The dysfunctional little brain!!!
Part I

“regulates ‘rate, range, and force’ of movement”

Irish neurologist Gordon Morgan Holmes (1876–1965)

#MedTwitter #neurotwitter #EndNeurophobia

1/
Dyssynergia

“lack of integration of the components of the act results in decomposition of movement”

- rapid ‘repetitive’ movement

via: Dr Timothy Conwell

2/
Dyssynergia

“lack of integration of the components of the act results in decomposition of movement”

- rapid ‘repetitive’ movement

via: MatthewHR1

3/
Dysmetria

“errors in judging distance and gauging the distance, speed, power, and direction of movement”

- past pointing
- hypermetria is more common

via: onlinemedicalvideo

4/
Dysmetria

“errors in judging distance and gauging the distance, speed, power, and direction of movement”

via: Dr Hashir Malik

5/
Dysmetria

“errors in judging distance and gauging the distance, speed, power, and direction of movement”

via: MatthewHR1

6/
Dysmetria

- clear instructions
- finger & foot
- index near & far

via: UCD Medicine

7/
Dysmetria

“errors in judging distance and gauging the distance, speed, power, and direction of movement”

- modified to chin test

via: Adrienne Jackson

8/
Dysmetria

“errors in judging distance and gauging the distance, speed, power, and direction of movement”

via: Mamata Chimmalgi

9/
Dysdiadochokinesia

“clumsy term (coined by Babinski) that means inability to make rapid ‘alternating’ movement”

- antagonist-agonist coordination

youtube.com/c/DrTimothyCon… via: Dr Timothy Conwell

10/
Dysdiadochokinesia

“clumsy term (coined by Babinski) that means inability to make rapid ‘alternating’ movement”

- antagonist-agonist coordination

via: Neuron Bundle

11/
Dysdiadochokinesia

“clumsy term (coined by Babinski) that means inability to make rapid ‘alternating’ movement”

- antagonist-agonist coordination

via: MatthewHR1

12/
Dysdiadochokinesia Song

Dysdiadochokinesia
indicates a cerebellar lesion
rapid alternating movements
thigh, hand and foot tapping

via: Sthornhil

13/
Holmes (Stewart-Holmes) rebound phenomenon

“reflex when one attempts to move a limb against resistance that is suddenly removed”

- antagonist-agonist coordination
- loss of checking response
- normal, spasticity, cerebellar

via: Mamata Chimmalgi

14/
Holmes (Stewart-Holmes) rebound phenomenon

“reflex that occurs when one attempts to move a limb against resistance that is suddenly removed”

- loss of checking response

youtube.com/shorts/iN5YbmY… via: Dr.Pawan Soni

15/
Holmes (Stewart-Holmes) rebound phenomenon

“reflex that occurs when one attempts to move a limb against resistance that is suddenly removed”

- checking response

via: UCD Medicine

16/
Pendular reflex

“muscle hypotonicity and the lack of normal checking of the reflex response”

- hypotonia
- decrease tonic output of the cerebellar nuclei

via: Mamata Chimmalgi

17/
Pendular reflex

“muscle hypotonicity and the lack of normal checking of the reflex response”

- hypotonia
- decrease tonic output of the cerebellar nuclei

via: Real Medicine

18/
Pendular reflex

“muscle hypotonicity and the lack of normal checking of the reflex response”

- hypotonia
- decrease tonic output of the cerebellar nuclei

via: sthornhil

19/
Cerebellar wrist

- hypotonia
- extended and arched dorsally
- fingers hyperextended
- tendency toward overpronation

20/
Scanning speech

“slow, slurred, staccato, monotonous”

- ataxic dysarthria and/or MS dysarthria
- oral motor ataxia
- speech asynergy

via: allornonelaw

21/
Scanning speech

“slow, slurred, staccato, monotonous”

- ataxic dysarthria and/or MS dysarthria
- oral motor ataxia
- speech asynergy

via: neuro by neurologist rids

22/
Scanning speech

“slow, slurred, staccato, monotonous”

- ataxic dysarthria and/or MS dysarthria
- oral motor ataxia
- speech asynergy

via: prohealthsys

23/
Scanning speech

“slow, slurred, staccato, monotonous”

- ataxic dysarthria and/or MS dysarthria
- oral motor ataxia
- speech asynergy

via: UCD Medicine

24/
To be continued…

Part 2 – Next week

List of "Twitter Threads"

neuronland.blogspot.com

25/

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More from @theneurolander

Nov 2
Through the eyes!!!

