NEURO 3 Flashcards
triad of motor features in parkinson’s
bradykinesia, rigidity and tremor
non motor features in parkinson’s
olfactory dysf - loss of smell, cogni imp, psych, autonomic dysf, pain and fatigue, RBD
what is rapid eye movement sleep disorder
abn behaious during rapid eye movement sleep - related to dream enactment
RBD and PDx
together - severe autonomic dysf, gait impairment and dementia
just RBD - increased risk of developing neurodegenerative condition
resting tremor
3-5Hz
frements
rigidity by voluntary movement of other body parts
what can happen if medications are not absorbed properly in parsons
increased risk of acute akinesia/neuroepileptic malignant syndrome - take a drug holiday
dopamine agonists examples and which drugs need investigations before they can be initiated and why
ropinerole, pramiperole, apomorphine
bromocriptine, cabergoline - ECHO, ESR, CXR
pulmonary , retroperitoneal and cardiac fibrosis
why shouldnt DA be prescribed in elderly and confused px
SE include hallucinations
what is given along with levodopa and why
cabidopa/berverazide to prevent peripheral metabolism of levodopa into dopamine
reddish colour on standing
levodopa
what can happen at peak concentrations of leveopa
beginning and end of dose - chloroform/dystonic movements - biphasic dyskinesia
fluctuations
add DA/MAOBI (sergelline), COMTI (enalapore/tolapore)
psychosis
clozapine
quetiapine
depression
antidep
visual hallucinations/delusions in dementia
late stage dementia
rivastigamine
other options for side effects of levodopa
direct delivery of stable levodopa
carbiopa gel
duodepal - in dueodenum
other optiosn for side effects of DA
subcut infusion of potent DA - apomorphine
excessive sleepiness
don’t drive
adjust meds
modafenil
constipation
GI motility
fatigue
hypotentsion
polythyleneglyco/lubiprostone
domperidone
methypheindate
meds review. midodrine, clomperidone, fludrostinoma, pyridogmistigive
parkinsonism - 6
vascular drug induced multisystem progressive supranuclear fragile X tremore ataxia syndrome essential tremor
vascular
lower body predom
drug induced
symmetry coarse postural tremor
multisystem
autonomic dysf
cerebellar symp
parkinsonism
hot cross bun sign
progressive supra nuclear palsy
symm
akinetic rigid synd with predominantly axial involevemtn
gait and balance imp
FXTAS
cerebellar signs
parkinsonism
autonomic
prom ovarian failure. early menopause
ET
ADom
12Hz
commonest cause of head tremor
improved by alcohol and rest, propranolol, primidone
