Parkinson's and Extrapyramidal Disorders Flashcards

1
Q

What is the clinical triad of parkinsonisms?

A

Bradykinesia
Resting tremor (pill rolling)
Rigidity (cogwheel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathological basis behind parkinson’s disease?

A

Dopamine depletion in the substantia nigra resulting in disruptions in the connections to the thalamus and motor cortex.

The cause is unknown.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the common clinical features/presentation of Parkinson’s disease?

A

Usually occurs in older people with the peak incidence between 55-65years of age.

Onset is insidious and may initially present with reduced dexterity or a fixed facial expression.

Main clinical features are:

  • a resting tremor (if not present may be induced by concentration aka reciting months of the year backwards)
  • bradykinesia
  • rigidity (cogwheeling, particularly to passive movement)

A shuffling gait is another common feature which is often seen later.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe some of the early non motor features of Parkinson’s disease?

A

Often precede motor symptoms of parkinson’s:

  • Loss of sense of smell
  • Constipation
  • Depression
  • Rapid eye movement sleep disorder (act out dreams)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the broad categories which the non motor features of Parkinson’s disease?

A

Autonomic dysfunction.

Cognitive and psychiatric symptoms

Sleep disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe some of the more common non motor features of Parkinson’s disease?

A

Autonomic:

  • Loss of smell.
  • Constipation
  • Postural hypotension.
  • Drooling, difficulty swallowing and speaking (requiring SALT)

Cognitive and psychiatrics:

  • Cognitive dysfunction and dementia occurs in 70% eventually (late complication)
  • Hallucinations
  • Depression (precedes motor symptoms in 30%

Sleep disorders:

  • Rapid eye movement sleep disorder
  • Excessive daytime sleepiness
  • Insomnia

There are many more but these are some of the more common non motor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe how dementia in Parkinson’s presents?

A

Dementia occurring more than one year after a diagnosis of Parkinson’s otherwise classified as Lewy Body dementia.

Presents similarly to lewy body:

  • Memory impairment
  • Parkinsonisms in limbs
  • Visual hallucinations
  • Frequent fluctuations into lucidity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathogenesis behind non motor symptoms in Parkinson’s disease?

A

Widespread neuronal degeneration in the brainstem.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly