Chorea and Athetosis - Presentation Neuro

Ppt presentation on chorea and athethosis

1. CHOREA AND ATHETHOSIS PRESENTED BY ROLL NO - 04

2. CHOREA - DEFINITION An involuntary, irregular, jerking movement affecting limb and axial muscle groups. These movements are suppressed with difficulty and are incorporated into voluntary gestures resulting in a ‘semi purposeful’ appearance, e.g. crossing and uncrossing of legs. It is a type of hyperkinetic movement disorder The involuntary movements flow from one body area to another which cannot be predicted beforehand

3. CAUSES Hereditary – Huntington’s disease, Benign chorea Metabolic – Hyperthyroidism, Hypocalcaemia Drugs – Antiparkinsonian drugs, Oral contraceptives Immunological – Systemic lupus erythematosus, Polyarteritis nodosa Toxins – alcohol, carbon monoxide poisoning Miscellaneous – Chorea gravidarum, Polycythaemia rubra vera Infections – Sydenham’s chorea, E ncephalitis

4. Types of chorea 1 ) PRIMARY CHOREA (genetical causes) Primary chorea develops as the result of a disease, of which it is a primary symptom. Eg : Hunington’s Syndrome Primary will be symmetrical symptoms with insidious onset 2) SECONDARY CHOREA (acquired causes) Drug induced Chorea, Immune mediated Chorea, Infectious Chorea, Vascular Chorea, Hormonal Disorders Secondary will be asymmetrical and most of time sudden onset

5. Clinical features Fidgeting involuntarily  Asymmetrical irregular movements Inability to maintain an ongoing motor activity, such as maintaining a constant grip or holding the tongue out Abrupt, interrupted speech Involuntary vocalization Loss of coordinated movements Gait disturbance – in the form of jerky movements Impaired balance

6. TREATMENT: MEDICAL MANAGEMENT 1. Dopamine-depleting agents : Tetrabenazine, Deutetrabenazine , Valbenazine . 2. Dopamine D2 receptor-blocking agents : Haloperidol, Clozapine, Olanzapine. 3. Anticonvulsants : Valproic acid, Carbamazepine, Benzodiazepines, Levetiracetam. 4. Anti-glutamatergic agents : Amantadine, Riluzole . 5. Cannabinoids : Nabilone. 6.  Deep Brain Stimulation

7. PHYSIOTHERAPY MANAGEMENT Gait re-education Balance retraining Fall  prevention/management Aerobic  capacity Muscle  strengthening Wheelchair  prescription and training Respiratory  function Task-specific reach, grasp, and manipulation.

8. ATHETOSIS - DEFINITION It consists of irregular, repetitive, writhing movements. Athetosis refers to the slow, involuntary, and writhing movements of the limbs, face, neck, tongue, and other  muscle groups. These movements may be continuous, slow, and rolling. They may also make maintaining a symmetrical and stable posture difficult .

9. CAUSES 1) Jaundice 2) Birth difficulty – Asphyxia can lead to brain damage 3) Cerebral Palsy 4) Stroke 5) Drug Toxicity 6) Head Trauma

10. CLINICAL FEATURES Slow, involuntary, writhing muscle movements Random and unpredictable changes in muscle movement Worsening symptoms with attempts at controlled movement W orsening symptoms with attempts at improved posture Inability to stand Difficulty talking

11. TREATMENT- MEDICAL MANAGEMENT A nti-dopamine medicines : drugs that suppress the hormone’s effect on the brain Botox injections : treatment that may temporarily limit involuntary muscle actions Lifestyle Management- Changing your lifestyle, eating healthier, and exercising regularly for muscle strengthening can help improve the complications Occupational therapy : muscle training to regain some control

12. PHYSIOTHERAPY MANAGEMENT 1) To prevent falls 2) To improve balance and coordination 3) Gait Training 4) Muscle strengthening 5) Task-specific reach, grasp, and manipulation.

13. T H A N K – Y O U