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AKINESIA/BRADYKINESIA.
RHYTHMIC TREMOR.
DYSTONIA.
MYOCLONUS.
CHOREA
STEREOTYPIES.
TICS.
PAROXYSMAL DYSKINESIA.
ATAXIA.
MORE
PROLONGED
OBSERVATION.
FEATURES REQUIRING
LONGER
OBSERVATION
IMMEDIATE
IMPRESSION.
IMMEDIATE IMPRESSION
RHYTHMIC
VERSUS
ARRHYTHMIC
SUSTAINED VERSUS
NON SUSTAINED.
PAROXYSMAL
VERSUS CONTINUAL
VERSUS CONTINO...
DIFFRENTIAL DX OF RHYTHMIC AND ARRHYTHMIC HYPERKINESIA
RHYTHMIC
• TREMOR(RESTING,POSTURAL,ACTION,INTENTION).
• DYSTONIC TR...
DIFFRENTIAL DX OF SUSTAINED HYPERKINESIA
DIFFRENTIAL DX OF PAROXYSMAL AND NONPAROXYSMAL HYPERKINESIA
PAROXYSMAL CONTINUAL CONTINOUS
TICS BALLISM ABDOMINAL DYSKINES...
DIFFRENTIAL DX OF HYPERKINESIA THAT ARE PRESENT ASLEEP OR AWAKE
• HYPNOGENIC DYSKINESIA.
• PERIODIC MOVEMENTS IN SLEEP.
AP...
MORE PROLONGED OBSERVATION
AT REST
VERSUS WITH
ACTION
PATTERNED
VERSUS NON
PATTERNED.
COMBINATIONS
OF VARIETIES
OF
MOVEMEN...
DIFFRENTIAL DX OF HYPERKINESIA THAT ARE PRESENT AT REST OR WIYH ACTION
AT REST ONLY(DISAPPEAR DURING ACTION) WITH ACTION O...
PATTERENED AND NON PATTERNED MOVEMENTS
PATTERENED(SAME MUSCLE GROUP)
ABDOMINAL DYSKINESIA
DYSTONIA
HEMIFACIAL SPASM
MOVING...
COMBINATIONS
OF VARAIETIES
OF
MOVEMENTS
PSYCHOGENIC
MOVEMENTS
DISORDERS
TARDIVE
SYNDROMES
NEUROACANTH
OCYTOSIS
WILSON
DISE...
FEATURES REQUIRING LONGER OBSERVATION
SPEED: SLOW VERSUS FAST
AMPLITUDE: BALLISTIC VERSUS NON BALLISTIC
FORCE: POWERFUL,PA...
SPEED
FASTEST INTERMEDIAT SLOWEST
MINIPOLYMYOCLONUS CHOREA ATHETOSIS
MYOCLONUS BALLISM MOVING TOES/FINGERS
HYPEREKPLEXIA J...
AMPLITUDE
BALLISTIC:
BALLISIM,JUMPY
STUMPS.
NOT
BALLISTIC:
CHOREA
AND ALL
OTHERS.
VERY SMALL:
MINIPOLYMY
OCLONUS
FORCE
POWERFUL
•STIFF PERSON,JUMPY STUMPS.
INTERMEDIATE
•DYSTONIA.
EASY TO OVER
COME
•ALL OTHER.
SUPPRESSIBILITY
• STEREOTYPY > TICS, AKATHETIC MOVEMENTS > CHOREA >
BALLISIM > DYSTONIA > TREMOR > MOVING TOES.
• NOT SUPP...
VOCALIZATION
VOCAL
TICS:SIMPLE
OR COMPLEX.
AKATHESIA:
MOANING.
HUNTIGTON
DISEASE.
NEUROACANT
HOCYTOSIS.
CRANIAL
DYSTONIA.
SELF
MUTILATION
LESCH –
NYHAN
SYNDROME.
NEUROACANT
HOCYTOSIS.
TOURETTE
SYNDROME.
PSYCHOGENIC
MOVEMENTS
DISOREDRS.
SENSORY
COMPONENETS
AKATHESIA.
MOVING
TOES,PAINFUL
LEGS.
RESTLESS
LEGS.
