Parkinson's and huntington's

Question 1

Risk factors of Parkinson’s

Answer 1

Decreased dopamine
Runs in family
Pesticide exposure
WAIT WHAT smoking decreases risk
Easier to quit. Nicotine causes release of dopamine

Question 2

Features of Parkinson’s

Answer 2

Bradykinesia, resting tremor, ataxia, rigidity postural instability

Question 3

Basal ganglia bit responsible for Parkinson’s

Answer 3

Substantia Nigra

By time see damage, already 60% damaged

Question 4

What’s the difference between Lewy bodies in Parkinson’s vs dementia?

Answer 4

In Parkinson’s, localized to substantia nigra. In Dementia, spread throughout brain

Question 5

Treatments for Parkinson’s?

Answer 5

Levodopa (with carbidopa)
Armantidine does same but not as good
Dopamine receptor agonist
     Bromocriptine Mirapex
MAOB inhibitors
     "-Galine"
Anticholinergics decrease trepor
Deep brain stimulation
Thalamotomy and Pallidotomy

Question 6

Symptoms of Huntington’s

Answer 6

Chorea, Dystonia, motor impersistence, More rigid in later stages, later dementia

Question 7

How many CAG repeats normally? Full penetrance? Juvenile?

Answer 7

Normal: 40

Kids >60

Question 8

Prognosis

Answer 8

10-25 years after onset

Question 9

Testing for Huntington’s?

Answer 9

MRI: Caudate deterioration

Genetic testing

Question 10

Treatment

Answer 10

OT, Increase calories
Tetrabenzaine for chorea
Decreases dopamine release and blocks receptors
Neuroleptics to block dopamine receptors. Last resort
Includes “-peri” and olanzapine