Lecture 1 - Pathologies PD, MS, MND

Question 1

What is the age of onset for Parkinsons, MS, MND

Answer 1

PD - 60-70
MS - 20-30
MND - 60-70

Question 2

What is the pathophysiology of PD

Answer 2

widespread degeneration in the CNS, affecting the dopaminergic and non-dopaminergic neural pathways. Many of the motor impairments are due to loss of dopaminergic neurons in the basal ganglia

olfactory part of brain also affected. Multi-system disease.

Neurodegenerative disorder, lose ability to do automated tasks

Question 3

What is the pathophysiology of MS

Answer 3

An autoimmune condition causing demyelination in the CNS. Resulting impairments are variable and unpredictable depending on the sites off myelin break down.

UMNL or LMNL, disorder of the CNS
myelin sheath breaks down due to an autoimmune response

Question 4

Pathophysiology of MND

Answer 4

- Degeneration of the Upper and Lower motor neurons. The presenting weakness depends on the location, severity and type of motor neuron involvement 
effects motor component of brain 
UMNL or LMNL 
motor neuron degeneration 
primary impairment is weakness

Question 5

Prognosis of MS

Answer 5

near-normal life expectancy

Question 6

prognosis of MND

Answer 6

6 mo - 5 years (18mo- 3 years?)

Question 7

Prognosis of PD

Answer 7

near normal life expectancy

Question 8

Motor Impairments of MS, MND, PD

Answer 8

MS - weakness, lack of coordination (possible cerebellar ataxia), spasticity, impairments depend on location of lesion

MND - weakness, spasticity (if UMNL)

PD - resting/action tremor, bradykinesia, hypokinesia, rigidity, akinesia, postural instability

Question 9

Sensory Impairments for MS,MND, PD

Answer 9

MS - numbness, visual disturbance, loss of proprioception, increased pain, loss of tactile sensation

MND - no sensation loss

PD - decreased olfactory sensation, decreased taste, pain!, sensory integrative problems (reactive movements)

Question 10

Cognitive/Emotional Impairments - MS,MND,PD

Answer 10

MND - 20% with UMNL get dementia

MS - 50% develop cog/emo imairments

PD - 80% get dementia within 20 yrs, 25% get cognitive changes on diagnosis - anxiety, depression, apathy

Question 11

What is Parkinsonism

Answer 11

primary idiopathic PD
parkinsonism plus syndromes

Progressive Supranuclear palsy (PSP)

Mutiple system atrophy (MSA) - brady and hypo, early cog changes

Drug induced parkinsonism

Vascular parkinsonism

Question 12

4 types of MND

Answer 12

APPP
ALS - Amyotrophic Lateral sclerosis - has UMN and LMN signs - affects bulbar trunk and limbs

PLS - primary lateral sclerosis - isolated UMN signs - affects bulbar, trunk, limb

PMA - Progressive muscle atrophy - isolated LMN signs, - affects bulbar, trunk, and limbs

Progressive Bulbar palsy - UMN and LMN signs - affects bulbar mm

Question 13

4 Types of MS

Answer 13

Relapse Remitting - 85% initial diagnosis - relapse remit, back to baseline after exacerbation

Secondary Progressive - initial RR course, followed by progression of variable rate, with occasional relapses and minor remissions

Primary Progressive - disease showing progression of disability from onset

Progressive relapse - shows progression from onset, with clear relapses with or without full recovery