Disorders of Movement M A R T I N H A R L E Y N E U R O L O G Y
|
|
- Isabel Horn
- 6 years ago
- Views:
Transcription
1 Disorders of Movement M A R T I N H A R L E Y N E U R O L O G Y
2 Educational Objectives Improved history taking in patients with movement disorders. Develop a systematic approach to observing and describing movement disorders. Understand the vocabulary used to describe movement disorders. Formulate differential diagnoses based on the history and examination. Begin to consider further investigations and management.
3 It s (almost) all in the history Time course Functional disability Past medical history, including infections and toxin exposures Drug history (current, previous, recreational) Alcohol responsiveness Family history Neuropsychiatric features Autonomic symptoms Sleep problems
4 It s (almost) all in the history Do specific actions provoke the movement? Do the movements occur during sleep? Are there any associated sensory symptoms? Can the movements be suppressed? Are there aggravating or alleviating factors?
5 Observation before formal examination What is there gait like? Any involuntary movement? Facial expression Spontaneity of movement Blink frequency BP assessment including orthostatic change Gross cognitive assessment
6 Movement disorders - categorisation
7 Movement disorders - categorisation Hypokinetic movement disorder - a partial or complete loss of voluntary muscle movement. Hyperkinetic movement disorder - an increase in muscular activity that can result in excessive abnormal movements, excessive normal movements, or a combination of both.
8 Movement disorders - categorisation Hypokinetic Movements Idiopathic Parkinson s Drug induced Parkinsonisim Multi-system atrophy Progressive Supernuclear Palsy Corticobasal Degeneration Dementia with Lewy bodies Hyperkinetic Movements Essential tremor Chorea Dystonia Ballism Myoclonus Tics Myokymia
9 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
10 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
11 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
12 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
13 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
14 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
15 Parkinsonisim Tremor at rest Bradykniesia Rigidity Flexed posture of the neck, trunk and limbs Loss of postural reflexes Freezing
16 Idiopathic Parkinson s Disease - Making a diagnosis To make a diagnosis of Parkinson s disease the patient must demonstrate: Bradykinesia and at least one of the following: Muscular rigidity 4-6 Hz rest tremor Postural instability not caused by primary visual, vestibular, cerebellar or proprioceptive dysfunction
17 Idiopathic Parkinson s Disease - Making a diagnosis The following are all features suggestive of IPD: Unilateral onset Rest tremor present Progressive disorder Persistent asymmetry affecting side of onset most Excellent response to levodopa in inital stage Severe levodopa-induced chorea Levodopa response for 5 years or more Clinical course of 10 years or more
18 Idiopathic Parkinson s Disease - Making a diagnosis Any of the following would suggest a diagnosis other than IPD : History of repeated head injury History of repeated strokes with stepwise progression History of definite encephalitis Oculogyric crises Neuroleptic treatment at onset of symptoms More than 1 affected relative Sustained remission Strictly unilateral features after 3 years Supranuclear gaze palsy Cerebellar signs Early severe autonomic involvement Early severe dementia with disturbances of memory, language, and praxis Babinski sign Presence of cerebral tumor or communication hydrocephalus on imaging study Negative response to large doses of levodopa in absence of malabsorption
