Parkinson's Flashcards
1
Q
Parkinson’s Defintion
A
Movement disorder characterised by
- Tremor at rest
- Rigidity
- Bradykinesia
Diagnosis based on clinical examination
2
Q
Parkinson’s Pathogenesis
A
- Reduction of dopamine in substantia nigra
- Can be drug induced
- Can occur following encephalitis or toxin exposure
3
Q
Parkinson’s Epidemiology
A
- Second most common neurodegenerative disorder after Alzheimer’s
- Between 55-65
- More common in men
4
Q
Parkinson’s RFs
A
- Male sex
- Pesticide exposure
- Being born in spring
5
Q
Parkinson’s Presentation
A
- Insidious onset with peak age of onset 55-65
- Commonly presents with impaired dexterity or slight dragging of one foot
- Fixed facial expression with infrequent blinking
- Tremor at rest at 4-6Hz (spiral)
- Rigidity
- Bradkinesia
Later features
-Gait disturbance
6
Q
Parkinson’s Diagnostic Criteria
A
- UK Parkinson’s disease Society Brain Bank Criteria
- Bradykinesia with one of
- Muscular rigidity
- 4-6Hz resting tremor
- Postural instability not caused by visual, vestibular, cerebellar or proprioceptive dysfunction)
(As well as three or more of
- Unilateral onset
- Resting tremor
- Progressive
- Response to L-dopa…)
7
Q
Parkinson’s Long-Term Problems
A
- After initial period those on L-dopa may experience:
- Motor fluctuations
- On/Off syndrome
- Wearing off of treatment
- Axial problems
- Parkinson’s dementia (similar to Alzheimer’s but with Parkinsonism, visual hallucinations and lucidity fluctuations)
8
Q
Parkinson’s Differentials
A
- ET
- Drug induced
- Huntington’s
- LBD
9
Q
Parkinson’s Referral
A
-Refer to specialist quickly and untreated
10
Q
Parkinson’s Ix
A
- Clinical diagnosis
- CT/MRI for those who fail to respond to treatment
- SPECT to can differentiate between PD and ET
11
Q
Parkinson’s Management
A
- Levodopa
- MAO-Bi (early treatment can delay need for levodopa)
- Dopaminergic agent or
- Amantadine or
- Trihexyphenidyl
