SlideShare a Scribd company logo
1 of 24
Download to read offline
Movement disorders   Dr. Mohamad Shaikhani.
1. Tremor: Rest tremore of parkisonism. Action tremore Flabing tremor of organ failure Intention tremore of cerebellar diseases 2. Myclonus 3.Tics  4. Extrapyramidal movement disorders
CAUSES OF ACTION TREMOR : Exaggerated physiological tremor  Essential tremor (familial)  Wilson's disease  Postural ('Holmes', 'rubral') tremor  Multiple sclerosis  Intention tremor of cerebellar lesions
CAUSES OF EXAGGERATED PHYSIOLOGICAL TREMOR Anxiety/Fatigue   Endocrine  Thyrotoxicosis  Cushing's disease  Phaeochromocytoma  Hypoglycaemia  Drugs  β-agonists (e.g. salbutamol) /Theophylline  Caffeine /Lithium  Dopamine agonists /Sodium valproate  Tricyclics /Phenothiazines /Amphetamines  Toxins  Mercury /Lead /Arsenic  Alcohol withdrawal
CAUSES OF ASTERIXIS (flabing tremor) Renal failure  Liver failure  Hypercapnic Resp Failure  Drug toxicity (e.g. phenytoin)  Acute focal parietal or thalamic lesions
Myoclonus: Brief, isolated, random, non-purposeful jerks of muscle groups in the limbs, may occur normally at the onset of sleep (hypnic jerks).  A myoclonic jerk is a component of the normal startle response which may be exaggerated in some rare (mostly genetic) disorders. Unlike EP movement disorders, myoclonus may occur in disorders of the cerebral cortex, when groups of pyramidal cells fire spontaneously. Causes:   M yoclonic epilepsy in which the jerks are fragments of seizure activity.  Subcortical structures. Rarely, from diseased segments of the spinal cord.  Treatment: Myoclonus, especially of cortical origin, often responds to clonazepam, sodium valproate or piracetam.
Tics:  Repetitive semi-purposeful movements as blinking, winking, grinning or screwing up of the eyes.  Distinguished from other involuntary movements by the ability of the patient to suppress their occurrence, at least for a short time.  An isolated tic may be no more than a mild embarrassment, but may become frequent at certain times in childhood & then disappear.  The uncommon syndrome of Gilles de la Tourette consists of a tendency to multiple tics & odd vocalisations, with obsessive behavioural abnormalities.  The pathogenic basis is not understood, but there may be some response to major tranquillisers.
Extrapyramidal Movement disorders
Movement disorder Site of lesion. Parkinsonism. Chorea. Dystonia& athetosis. Hemibalismus. Substantia nigra & corpus striatum. Caudate nucleus. Putamin & corpus striatum. Subthalamic nucleus.
Other movement disorders: Chorea Hemibalismus. Athetosis & dystonias: Tardive dyskinesia:
Chorea, athetosis, ballism & dystonia  : ,[object Object],[object Object]
Hemibalismus:   ,[object Object],[object Object],[object Object]
Chorea(dance in Greek)  :   ,[object Object],[object Object],[object Object],[object Object]
Chorea  :causes   Hereditary  Huntington's disease /Wilson's/Neuroacanthocytosis  Porphyria  Paroxysmal choreoathetosis  Cerebral birth injury (including kernicterus) Cerebral trauma Drugs  Levodopa /Dopamine agonists /Phenothiazines /Tricyclics  Oral contraceptive  Pregnancy  Endocrine: Thyrotoxicosis /Hypoparathyroidism /Hypoglycaemia  Infective/inflammatory  Post-streptococcal (Sydenham's chorea)  Henoch-Schönlein purpura  Creutzfeldt-Jakob disease  Antiphospholipid antibody syndrome  SLE   Vascular:  Lacunar infarction /Arteriovenous malformation
Athetosis & dystonias:   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Athetosis & dystonias:   ,[object Object],[object Object],[object Object]
Athetosis & dystonias:   ,[object Object],[object Object],[object Object],[object Object]
Tardive dyskinesia: ,[object Object],[object Object],[object Object]
Paraneoplastic neurological features: ,[object Object]
Paraneoplastic neurological features: Brain & cerebellum. Neuroblastoma, Lung Ca. Dancing eye & feet,ataxia. Opsoclonus – myoclonus. SCC,Ovarian,breast,Hodgkin. Ataxia, dysarthria. Subacute cerebellar degener SCC Nystagmus,diplopia,vertigo. Brainstem = SCC Agitation,confusion, dementia. Limbic encephalitis. SCC,rarely cerv Visual loss to blind Photorec retinal degeneration.
Paraneoplastic neurological features: spinal cord. SCC Nystagmus,diplopia,vertigo. Subacute motor neuropathy. SCC, lymphoma Para, quadriplegia,areflexia, sensory loss, bladder dysf. Necrotizing myelopathy. Causative Ca. Features Site
Paraneoplastic neurological features: Peripheral nerve. SCC & others. Distal sensory & motor loss with areflexia. Subacute sensory & sensimotor neuropathy. Neuroblastoma, Lung Ca. Dancing eye & feet,ataxia. Opsoclonus – myoclonus. Myeloma specially osteosclerotic type. Chronic, sensory or motor. Neuropathy with paraproteinemia. Lung, breast,gastric,lymphoma,myeloma. Chronic weakness & sensory loss Chronic demyelinating PN. Hohgkin lymphoma Assending paralysis, areflexia. Gullain Barre. Causative Ca. Features Site
Paraneoplastic neurological features: NMJ. = = Myasthenia gravis. SCC,Thymoma, breast,prostate, stomach. Mentioned before. Eaton – Lambert or myasthenic syndrome. Causative Ca. Features Site
Paraneoplastic neurological features: Muscle. SCC, other lung Cas. Rapidly progressive Proximal weakness, dysphagia & dyspnea Necrotizing myopathy. breast,ovary, lung,lymphoma. Proximal weakness,myalgia,CMP, High CK. Polymyositis. Causative Ca. Features Site

