3.1 Parkinsons

Question 1

imaging in PD shows

Answer 1

there is a swallow tail sign.

Question 2

Normal pressure hydrocephalus

Answer 2

there is a buildup of cerebral spinal fluid in the ventricles of brain due to blockage.
Ventricles enlarge - increases intracranial pressure which results in dementia, gait disturbances, imbalance, urinary incontinence.

wide base of support and external rotation at the hips.

Question 3

progressive Supranuclear palsy

Answer 3

damage to many areas of the brain.
impacts ocular movement, frontal lobe function and cerebellum.

excessive neck rigidity
flexed elbows
loss of vertical excursion - loss of horizontal excursions in doll’s eye maneuvers

pt will stand in hyperextension - different from PD which is a flexed position.

lifespan is shorter - 5-7 years after diagnosis.

Question 4

multi-system atrophy

Answer 4

” hot cross bun” sign typical for MSA
neurodegeneration that impacts autonomic function, including blood pressure regulation, bowel and bladder control.

tremors, rigidity, postural instability

Question 5

Cortico-basal ganglionic degeneration

Answer 5

degeneration of the frontal parietal cortex and basal ganglia.

asymmetric presentation that is dependent on the location of the parietal lobe atrophy

rigidity is common. apraxia, alien limb syndrome - involuntary but purposeful hand movement

Question 6

Lewy-body dementia

Answer 6

hypomania, rigidity, flex posture, tremor and short shuffling gait pattern

ppl have impaired acteylcholine availability and lewy-body formation

visual hallucination are a hallmark finding.

Question 7

Parkinson’s Disease

Answer 7

2nd most common neuro degenerative disease after Alzheimer’s.
Attributed to the loss of neurons, decreased dopamine in substantia nigra.

Rigidity
Micrography
Bradykinesia
Masked face
Postural abnormalities
Resting tremor

Question 8

Pathophysiology of PD

Answer 8

Results in altered function of both direct and indirect motor loops.

Decreased dopamine results in less inhibition of the striatum to the indirect pathway.
Decreased inhibition of the striatum causes increased inhibition of globus pallidus.

Question 9

Secondary Parkinsonism

Answer 9

Disorder affecting the CNS and basal ganglia

Caused by drugs or toxins

Question 10

Parkinson + Syndrome

Answer 10

Outside of basal ganglia - not responsive to normal medication / treatment.

Alzheimer’s, spinocerebellar ataxia, inherited dystonia, genetic metabolic abnormalities.