Neuroteach 15 - Jack-in-the-box tongue

 Jack-in-the-box tongue!!!

“The English Hippocrates”

English physician Thomas Sydenham (1624 – 1689) discovered Sydenham's chorea

2) Pathophysiology

“combination of chorea & motor impersistence” Motor impersistence - inability to maintain tetanic muscle contraction - positioning & compensatory repositioning - independent of chorea - linearly progressive (marker of disease severity?) - frontal lobe

3) Examples of motor impersistence

- Milkmaid’s grip - inability to maintain eye closure - ‘Jack in the box’ tongue

4) Definition

“unable to maintain tongue in protruded state and the tongue moves in and out”

5) Also known as

-jack-in-the-box, chorea -flycatcher tongue, tardive dyskinesia -‘bon-bon’ sign, tongue alternately pushes against the buccinator -trombonist’s tongue, chronic alcoholism -other: lizard tongue, chameleon tongue, snake tongue, adder tongue, harlequin tongue

6) Jack-in-the-box tongue

“unable to maintain tongue in protruded state and the tongue moves in and out” - chorea - motor impersistence - positioning & compensatory repositioning

7) Jack-in-the-box tongue

8) Jack-in-the-box tongue

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“unable to maintain tongue in protruded state and the tongue moves in and out” Videofluoroscopic swallow in HD - look at tongue movements