More Related Content

What's hot

Involuntary movements
Involuntary movementsInvoluntary movements
Involuntary movementsVitrag Shah
 
approach to Dystonia and myoclonus movement disorders
approach to Dystonia and myoclonus movement disordersapproach to Dystonia and myoclonus movement disorders
approach to Dystonia and myoclonus movement disordersOsama Ragab
 
Hyperkinetic movement disorders
Hyperkinetic movement disordersHyperkinetic movement disorders
Hyperkinetic movement disordersKavindya Fernando
 
Approach to treatment of movement disorders
Approach to treatment of movement disordersApproach to treatment of movement disorders
Approach to treatment of movement disorderschindo mallum
 
Pediatric movement disorders
Pediatric movement disordersPediatric movement disorders
Pediatric movement disordersKiran Sharma
 
Athetosis and dystonia
Athetosis and dystoniaAthetosis and dystonia
Athetosis and dystoniaPS Deb
 
Movement disorders
Movement disordersMovement disorders
Movement disordersRavi Soni
 
Management of Tremor
Management of Tremor Management of Tremor
Management of Tremor PS Deb
 
An approach to a child with abnormal movement
An approach to a child with abnormal movementAn approach to a child with abnormal movement
An approach to a child with abnormal movementSunil Agrawal
 
Movement disorders
Movement disordersMovement disorders
Movement disordersHelao Silas
 
Movement Disorders ShortNote
Movement Disorders ShortNoteMovement Disorders ShortNote
Movement Disorders ShortNoteKavindya Fernando
 
Abnormal body movement in children
Abnormal body movement in childrenAbnormal body movement in children
Abnormal body movement in childrenMaryamAbdulqadir
 

What's hot (20)

Involuntary movements
Involuntary movementsInvoluntary movements
Involuntary movements
 
movement disorders
 movement disorders movement disorders
movement disorders
 
approach to Dystonia and myoclonus movement disorders
approach to Dystonia and myoclonus movement disordersapproach to Dystonia and myoclonus movement disorders
approach to Dystonia and myoclonus movement disorders
 
Hyperkinetic movement disorders
Hyperkinetic movement disordersHyperkinetic movement disorders
Hyperkinetic movement disorders
 
Pediatric movement disorder
Pediatric movement disorderPediatric movement disorder
Pediatric movement disorder
 
Approach to treatment of movement disorders
Approach to treatment of movement disordersApproach to treatment of movement disorders
Approach to treatment of movement disorders
 
