Degenerative Diseases of the CNS Flashcards
What are the common features of neurodegenerative diseases?
Largely unknown aetiology
Gradual progression
Usually late onset
Neuronal loss
What is dementia?
Progressive impairment of multiple domains of cognitive function in alert patient leading to loss of acquired skills and interference in occupational and social role
What are the causes of dementia?
Alzheimer’s
Vascular
Lewy body
Frontotemporal
What are the mimics of dementia?
Hydrocephalus
Tumour
Depression (pseudodepression)
What are the treatable reasons which cause dementia?
B12 deficiency
Thyroid disease
HIV
Syphilis
What investigations are used to diagnose dementia?
Bloods CT/MRI CSF EEG Functional imaging Genetics
How is cognitive function examined?
Screening tests ( mini mental, Montreal) Memory, attention, language, visuospatial, behaviour, emotion, executive function, aspraxias
What type of dementia is associated with Alzheimer’s disease?
Temporo-parietal dementia
What clinical signs are associated with Alzheimer’s disease?
Early memory disturbance
Language and visuospatial problems
Personality preserved until later
What affects are observed with fronto-temporal dementia?
Early change in dementia/ behaviour
Often change in eating habits
Early dysphasia
Memory/visuospatial relatively preserved
What are the non pharmacological symptomatic treatments for dementia?
Occupational therapy
Information and support, dementia services
Social work/ respite/ placement
What aspects of dementia can be treated pharmacologically?
Insomnia
Behaviour
Depression
What are the specific treatments for Alzheimer’s?
Cholinesterase inhibitors
NMDA antagonist
What are the different types of cholinesterase inhibitors?
Donepezil
Rivastigmine
Galantamine
What is an example on an NMDA antagonist?
Mematine
How is Parkinson’s disease diagnosed?
Bradykinesia
Rigidity
Tremor
Postural instability (MUST HAVE AT LEAST 2)
What are the causes of Parkinson’s?
Idiopathic (dementia with Lewy bodies)
Drug induced (dopamine antagonists)
Vascular parkinsonism
What functional imaging is used within Parkinson’s?
Dopamine transporter SPECT
What are some of the drug induced complications of Parkinson’s treatment?
Motor fluctuations (levodopa wears off)
Dyskinesias (involuntary movements)
Hallucinations, impulse control
What are some of the non drug induced complications of Parkinson’s treatment?
Depression Dementia Speech, swallow, Balance Autonomic (BP, bladder, bowel)
What are some of later treatments offered for Parkinson’s?
Deep brain stimulation
Continuous infusion of apomorphine or Duodopa
