Parkinson's Disease

Question 1

In comparison to PD, the atypical parkinsonims are characterized by…?

Answer 1

Early involvement of speech and gait, absence of rest tremor, lack of motor asymmetry, poor or no response to levodopa and a more aggressive clinical course.

Question 2

Proggressive Supranuclear Palsy is characterized by…?

Answer 2

Slow occular saccades, eylid apraxia, restricted vertical eye movements, especially of downward gaze.

Question 3

MCC of secondary parkinsonism ?

Answer 3

Dopamine-blocking agents such as neuroleptics (metoclopramide is also an important potential cause)

Question 4

Which features are the primary source of disabillity for patients with advanced PD ?

Answer 4

Falling and dementia

Question 5

How can peak-dose dyskinesias manifest ?

Answer 5

They are usually choreiform,but can manifest as dystonic movements, myoclonus or other movement disorders.

Question 6

Long-term side effecs of dopamine agonists ?

Answer 6

Hallucinations and cognitive impairment, sedation with sudden unintented episodes of falling asleep, impulse-control disorders.

Question 7

Only oral agent that reduces dyskinesia without worsening parkinsonian features ?

Answer 7

Amantadine ( cognitive impairment, weight gain, levido reticularis are some side effects)

Question 8

Stimulation-associated side effects of DBS ?

Answer 8

Ocular and speech abnormalities, muscle twitches, paresthesias, depression and rarely suicide.

Question 9

What percentage of PD patients is ultimately affected by dementia ? (+ cardinal features)

Answer 9

Around 80%, it primarilly affects executive functions and attention, with relative sparing of language,memory and calculation.