Movement disorder
Movement disorderMovement disorder
Movement disorder
 
Pediatric movement disorders
Pediatric movement disordersPediatric movement disorders
Pediatric movement disorders
 
Athetosis and dystonia
Athetosis and dystoniaAthetosis and dystonia
Athetosis and dystonia
 
Movement Disorders
Movement DisordersMovement Disorders
Movement Disorders
 
Movement disorders
Movement disordersMovement disorders
Movement disorders
 
Movement disorder
Movement disorderMovement disorder
Movement disorder
 
Management of Tremor
Management of Tremor Management of Tremor
Management of Tremor
 
An approach to a child with abnormal movement
An approach to a child with abnormal movementAn approach to a child with abnormal movement
An approach to a child with abnormal movement
 
MEDICATION INDUCED MOVEMENT DISORDERS
MEDICATION INDUCED MOVEMENT DISORDERSMEDICATION INDUCED MOVEMENT DISORDERS
MEDICATION INDUCED MOVEMENT DISORDERS
 
Movement disorders
Movement disordersMovement disorders
Movement disorders
 
Presentation1
Presentation1Presentation1
Presentation1
 
Movement Disorders ShortNote
Movement Disorders ShortNoteMovement Disorders ShortNote
Movement Disorders ShortNote
 
Abnormal body movement in children
Abnormal body movement in childrenAbnormal body movement in children
Abnormal body movement in children
 
Movement disorders
Movement disordersMovement disorders
Movement disorders
 

Similar to Cns Movement2007.

practical approach to movement disorders by M.Habeel.pdf
practical approach to movement disorders by M.Habeel.pdfpractical approach to movement disorders by M.Habeel.pdf
practical approach to movement disorders by M.Habeel.pdfMohamed Habeel
 
03 01-06 approach to ataxia
03 01-06 approach to ataxia03 01-06 approach to ataxia
03 01-06 approach to ataxiaAndrea Pardo
 
Ataxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxj
Ataxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxjAtaxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxj
Ataxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxjepicsoundever
 
seizure and vertigo.pptx
seizure and vertigo.pptxseizure and vertigo.pptx
seizure and vertigo.pptxBIMALESHYADAV2
 
Movement Disorders (pract).ppt...... .....
Movement Disorders (pract).ppt...... .....Movement Disorders (pract).ppt...... .....
Movement Disorders (pract).ppt...... .....TARUNKUMAR472866
 
EXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHANEXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHANthesalberry
 
EXTRAPYRAMIDAL DISEASES NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES  NANNIKA PRADHANEXTRAPYRAMIDAL DISEASES  NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES NANNIKA PRADHANNannikaPradhan
 
dystonia upt.pptx
dystonia upt.pptxdystonia upt.pptx
dystonia upt.pptxCheruKetema
 
Navin agrawal syncope presentation
Navin agrawal syncope presentationNavin agrawal syncope presentation
Navin agrawal syncope presentationNavin Agrawal
 
Neurological differential diagnosis...Vertigo
Neurological differential diagnosis...VertigoNeurological differential diagnosis...Vertigo
Neurological differential diagnosis...VertigoProfessor Yasser Metwally
 
Parkinson’s disease
Parkinson’s diseaseParkinson’s disease
Parkinson’s diseaseRenard Mulla
 
The Shake Down: An In-Depth Look at Epilepsy
The Shake Down: An In-Depth Look at EpilepsyThe Shake Down: An In-Depth Look at Epilepsy
The Shake Down: An In-Depth Look at EpilepsyAmanda Furda
 
The shake down: An in depth look at epilepsy
The shake down: An in depth look at epilepsyThe shake down: An in depth look at epilepsy
The shake down: An in depth look at epilepsyupstatevet
 
Akinetic rigid syndrome
Akinetic rigid syndromeAkinetic rigid syndrome
Akinetic rigid syndromePS Deb
 
Epilepsy and its homeopathic treatment in Chembur,Mumbai,India
Epilepsy and its homeopathic treatment in Chembur,Mumbai,IndiaEpilepsy and its homeopathic treatment in Chembur,Mumbai,India
Epilepsy and its homeopathic treatment in Chembur,Mumbai,IndiaShewta shetty
 

Similar to Cns Movement2007. (20)

practical approach to movement disorders by M.Habeel.pdf
practical approach to movement disorders by M.Habeel.pdfpractical approach to movement disorders by M.Habeel.pdf
practical approach to movement disorders by M.Habeel.pdf
 
Common Neurological Disorders for undergraduates( MBBS, NURSING,PHRMA STUDENT...
Common Neurological Disorders for undergraduates( MBBS, NURSING,PHRMA STUDENT...Common Neurological Disorders for undergraduates( MBBS, NURSING,PHRMA STUDENT...
Common Neurological Disorders for undergraduates( MBBS, NURSING,PHRMA STUDENT...
 
