Parkinson's Flashcards

1
Q

Define Parkinsonism

A

A clinical syndrome of Bradykinesia + atleast one of:

  • Tremors
  • Rigidity
  • Postural Instability
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2
Q

Describe the epidemiology of parkinson’s?

A

2nd commenest neurodegenerative disorder after Dementia.

Its age dependant and more common in males

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3
Q

How does Parkinsons work?

A

Gradual loss of dopaminergic neurons in the basal ganglia (particularly the Substantia Nigra)

This makes people slow to enact movements and have problems inhibit inappropriate ones

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4
Q

What causes parkinsonism?

A
  • Drug Induced (Dopamine Antagonists)
  • Vascular (mini-strokes to basal ganglia)
  • Idiopathic (Include Lewy Body Dementia)
  • Parkinson’s Plus Sydromes
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5
Q

What are parkinsons plus syndromes?

A

Parkinsonism as part of a multi-system atrophy such as corticobasal degeneration

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6
Q

How do you diagnose parkinsonism?

A
  • The symptoms
  • Should be slowly progressive (over 5-10 yrs)
  • Symptoms will often be assymetric
  • Response to treatment
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7
Q

How do image Parkinsons?

A

Dopamine Transporter SPECT (a functional imaging technique)

It will show up asymmetric reduction of activity in the basal ganglia

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8
Q

What do we treat parkinson’s with?

A
  • Levodopa (a dopamine precursor)
  • Oral Dopamine Agonists
  • Functional Neurosurgery (i.e. Deep Brain Stimulation)
  • Care packages and Occ/Physiotherapy
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9
Q

What can we do to improve the half life of levodopa?

A
  • MAO-B inhibitors
  • COMT inhibitors
  • Slow Release Levodopa
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10
Q

What are the complications of parkinson’s?

A
  • Depression
  • Dementia (E.g. Lewy Body)
  • Speech and balance issues
  • Autonomic (E.g. problems controlling BP & continence)
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11
Q

What -ve effects can levodopa treatment have?

A
  • Motor Fluctuations as it eventually wears off
  • Dyskinesias
  • Psychiatric problems such as hallucinations or loss of impulse control
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12
Q

What are the non-motor presentations of parkinson’s?

A

Progressive:

  • Cognitive Impairment (Dementia)
  • Incontinence / increase in frequency/urgency
  • Drool
  • ~/visual Hallucinations
  • ~Anosmia
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