BG disorders Flashcards
what is vascular parkinsonism
features of parkinsonism caused by multiple small CVAs
common symptoms of vascular parkinsonism
symmetrical LE typical parkinsonisms
treatment and prognosis for vascular parkinsonism
CVA management
fair - multi-focal strokes prognosis is low
atypical parkinsonism
progressive supranuclear palsy
multiple system atrophy
lewy body dementia
cortical basal degeneration
what is the most common atypical parkinsonism
progressive supranuclear palsy
how is PSP caused
atrophy of frontal convexity, subthalamic nucleaus, thalamus and midbrain structures
depigmentation of substantia nigra and other brainstem nuclei
rapid atrogliosis and neuronal loss
how is PSP diagnosed
clinical exam
MRI
what is seen in an MRI with PSP
frontal lobe, subthalamic and putamen atrophy
morning glory sign
hummingbird sign
what is the morning glory sign with PSP
concave midbrain - looks like a flower
what is the hummingbird sign with PSP
flat midbrain looks like a hummingbird in the sagittal view
what symptoms are more significant with PSP
gait and falls
what is seen in regards to their eyes when having PSP
supranuclear opthalmoplegia
what is supranuclear opthalmoplegia
limited vertical eye movement
loss of convergence
impaired vertical saccades
loss of visual acuity
loss of eyelid control
what is a significant sign with PSP
fixed mona lisa stare - suprised expression
treatment and prognosis for PSP?
treatment: no effective treatment, meds may help
prognosis: mortality 5-8 yrs
what is multiple system atrophy
rare neurodegenerative disorder with autonomic dysfunction
accumulation of proteins in glial cells - involved in oligodendrocytes
what regions are most involved with MSA
basal ganglia
cerebellum
pons
inferior olivary nucleus
intermediolateral column of thoracic and sacral spinal cord
MSA diagnosis
clinical exam
PET scan
MRI - hot cross buns
what is the premotor phase with MSA
disorder months to years before first motor symptoms appear
sexual dysfunction, urinary urge incontinence, OH, inspiratory stridor, REM sleep behavior
what are some unique symptoms present with MSA
coat hanger pain - worse standing up
antecollis - chin on chest
pisa syndrome - leaning to one side
REM sleep behavior disorder
