Parkinson's Disease

Question 1

What are some Parkinson’s Disease mimics?

Answer 1

Medication

1) anti-psychotic use i.e haloperidol
2) dopamine antagonists i.e metoclopramide
3) Sodium valproate

Tremor

1) Essential tremor
2) Fragile X tremor–ataxia syndrome

Gait disorders

1) Normal pressure hydrocephalus
2) Progressive supranuclear palsy
3) Frontal gait disorder

Atypical parkinsonian disorders
▸ Multiple system atrophy (‘hot cross bun’ sign)
▸ Corticobasal degeneration
▸ Dementia with Lewy bodies

Early-onset parkinson’s

1) Wilson’s Disease
2) Juvenile huntington’s disease

Question 2

3 characteristic features of parkinsons

Answer 2

Bradykinesia
Resting tremor (pill rolling tremor)
Cogwheel rigidity

Question 3

Surgical treatment for Parkinsons?

Answer 3

Deep Brain stimulation

Question 4

Medical treatment for Parkinson’s and MOA?

Answer 4

L-DOPA + peripheral dopa-decarboxylase inhibitor (cocareldopa) –> prevents conversion to peripheral dopamine
Dopamine agonist i.e cabergoline
MAO-inhibitor i.e selegeline –> prevents breakdown of dopamine by Monoamine oxidase
COMT inhibitor ie Comtess –> inhibits peripheral breakdown of levodopa by COMT enzyme

Question 5

Histopathological findings in Parkinson’s

Answer 5

Loss of dopaminergic neurons in the substantia nigra pars compacta
Presence of Lewy bodies in basal ganglia, brainstem and cortex