Movement disorders Flashcards
Pathological hallmarks of PD
Lewy bodies and loss of dopaminergic neurones from substantia nigra
Lewy bodies become more widespread as condition progresses. They spread from lower brainstem to the midbrain and then into the cortex
The extent of dopaminergic cell loss correlates with what?
The extent of dopaminergic cell loss correlates with the degree of akinesia
What is one of the first structures to be affected in PD?
The olfactory bulb
The cardinal clinical feature of parkinsonism and the main cause of disability?
Akinesia (bradykinesia)
How do you distinguish akinesia from slowing of movement?
Akinesia= progressively fatiguing and decrement in amplitude of repetitive movements
What does the face look like in PD?
Doesn’t move and person looks depressed because of this
What simple personal tasks might patients with PD find difficult?
Doing up buttons and zips etc
Blinking and PD?
Patient’s blink less and this gives them a “serpentine stare”
How do you test for akinesia?
Ask a patient to perform rapid alternating movements e.g. opening and closing hand repetitively –> look for progressive slowing and decrement in amplitude of movement
Presenting complaint in 70% of patients with PD?
Tremor
- almost always starts in the fingers and hand
- like AKINESIA, is unilateral initially, spreading later to the leg on the same side and then the opposite arm
Tremor and motion?
The tremor is present at rest and reduces or stops completely when arm is in motion
Why is the tremor described as “pill rolling”?
Because it looks like they are rolling something between their thumb and forefinger
Frequency of tremor in PD?
3-6 Hz
What makes the tremor worse? Lol me
Emotion or stress :(
