Parkinson's disease Flashcards
What is Parkinson’s disease?
A movement disorder characterised by: tremor at rest, rigidity, bradykinesia (Slowness of movement and increasing slowness of movement over constant movement)
Describe the aetiology of Parkinson’s disease
1% of people over 65 are affected
Median age of onset is 60 years old
What are some risk factors for Parkinson’s disease?
- Increasing age
- Positive family history
- Male gender
- Environmental factors
- Genetic factors
What are some environmental factors that increase risk of Parkinson’s disease?
Pesticide exposure
Prior head injury
Rural living
ß-Blocker use
Well-water drinking
What are some factors that may decrease risk of Parkinson’s disease?
Tobacco smoking
Coffee drinking
NSAID use
Ca2+ channel blocker use
Alcohol consumption
Describe the pathology of Parkinson’s disease?
Parkinson’s disease is caused by loss of domaminergic (Inhibitory) cells in the substantia nigra and locus coeruleus
What are the main sub-types of motor symptoms in Parkinson’s disease?
Tremor dominant
Non-tremor dominant
Mixed
What are some motor symptoms of Parkinson’s disease?
Bradykinesia
Resting tremor
Rigidity
Postural and gait impairment
What is bradykinesia?
Slowness of movement with progressive loss of amplitude or speed during attempted rapid alternating movement of body segments
What is a resting tremor?
Rhythmic oscillatory involuntary movement of affected body part at rest
Often described aspill-rollingbecause the patient appears to be rolling something between thumb and forefinger
What is rigidity?
Stiffness on passive limb movement is described as ‘lead pipe’, as it is present throughout the range of movement and, unlike spasticity, is not dependent on speed of movement
What are some signs of postural and gait impairment in Parkinson’s disease?
- Stooped posture owing to impaired postural reflexes (major contributor to falls risk)
- Gait gradually becomes shuffling
- Reduced arm swing during movement
What are some non-motor symptoms of Parkinson’s disease?
- Sleep disorders
- Hallucinations
- GI dysfunction
- Depression
- Cognitive impairment/dementia
- Anosmia (Loss of smell) - May be a prodrome of Parkinson’s disease
- Issues with speech and swallowing
What are some issues in speech and swallowing that can occur in Parkinson’s disease?
- Speech becomes quiet, indistinct and flat
- Drooling
- Swallowing difficulty is a late feature that may eventually lead to aspiration pneumonia as a terminal event
How is a diagnosis of Parkinson’s disease made?
- Parkinsonism
- No alternative explanation
- Responds to dopamine
- No tests usually required (DaTSCAN may be used)