19 Not Idiopathic Parkinson s?
20 Idiopathic Parkinson s Disease not just a motor problem
21 Treatment of IPD
22 Levodopa Induced Dyskinesia
23 Moderate amplitude tremor Can have significant impact on ADL Often have a long and insidious history Tends to run in families Can be eased with alcohol Propranolol is first choice for treatment Essential Tremor
24 Involuntary, irregular, purposeless, nonrthymic, abrupt, rapid, unsustained movements that seem to flow from one body part to another Characteristically unpredictable in timing, direction and distribution Can be partially suppressed or camouflaged into semipurposeful voluntary movements Prototypical example is Huntington s disease Chorea
25 Large amplitude choreic movements of the proximal parts of the limbs Flailing or flinging movements Most common cause of hemiballism is stroke Ballism
26 Sudden, shock-like involuntary movements caused by muscular contractions or inhibitions Can occur at rest or during activity (action myoclonus) Can be both arrhythmic or rhythmic Myoclonus
27 Consist of abnormal movements and abnormal sounds Vary in severity over time Usually preceded by uncomfortable feeling or sensory urge that is relieved by carrying out the movement May be simple or complex Often suppressible Tic dissorders
28 Unilateral facial muscle contractions Continual, rapid, brief, repetitive spasms Can evolve into sustained tonic spasms Can often be brought out when patient voluntarily and forcefully contracts the facial muscles Myokymia
29 Refers to twisting movements that tend to be sustained at the peak of the movement, are frequently repetitive and often progress to prolonged abnormal postures Tend to be patterned (in the same muscles) Dystonia
30 Dystonia Focal When a single body part is affected Segmental Involvement of 2 or more contiguous regions of the body are affected Multifocal Involves 2 or more regions, not conforming to segmental or generalized dystonia Generalized Movements of one or both of the legs, trunk and some other part of the body
31 Thank you Any questions? If you want to know more : Youtube - Springer Video Atlas of Movement Disorders Parkinsons.org.uk learning module for junior doctors coming January
DIFFERENTIAL DIAGNOSIS SARAH MARRINAN
Parkinson s Academy Registrar Masterclass Sheffield DIFFERENTIAL DIAGNOSIS SARAH MARRINAN 17 th September 2014 Objectives Importance of age in diagnosis Diagnostic challenges Brain Bank criteria Differential
More informationParkinson s Disease in the Elderly A Physicians perspective. Dr John Coyle
Parkinson s Disease in the Elderly A Physicians perspective Dr John Coyle Overview Introduction Epidemiology and aetiology Pathogenesis Diagnosis and clinical features Treatment Psychological issues/ non
More informationProfessor Tim Anderson
Professor Tim Anderson Neurologist University of Otago Christchurch 11:00-11:55 WS #91: Shakes Jerks and Spasms - Recognition and Differential Diagnosis 12:05-13:00 WS #102: Shakes Jerks and Spasms - Recognition
More informationParkinson s Disease. Sirilak yimcharoen
Parkinson s Disease Sirilak yimcharoen EPIDEMIOLOGY ~1% of people over 55 years Age range 35 85 years peak age of onset is in the early 60s ~5% of cases characterized by an earlier age of onset (typically
More informationInvoluntary Movements in Children and Adolescents: Is it Seizure, Tic or Something Else?
Involuntary Movements in Children and Adolescents: Is it Seizure, Tic or Something Else? California Association of Nurse Practitioners Monterey, March 22, 2013 Julie Sprague-McRae, MS, RN, PPCNP-BC Ruth
More informationPhenomenology of Movement Disorders
Phenomenology of Movement Disorders Raja Mehanna MD Anatomical reasoning Anatomical reasoning Phenomenological reasoning Abnormal movement Hypokinetic Hyperkinetic Ataxia Video 1 But there is a tremor!
More informationProfessor Tim Anderson
Professor Tim Anderson Neurologist University of Otago Christchurch 11:00-11:55 WS #91: Shakes Jerks and Spasms - Recognition and Differential Diagnosis 12:05-13:00 WS #102: Shakes Jerks and Spasms - Recognition
More informationAn Approach to Patients with Movement Disorders
An Approach to Patients with Movement Disorders Joaquim Ferreira, MD, PhD Laboratory of Clinical Pharmacology and Therapeutics Faculty of Medicine University of Lisbon EDUCATIONAL TOOLS MDS video library
More informationDifferential Diagnosis of Hypokinetic Movement Disorders
Differential Diagnosis of Hypokinetic Movement Disorders Dr Donald Grosset Consultant Neurologist - Honorary Professor Institute of Neurological Sciences - Glasgow University Hypokinetic Parkinson's Disease
More informationMovement Disorders Will Garrett, M.D Assistant Professor of Neurology
Movement Disorders Will Garrett, M.D Assistant Professor of Neurology I. The Basal Ganglia The basal ganglia are composed of several structures including the caudate and putamen (collectively called the
More informationPresented by Joanna O Leary, MD Providence St. Vincent Medical Center Movement Disorder Department
Presented by Joanna O Leary, MD Providence St. Vincent Medical Center Movement Disorder Department Hyperkinetic movement disorders Increase in muscle movements causing involuntary motion Tremor Dystonia
More informationAn approach to movement disorders. Kailash Bhatia, DM, FRCP Professor of Clinical Neurology Institute of Neurology Queen Square, London
An approach to movement disorders Kailash Bhatia, DM, FRCP Professor of Clinical Neurology Institute of Neurology Queen Square, London Neurology Diagnosis Two main questions: What parts of the nervous
More informationMovement disorders. Dr Rick Leventer Royal Children s Hospital
Movement disorders Dr Rick Leventer Royal Children s Hospital richard.leventer@rch.org.au Movement disorders! conditions that affect the speed, fluency, quality, and ease of movement! usually affect TONE
More informationIdentification number: TÁMOP /1/A
Manifestation of Novel Social Challenges of the European Union in the Teaching Material of Medical Biotechnology Master s Programmes at the University of Pécs and at the University of Debrecen Identification
More informationIII./3.1. Movement disorders with akinetic rigid symptoms
III./3.1. Movement disorders with akinetic rigid symptoms III./3.1.1. Parkinson s disease Parkinson s disease (PD) is the second most common neurodegenerative disorder worldwide after Alzheimer s disease.