03 01-06 approach to ataxia
03 01-06 approach to ataxia03 01-06 approach to ataxia
03 01-06 approach to ataxia
 
Ataxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxj
Ataxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxjAtaxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxj
Ataxia.pptx dbdhndjsjsjdkjzjxjdbfbxnzndndnxj
 
ttt
tttttt
ttt
 
Approach to coma
Approach to comaApproach to coma
Approach to coma
 
seizure and vertigo.pptx
seizure and vertigo.pptxseizure and vertigo.pptx
seizure and vertigo.pptx
 
Movement Disorders (pract).ppt...... .....
Movement Disorders (pract).ppt...... .....Movement Disorders (pract).ppt...... .....
Movement Disorders (pract).ppt...... .....
 
EXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHANEXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES-DR NANNIKA PRADHAN
 
EXTRAPYRAMIDAL DISEASES NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES  NANNIKA PRADHANEXTRAPYRAMIDAL DISEASES  NANNIKA PRADHAN
EXTRAPYRAMIDAL DISEASES NANNIKA PRADHAN
 
dystonia upt.pptx
dystonia upt.pptxdystonia upt.pptx
dystonia upt.pptx
 
Navin agrawal syncope presentation
Navin agrawal syncope presentationNavin agrawal syncope presentation
Navin agrawal syncope presentation
 
Neurological differential diagnosis...Vertigo
Neurological differential diagnosis...VertigoNeurological differential diagnosis...Vertigo
Neurological differential diagnosis...Vertigo
 
Parkinson’s disease
Parkinson’s diseaseParkinson’s disease
Parkinson’s disease
 
Anti-epileptics.pptx
Anti-epileptics.pptxAnti-epileptics.pptx
Anti-epileptics.pptx
 
The Shake Down: An In-Depth Look at Epilepsy
The Shake Down: An In-Depth Look at EpilepsyThe Shake Down: An In-Depth Look at Epilepsy
The Shake Down: An In-Depth Look at Epilepsy
 
The shake down: An in depth look at epilepsy
The shake down: An in depth look at epilepsyThe shake down: An in depth look at epilepsy
The shake down: An in depth look at epilepsy
 
Akinetic rigid syndrome
Akinetic rigid syndromeAkinetic rigid syndrome
Akinetic rigid syndrome
 
Ataxia
AtaxiaAtaxia
Ataxia
 
Epilepsy and its homeopathic treatment in Chembur,Mumbai,India
Epilepsy and its homeopathic treatment in Chembur,Mumbai,IndiaEpilepsy and its homeopathic treatment in Chembur,Mumbai,India
Epilepsy and its homeopathic treatment in Chembur,Mumbai,India
 

More from Shaikhani.

Git j club fiber in git20
Git j club fiber in git20Git j club fiber in git20
Git j club fiber in git20Shaikhani.
 
Med j club mm covid20
Med j  club mm covid20Med j  club mm covid20
Med j club mm covid20Shaikhani.
 
GIT J Club IBD- sexual dysfunction20.
GIT J Club IBD- sexual dysfunction20.GIT J Club IBD- sexual dysfunction20.
GIT J Club IBD- sexual dysfunction20.Shaikhani.
 
GIT J Club IBD- pregnancy2020
GIT J Club IBD- pregnancy2020GIT J Club IBD- pregnancy2020
GIT J Club IBD- pregnancy2020Shaikhani.
 
Med 5th geriatrics20
Med 5th geriatrics20Med 5th geriatrics20
Med 5th geriatrics20Shaikhani.
 
GIT 4th abd wall pain
GIT 4th abd wall painGIT 4th abd wall pain
GIT 4th abd wall painShaikhani.
 
