Parkinson's diagnosis/prognosis Flashcards
PD affects what part of basal ganglia?
subcortical gray matter (dopamine loss)
Cardinal signs of PD?
TRAP tremor rigidity akinesia postural instability
Common movement related symptoms?
Micrographia festinating gait soft speech emotionless drooling
Common non-movement symptoms?
Anxiety Apathy breathing cognitive nausea fatigue sleep
Is there a diagnostic test for PD?
No, based on clinical exam
Supportive criteria for PD
dramatic response to dopamine therapy
levodopa induced dyskinesia
resting tremor
loss of olfaction, abnormal cardiac MIBG
Negative criteria for PD
cerebellar abnormalities supranuclear gaze palsy frontotemporal dementia lower limbs only dopamine receptor blocker no response to levodopa cortical sensory loss normal dopaminergic system documentation of another condition
How do symptoms change with time?
unilateral to bilateral
increase rigidity
limited mobility
WC/bed bound
Stage 1
unilateral symptoms, TRAP
stage 1.5
unilateral, axial involvement (posture issues)
stage 2
bilateral now!
minor sxs like swallowing, talking, expression
stage 2.5
bilateral
recovers on push/pull test
stage 3
bilateral
postural instability but independent
stage 4
bilateral
severe disability, need help with ADLS
stage 5
bed bound or WC bound, total assist
