Parkinson's Disease Flashcards
what is parkinsons disease
neurodegenerative disease of the dopaminergic neurons of the substantia nigra
what is the mean age of onset of parkinsons
57 yrs
what 4 features is parkinsons mainly characterised by
bradykinesia,
rigidity,
resting tremor,
postural instability
summarise pathophysiology of parkinsons
Degeneration of dopaminergic neurones projecting from the substantia nigra to the striatum
Patients are only symptomatic after the loss of > 70% of dopaminergic neurones
what are the causes of parkinsons
Sporadic Parkinsons-
May be related to environmental toxins and oxidative stress
Secondary parkinsons-
neuroleptic therapy, vasculr insults, post encephalitis and repeated head injury
what type of onset does parkinsons have
insidious onset and is a progressive disease
main presenting symptoms of a patient with parkinsons
resting tremor, stiffness and slowness of movements, difficulty initiating movements, frequent falls, micrographia (small handwriting), insomnia and mental slowness
what signs will be seen on physical examination of a patient
cogwheeling- due to rigidity and tremor
Key features of the gait in idiopathic parkinson’s disease include small, shuffling steps, slowness of movement (especially on initiation of movement and on turning), flexed posture, and asymmetric tremor
extra info?
see Laz notes
what investigations will be done for people with Parkinson’s
you will do a dopaminergic agent (Levodopa) trial and there will be an improvement of symptoms in patients with Parkinsons
-CLINICAL DIAGNOSIS
bloods will be done to rule out Wilsons disease
CT/MRI brain to exclude other causes such as hydrocephalus
what will the treatment of Parkinson’s
levodopa, dopamine agonists, MAO-B inhibitor, amantidine or trihexyphenidyl
what do Monoamine oxidase inhibitors do? (Mechanism of action)
reduce the breakdown of dopamine so relieve the symptoms of Parkinson’s