More informationPARKINSON S DISEASE: current aspects of ETIOLOGY, DIAGNOSIS and TREATMENT. Dilek Ince Gunal, MD Assoc. Prof
PARKINSON S DISEASE: current aspects of ETIOLOGY, DIAGNOSIS and TREATMENT Dilek Ince Gunal, MD Assoc. Prof Definition Clinical symptoms: Pathogenesis: Etiology: Neurodegenerative syndrome with chronic,
More informationMovement Disorders- Parkinson s Disease. Fahed Saada, MD March 8 th, th Family Medicine Refresher Course St.
Movement Disorders- Parkinson s Disease Fahed Saada, MD March 8 th, 2019 48 th Family Medicine Refresher Course St. Joseph s Health Disclosure ACADIA Pharmaceuticals Objectives Review the classification
More informationParkinson Disease. Lorraine Kalia, MD, PhD, FRCPC. Presented by: Ontario s Geriatric Steering Committee
Parkinson Disease Lorraine Kalia, MD, PhD, FRCPC Key Learnings Parkinson Disease (L. Kalia) Key Learnings Parkinson disease is the most common but not the only cause of parkinsonism Parkinson disease is
More informationShake It Off: Recognizing & Treating Movement Disorders
Ooi Phaik Yee Annual scientific meeting College of Medicine, Academy of Medicine of Malaysia 12 th November 2017 Shake It Off: Recognizing & Treating Movement Disorders MOVEMENT DISORDER A group of symptoms
More informationSTEADY YOUR APPROACH TO TREMOR (OVERVIEW OF DIFFERENTIAL DIAGNOSIS)
STEADY YOUR APPROACH TO TREMOR (OVERVIEW OF DIFFERENTIAL DIAGNOSIS) Karen M. Thomas D.O. Diplomate, ABPN Director of Movement Disorders Program Director of Comprehensive Parkinson s Disease Program Sentara
More informationDepartment of Neurology, Rigshospitalet, 9 Blegdamsvej, PAULSON, O.B. Involuntary Movements. Tohoku J. Exp. Med., 1990, 161,
Tohoku J. Exp. Med., 1990, 161, Suppl., 21-27 Involuntary Movements OLAF B. PAULSON Department of Neurology, Rigshospitalet, 9 Blegdamsvej, DK-2100, Copenhagen, Denmark PAULSON, O.B. Involuntary Movements.
More informationParkinson s Disease and other related movement disorders a video guide to diagnosis
Parkinson s Disease and other related movement disorders a video guide to diagnosis Parkinson s Disease Masterclass November 2017 Dr Frank Phelan MidYorkshire Hospitals NHS Trust Ideopathic Parkinson s
More informationHypokinetic Movement Disorders
Hypokinetic Movement Disorders Ariane Park, MD, MPH Assistant Professor-Clinical Division of Neurology The Ohio State University Wexner Medical Center Hypokinetic movement disorders Diminished voluntary
More informationMovement Disorders. Eric Kraus, MD! Neurology!
