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Mini Cases in Movement Disorders

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Christy Chan

on 10 June 2014

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Transcript of Mini Cases in Movement Disorders

www.cdc.gov/ncbddd/tourette/images/tourette-data-graphic
Detailed Description:
Case 1 - Kenny
Who?
- Kenny, a teenage boy
What?
- experienced compulsions and uncontrollable facial and body movements and a vocal tic
When?
- began experiencing symptoms from a young age, but got better as he got older; symptoms worsen under stress
Where?
- frequent blinking and lip puckering; compulsions to touch parts of his body; compulsions to wash hands
Why?
- likely has
Tourette Syndrome

Detailed Description:
Case 6 - Jim
Tourette Syndrome
www.aafp.org/afp/1999/0415/afp19990415p2263-f1.gif
parkinsondisease.in/yahoo_site_admin/assets/images/Parkinsons-Disease.204114724_std
Movement Disorders
Prior Knowledge:
Case 1
Kenny most likely has
Tourette Syndrome
Motor and verbal tic(s)
, both of which have occurred for at least a year, and had to have occurred before 18
Sometimes
co-morbid with ADHD and/or OCD
No cure, but tics can be suppressed
Recent research
: MRI parcellation of the frontal lobe in boys with attention deficit hyperactivity disorder or Tourette syndrome
Recent research:
Chronic bilateral thalamic high frequency stimulation (HFS) may be an effective and safe treatment for medically intractable TS in adult patients; unwanted stimulation-induced side effects may occur

Case 2
Jim most likely has
Parkinson’s Disease
Rigidity of muscles, tremors and shaking and a short “shuffling” gait
Either comes from
genetics
or
drug exposure
No treatment, but symptoms can be relieved
Recent research:
Mutation in the α-synuclein gene identified in families with Parkinson's disease
Recent research:
Oxidative processes clearly contribute to the pathology of Parkinson's disease but are probably secondary to some other primary unidentified cause, presumably genetic or environmental
Who?
- Jim, a 70 year old university professor
What?
- After taking Serpalan, Jim started to notice uncontrollable hand and arm shaking. After the new prescription, his hands and arms no longer shook, but he now had a shoulder twitch and noticeable tremors in his right arm and leg. Doctor told him it was due to stress. After a relaxing summer off, doctor insisted on neurological exam.
Results:
mild voice tremor, mild bradykinesia, mild intention tremor of the arm, rigidity of his limbs and trunk
When?
- At the age of 70 after taking Serpalan
Where?
- tremors on the right side of his body
Why?
- very likely has
Parkinson’s disease
http://www.braintumouruk.org.uk/node/216

Bio-psychology
- a branch of psychology that analyzes how the brain and neurotransmitters influence our behaviors, thoughts and feelings

Frontal Lobe
-contains the
primary motor cortex
, which contains a map of the body areas that can be voluntarily controlled
-contains
premotor and supplementary motor areas
that are involved in movement planning
-control is
contralateral
(hemispheres control opposite body side)

Motor Cortex
- controls voluntary movements

Basal Ganglia
-a region part of the gray matter within the brain
-aids in voluntary movement

Neurotransmitter
- a chemical messenger that carries, boosts and modulates signals between neurons and other cells in the body
Movement Disorders
• Neurological conditions that affect the
speed, fluency, quality, and ease of movement
• Abnormal fluency or speed of movement (called
dyskinesia
) may involve excessive or involuntary movement (
hyperkinesia
) or slowed or absent voluntary movement (
hypokinesia
)
• Associated with pathological changes in the brain especially in the
basal ganglia
• Defects may also lie in the base of the brain or the
cerebellum
-leads to difficulty in walking, locomotion or maintenance of posture and normal body balance
• Movement disorders are widely prevalent and many of them have
genetics
as the common cause
"Common Causes of Bradykinesia." Right Diagnosis. Health Grades Inc., Mar.-Apr. 2014. Web. 08 June 2014.
Dubuc, Bruno. "THE BRAIN FROM TOP TO BOTTOM." THE BRAIN FROM TOP TO BOTTOM. N.p., 2002. Web. 08 June 2014.
"NINDS Parkinson's Disease Information Page." Parkinson's Disease Information Page: National Institute of Neurological Disorders and Stroke (NINDS). National Institutes of Health, 6 June 2014. Web. 07 June 2014.
"Statistics by Country for Parkinson's Disease." Right Diagnosis. Health Grades Inc., n.d. Web. 08 June 2014.
"What Are Neurotransmitters?" What Are Neurotransmitters? Vertex Site Press, 2014. Web. 08 June 2014.
"What Is Tourette Syndrome Descrip History." What Is Tourette Syndrome Descrip History. Tourette Syndrome Association, Inc., 2007. Web. 06 June 2014.
http://wileywitch.com/2013/medicine/brain-neurons-longevity/
Tourette Syndrome
• A tic disorder defined by multiple physical tics and at least one vocal tic
• Areas of the brain involved are the basal ganglia, frontal lobes, and cortex
http://www.schoolbehavior.com/disorders/tourettes-syndrome/
http://3.bp.blogspot.com/-rbcp_ZIeMaI/UwzFsGLcJGI/AAAAAAAAKsk/AZX1Y2xabwk/s1600/Tourette+syndrome
Parkinson's Disease
• A progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movement (
bradykinesia
)
• Chiefly affecting middle-aged and elderly people
• Associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter
dopamine
http://www.doctortipster.com/10064-parkinson-disease-symptoms-and-diagnosis.html
Citations
Mini Cases in
Movement Disorders


Vincent Cangiarella, Christy Chan,
Melissa Gallo, Jason Lukose
{Period 2}
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