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Movement disorders and sleep

Topic: Adult

Created on Sunday, April 15 2007 by ambarrett

Last modified on Sunday, April 15 2007.

Which of the following movement disorders is present (persists) during sleep?

 
        A) Essential tremor
 
        B) Typical tremor of Parkinson Disease
 
        C) Palatal myoclonus
 
        D) Tics
 
        E) Spasmodic torticollis
 

 


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This question was created on April 15, 2007 by ambarrett.
This question was last modified on April 15, 2007.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Essential tremor

This answer is incorrect.


This tremor, more rapid than that observed in Parkinson Disease (about 5-8 Hz) but not as rapid as a physiologic tremor such as that observed with hyperthyroidism or stimulants(8-10 Hz), nevertheless occurs (like the physiologic tremors) only with intentional action. The classical difficulty is with dextrous movements, for example pouring liquids, manipulating peas on a fork, or balancing a cup on a saucer.  (See References)

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B) Typical tremor of Parkinson Disease

This answer is incorrect.


The 3-5 Hz resting tremor of PD does emerge "when the subject is not thinking about his/her hand," and with unrelated activity (mental calculations, walking), but it disappears with sleep.  (See References)

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C) Palatal myoclonus

This answer is correct.


It's a segmental myoclonus not usually affected by level of arousal or stimulus/conscious inhibition. There are reports of reduction in frequency during sleep and with different sleep stages, but this is the exception rather than the rule.  (See References)

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D) Tics

This answer is incorrect.


These are very sensitive to conscious and emotional state.  (See References)

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E) Spasmodic torticollis

This answer is incorrect.


By definition this, often painful, focal or segmental dystonia with forced muscle contraction into an abnormal head/neck postures improves markedly or resolves completely with sleep.  (See References)

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References:

1. Jankovic, J., and Lang, A.E. (2004). Movement disorders: diagnosis and assessment. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, Fourth Edition. Butterworth Heinemann, Philadelphia, pp. 293-322.
2. Rowland, L.P. (Ed.) (2005). Merrit's Neurology, 11th Edition. Lippincott Williams & Wilkins, Philadelphia.
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adult
Movement disorders and sleep
Question ID: 041507140
Question written by ambarrett. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 04/15/2007
Modified: 04/15/2007
Estimated Permutations: 240

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