Movement Disorders Eric Kraus, MD! Neurology! Classify Bradykinesia! Tic! Myoclonus! Tremor! Dystonia! Athetosis! Chorea! Ballismus! Case 1 This 64 year-old female has had progression of a tremor over
More informationTypes of involuntary movements
Tremor Types of involuntary movements Dystonia Chorea Myoclonus Tics Tremor Rhythmic shaking of muscles that produces an oscillating movement Parkinsonian tremor Rest tremor > posture > kinetic Re-emergent
More informationMovement Disorders. Psychology 372 Physiological Psychology. Background. Myasthenia Gravis. Many Types
Background Movement Disorders Psychology 372 Physiological Psychology Steven E. Meier, Ph.D. Listen to the audio lecture while viewing these slides Early Studies Found some patients with progressive weakness
More informationParkinson s Disease Initial Clinical and Diagnostic Evaluation. J. Timothy Greenamyre, MD, PhD
Parkinson s Disease Initial Clinical and Diagnostic Evaluation J. Timothy Greenamyre, MD, PhD Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported
More informationChildhood Movement Disorders Alessandro Capuano, MD, PhD Federica Graziola, MD
Childhood Movement Disorders Alessandro Capuano, MD, PhD Federica Graziola, MD Movement Disorders Center Department of Neuroscience Bambino Gesù Pediatric Hospital, Rome Two categories: Approach to diagnosis
More informationUpdate on Parkinson s disease and other Movement Disorders October 2018
Update on Parkinson s disease and other Movement Disorders October 2018 DR. JONATHAN EVANS CONSULTANT IN NEUROLOGY QUEEN S MEDICAL CENTRE NOTTINGHAM Disclosures: Honoraria UCB, Britannia, Allergan, AbbVie
More informationMovement disorders in childhood: assessment and diagnosis. Lucinda Carr
Movement disorders in childhood: assessment and diagnosis Lucinda Carr Movement disorders in childhood: Assessment Classification Causes Diagnosis Presentation of movement disorders in childhood: Concerns
More informationParts of the motor circuits
MOVEMENT DISORDERS Parts of the motor circuits cortical centers: there are centers in all the cortical lobes subcortical centers: caudate nucleus putamen pallidum subthalamical nucleus (Luys) nucleus ruber
More informationParkinson s Disease: initial diagnosis, initial treatment & non-motor features. J. Timothy Greenamyre, MD, PhD
Parkinson s Disease: initial diagnosis, initial treatment & non-motor features J. Timothy Greenamyre, MD, PhD Involuntary tremulous motion, with lessened muscular power, in parts not in action and even
More informationVL VA BASAL GANGLIA. FUNCTIONAl COMPONENTS. Function Component Deficits Start/initiation Basal Ganglia Spontan movements
BASAL GANGLIA Chris Cohan, Ph.D. Dept. of Pathology/Anat Sci University at Buffalo I) Overview How do Basal Ganglia affect movement Basal ganglia enhance cortical motor activity and facilitate movement.
More information10/13/2017. Disclosures. Deep Brain Stimulation in the Treatment of Movement Disorders. Deep Brain Stimulation: Objectives.
Deep Brain Stimulation in the Treatment of Movement Disorders Disclosures None Eleanor K Orehek, M.D. Movement Disorders Specialist Noran Neurological Clinic 1 2 Objectives To provide an overview of deep
More informationTable of Contents. Preface... xi. Part I: Introduction to Movement Disorders
Table of Contents Visit www.healthreferenceseries.com to view A Contents Guide to the Health Reference Series, a listing of more than 14,000 topics and the volumes in which they are covered. Preface...
More informationThe motor regulator. 1) Basal ganglia/nucleus
The motor regulator 1) Basal ganglia/nucleus Neural structures involved in the control of movement Basal Ganglia - Components of the basal ganglia - Function of the basal ganglia - Connection and circuits
More informationDr Barry Snow. Neurologist Auckland District Health Board
Dr Barry Snow Neurologist Auckland District Health Board Dystonia and Parkinson s disease Barry Snow Gowers 1888: Tetanoid chorea Dystonia a movement disorder characterized by sustained or intermittent
More informationMAXIMIZING FUNCTION IN PARKINSON S DISEASE
1 MAXIMIZING FUNCTION IN PARKINSON S DISEASE September 13, 2016 End Falls This Falls Conference Jan Goldstein Elman One Step Ahead Mobility Toronto, Ontario Outline An overview of Parkinson s disease (PD):
More informationIssues for Patient Discussion
onmotor complications radykinesia Screening Tools asked PD micrographia eurodegeneration Designed for Use by Family Practitioners remor on-off opamine agonists tiffness depression ostural instability wearing
More informationParkinson s Disease Update. Presented by Joanna O Leary, MD Movement disorder neurologist Providence St. Vincent s