GIT 4th endoscopy indications20
GIT 4th endoscopy indications20GIT 4th endoscopy indications20
GIT 4th endoscopy indications20Shaikhani.
 
GIT J Club from UEG Week 2018.
GIT J Club from UEG Week 2018.GIT J Club from UEG Week 2018.
GIT J Club from UEG Week 2018.Shaikhani.
 
Med j club dm antithrombosis19
Med j club dm antithrombosis19Med j club dm antithrombosis19
Med j club dm antithrombosis19Shaikhani.
 
GIT J Club IBS NEJM17.
GIT J Club IBS NEJM17.GIT J Club IBS NEJM17.
GIT J Club IBS NEJM17.Shaikhani.
 
GIT 4th indication for upper GI endoscopy.
GIT 4th indication for upper GI endoscopy.GIT 4th indication for upper GI endoscopy.
GIT 4th indication for upper GI endoscopy.Shaikhani.
 
GIT Cholestatic AI HBD 17
GIT Cholestatic AI HBD 17 GIT Cholestatic AI HBD 17
GIT Cholestatic AI HBD 17 Shaikhani.
 
GiIT 4th CRC 2017.
GiIT 4th CRC 2017.GiIT 4th CRC 2017.
GiIT 4th CRC 2017.Shaikhani.
 
Git j club colonoscopy mistakes.
Git j club colonoscopy mistakes.Git j club colonoscopy mistakes.
Git j club colonoscopy mistakes.Shaikhani.
 
GIT 4th ibd 2017
GIT 4th ibd 2017GIT 4th ibd 2017
GIT 4th ibd 2017Shaikhani.
 
GIT 4th IBS 2017
GIT 4th IBS 2017GIT 4th IBS 2017
GIT 4th IBS 2017Shaikhani.
 
Ppi seminar hiwa.
Ppi seminar hiwa.Ppi seminar hiwa.
Ppi seminar hiwa.Shaikhani.
 
Ppi symposium araz.
Ppi symposium araz.Ppi symposium araz.
Ppi symposium araz.Shaikhani.
 
Ppi symposium muhsin
Ppi symposium muhsinPpi symposium muhsin
Ppi symposium muhsinShaikhani.
 

More from Shaikhani. (20)

Git j club fiber in git20
Git j club fiber in git20Git j club fiber in git20
Git j club fiber in git20
 
Med j club mm covid20
Med j  club mm covid20Med j  club mm covid20
Med j club mm covid20
 
GIT J Club IBD- sexual dysfunction20.
GIT J Club IBD- sexual dysfunction20.GIT J Club IBD- sexual dysfunction20.
GIT J Club IBD- sexual dysfunction20.
 
GIT J Club IBD- pregnancy2020
GIT J Club IBD- pregnancy2020GIT J Club IBD- pregnancy2020
GIT J Club IBD- pregnancy2020
 
Med 5th geriatrics20
Med 5th geriatrics20Med 5th geriatrics20
Med 5th geriatrics20
 
GIT 4th abd wall pain
GIT 4th abd wall painGIT 4th abd wall pain
GIT 4th abd wall pain
 
GIT 4th endoscopy indications20
GIT 4th endoscopy indications20GIT 4th endoscopy indications20
GIT 4th endoscopy indications20
 
GIT J Club from UEG Week 2018.
GIT J Club from UEG Week 2018.GIT J Club from UEG Week 2018.
GIT J Club from UEG Week 2018.
 
Med j club dm antithrombosis19
Med j club dm antithrombosis19Med j club dm antithrombosis19
Med j club dm antithrombosis19
 
Git 4th GC18.
Git 4th GC18.Git 4th GC18.
Git 4th GC18.
 
GIT J Club IBS NEJM17.
GIT J Club IBS NEJM17.GIT J Club IBS NEJM17.
GIT J Club IBS NEJM17.
 
GIT 4th indication for upper GI endoscopy.
GIT 4th indication for upper GI endoscopy.GIT 4th indication for upper GI endoscopy.
GIT 4th indication for upper GI endoscopy.
 
GIT Cholestatic AI HBD 17
GIT Cholestatic AI HBD 17 GIT Cholestatic AI HBD 17
GIT Cholestatic AI HBD 17
 
GiIT 4th CRC 2017.
GiIT 4th CRC 2017.GiIT 4th CRC 2017.
GiIT 4th CRC 2017.
 
