7. Parkinson's / Parkinsonism Flashcards
1
Q
How common is it?
A
1 in 500
2
Q
How does it present?
A
Bradykinesia Resting (pill-rolling) tremor Hypertonia (cog-wheel rigidity) Impaired balance / coordination Festinant gait
3
Q
What causes it?
A
Dopaminergic motor neurons become impaired / die so less dopamine is produced
Many secondary causes eg Drug-induced (antipsychotics), vascular Parkinsonism, Wilson’s disease, neurosyphilis
4
Q
What risk factors are there?
A
FH
Male gender
Link to pesticide exposure
PMH of depression
5
Q
What signs may the patient have on examination?
A
Postural hypotension
Abnormal neuro exam findings (adiadochokinesia, cogwheel rigidity, shuffling gait)
6
Q
What other conditions might present similarly?
A
Dementia
7
Q
What other conditions might present similarly?
A
Dementia (esp fronto-temporal) Cerebellar disease Multiple system atrophy Progressive supranuclear palsy Arthritis
8
Q
How would you investigate?
A
Dopaminergic medication trials
Functional neuroimaging eg PET, DaTscan
MRI to rule out structural pathology