Parkinson s Disease Update Presented by Joanna O Leary, MD Movement disorder neurologist Providence St. Vincent s What is a movement disorder? Neurological disorders that affect ability to move by causing
More informationPathogenesis of Degenerative Diseases and Dementias. D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria)
Pathogenesis of Degenerative Diseases and Dementias D r. Ali Eltayb ( U. of Omdurman. I ). M. Path (U. of Alexandria) Dementias Defined: as the development of memory impairment and other cognitive deficits
More informationMoving fast or moving slow: an overview of Movement Disorders
Moving fast or moving slow: an overview of Movement Disorders Mini Medical School October 25, 2018 Heather Rigby, MD, FRCPC 2014 MFMER slide-1 2014 MFMER slide-2 Basal Ganglia Dysfunction - Movement Disorders
More informationData Collection Worksheets
Data Collection Worksheets PhenX Measure: Antipsychotic Medication Extrapyramidal Side Effects (#661600) PhenX Protocol: Antipsychotic Medication Extrapyramidal Side Effects (#661601) Date of Interview/Examination/Bioassay
More informationEvaluation of Parkinson s Patients and Primary Care Providers
Evaluation of Parkinson s Patients and Primary Care Providers 2018 Movement Disorders Half Day Symposium Elise Anderson MD Medical Co-Director, PBSI Movement Disorders 6/28/2018 1 Disclosures GE Speaker,
More informationOverview. Overview. Parkinson s disease. Secondary Parkinsonism. Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits
Overview Overview Parkinsonism: Motor symptoms associated with impairment in basal ganglia circuits The differential diagnosis of Parkinson s disease Primary vs. Secondary Parkinsonism Proteinopathies:
More informationTremor. Mario Zappia. Università degli Studi di Catania
Tremor Mario Zappia Università degli Studi di Catania Tremor: Definition Rhythmical, Involuntary, Oscillatory movement of a body part Classification of Dyskinesias Based on Rhythmicity Rhythmical Dyskinesias:
More informationMOVEMENT DISORDERS UPDATE H. MURRAY TODD, M.D., F.A.A.N.
MOVEMENT DISORDERS UPDATE H. MURRAY TODD, M.D., F.A.A.N. Movement Disorders Hypokinesia : decreased voluntary and automatic movements Hyperkinesia : excessive movements HYPOKINESIAS Parkinson s disease
More informationDISORDERS OF THE MOTOR SYSTEM. Jeanette J. Norden, Ph.D. Professor Emerita Vanderbilt University School of Medicine
DISORDERS OF THE MOTOR SYSTEM Jeanette J. Norden, Ph.D. Professor Emerita Vanderbilt University School of Medicine THE MOTOR SYSTEM To understand disorders of the motor system, we need to review how a
More informationMargo J Nell Dept Pharmacology
Margo J Nell Dept Pharmacology 1 The extra pyramidal system Separation of cortico-spinal system (pyramidal system, (PS)) from the basal ganglia (extra pyramidal motor system (EPS)) because they produce
More informationJoint Session with ACOFP and Mayo Clinic. Parkinson's Disease: 5 Pearls. Jay Van Gerpen, MD
Joint Session with ACOFP and Mayo Clinic Parkinson's Disease: 5 Pearls Jay Van Gerpen, MD Parkinson s Disease: 5 Pearls J.A. van Gerpen, MD Sections of Movement Disorders and Clinical Neurophysiology
More informationTremor 101. Objectives 9/30/2015. Importance of tremors
Tremor 101 Umer Akbar, MD Assistant Professor, Brown University Movement Disorders Program, Rhode Island Hospital & Butler Hospital Objectives Recognize and describe the qualities of common types of tremor
More informationBasal ganglia Sujata Sofat, class of 2009
Basal ganglia Sujata Sofat, class of 2009 Basal ganglia Objectives Describe the function of the Basal Ganglia in movement Define the BG components and their locations Describe the motor loop of the BG
More informationASHI691: Why We Fall Apart: The Neuroscience and Neurophysiology of Aging. Dr. Olav E. Krigolson Lecture 5: PARKINSONS DISEASE
ASHI691: Why We Fall Apart: The Neuroscience and Neurophysiology of Aging Dr. Olav E. Krigolson krigolson@uvic.ca Lecture 5: PARKINSONS DISEASE The Basal Ganglia Primary motor cortex Execution of movement
More informationUnited Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline
United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline REV 3/24/09 The UCNS Geriatric Neurology examination was established to determine the level of competence
More informationParkinson s Disease. Prevalence. Mark S. Baron, M.D. Cardinal Features. Clinical Characteristics. Not Just a Movement Disorder
Prevalence Parkinson s Disease Mark S. Baron, M.D. Associate Professor of Neurology Movement Disorders Section VCU School of Medicine Common disorder Approaching 1% by 65 yrs of age, 2% by 80 yrs of age
More informationDEEP BRAIN STIMULATION
DEEP BRAIN STIMULATION Non-Discrimination Statement and Multi-Language Interpreter Services information are located at the end of this document. Coverage for services, procedures, medical devices and drugs
