Parkinson's and related syndromes Flashcards
What are the atypical Parkinsonisms (4)?
- Progressive supranuclear palsy
- corticobasal degeneration
- multiple system atrophy
- dementia with lewy bodies
What features of MSA help you distinguish from PD?
- Early, prominent autonomic dysfunction (orthostatic hypotension, incontinence, anhidrosis)
- AXIAL (rather than appendicular) rigidity
- severe postural abnormalities (lateral trunk bending)
- polyneuropathy
- stridor
- UMN signs
- Young onset (in early 50s)
What features of CBD help you distinguish it from PD?
think cortical sx and basal (BG) sx
- alien limb or limb apraxia early in course
- May develop dementia and visuospatial difficulties
- focal or hemidystonia
- cortical signs (apraxia, aphasia, asterognosis)
Hot cross bun sign: which disease?
MSA
caused by pontine atrophy
Which features of PSP help you differentiate from PD?
- Supranuclear gaze palsy (inability to look up or down on command but intact vertical VOR)
- Early postural instability and falls
- continuous square wave jerks
- early dysphagia
- subcortical dementia
Why do you get autonomic dysfunction in MSA?
Involvement of intermediolateral cell column
Which parkinson’s syndromes are tauopathies?
PARKINSONISM TAUOPATHIES:
CORTICOBASAL DEGENERATION
PROGRESSIVE SUPRANEUCLAR PALSY
Which parkinsonisms are synucleinopathies?
Parkinson’s Disease
Dementia with Lewy Bodies
MSA
Hummingbird sign - what is it and what disease?
Midbrain atrophy in PSP
Globose neurofibrillary tangles: which disease
PSP
Astrocytic plaques: which disease
cortocobasal degeneration
Fahr disease: clinical and radiographic findings
Can present in 20s-40s with psychosis OR 40s-60s with dementia, parkinsonism
bilateral idiopathic calcifications of BG
