Parkinson's Disease Flashcards
What is Parkinsonism? (3)
Not a disease!
A clinical syndrome characterised by bradykinesia, resting tremor, and rigidity.
What causes Parkinson’s disease?
Loss of dopaminergic neurons in the substantia nigra
What are the clinical features of Parkinson’s disease? (5)
- Resting tremor
- Hypertonia/ rigidity
- Bradykinesia
- Festinant gait
- Postural instability
A patient presents with ‘pill-rolling’ of thumb over fingers. What sign is this?
Resting tremor
A patient complains about inability to turn in bed and has ‘cogwheel rigidity’. What sign is this?
Hypertonia/ rigidity
The patient struggles to do up buttons, typing on a keyboard and has an expressionless face. What sign is this?
Bradykinesia
A patient has noticed their handwriting is getting smaller and more cramped. What is this called? What is this a sign of?
Micrographia
Bradykinesia
What are some non-motor presentations of a pt w/ Parkinson’s disease? (5)
- Depression
- Dementia
- Psychiatric problems (hallucinations)
- Autonomic problems (constipation, urinary frequency, postural hypotension)
- Sleep problems
How would you investigate Parkinson’s disease? (2)
- Clinical
- CT head/ MRI head: show atrophy of substantia nigra
What is the main aim of treatment in Parkinson’s disease?
No cure, symptomatic management
How would you treat bradykinesia + rigidity in Parkinson’s disease? (3)
- Increase amount of dopamine in CNS = co-careldopa
- Mimic action of dopamine = ropinirole, pramipexole, rotigotine
- Inhibit enzymatic breakdown of dopamine = rasagiline, selegiline (MOA-B); entacapone, tolcapone (COMT)
How would you treat tremor in Parkinson’s disease?
Amantadine (anticholinergic)
When should levodopa be given? (2)
Later in the disease (> 70 years) or PD severely interferes w/ life
