INVOLUNTARY MOVEMENTS

Involuntary movements usually imply a disorser in basal ganglia.

Movement dissorders:
1) parkinsonism  - lesion at sustancia nigra
2) chorea - caudate nucleus
3) hemibalismus - subthalamic nucleus
4) myoclonus - different areas

Drugs causing tremors:
- nifidipine
- nicotine
- lithium
- valproic acid
- tricyclic antidepressants
- antihistaminics
- thyroxine



Types of tremours.
1) rest or static tremors
      Typically sren in parkinsonism
2) postural tremors:
      Common in drugs like non selective beta
      blockers, also intramuscular inj of botuline
      toxine type A.
3) intension tremors:
      Typical sign of cerebellar lesion

CHOREA:
  Non-repetative jerky semipurposfull movements of
  face, trunk and limbs
  Causes:
     Rheumatic (sydenhams chorea)
     Huntington's chorea
     Hyperthyroidism
     SLE
     Hyperparathyroidism
  
   Rx:
     Symptonatic:
         - haloperidol 0.5-1.5 mg BD
         - sodium valproate 200-600 mg TID
         - carbamazepin
         - phenobarbitone
     In rheumatic chorea, penicillin prophylaxis

Myoclonus:
   It is rapid brief irregular movements of part of body.
 
Causes:
    - metabolic disturbance--eletrolyte imbalance
    - encephalitis
    - tricyclic antidepressant
    - lipid storage diseases
    - myoclonic epilepsy
  
  Rx:
    - sod valproate 300-1200 mg/day
    - clinazipam 0.5-10 mg/day