(18) Movement Disorders The Novel Flashcards
What are the 4 cardinal features of Parkinson’s?
- resting tremor
- rigidity
- Bradykinesia
- Postural Instability (late)
**assymetric onset early with bilateral late
How is rigidity characterized
inc tone even with passive movement
dementia + lewy bodies =
parkinsonism plus
key pathologic abnormality in PD
degeneration of pigmented neurons in the SNc
**also affects neurons in the locus curuleus, dorsal vagal nucleus
microsocpic pathology assc with PD
lewy bodies
What are lewy bodies?
aggregates of alpha-synuclein
Where are lewy bodies found in PD
CNS and ENS
PD does not affect DA system exclusively, what other NT systems are affects
NE, serotonin, glutamate
Where is DA deficieincy seen classically in PD
SNc and striatum within the cerebrum
Age of onset of Supranuclear Palsy and life expectance
50-60 yo with 10 yr life expectancy
how is the neuo features of supranuclear palsy different than PD
SNP has supranuclear gaze palsy
postural instabiliy is early in SNP and late in PD
tremor is unusual in SNP and common in PD
features are symmetric in SNP and assymetric in PD
astonished face in SNP and mask in PD
SNP has PD + dementia
describe the supranuclear gaze palsy . what is it due to?
difficulty with down gaze then up gaze then horizontal gaze
due to dysfuction above brainstem (eyes are still capable of moving as noted with oculocephalic maneuver)
characteristic pathology assc with SNP
midbrain and cerebral atrophy due to neuronal loss and gliosis (in multiple areas)
pathological hallmark of supranuclear palsy
neurofibrillary tangles = unpaired straight fialments that contain abn phosphorylated tau protien
neurochemical abn seen with PSP
DA deficieny most prominetns with Ach, GABA, and NE also affected
