Page 563 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat

Neurology aNd Special SeNSeS ` neurology—PAthology Neurology aNd Special SeNSeS ` neurology—PAthology SecTioN iii 519

Movement disorders
disorder PresentAtion ChArACteristiC lesion notes
Akathisia Restlessness and intense urge Can be seen with neuroleptic
to move. use or as a side effect of
Parkinson treatment.
Asterixis Extension of wrists causes Associated with hepatic
“flapping” motion. encephalopathy, Wilson
disease, and other metabolic
derangements.
Athetosis Slow, snake-like, writhing Basal ganglia. Seen in Huntington disease.
movements; especially seen in
the fingers.
Chorea Sudden, jerky, purposeless Basal ganglia. Chorea = dancing.
movements. Seen in Huntington disease
and in acute rheumatic fever
(Sydenham chorea).
Dystonia Sustained, involuntary muscle Writer’s cramp, blepharospasm,
contractions. torticollis.
Treatment: botulinum toxin
injection.
Essential tremor High-frequency tremor Often familial. Patients often
with sustained posture self- medicate with alcohol,
(eg, outstretched arms), which  tremor amplitude.
worsened with movement or Treatment: nonselective
when anxious. β-blockers (eg, propranolol),
primidone.
Intention tremor Slow, zigzag motion when Cerebellar dysfunction.
pointing/extending toward a
target.
Resting tremor Uncontrolled movement of Substantia nigra (Parkinson Occurs at rest; “pill-rolling
distal appendages (most disease). tremor” of Parkinson disease.
noticeable in hands); tremor When you park your car, it is
alleviated by intentional at rest.
movement.
Hemiballismus Sudden, wild flailing of one Contralateral subthalamic Pronounce “Half-of-body
side of the body. nucleus (eg, lacunar stroke). ballistic.”
Myoclonus Sudden, brief, uncontrolled Jerks; hiccups; common in
muscle contraction. metabolic abnormalities such
as renal and liver failure.
Restless legs Worse at rest/nighttime. Associated with iron deficiency,
syndrome Relieved by movement. CKD.
Treatment: dopamine agonists
(pramipexole, ropinirole).

FAS1_2019_12-Neurol.indd 519 11/8/19 7:39 AM