Huntington's and Parkinson's Flashcards
How is Huntington’s disease inherited?
autosomal dominant
What is Huntington’s disease?
incurable, progressive, neurodegenerative disorder
When does Huntington’s disease present?
middle age
What are the symptoms of early Huntington’s disease?
irritability
incoordination
depression
What do the early symptoms of Huntington’s disease progress to?
chorea
dementia
+/- fits and death
What is the pathology of Huntington’s disease?
Atrophy and neuronal loss of striatum and cortex
What is the genetic basis of Huntington’s disease?
Expansion of CAG repeat on chromosome 4
How is Huntington’s disease diagnosed?
clinical diagnosis
genetic testing - CAG repeat testing
What is the treatment of Huntington’s disease?
No cure
Supportive measures - therapy, antidepressants
What is Parkinson’s disease?
Chronic neurodegenerative disease characterised by motor features of parkinsonism
What are the symptoms of parkinsonism?
bradykinesia
resting tremor
rigidity
What is the rigidity like in parkinsonism?
cogwheel rigidity - felt during rapid pronation/supination
What are some non motor symptoms that occur in Parkinson’s?
constipation reduced sense of smell hallucinations dribbling of saliva depression, dementia pain
When do non motor symptoms present in Parkinsons?
Common in early disease - before motor
What are some causes of Parkinsons?
idiopathic parkinsons
drug induced
What is the pathology of parkinson?
degeneration of dopaminergic neurones in substantia nigra in basal ganglia
What is the treatment in Parkinson’s disease?
symptomatic treatment
- Levodopa (dopamine precursor, give with decarboxylase inhibitor)
- Dopamine agonists - ropinirole
- Monoamine oxidase type B (MAO-B) inhibitors - rasagiline
- Amantadine
What is the aim of treatment in parkinson?
to enhance intracerebral dopamine concentration or stimulate dopamine receptors
What parkinson’s drug has reduced effectiveness with time?
levodopa
What are some side effects of levodopa?
nausea somnolence oedema hallucinations psychosis hypotension
What are side effects of MAO-B inhibitors?
postural hypotension
AF
What are side effects of dopamine agonists?
nausea, somnolence, oedema, hallucinations, compulsive behaviour
What can levodopa cause in the long term?
dyskinesia
What drugs can cause parkinsons?
neuroleptics
metoclopramide
prochlorperazine
Who do you avoid giving dopamine agonists to?
elderly people
gamblers
history of addiction
Tremor?
clozapine
Anti emetic?
dompiridone
DONT GIVE cyclazine, prochloropenazine
Depression?
Tricyclics or SSRIs
