Interactive Transcript
0:00
Let's talk about the various types of movement
0:03
disorders that we see in individuals
0:04
and begin with Chorea.
0:06
Chorea is defined as a syndrome
0:08
characterized by abrupt,
0:10
involuntary movements, resulting from a continuous
0:13
flow of random muscle contractions.
0:16
And I emphasize random.
0:18
The pattern of movement can sometimes seem playful
0:22
and convey a feeling of restlessness
0:24
to the observer.
0:26
When choreic movements are more severe,
0:29
they can assume a flinging movement,
0:32
almost like hemiballismus,
0:34
and they're sometimes violent.
0:36
This violent character is often addressed
0:39
by the synonym ballism.
0:42
The unpredictable nature of Chorea is a feature
0:44
that distinguishes it from tremor and dystonia.
0:48
Tremor is a repetitive,
0:51
small movement of a muscle, such as the hand
0:53
or a group of muscles in the hand,
0:55
and that tremor can be broken down into intention
0:57
tremor where you try and point at something and
1:00
develop a tremor versus a resting tremor,
1:03
which you know is more classic
1:05
for Parkinson's syndrome.
1:07
And then you've got this entity known as dystonia.
1:10
Now,
1:10
Chorea is characterized by rhythmic and oscillatory
1:15
movements of body parts, although it can be random
1:18
in any body part, where the hallmark of dystonia is
1:21
the presence of a sustained muscular contraction
1:25
resulting in abnormal postures
1:26
or torsion movements.
1:27
So the patient may get into a movement like this
1:29
and get stuck there, whereas they don't get stuck in Chorea.
1:33
It's a constant flow of motion.
1:35
That's a very important distinguishing feature.
1:38
Unlike Chorea,
1:39
the resulting movements mimic complex motor
1:42
behaviors in dystonia that are part
1:45
of the normal human repertoire.
1:46
So the patient can have the appearance that
1:49
they're reaching for something and then get
1:51
stuck in that reaching-type position.
1:54
Whereas the Chorea movements are totally random
1:57
they may not mimic normal human
1:59
voluntary movement.
2:01
Tics.
2:01
Tics can be readily differentiated from
2:05
Chorea because they also reproduce normal human
2:08
movements as well.
2:09
Sometimes, vocalizations,
2:11
they're commonly preceded by a local unpleasant
2:14
sensation, a sensory tic, or a prodrome,
2:17
almost like a migraine.
2:18
They can be voluntarily suppressed
2:20
by the individual, if so desired
2:23
in most of the cases.
2:26
Myoclonic jerks, these are brief,
2:28
and I mean brief, less than one fifth of a second
2:31
or 200 milliseconds, shock-like muscular
2:34
contractions that lack the continuous random
2:37
flow of movement typical of Chorea.
2:40
Don't confuse these for those little
2:42
fasciculations you get under your eyes when
2:44
you're tired. Everybody has those.
2:47
So with that, we'll stop.
2:49
Those are some of the major movement abnormalities
2:52
that we're going to be dealing with.
2:53
Of course,
2:54
one of the most important will be tremor,
2:56
intention tremor and especially pill rolling,
2:59
resting tremor that is seen with
3:01
PD or Parkinson's disease.
© 2024 Medality. All Rights Reserved.