Why get a CXR with MG?
Thymic hyperplasia or thymoma
Most common form of motor neuron disease
ALS
Largest cause of hemifacial spasm (HFS)
2/3 are caused by CN VII compression
80-90% improve with botox therapy
htn med that can be used for essential tremor
propanolol
4 secondary causes of RLS
neuropathy, Fe deficiency, pregnancy and renal failure
Most common initial feature of MS
paresthesia/sensory symptoms
Nonspecific lab finding suggestive of serotonin syndrome
elevated CPK and myoglobin
What age and gender is MS more common in?
usually dx age 15-45 but mean dx age 28-31
females 2-3x more common than men
What treatment should you AVOID giving pts with guillian barre?
steroids
In any pt <50 with a movement disorder what labs/physical exam findings do you need to check for?
Urine copper, serum ceruloplasm, and KF rings in eyes to r/o Wilson's disease
Describe the distribution of pts dx with MG
Bimodal age distribution: women in 20-30s and men in 60-80s
Antidote for serotonin syndrome
Cyproheptadine (used if benzos not improving sxs)
Sensory trick that leads to improvement of dystonia
Geste Antagoniste
Most common type of seizure in adults with epilepsy
complex partial
This movement disorder is present in 10% of boys and is associated with OCD and ADD
Tics
First line therapy for acute MS exacerbation?
IV methylprednisolone 100mg dialy for 5days (Alt large dose of oral prednisone for 3-7d)
If pt has lots of money they can do ACTH therapy instead
If response to roids is poor plasmapharesis/plasma exchange
ALS sensory exam and NCS are
normal
How do you differentiate peripheral and central nystagmus?
Horizontal or rotary/torsional-peripheral
vertical-central
How do you treat parkinon's disease if pt is >70 or <70?
>70, or refractory use carbidopa/levodopa
<70 dopamine agonist (pramipexole, ropinirole or rotigotine)
How does parkinsons affect basal ganglian function?
Increased activation of the indirect pathway (globus pallidus and subthalmic nucleus) and decreased activity of direct pathway (substantia nigra pars compacta)
In GM symptoms worsen with activity/exercise
In Lamber-Eaton symptoms improve with activity/exercise
Complications of malignant hyperthermia
DIC and multiple organ failure
Drugs to avoid in myasthenia Gravis (3)
Fluoroquinolones
Beta blockers
hydroxycholoquine
Treatment steps for status epilepticus
IV lorazepam or diazepam
IV phenytoin of fosphenytoin
IV phenobarbital or midazolam