Basal Ganglia Disorders Flashcards
What is the pathogenesis of Parkinson’s disease?
Degeneration of the DOPA neurons of the substantia nigra causes less direct pathway action and more indirect pathway action leads to inhibition of movement
What happens in hemiballismus?
Destruction of the STN decreases GPi output onto the thalamus which leads to excessive movement
What are the signs of Parkinson’s disease?
- Resting Tremor
- Rigidity
- Bradykinesia
- Impaired Postural Reflexes
What does impairment of postural reflexes refer to?
Balance instability while standing or walking such that any irregularity or a jostle can send a patient into a fall
What is the pathological hallmark of Parkinson’s disease?
Loss of the pigmented DOPA neurons in the substantia nigra
What are the inclusions seen in Parkinson’s called?
Lewi Bodies - filled with alpha-synuclein
What is the most effective medication for Parkinson’s disease?
L-DOPA
What is L-DOPA combined with?
Carbidopa - it increases the amount of L-DOPA that actually reaches the brain
What is the surgical method for treatment of Parkinson’s?
An electrode is inserted into the STN leading to its inhibition which will cause less stimulation of the GPi and therefore less inhibition of the VA/VL of the thalamus.
What is the genetic mutation in Huntington’s disease?
Mutation with a multiple CAG repeat on the huntingtin gene of Ch4
What are the characteristics of Huntington’s disease?
- Choreoathetosis
- Dementia
- Behavioral Syndromes
What drugs are used in Huntington’s?
DOPA antagonists
