Movement Disorders

This video is intended to serve as an overview of movement disorders for medical students. Students This video is intended to serve as an overview of movement disorders for medical students. Students will learn to identify and classify a movement disorder, look for parkinsonism on the neurological examination, list differential diagnoses of tremor and parkinsonism, and recall early and late treatment options for Parkinson's disease.

00:06 - Intro
00:33 - Objectives
01:41​ - Case of a person with hand shaking
03:07 - MOVEMENT PHENOMENOLOGY
04:06 - Parkinsonism
07:13 - Tremor
08:50 - Dystonia
11:35 - Chorea and hemiballismus
13:23 - Tics
15:58 - Myoclonus
17:38 - MOVEMENT PHENOMENOLOGY: Summary
19:00 - Back to the case: What is the movement phenomenology?
19:35 - MOVEMENT DISORDER EXAMINATION
20:00 - Classification of tremor and tremor exam
22:51 - Examining rigidity
24:04 - Examining bradykinesia
25:35 - Examining ataxia and gait
27:47 - Our patient's examination
28:56 - PATHOLOGICAL DIFFERENTIAL OF TREMOR
32:19 - Parkinsonian tremor versus essential tremor
34:28 - Back to the case: What type of tremor is our patient exhibiting?
37:31 - DaT Scan: Differentiating parkinson's from essential tremor
39:43 - EARLY TREATMENT OF PARKINSON'S DISEASE: Levodopa, dopamine agonists, MAO-B inhibitors
47:47 - Back to the case: Progression of disease
49:10 - NON-MOTOR FEATURES OF PARKINSON'S DISEASE
53:10 - Progressive motor symptoms
55:16 - DIFFERENTIAL DIAGNOSIS OF PARKINSONISM
57:56 - Atypical parkinsonisms
1:03:18 - DIAGNOSTIC APPROACH TO PARKINSON'S DISEASE
1:05:53 - TREATING ADVANCING PARKINSON'S DISEASE
1:06:01 - Dyskinesias
1:08:44 - Gait freezing
1:09:42 - Amantadine, anticholinergics, COMT inhibitors
1:11:39 - Deep brain stimulation


Created, produced, and narrated by:
Igor Rybinnik MD
Neurology Clerkship Director
Rutgers Robert Wood Johnson Medical School

Content experts:
Jennifer Chen MD, Marco Russo MD, Gian Pal MD
Division of Movement Disorders
Department of Neurology
Rutgers Robert Wood Johnson Medical School


Images, videos adapted from:
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- "Presentations of tardive dyskinesia symptoms," "Involuntary facial and neck movements in TD." Teva Neuroscience, 2021.
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- DaT scan image, Parkinson’s Foundation
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- Rajan, S. Lewy bodies (alpha synuclein inclusions). Wikipedia.org, 2012.
- Hauser RA. Motor fluctuations.

Music:
- "The Plan's Working" by Cooper Cannell

DISCLAIMER: Please note that this material was simplified for educational purposes. For patient management, please review your clinical society's guidelines and engage expert consultation where appropriate. Also, the opinions of the presenters do not necessarily reflect those of Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, RWJBarnabus Health, or Rutgers University as a whole.