Parkinson's Disease Flashcards
What are features of pyramidal/ upper motor neurone disturbance?
pyramidal weakness and spasticity
What are features of parkinsonian syndrome?
rigidity; akinesia/bradykinesia and resting tremor
What is characteristic of a tremor caused by cerebellar dysfunction?
an intention tremor- irregular lage-amplitude, worse at the end of purposeful movements
What are the 2 subtypes of the motor features in PD?
termor dominanat and non-tremor dominant PD
What are the non-motor features of PD?
olfactory dysfunction, cognitive impairment, psychiatric symptoms, sleep disorders, autonomic dysfunction, pain and fatigue
What is the timeline of developing non-motor symptoms compared to motor symptoms in PD?
non-motor often present before the onset of classical motor features
What must be present for a diagnosis of PD to be made?
motor features
What is the diagnostic criteria for the diagnosis of PD?
bradykinesia plus muscular rigidity; rest tremor; postural instaibility
What are Lewy bodies?
insoluble and aggregated intracellular inclusions of misfolded a-synuclein
What is the neurohystological hallmark of PD?
Lewy bodies
What is the most common genetic cause of dominant PD?
LRRK2
What ist he most common cause of recessive PD?
parkin
what side effects are assocaited with dopamine agonists and levodopa?
nausea, daytime somnolence and oedmea; impulse control disorders; hallucinations
What is longterm use of levodopa associated with?
motor complocations- dyskinesia and motor fluctuations
What is thought to be the caues of motor fluctuations and dyskinesia with levodopa?
the pulsatile stimulation of striatal dopamine receptors in later disease stages
What can be used to manage psychosis in PD?
clozapine
How can bradykinesia be assessed?
asking the patient to perform some repetitive movements as quickly and widely as possible
What is a feature of tremor seen in PD in addition to at rest?
reemerging tremor- typically reappears after 10 seconds when arms held outstretched
When is a resting tremor best observed?
while patient is focused on a particular mental task
What is rigidity?
increased muscle tone felt during examination by passive movmeent
What distinguishes rigidity from spasticitiy?
no increase in resisitance with higher mobilizing speed with rigidity
What is festination?
very fast succession of steps and difficulties stopping
How many patients with PD develop dementia after 20 years?
> 80%
What are the features of vascular parkinsonism?
affects predominantly lower limbs; rest tremor is uncommon; poo levodopa response
What are the features of drug induced parkinsonism?
symmetrical; coarse postural tremor
What type of tremor is responsive to alcohol?
essential tremor
