Neuro - Degenerative Conditions Flashcards
What is Parkinson’s Disease?
Movement disorder due to progressive reduction of dopamine within the basal ganglia
What is the classical triad associated with Parkinson’s?
Tremor
Rigidity
Bradykinesia
How does the Tremor appear in Parkinson’s?
"Pill-Rolling Tremor" 4-6Hz Unilateral Tremor More Pronounced when resting Improves on voluntary movement Exaggerated when distracted
What is Bradykinesia?
Slower or Smaller Movements
What are some presentations of Bradykinesia found in Parkinson’s disease?
Micrographia Small Steps - Shuffling Gait Difficulty initiating movement Difficulty turning when standing Reduced facial expression
What are some common symptoms associated with Parkinson’s disease?
Depression Sleep disturbance and Insomnia Anosmia Postural instability Cognitive impairment
How is the rigidity in Parkinson’s often described?
Cogwheel Rigidity
Lead pipe rigidity
How is Parkinson’s diagnosed?
Clinical Diagnosis
Which is the primary drug used to manage Parkinson’s?
Co-benyldopa
How does Co-benyldopa work in Parkinson’s?
Combination of synthetic dopamine and a dopa-decarboxylase inhibitor
What are some side-effects of Co-benyldopa?
Overactivity of the motor cortex giving dyskinesias, dystonia, chorea and athetosis
What is Athetosis?
Involuntary twisting/writhing movements of the hands and feet
How does Entacapone work?
COMT inhibitor extending the duration of action of Levodopa
What are some examples of Dopamine Agonists?
Bromocriptine
Pergolide
What is a key side effect of Dopamine Agonists?
Pulmonary Fibrosis
What is an example of a MOAB?
Selegiline
How do MOABs help with Parkinson’s?
Prevent breakdown of Dopamine
What is a Benign Essential Tremor?
A fine tremor affecting all the voluntary muscles, notably the hands, head, jaw and voice
When does a Benign Essential Tremor usually present?
In older age
What are some typical features of a Benign Essential Tremor?
Fine symmetrical tremor More prominent on voluntary movement Worse when tired, stressed or after Caffeine Improved by alcohol Absent during Sleep
What management can be offered for a Benign Essential Tremor?
Propanolol if giving functional impairment or psychological issues
