Jamir Pitton Rissardo Profile picture
Oct 15, 2022 25 tweets 12 min read Read on X
Movement Disorders - Ballism

“chorea that affects proximal joints such as shoulder or hip” Mov Disord Society, 2011

- Freq causes: vascular and metabolic

- Good response to antipsychotics, usually self-limiting

#MedTwitter #neurotwitter #EndNeurophobia #movementdisorder

1/ Image
First report

In 1927 James Purdon Martin
Hemichorea resulting from a local lesion of the brain

doi.org/10.1093/brain/…

2/ Image
Hemichorea-hemiballismus: nonketotic hyperglycemia

doi.org/10.1212/WNL.0b… via: Neurology

3/
Hemiballismus: parietal lobe infarction

doi.org/10.7759/cureus… via: Cureus

4/
Hemichorea-hemiballismus: nonketotic hyperglycemia

doi.org/10.14802%2Fjmd… via: Journal of Movement Disorders

5/
Hemiballismus: Lacunar infarct in the right centrum semiovale

doi.org/10.4103%2Faian… via: Annals of Indian Academy of Neurology

6/
Bilateral chorea–ballism: hyperthyroidism

doi.org/10.1002/mds.20… via: Movement Disorders

7/
Hemichorea-hemiballismus: vaccine-Induced

doi.org/10.5334%2Ftohm… via: Tremor and Other Hyperkinetic Movements

8/
Hemichorea-hemiballismus: nonketotic hyperglycemia

doi.org/10.1002/mds.21… via: Movement Disorders

9/
Hemichorea-hemiballismus: nonketotic hyperglycemia

doi.org/10.14802%2Fjmd… via: Journal of Movement Disorders

10/
Bilateral ballism: herpes encephalitis with thalamic lesion

doi.org/10.1016/j.park… via: Parkinsonism & Related Disorders

11/
Hemichorea-hemiballismus: cryptococcal Meningitis

doi.org/10.7759/cureus… via: Cureus

12/
Hemichorea-hemiballismus: nonketotic hyperglycemia

doi.org/10.1007/s10072… via: Neurological Sciences

13/
Hemichorea-hemiballismus: intracranial toxoplasmosis and tuberculosis

doi.org/10.5334%2Ftohm… via: Tremor and Other Hyperkinetic Movements

14/
Bilateral chorea-ballism: after cardiac arrest

doi.org/10.1212/wnl.64… via: Neurology

15/
Bilateral ballism: limb-shaking transient ischemic attacks

doi.org/10.1016/j.jstr… via: Journal of Stroke and Cerebrovascular Diseases

16/
Hemiballismus: insular and temporal lobe infarct

doi.org/10.1001/jamane… via: JAMA Neurology

17/
Bilateral ballism: fever-induced

doi.org/10.1002/mds.21… via: Movement Disorders

18/
Hemichorea-hemiballism: after external ventricular drainage

doi.org/10.14802%2Fjmd… via: Journal of Movement Disorders

19/
Hemichorea-hemiballismus: diabetic ketoacidosis

doi.org/10.1016%2Fj.ds… via: Diabetes Metab Syndr

20/
Hemichorea‐hemiballism: CNS tuberculosis

doi.org/10.1002%2Fmdc3… via: Mov Disord Clin Pract

21/
Hemiballismus: anti-Yo

doi.org/10.1016/j.jocn… via: Journal of Clinical Neuroscience

22/
Hemichorea-hemiballismus: after clipping MCA aneurysm

doi.org/10.4103%2F2152… via: Surg Neurol Int

23/
Hemichorea-hemiballism: postoperative stroke

doi.org/10.7916%2FD8C5… via: Tremor and Other Hyperkinetic Movements

24/
Hemichorea-hemiballism: Nonketotic Hyperglycemia

doi.org/10.7916%2FD8QZ… via: Tremor and Other Hyperkinetic Movements

25/

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More from @theneurolander

Jan 26, 2023
Diencephalon location
- around the 3rd ventricle

The cavity of the diencephalon is ----- the 3rd ventricle
All of the structures of the diencephalon are around the 3rd ventricle, so the cavity of the diencephalon is the 3rd ventricle.

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Diencephalon embryology

- prosencephalon

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Jan 12, 2023
The Examination in Coma

“the father of modern neurological surgery”

American neurosurgeon Harvey Williams Cushing (1869–1939)

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1/ Image
Definition

“a state of unarousable unresponsiveness”

Parts
a. level of consciousness
b. vital signs (BP & breathing pattern)
c. cranial nerves (fundoscopy + vision + brainstem)
d. motor & sensory
e. reflex
f. meningeal signs

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Level of consciousness

Normal
Clouding of consciousness
Confusion/delirium
Lethargy
Obtundation
Stupor
Coma

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Read 30 tweets
Dec 26, 2022
Drifts!!!

French neurologist Jean Alexandre Barré (1880–1967)

#MedTwitter #neurotwitter #EndNeurophobia #tweetorials

1/
The four types of drift

“pronator, cerebellar, parietal, and functional”

- pronator drift (pyramidal drift) was the 1st to be described
- Dr. Barre was the 1st to report it

2/
Pronator drift (Barre’s sign)

progress from distal to proximal

1st downward arm drift
2nd forearm pronation
3rd flexion of the wrist and elbow

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Read 18 tweets
Dec 22, 2022
Brachial plexus!!!

“Erb-Duchenne palsy, Erb-Charcot paralysis, Erb's point, Erb-Westphal symptom, Erb's spot”

German neurologist Wilhelm Heinrich Erb (1840–1921)

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1/
Components

“Ready To Drink Cold Beer”

Root (5): C5-T1
Trunk (3): upper, middle, lower
Division (6): anterior & posterior from each of the trunks
Cord (3): lateral, posterior, medial
Branch (5)

2/
How are roots formed?

“formed by the anterior (ventral) rami of C5 to T1 spinal nerves”

Extent
- interscalene triangle (bounded by anterior scalene and middle scalene)

3/
Read 24 tweets
Dec 21, 2022
Signs of tetany!!!

“Trousseau sign of malignancy, Trousseau sign of latent tetany, Trousseau–Lallemand bodie”

French internist Armand Trousseau (1801–1867)

#MedTwitter #neurotwitter #EndNeurophobia #tweetorials

1/
Definition

Tetanus
- it is different disease w/ different pathology

Tetanic contractions (physiologic tetanus)
- broad range of muscle contraction types

Tetany
- a type of tetanic contraction

2/
Clinical manifestations of tetany

“spasm and tonic contractions of the skeletal muscles, principally the distal muscles of the extremities”

3/
Read 25 tweets
Dec 19, 2022
Meningeal signs

“Brudziński neck sign, Brudziński symphyseal sign, Brudziński cheek sign, Brudzinski's reflex”

Polish pediatrician Józef Polikarp Brudziński (1874–1917)

#MedTwitter #neurotwitter #EndNeurophobia #tweetorials

1/
Definitions

Meningitis
-inflammation of leptomeninges & underlying subarachnoid CSF

Meningismus
-morbid state characterized by meningitic syndrome (triad: headache, photophobia, nuchal rigidity)

Meningism
-synonymous of meningismus
-neck stiffness w/o meningeal inflammation
2/
Mechanism

“maneuvers used to elicit meningeal signs produce tension on inflamed and hypersensitive spinal nerve roots, and the resulting signs are postures, protective muscle contractions, or other movements that minimize the stretch and distortion of the meninges and roots”

3/
Read 27 tweets

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