“ocular reflexes are the simplest ocular motor responses”

German psychiatrist Carl Friedrich Otto Westphal (1833–1890)

#MedTwitter #neurotwitter #EndNeurophobia
1/ http://dcmny.org/islandora/object/nyam%3A1116/datastream/OBJ
Pupillary light reflex

“constricts the pupil in response to light”

via: onlinemedicalvideo

2/
Pupillary light reflex – pathway

afferent – CN II

efferent – CN III

eyewiki.aao.org/w/images/1/4/4… via: Eyewiki

3/
Read 35 tweets
Nov 2
The arcane superficial reflex!!!

“response to stimulation of either the skin or mucous membrane”

- polysynaptic, slow, longer latency, easily fatigable
- abolished by pyramidal tract lesions

#MedTwitter #neurotwitter #EndNeurophobia

1/
Palmar reflex

“stroking the palm of the hand is followed by flexion of fingers or closing of the hand”

via: Dr. Sourya Acharya

2/
Scapular reflex

“scratching the skin over the scapula/interscapular space causes contraction of scapular muscles”

via: Department of Physiology

3/
Read 26 tweets
Oct 28
The Sound of Footsteps!!!

“it's possible to learn more about neurologic status from watching a patient walk than from any other single procedure”

Russell Nelson DeJong (1907-1990)

#MedTwitter #neurotwitter #EndNeurophobia

1/
Phases of gait

Critical incidents!

Stance (60%): (1) heel strike (2) foot flat (3) heel off

(4) toe-off

Swing (40%): (5) toe clearance (6) heel strike

via: Morgan E

2/
Cerebellar ataxic gait

“Wide based, reeling, careening (drunken sailor)”

- inability to walk tandem
- step length varies unpredictably
- turning may bring out a stagger
- acute alcohol intoxication

via: Matthewhr1

3/
Read 25 tweets
Oct 26
Hoffmann and his Assistant!!!

“upper limb equivalent of the Babinski sign test”

- hyperreflexia
- cervical cord

#MedTwitter #neurotwitter #EndNeurophobia

1/ Image
Hoffmann's sign

“snaps the nail of the middle finger leads to flexion of the thumb and/or index”

discovered by German neurologist Johann Hoffman (1857–1919), but
it was described by his assistant Hans Curschmann in 1911

via: virtualmedstudent

2/
Mayer's reflex

“forceful passive flexion of the middle finger. Involuntary adduction of the thumb normally follows; absence of the reflex suggests a lesion”

discovered by Austrian neuropsychiatry Carl Mayer (1862–1936)

doctorlib.info/neurology/fund… via: doctorlib

3/ Image
Read 11 tweets
Oct 24
Babinski and Friends!!!

“Loss of descending pyramidal control of the reflex arc to suppress extensor withdrawal results in the upgoing toes in the plantar reflex known as Babinski's sign”

1st described by Joseph Babinskiin 1896

#MedTwitter #neurotwitter #EndNeurophobia

1/
Bing's sign

“pricking of the dorsum of foot or the 1st toe with a pin”

discovered by Swiss neurologist Paul Robert Bing (1878–1956)

youtube.com/shorts/SgIBzIG… via: Nagesh's Clinical Medicine

2/
Cornell's sign

“stroking the dorsum of foot along the extensor tendon of the 1st toe”

discovered by American neuropsychologist Ethel Letitia Cornell (1892–1963)

via: UM Clinical Skills

3/
Read 24 tweets
Oct 23
Movement Disorders – Dystonia (Writer's cramp)

“abnormal postures and muscle spasms interfering in writing motor performance”

- Most freq focal, task-specific dystonia.
- Managed botox > orals (anticholinergic)

#MedTwitter #neurotwitter #EndNeurophobia #movementdisorder
1/ Image
History #dystonia

First description

Bernardino Ramazzini (1633-1714) discussed focal hand dystonia as a muscle strain in “Scribes and Notaries” De Morbis Artificum Diatriba.

doi.org/10.1016/s0140-…

2/ ImageImage
Writer's cramp (focal hand dystonia)

doi.org/10.1002/mds.23… via: Mov Disord

3/
Read 13 tweets

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