Parkinson's Disease Flashcards
What is needed for diagnosis of Parkinson’s disease
Bradykinesia/Hypokinesia PLUS - Tremor - postural instability - Cogwheel rigidity
What is the difference between a parkinsons tremor and a cerebellar tremor or a benign tremor
Parkinson’s tremor is at rest and diminishes with movement
What are the other motor features of PD
Stoop posture
Shuffling gait
Pedestal turning
Expressionless face
What is the pathway affected in PD
Nigrostriatal pathway
Which part of the brain is affected in PD
Pars compacta - part of substantia nigra in the basal ganglia
What is the pathophysiology of PD
Death of dopaminergic neurones in the pars compacta resulting in a reduction of dopamine
What are the non-mmotor features of PD
Loss of smell Constipation Depression Dementia REM sleep disruption Visual hallucinations Frequency/urgency Dribbling of saliva Poor executive functioning Poor decoding of emotional speech
How does freezing occur in PD
Freezing when walking occurs to PD patients due to decrease in cognitive function and motor function
What are some ddx for PD
Benign essential tremor Huntingdons Disease Wilsons disease Other Parkinsonianisms Cerebellar disorders -> intention tremor and ataxia Cerebelllar tumour Drug/toxin tremor
What are some treatment options for PD
Levodopa + Carbidopa Dopamine agonists Caechol-o-methyltransferase inhibitors Monoamine oxidase B inhibitors Amantadine
How does levodopa work
Crosses the blood brain barrier and dopa decarboxylase in the brain converts it to dopamine
Why is carbidopa given alongside levodopa
To Stop peripheral dopa decarboxylase breaking down levodopa to dopamine in the peripheral circulation which converts to adrenaline –> side effects, arrhythmias
What is amantadine
Anti viral medication
increases dopamine production
What are some examples of monoamine oxidase B inhibitors
Selegiline and rosagiline
What is the average age of onset of PD
65