Git j club colonoscopy mistakes.
Git j club colonoscopy mistakes.Git j club colonoscopy mistakes.
Git j club colonoscopy mistakes.
 
GIT 4th ibd 2017
GIT 4th ibd 2017GIT 4th ibd 2017
GIT 4th ibd 2017
 
GIT 4th IBS 2017
GIT 4th IBS 2017GIT 4th IBS 2017
GIT 4th IBS 2017
 
Ppi seminar hiwa.
Ppi seminar hiwa.Ppi seminar hiwa.
Ppi seminar hiwa.
 
Ppi symposium araz.
Ppi symposium araz.Ppi symposium araz.
Ppi symposium araz.
 
Ppi symposium muhsin
Ppi symposium muhsinPpi symposium muhsin
Ppi symposium muhsin
 

Recently uploaded

Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...DhatriParmar
 
Narcotic and Non Narcotic Analgesic..pdf
Narcotic and Non Narcotic Analgesic..pdfNarcotic and Non Narcotic Analgesic..pdf
Narcotic and Non Narcotic Analgesic..pdfPrerana Jadhav
 
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...DhatriParmar
 
MS4 level being good citizen -imperative- (1) (1).pdf
MS4 level   being good citizen -imperative- (1) (1).pdfMS4 level   being good citizen -imperative- (1) (1).pdf
MS4 level being good citizen -imperative- (1) (1).pdfMr Bounab Samir
 
Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17Celine George
 
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptxDecoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptxDhatriParmar
 
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...Association for Project Management
 
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxGrade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxkarenfajardo43
 
How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17Celine George
 
Objectives n learning outcoms - MD 20240404.pptx
Objectives n learning outcoms - MD 20240404.pptxObjectives n learning outcoms - MD 20240404.pptx
Objectives n learning outcoms - MD 20240404.pptxMadhavi Dharankar
 
How to Uninstall a Module in Odoo 17 Using Command Line
How to Uninstall a Module in Odoo 17 Using Command LineHow to Uninstall a Module in Odoo 17 Using Command Line
How to Uninstall a Module in Odoo 17 Using Command LineCeline George
 
Q-Factor General Quiz-7th April 2024, Quiz Club NITW
Q-Factor General Quiz-7th April 2024, Quiz Club NITWQ-Factor General Quiz-7th April 2024, Quiz Club NITW
Q-Factor General Quiz-7th April 2024, Quiz Club NITWQuiz Club NITW
 
Scientific Writing :Research Discourse
Scientific  Writing :Research  DiscourseScientific  Writing :Research  Discourse
Scientific Writing :Research DiscourseAnita GoswamiGiri
 
Unraveling Hypertext_ Analyzing Postmodern Elements in Literature.pptx
Unraveling Hypertext_ Analyzing  Postmodern Elements in  Literature.pptxUnraveling Hypertext_ Analyzing  Postmodern Elements in  Literature.pptx
Unraveling Hypertext_ Analyzing Postmodern Elements in Literature.pptxDhatriParmar
 
31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...
31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...
31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...Nguyen Thanh Tu Collection
 
4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptx4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptxmary850239
 
Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...
Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...
Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...DrVipulVKapoor
 
BIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptx
BIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptxBIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptx
BIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptxSayali Powar
 

Recently uploaded (20)

Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
Beauty Amidst the Bytes_ Unearthing Unexpected Advantages of the Digital Wast...
 
Narcotic and Non Narcotic Analgesic..pdf
Narcotic and Non Narcotic Analgesic..pdfNarcotic and Non Narcotic Analgesic..pdf
Narcotic and Non Narcotic Analgesic..pdf
 
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
Blowin' in the Wind of Caste_ Bob Dylan's Song as a Catalyst for Social Justi...
 
MS4 level being good citizen -imperative- (1) (1).pdf
MS4 level   being good citizen -imperative- (1) (1).pdfMS4 level   being good citizen -imperative- (1) (1).pdf
MS4 level being good citizen -imperative- (1) (1).pdf
 
Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17Tree View Decoration Attribute in the Odoo 17
Tree View Decoration Attribute in the Odoo 17
 
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptxDecoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
Decoding the Tweet _ Practical Criticism in the Age of Hashtag.pptx
 
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
Team Lead Succeed – Helping you and your team achieve high-performance teamwo...
 