More informationM. Carranza M. R. Snyder J. Davenport Shaw T. A. Zesiewicz. Parkinson s Disease. A Guide to Medical Treatment
M. Carranza M. R. Snyder J. Davenport Shaw T. A. Zesiewicz Parkinson s Disease A Guide to Medical Treatment SEEd srl. All rights reserved Piazza Carlo Emanuele II, 19 10123 Torino, Italy Tel. 011.566.02.58
More informationDeep Brain Stimulation: Indications and Ethical Applications
Deep Brain Stimulation Overview Kara D. Beasley, DO, MBe, FACOS Boulder Neurosurgical and Spine Associates (303) 562-1372 Deep Brain Stimulation: Indications and Ethical Applications Instrument of Change
More informationParkinson s Disease Update
Parkinson s Disease Update Elise Anderson MD Providence Center for Parkinson s Disease October 26, 2017 11/6/2017 1 Disclosures GE Speaker, DaTSCAN 11/6/2017 2 Outline PD diagnosis Motor and nonmotor symptoms
More informationMUSCULOSKELETAL AND NEUROLOGICAL DISORDERS
MUSCULOSKELETAL AND NEUROLOGICAL DISORDERS There are a wide variety of Neurologic and Musculoskeletal disorders which can impact driving safety. Impairment may be the result of altered muscular, skeletal,
More informationHyperkinetic movement disorders are. Hyperkinetic Movement Disorders. Cases in Movement Disorders. James case. About Tom
Hyperkinetic Movement Disorders Sarah Furtado, MD, PhD, FRCPC James case A mother brings her son James, 10, to your office because of repetitive sniffing sounds and repetitive eye blinking. This sniffing
More informationCN V! touch! pain! Touch! P/T!
CN V! touch! pain! Touch! P/T! Visual Pathways! L! R! B! A! C! D! LT! E! F! RT! G! hypothalamospinal! and! ALS! Vestibular Pathways! 1. Posture/Balance!!falling! 2. Head Position! 3. Eye-Head Movements
More informationFunctional Distinctions
Functional Distinctions FUNCTION COMPONENT DEFICITS Start Basal Ganglia Spontaneous Movements Move UMN/LMN Cerebral Cortex Brainstem, Spinal cord Roots/peripheral nerves Plan Cerebellum Ataxia Adjust Cerebellum
More informationAtypical parkinsonism
Atypical parkinsonism Wassilios Meissner Service de neurologie et CMR atrophie multisystématisée, CHU de Bordeaux Institut des Maladies Neurodégénératives, Université Bordeaux 2, CNRS UMR 5293 Parkinsonism?
More informationClinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries
Clinical Differences Among Four Common Dementia Syndromes a program of Morningside Ministries Introduction Four clinical dementia syndromes account for 90% of all cases after excluding reversible causes
More informationEnhanced Primary Care Pathway: Parkinson s Disease
Enhanced Primary Care Pathway: Parkinson s Disease 1. Focused summary of PD relevant to primary care Parkinson s Disease (PD) and Essential tremor (ET) are two of the most common movement disorders encountered
More informationTremor What is tremor? What causes tremor? What are the characteristics of tremor? What are the different categories of tremor?
Tremor What is tremor? Tremor is an unintentional, somewhat rhythmic, muscle movement involving to-and-fro movements (oscillations) of one or more parts of the body. It is the most common of all involuntary
More informationPatient selection for surgery: Hyperkinetic movement disorders
Patient selection for surgery: Hyperkinetic movement disorders Alfons Schnitzler, MD, PhD Dept. of Neurology, Movement Disorder and Neuromodulation, Heinrich-Heine-University Düsseldorf, Germany Hyperkinetic
More informationNeonatal Seizure Cases. Courtney Wusthoff, MD MS Assistant Professor, Neurology Neurology Director, LPCH Neuro NICU
Neonatal Seizure Cases Courtney Wusthoff, MD MS Assistant Professor, Neurology Neurology Director, LPCH Neuro NICU Disclosures I have no conflicts of interest I will discuss off-label use of anti-epileptic
More informationSemivoluntary movement (=unvoluntary)
EXTRAPYRAMIDAL DISORDERS = Movement disorders = Degenerative disease 1 4 types of movements: Voluntary movement Semivoluntary movement (=unvoluntary) Involuntary movement Automatic movement 2 3 Movement
More informationApproach to a Neurologic Diagnosis
Approach to a Neurologic Diagnosis Neurologic Diagnosis History Physical & Neurological Examination Ancillary Procedures 3 Questions Asked Focal neurologic deficits Increased intracranial pressure Signs
More informationDone By: manar aljebreen Abdulrahman alsharidah
Female Side Male side Done By: manar aljebreen Abdulrahman alsharidah Revised By: Nour Al-Khawajah Mohammed Asiri 2 Slide No.( 1 ) Slide No.( 2 ) 3 Slide No.( 3 ) Slide No.( 4 ) Upper motor neurons are
More informationReflexes. Dr. Baizer
Reflexes Dr. Baizer 1 Learning objectives: reflexes Students will be able to describe: 1. The clinical importance of testing reflexes. 2. The essential components of spinal reflexes. 3.The stretch reflex.