TICS.
OCULAR MOVEMENTS
TICS.
OCULOGYRIC
CRISES.
OPSOCLONU
S.
OCULAR
MYOCLONUS
.
OCULAR
MYORHYTH
MIA.
OCULAR
DYSMETRIA.
NYSTAGMUS.
The clinical approach to differentiate the dyskinesia
The clinical approach to differentiate the dyskinesia
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The clinical approach to differentiate the dyskinesia

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dyskinesia is very difficult issue

Publié dans : Santé & Médecine
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The clinical approach to differentiate the dyskinesia

  1. 1. AKINESIA/BRADYKINESIA. RHYTHMIC TREMOR. DYSTONIA. MYOCLONUS. CHOREA STEREOTYPIES. TICS. PAROXYSMAL DYSKINESIA. ATAXIA.
  2. 2. MORE PROLONGED OBSERVATION. FEATURES REQUIRING LONGER OBSERVATION IMMEDIATE IMPRESSION.
  3. 3. IMMEDIATE IMPRESSION RHYTHMIC VERSUS ARRHYTHMIC SUSTAINED VERSUS NON SUSTAINED. PAROXYSMAL VERSUS CONTINUAL VERSUS CONTINOUS SLEEP VERSUS AWAKE
  4. 4. DIFFRENTIAL DX OF RHYTHMIC AND ARRHYTHMIC HYPERKINESIA RHYTHMIC • TREMOR(RESTING,POSTURAL,ACTION,INTENTION). • DYSTONIC TREMOR. • DYSTONIC MYORHYTHMIA. • MYOCLONUS,SEGMENTAL. • EPILEPSIA PARTIALIS CONTINUA. • MYOCLONUS,OSCILLATORY. • MOVING TOES,FINGERS. • MYORHYTHMIA. • PERIODIC MOVMENTS IN SLEEP. • TARDIVE DYSKINESIA(TARDIVE STEREOTYPY). ARHYTHMIC • AKATHETIC MOVEMENTS. • ATHETOSIS • BALLISM. • CHOREA. • DYSTONIA. • HEMIFACIAL SPASIM. • HYPEREKPELXIA. • ARRHYTHMIC MYOCLONUS. • STEREOTYPY. • TICS.
  5. 5. DIFFRENTIAL DX OF SUSTAINED HYPERKINESIA
  6. 6. DIFFRENTIAL DX OF PAROXYSMAL AND NONPAROXYSMAL HYPERKINESIA PAROXYSMAL CONTINUAL CONTINOUS TICS BALLISM ABDOMINAL DYSKINESIA PKD CHOREA ATHETOSIS PNKD DYSTONIC MOVEMENTS TREMORS PED MYOCLONUS,ARRHYTHMIC DYSTONIC POSTURES PRAOXYSMAL ATAXIA SOME STEREOTYPIES MYOCOLNUS,RHYTHMIC PRAOXYSMAL TREMOR AKATHETIC MOANING TARDIVE STEREOTYPY HYPNOGENIC DUSTONIA MYOKYMIA STEREOTYPY TIC STATUS AKATHETIC MOVEMENTS JUMPY STUMPS MOVING TOES MYOARRHYTHMIA
  7. 7. DIFFRENTIAL DX OF HYPERKINESIA THAT ARE PRESENT ASLEEP OR AWAKE • HYPNOGENIC DYSKINESIA. • PERIODIC MOVEMENTS IN SLEEP. APPEARS DURING SLEEP AND DISAPPEARS WHEN AWAKENED • SECONDARY PALATAL MYOCLONUS. • OCULAR MYOCLONUS. • OCULOFACIOMASTICTORY MYOARHYTHMIA. • MOVING TOES. • MYOKEMIA. • NEUROMYOTONIA(ISAACS SYNDROME) PERSISTS DURING SLEEP
  8. 8. MORE PROLONGED OBSERVATION AT REST VERSUS WITH ACTION PATTERNED VERSUS NON PATTERNED. COMBINATIONS OF VARIETIES OF MOVEMENTS.