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptxGrade Three -ELLNA-REVIEWER-ENGLISH.pptx
Grade Three -ELLNA-REVIEWER-ENGLISH.pptx
 
How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17How to Manage Buy 3 Get 1 Free in Odoo 17
How to Manage Buy 3 Get 1 Free in Odoo 17
 
Objectives n learning outcoms - MD 20240404.pptx
Objectives n learning outcoms - MD 20240404.pptxObjectives n learning outcoms - MD 20240404.pptx
Objectives n learning outcoms - MD 20240404.pptx
 
How to Uninstall a Module in Odoo 17 Using Command Line
How to Uninstall a Module in Odoo 17 Using Command LineHow to Uninstall a Module in Odoo 17 Using Command Line
How to Uninstall a Module in Odoo 17 Using Command Line
 
Q-Factor General Quiz-7th April 2024, Quiz Club NITW
Q-Factor General Quiz-7th April 2024, Quiz Club NITWQ-Factor General Quiz-7th April 2024, Quiz Club NITW
Q-Factor General Quiz-7th April 2024, Quiz Club NITW
 
Scientific Writing :Research Discourse
Scientific  Writing :Research  DiscourseScientific  Writing :Research  Discourse
Scientific Writing :Research Discourse
 
Plagiarism,forms,understand about plagiarism,avoid plagiarism,key significanc...
Plagiarism,forms,understand about plagiarism,avoid plagiarism,key significanc...Plagiarism,forms,understand about plagiarism,avoid plagiarism,key significanc...
Plagiarism,forms,understand about plagiarism,avoid plagiarism,key significanc...
 
Unraveling Hypertext_ Analyzing Postmodern Elements in Literature.pptx
Unraveling Hypertext_ Analyzing  Postmodern Elements in  Literature.pptxUnraveling Hypertext_ Analyzing  Postmodern Elements in  Literature.pptx
Unraveling Hypertext_ Analyzing Postmodern Elements in Literature.pptx
 
31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...
31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...
31 ĐỀ THI THỬ VÀO LỚP 10 - TIẾNG ANH - FORM MỚI 2025 - 40 CÂU HỎI - BÙI VĂN V...
 
4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptx4.11.24 Poverty and Inequality in America.pptx
4.11.24 Poverty and Inequality in America.pptx
 
Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...
Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...
Geoffrey Chaucer Works II UGC NET JRF TGT PGT MA PHD Entrance Exam II History...
 
BIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptx
BIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptxBIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptx
BIOCHEMISTRY-CARBOHYDRATE METABOLISM CHAPTER 2.pptx
 
CARNAVAL COM MAGIA E EUFORIA _
CARNAVAL COM MAGIA E EUFORIA            _CARNAVAL COM MAGIA E EUFORIA            _
CARNAVAL COM MAGIA E EUFORIA _
 

Cns Movement2007.