More informationObjectives. Distinguishing Parkinson s disease from other parkinsonian and tremor syndromes. Characteristics. Basal Ganglia Structures
12:45 1:30 pm PD or not PD? Distinguishing Parkinson s Disease From Other Parkinsonian and Tremor Syndromes SPEAKER Jennifer G. Goldman, MD, MS Presenter Disclosure Information The following relationships
More informationHubert H. Fernandez, MD
Hubert H. Fernandez, MD Associate Professor Co-Director, Movement Disorders Center Director, Clinical Trials for Movement Disorders Program Director, Neurology Residency and Movement Disorders Fellowship
More informationTreatment of Parkinson s Disease: Present and Future
Treatment of Parkinson s Disease: Present and Future Karen Blindauer, MD Professor of Neurology Director of Movement Disorders Program Medical College of Wisconsin Neuropathology: Loss of Dopamine- Producing
More informationClinical Features and Treatment of Parkinson s Disease
Clinical Features and Treatment of Parkinson s Disease Richard Camicioli, MD, FRCPC Cognitive and Movement Disorders Department of Medicine University of Alberta 1 Objectives To review the diagnosis and
More informationFaculty. Joseph Friedman, MD
Faculty Claire Henchcliffe, MD, DPhil Associate Professor of Neurology Weill Cornell Medical College Associate Attending Neurologist New York-Presbyterian Hospital Director of the Parkinson s Institute
More information8/28/2017. Behind the Scenes of Parkinson s Disease
BEHIND THE SCENCES IN Parkinson s Disease Behind the Scenes of Parkinson s Disease Anna Marie Wellins DNP, ANP C Objectives Describe prevalence of Parkinson's disease (PD) Describe the hallmark pathologic
More informationPrior Authorization with Quantity Limit Program Summary
Gocovri (amantadine) Prior Authorization with Quantity Limit Program Summary This prior authorization applies to Commercial, NetResults A series, SourceRx and Health Insurance Marketplace formularies.
More informationCONTRIBUTORS The American Academy of Neurology Institute.
Several of these multiple-choice questions were originally published in Continuum: Lifelong Learning in Neurology Movement Disorders, Volume 22, Issue 4, August 2016 based on the content in the issue developed
More informationApproach to Tremor in Older Adults
Neurology Primer Approach to Tremor in Older Adults Joel S. Hurwitz, MB, FRCPC, FRCP (London), Associate Professor, Department of Medicine (Division of Geriatric Medicine), University of Western Ontario,
More informationClinical Aspects of Movement Disorders:
Clinical Aspects of Movement Disorders: 2 Effects on Walking and Posture Henrique Ballalai Ferraz and Roberta Arb Saba Abstract Movement disorders are a group of syndromes which includes parkinsonism,
More informationMovement Disorders Fox & Hedgehog
Movement Disorders Fox & Hedgehog - Video Show & Tell (Fox Part) - - Focus on Essential Tremor and Parkinson's Disease (Hedgehog Part) - U. Shivraj Sohur, M.D., Ph.D. The Massachusetts General Hospital
More informationObjectives. Amanda Diamond, MD
Amanda Diamond, MD Objectives Recognize symptoms suggestive of seizure and what those clinical symptoms represent Understand classification of epilepsy and why this is important Identify the appropriate
More informationDisorders of gait and balance
Disorders of gait and balance clinical assessment and classification Evžen Růžička Charles University in Prague 1st Medical Faculty and General University Hospital handout additional videos and photos
More informationPARKINSON S DISEASE. Nigrostriatal Dopaminergic Neurons 5/11/16 CARDINAL FEATURES OF PARKINSON S DISEASE. Parkinson s disease
5/11/16 PARKINSON S DISEASE Parkinson s disease Prevalence increases with age (starts 40s60s) Seen in all ethnic groups, M:F about 1.5:1 Second most common neurodegenerative disease Genetics role greater
