Neurodegenerative Disorders Flashcards
Is Parkinson’s disease typically a cerebellar, pyramidal tract or extra-pyramidal tract problem?
Extra-pyramidal
List the triad of the “Parkinsonian syndrome”
Rigidity
Bradykinesia
Resting tremor
List clinical motor features of Parkinson’s disease
Resting tremor Muscle rigidity +/- cogwheeling Bradykinesia Gait Postural impairment
List clinical non-motor features of Parkinson’s disease
Olfactory dysfunction Cognitive impairment Psychiatric symptoms Sleep problems Pain and fatigue
Diagnosis of Parkinson’s disease occurs with the onset of motor symptoms. True/False?
True
List side effects of levodopa and dopamine agonists
Nausea Daytime somnolence Oedema Impulse control disorders Hallucinations
Levodopa is associated with dyskinesia and motor fluctuations in the long-term. True/False?
True
What is the protein significant in Parkinson’s disease?
α-synuclein
Lewy bodies
How does Parkinson’s disease dementia differ from lewy body dementia?
Lewy Body dementia = dementia <1 year after presentation
Parkinson’s disease dementia = >1year after presentation
What is the main management of Parkinson’s disease?
Levodopa or dopamine agonists
What genetic condition increases the risk of Alzheimer’s disease?
Down’s syndrome
What is the protein significant in Alzheimer’s disease?
Amyloid
What are the early vs late symptoms of Alzheimer’s?
Early:
• Insidious impairment of higher intellectual function (eg forgetfulness - memory loss particularly short term) – gradual deterioration
• Alterations in mood and behaviours
Later:
• Progressive disorientation
• Memory loss
• Aphasia - impairment of language
What lobes of the brain atrophy in Alzheimer’s disease?
Temporal & parietal
What is the treatment for mild Alzheimer’s?
Cholinesterase inhibitors (eg rivastigmine / galantamine / donepezil)
What is the treatment for moderate/severe Alzheimer’s?
NMDA receptor blocker (eg Memantine)
What are the side effects of cholinesterase inhibitors
- GI upset Tiredness - Headache - Sleep disturbance - Muscle cramps - Worsen COPD/asthma - Bradycardia
What are the side effects of NMDA receptor blockers
Dizziness, hypertension, confusion, agitation, sedation, headache, insomnia, constipation and hallucinations
What is the protein significant in Lewy body dementia?
α-synuclein
What type of hallucinations are experienced in lewy body dementia?
Recurrent well-formed visual hallucinations
Cognitive impairment occurs before or around the same time as the movement disorder in lewy body dementia. True or false?
True
as opposed to PD dementia where the movement disorder is present for at least 1 year before cognitive impairment
What is the treatment of lewy body dementia?
Small dose levodopa/cholinesterase inhibitors (Rivastigmine)
What is the protein significant in Huntington’s disease?
Huntingtin
What is the triad of symptoms in Huntington’s disease?
Emotional, cognitive and motor disturbance
What is chorea?
Involuntary dance like movements
What is myoclonus?
Quick, involuntary muscle jerk
What is the protein significant in fronto-temporal (Pick’s) dementia?
Tau
What assessment is used for fronto-temporal dementia?
Frontal Assessment Battery (FAB)
What are the core criteria for vascular dementia?
Presence of cerebrovascular disease
+
A clear temporal relationship between the onset of dementia and cerebrovascular disease – stepwise dementia with plateaus and then drops in cognition
