Parkinson's Disease Flashcards
1
Q
What are risk factors for Parkinson’s?
A
- M>F
- Caucasian
- Family history
- Rural living & farmers
- Advancing age
2
Q
What clinical features make up parkinsonism?
A
- Bradykinesia +
- Tremor
- Rigidity
- Postural instability
3
Q
What are causes of Parkinsonism?
A
- Neuro: Parkinson’s disease, Lewy body dementia, progressive supra nuclear palsy, multiple system atrophy
- Drugs: dopamine antagonists, sodium valproate, MPTP
- Vascular
- Metabolic: Wilson’s disease
4
Q
What are signs of bradykinesia?
A
- Small handwriting
- Slowed gait w/shuffling
- Reduced facial expression & blinking
- Reduced gesticulation
5
Q
Describe the gait of someone with Parkinson’s disease
A
- Difficulty initiating
- Slow pace
- Small steps
- Stooped flexed posture
- Festinating
- Several steps to turn
- Freezing
- Reduced arm swing
6
Q
What are clinical features of Parkinson’s?
A
- Anosmia
- Sleep disturbance
- Hypophonia
- Dysphagia
- Dystonia
- Dementia
- Autonomic disturbance
- Constipation w/urinary disturbance
- Depression & anxiety
7
Q
What is the pathophysiology of Parkinson’s disease?
A
- Dopaminergic neurons from substantial nigra to caudate & thalamus degenerate
- Less dopamine in basal ganglia
- Dopamine important for movement
8
Q
What treatment is available?
A
- Non-pharm: OT, speech & language therapy, physic
- Pharm: dopamine agonists, L-dopa containing drugs, MAO-I, COMT-I
- Apomorphine subcutaneous infusion
- Duodopa-continous delivery of L-dopa gel via PEJ tube
- Deep brain stimulation