  • 1. Movement disorders Dr. Mohamad Shaikhani.
  • 2. 1. Tremor: Rest tremore of parkisonism. Action tremore Flabing tremor of organ failure Intention tremore of cerebellar diseases 2. Myclonus 3.Tics 4. Extrapyramidal movement disorders
  • 3. CAUSES OF ACTION TREMOR : Exaggerated physiological tremor Essential tremor (familial) Wilson's disease Postural ('Holmes', 'rubral') tremor Multiple sclerosis Intention tremor of cerebellar lesions
  • 4. CAUSES OF EXAGGERATED PHYSIOLOGICAL TREMOR Anxiety/Fatigue Endocrine Thyrotoxicosis Cushing's disease Phaeochromocytoma Hypoglycaemia Drugs β-agonists (e.g. salbutamol) /Theophylline Caffeine /Lithium Dopamine agonists /Sodium valproate Tricyclics /Phenothiazines /Amphetamines Toxins Mercury /Lead /Arsenic Alcohol withdrawal
  • 5. CAUSES OF ASTERIXIS (flabing tremor) Renal failure Liver failure Hypercapnic Resp Failure Drug toxicity (e.g. phenytoin) Acute focal parietal or thalamic lesions
  • 6. Myoclonus: Brief, isolated, random, non-purposeful jerks of muscle groups in the limbs, may occur normally at the onset of sleep (hypnic jerks). A myoclonic jerk is a component of the normal startle response which may be exaggerated in some rare (mostly genetic) disorders. Unlike EP movement disorders, myoclonus may occur in disorders of the cerebral cortex, when groups of pyramidal cells fire spontaneously. Causes: M yoclonic epilepsy in which the jerks are fragments of seizure activity. Subcortical structures. Rarely, from diseased segments of the spinal cord. Treatment: Myoclonus, especially of cortical origin, often responds to clonazepam, sodium valproate or piracetam.
  • 7. Tics: Repetitive semi-purposeful movements as blinking, winking, grinning or screwing up of the eyes. Distinguished from other involuntary movements by the ability of the patient to suppress their occurrence, at least for a short time. An isolated tic may be no more than a mild embarrassment, but may become frequent at certain times in childhood & then disappear. The uncommon syndrome of Gilles de la Tourette consists of a tendency to multiple tics & odd vocalisations, with obsessive behavioural abnormalities. The pathogenic basis is not understood, but there may be some response to major tranquillisers.
  • 9. Movement disorder Site of lesion. Parkinsonism. Chorea. Dystonia& athetosis. Hemibalismus. Substantia nigra & corpus striatum. Caudate nucleus. Putamin & corpus striatum. Subthalamic nucleus.
  • 10. Other movement disorders: Chorea Hemibalismus. Athetosis & dystonias: Tardive dyskinesia:
  • 11.
  • 12.
  • 13.
  • 14. Chorea :causes Hereditary Huntington's disease /Wilson's/Neuroacanthocytosis Porphyria Paroxysmal choreoathetosis Cerebral birth injury (including kernicterus) Cerebral trauma Drugs Levodopa /Dopamine agonists /Phenothiazines /Tricyclics Oral contraceptive Pregnancy Endocrine: Thyrotoxicosis /Hypoparathyroidism /Hypoglycaemia Infective/inflammatory Post-streptococcal (Sydenham's chorea) Henoch-Schönlein purpura Creutzfeldt-Jakob disease Antiphospholipid antibody syndrome SLE Vascular: Lacunar infarction /Arteriovenous malformation
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20. Paraneoplastic neurological features: Brain & cerebellum. Neuroblastoma, Lung Ca. Dancing eye & feet,ataxia. Opsoclonus – myoclonus. SCC,Ovarian,breast,Hodgkin. Ataxia, dysarthria. Subacute cerebellar degener SCC Nystagmus,diplopia,vertigo. Brainstem = SCC Agitation,confusion, dementia. Limbic encephalitis. SCC,rarely cerv Visual loss to blind Photorec retinal degeneration.
  • 21. Paraneoplastic neurological features: spinal cord. SCC Nystagmus,diplopia,vertigo. Subacute motor neuropathy. SCC, lymphoma Para, quadriplegia,areflexia, sensory loss, bladder dysf. Necrotizing myelopathy. Causative Ca. Features Site
  • 22. Paraneoplastic neurological features: Peripheral nerve. SCC & others. Distal sensory & motor loss with areflexia. Subacute sensory & sensimotor neuropathy. Neuroblastoma, Lung Ca. Dancing eye & feet,ataxia. Opsoclonus – myoclonus. Myeloma specially osteosclerotic type. Chronic, sensory or motor. Neuropathy with paraproteinemia. Lung, breast,gastric,lymphoma,myeloma. Chronic weakness & sensory loss Chronic demyelinating PN. Hohgkin lymphoma Assending paralysis, areflexia. Gullain Barre. Causative Ca. Features Site
  • 23. Paraneoplastic neurological features: NMJ. = = Myasthenia gravis. SCC,Thymoma, breast,prostate, stomach. Mentioned before. Eaton – Lambert or myasthenic syndrome. Causative Ca. Features Site
  • 24. Paraneoplastic neurological features: Muscle. SCC, other lung Cas. Rapidly progressive Proximal weakness, dysphagia & dyspnea Necrotizing myopathy. breast,ovary, lung,lymphoma. Proximal weakness,myalgia,CMP, High CK. Polymyositis. Causative Ca. Features Site