Parkinson's Disease

Question 1

What is parkinsonism?

Answer 1

1) Tremor
2) Rigidity
3) Bradykinesia

Question 2

What are the causes of parikinsonism?

Answer 2

1) Idiopathic parkinson’s disease
2) multiple cerebral infarct
3) post encephalopathy
4) drug induced

Question 3

What is the epidemiology of parkinson’s disease

Answer 3

prevalence = 1.6%

mean onset = 65yrs

Question 4

What is the cause of parkinson’s disease?

Answer 4

degeneration of dopaminergic neurons in the substantial nigra, pars compacta, associated with lewy bodies.

This causes decreased striatal dopamine levels.

Question 5

What is the typical presentation of parkinson’s disease?

Answer 5

1) Tremor that is worst at rest + pill rolling
2) Increased rigidity
3) Bradykinesia (slowness of movement initiation, with progressive reduction in speed and amplitude of repetitive actions)
4) Expressionless face, decreased blink rate
5) monotonous speech
6) Gait : reduced arm swing, rapid acceleration, freezing at obstacles and doors

Question 6

Essential tremor is a differential of parkinson’s. What makes them different?

Answer 6

1) Essential tremor is on movement, parkinson’s is on rest.

2) Parkinsons tremor is slower than essential tremor

Question 7

What is the treatment for parkinson’s disease?

Answer 7

1) L-dopa
2) dopamine antagonists
3) Anticholinergics (decrease tremor but cause confusion)
4) MAO-B inhibitors
5) COMT inhibitors