  9. 9. DIFFRENTIAL DX OF HYPERKINESIA THAT ARE PRESENT AT REST OR WIYH ACTION AT REST ONLY(DISAPPEAR DURING ACTION) WITH ACTION ONLY AT REST AND CONTINOUS WITH ACTION AKATHETIC MOVEMENTS ATAXIA ABDOMINAL DYSKINESIA PARADOXICAL DYSTONIA ACTION DYSTONIA ATHETOSIS RESTING TREMOR ACTION MYOCLONUS BALLISM RESTLESS LEGS ORTHOSTATIC TREMOR CHOREA ORTHOSTATIC TREMOR(ONLY ON STANDING) TREMOR:POSTURAL,ACTION,INTENTION. DYSTONIA TASK SPECIFIC TREMOR JUMPY STUMPS TASK SPECIFIC DYSTONIA MINIPOLYMYOCLONUS MOVING TOES /FINGERS MYOCLONUS MYOKEMIA PSEUDODYSTONIA TICS
  10. 10. PATTERENED AND NON PATTERNED MOVEMENTS PATTERENED(SAME MUSCLE GROUP) ABDOMINAL DYSKINESIA DYSTONIA HEMIFACIAL SPASM MOVING TOES/FINGERS SEGMENTAL MYOCLONUS MYORHYTMIA MYOKEMIA TARDIVE STEREOTYPY TREMOR NON PATTERENED ALL OTHERS
  11. 11. COMBINATIONS OF VARAIETIES OF MOVEMENTS PSYCHOGENIC MOVEMENTS DISORDERS TARDIVE SYNDROMES NEUROACANTH OCYTOSIS WILSON DISEASE HUNTIGTON DISEASE DRPLA DYSTONIA
  12. 12. FEATURES REQUIRING LONGER OBSERVATION SPEED: SLOW VERSUS FAST AMPLITUDE: BALLISTIC VERSUS NON BALLISTIC FORCE: POWERFUL,PAINFUL VERSUS EASY TO OVERCOME SUPPRESSIBILTY VOCALIZATION SELF MUTILATION COMPLEXITY OF MOVEMENTS SENSORY COMPONENT
  13. 13. SPEED FASTEST INTERMEDIAT SLOWEST MINIPOLYMYOCLONUS CHOREA ATHETOSIS MYOCLONUS BALLISM MOVING TOES/FINGERS HYPEREKPLEXIA JUMPY STUMPS MYOARHYTHMIA HEMIFACIAL SPASM TREMORS AKATHETIC MOVEMENTS TICS TARDIVE STEREOTYPY
  14. 14. AMPLITUDE BALLISTIC: BALLISIM,JUMPY STUMPS. NOT BALLISTIC: CHOREA AND ALL OTHERS. VERY SMALL: MINIPOLYMY OCLONUS
  15. 15. FORCE POWERFUL •STIFF PERSON,JUMPY STUMPS. INTERMEDIATE •DYSTONIA. EASY TO OVER COME •ALL OTHER.
  16. 16. SUPPRESSIBILITY • STEREOTYPY > TICS, AKATHETIC MOVEMENTS > CHOREA > BALLISIM > DYSTONIA > TREMOR > MOVING TOES. • NOT SUPPRESSIBLE: • HEMIFACIAL SPASM, MYOCLONUS, HYPEREKPLEXIA, MYORHYTHMIA, MOVING TOES.
  17. 17. VOCALIZATION VOCAL TICS:SIMPLE OR COMPLEX. AKATHESIA: MOANING. HUNTIGTON DISEASE. NEUROACANT HOCYTOSIS. CRANIAL DYSTONIA.
  18. 18. SELF MUTILATION LESCH – NYHAN SYNDROME. NEUROACANT HOCYTOSIS. TOURETTE SYNDROME. PSYCHOGENIC MOVEMENTS DISOREDRS.
  19. 19. SENSORY COMPONENETS AKATHESIA. MOVING TOES,PAINFUL LEGS. RESTLESS LEGS. TICS.
  20. 20. OCULAR MOVEMENTS TICS. OCULOGYRIC CRISES. OPSOCLONU S. OCULAR MYOCLONUS . OCULAR MYORHYTH MIA. OCULAR DYSMETRIA. NYSTAGMUS.

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