Parkinson's Disease Flashcards
What is it? (3)
A movement disorder characterised by Tremor at rest, rigidity and bradykinesia
What causes parkinsons?
Mitochondrial DNA dysfunction that causes degeneration of Dopaminergic Neurons in the Substantia Nigra pars compacta resulting in reduced dopamine levels
What is drug-induced parkinsonism?
Drugs that block dopamine receptors or reduce storage of dopamine e.g Major tranquilisers or Metoclopramide
What else can cause parkinsonism?
Following Encephalitis or exposure to toxins e.g Manganese dust, CO poisoning
Is it common?
125 per 100,000 people
Who is affected?
Incidence rises steeply with age, 17 per 100,000 50-59 year olds, 93 per 100,000 70-79 year olds, males affected more
Risk factors
Age, male, pesticide exposure, patients born in spring
Symptoms (6)
Reduced smell, constipation, visual hallucinations, frequency/urgency to urinate, depression, poor executive functioning
Signs (11)
bradykinesia, resting tremor, postural instability, muscular rigidity, slow to initiate movements, cogwheel rigidity, reduced blink rate, shuffling steps, lack of arm swing, tremor worse on concentration, mask face
Differentials (4)
Benign Essential tremor, drug/toxin induced, huntingtons, Lewy body dementia
Investigations
CT, MRI, Transcranial Sonography, PET scan (localises dopamine deficiency)
Drug Treatment (5)
Levodopa (e.g sinnemet, madopar), Dopamine agonists, anticholinergics, Monoamine Oxidase Inhibitors, COMT inhibitors
Other treatments (4)
Deep brain stimulation, respite care, physiotherapy, walking aids
Complications (10)
Depression, dementia, psychosis, infections, aspiration pneumonia, bed sores, poor nutrition, falls, contractures, bowel/bladder disorders
Is there a good prognosis?
It is an incurable condition with slow progression. Mean duration is 15 years