More informationDystonia: Title. A real pain in the neck. in All the Wrong Places
Focus on CME at the University of Western Ontario Dystonia: Title in All the Wrong Places A real pain in the neck By Mandar Jog, MD, FRCPC and; Mary Jenkins, MD, FRCPC What is dystonia? Dystonia is a neurologic
More informationDeep Brain Stimulation for Parkinson s Disease & Essential Tremor
Deep Brain Stimulation for Parkinson s Disease & Essential Tremor Albert Fenoy, MD Assistant Professor University of Texas at Houston, Health Science Center Current US Approvals Essential Tremor and Parkinsonian
More informationUniversity of Manitoba - MPT: Neurological Clinical Skills Checklist
Name: Site: Assessment Skills Observed Performed Becoming A. Gross motor function i. Describe movement strategies (quality, devices, timeliness, independence): supine sidelying sit stand supine long sitting
More informationTranscranial sonography in movement disorders
Transcranial sonography in movement disorders Uwe Walter 1st Residential Training of the European Society of Neurosonology and Cerebral Hemodynamics September 7-12, 2008 Bertinoro, Italy Department of
More information2/20/18. History of Parkinson s. What is happening in the brain? DOPAMINE! Epidemiology. Parkinson s Disease. It s much more than tremor
Parkinson s Disease History of Parkinson s It s much more than tremor Laura Dixon, DNP, MPA, APRN, FNP-BC University of Louisville Department of Neurology Movement Disorders Division Parkinson s Disease
More informationMultiple choice questions: ANSWERS
Multiple choice questions: ANSWERS Chapter 1. Redefining Parkinson s disease 1. Common non-motor features that precede the motor findings in Parkinson s disease (PD) include all of the following except?
More informationParkinson s Disease WHERE HAVE WE BEEN, WHERE ARE WE HEADING? CHARLECE HUGHES D.O.
Parkinson s Disease WHERE HAVE WE BEEN, WHERE ARE WE HEADING? CHARLECE HUGHES D.O. Parkinson s Epidemiology AFFECTS 1% OF POPULATION OVER 65 MEAN AGE OF ONSET 65 MEN:WOMEN 1.5:1 IDIOPATHIC:HEREDITARY 90:10
More informationPARKINSON S PRIMER. Dr. Kathryn Giles MD, MSc, FRCPC Cambridge, Ontario, Canada
PARKINSON S PRIMER Dr. Kathryn Giles MD, MSc, FRCPC Cambridge, Ontario, Canada COPYRIGHT 2017 BY SEA COURSES INC. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted
More informationSTAFF DEVELOPMENT in SPECIAL EDUCATION
STAFF DEVELOPMENT in SPECIAL EDUCATION Tourette Syndrome AASEP s Staff Development Course TOURETTE SYNDROME Copyright AASEP (2006) 1 of 6 Course Objectives To provide a definition of Tourette syndrome
More informationNervous System. Unit 6.6 (6 th Edition) Chapter 7.6 (7 th Edition)
Nervous System Unit 6.6 (6 th Edition) Chapter 7.6 (7 th Edition) 1 Learning Objectives Identify the main parts (anatomy) of a neuron. Identify the 2 divisions of nervous system. Classify the major types
More informationNeurodegenerative Disease. April 12, Cunningham. Department of Neurosciences
Neurodegenerative Disease April 12, 2017 Cunningham Department of Neurosciences NEURODEGENERATIVE DISEASE Any of a group of hereditary and sporadic conditions characterized by progressive dysfunction,
More informationGENETICS AND TREATMENT OF DYSTONIA
GENETICS AND TREATMENT OF DYSTONIA Oksana Suchowersky, M.D., FRCPC, FCCMG Professor of Medicine, Medical Genetics, and Psychiatry Toupin Research Chair in Neurology DYSTONIA Definition: abnormal sustained
More informationDeep Brain Stimulation: Surgical Process
Deep Brain Stimulation: Surgical Process Kia Shahlaie, MD, PhD Assistant Professor Bronte Endowed Chair in Epilepsy Research Director of Functional Neurosurgery Minimally Invasive Neurosurgery Department
More information