Question 1

A patient reports trembling of both hands causing difficulty performing tasks with the hands. The provider notes symmetric, rhythmic movements which are present at rest and no other neurological findings. A history reveals that the trembling decreases when the patient has a glass of wine with dinner. What is the initial action?

A) Evaluation in an emergency department (ED)
B) Prescribing a beta blocker medication
C) Reassurance that these will subside
D) Referral to a neurologist

B

Accepted Answer

The patient's symptoms are consistent with essential tremor, which responds well to beta blockers. Referral to a neurologist may be warranted if there are other neurological findings, but this is not necessary at this time. Evaluation in an ED is not necessary for this chronic, non-emergent condition. Reassurance alone may not adequately address the patient's symptoms.

Question 2

Which are common hyperkinetic movement disorders? (Select all that apply.)&#10;A) Dystonia&#10;B) Essential tremor&#10;C) Parkinson's disease&#10;D) Progressive supranuclear palsy&#10;E) Tourette's syndrome

Accepted Answer

Dystonia, essential tremor, and Tourette's syndrome are common hyperkinetic movement disorders characterized by excessive, involuntary movements.

Deck 179: Movement Disorders and Essential Tremor