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Year 3 - Neuro > Akinetic-Rigid Movement Disorders > Flashcards

Akinetic-Rigid Movement Disorders Flashcards

1
Q

Which parts of the brain make up the extra-pyramidal system?

A

Basal ganglia

Thalamus

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2
Q

What characterises akinetic-rigid movement disorders?

A

Reduced movements and increased muscle tone

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3
Q

Briefly describe the pathophysiology in Parkinson’s

A

Loss of dopaminergic neurons in the substantia nigra pars compacta

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4
Q

What is the peak age of presentation of Parkinsons?

A

70s

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5
Q

How does Parkinson’s present?

A 
Bradykinesia
Rigidity
Resting tremor
Small, shuffling gait
Dementia
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6
Q

“Spidery handwriting” is a buzzword for what?

A

Parkinsons

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7
Q

Describe how the bradykinesia in Parkinson’s shows itself clinically

A

Fixed facial expression
Reduced blinking
Soft, slow speech
Slowness

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8
Q

Describe the rigidity in Parkinson’s disease

A

Lead-pipe - when tone sustained throughout movement

Cogwheel - rigidity imposed on tremor

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9
Q

How is the Parkinson’s tremor classically described?

A

Pill-tremor

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10
Q

Why are Parkinson’s patients more susceptible to falls?

A

Loss of postural righting reflex

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11
Q

How is Parkinson’s investigated?

A

Usually a clinical diagnosis

MRI to rule out Parkinson plus

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12
Q

How is Parkinson’s managed?

A

Dopamine agonists

Levodopa

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13
Q

Give examples of dopamine agonists

A

Ropinirole

Pramipexole

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14
Q

What is levodopa given in combination with?

A

Decarboxylase inhibitors (carbidopa)

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15
Q

What do decarboxylase inhibitors do?

A

Prevent conversion of dopamine outside of brain

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16
Q

How does amantadine work?

A

Antagonises glutamate

17
Q

What is amantadine used for?

A

Levodopa-associated dyskinesias

18
Q

What do COMT inhibitors do in Parkinson’s disease?

A

Prevent breakdown of levodopa

19
Q

What drugs are given for tremor in Parkinsons? Give examples.

A

Clomipramine
Chlorpromazine
Biperiden
Diphenhydramine

20
Q

What is an absolute last resort treatment in Parkinsons?

A

Stereotactic neurosurgery

21
Q

Domperidone is safe to given in Parkinsons

true/false

A

True as it does not cross the BBB

22
Q

Which class of drugs are known to cause Parkinsonism?

A

Anti-psychotics

23
Q

How does drug induced Parkinson’s differ from Parkinsons disease?

A

Symmetrical in drug induced

24
Q

What are the Parkinson Plus syndromes?

A

Group of conditions which cause Parkinsonism
Progressive supranuclear palsy
Multisystem atrophy
Corticobasal degeneration

25
Q

How does progressive supranuclear palsy present?

A

Symmetrical parkinsonism
Eye movements abnormality
Rigidity
Cognitive impairment

26
Q

What is multi-system atrophy?

A

Cerebellar ataxia

Autonomic dysfunction

27
Q

How does cerebellar degeneration present?

A

Parkinsonism
Myoclonus
Dysphagia
Alien limb

Year 3 - Neuro (19 decks)

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