Parkinson's Disease

Question 1

PD facts

Answer 1

• second most common neurodegenerative disorder, afer AD
• earlier the age, slower the progression

Question 2

Characterizations

Answer 2

1. tremor-resting tremor
2. bradykinesia- slowness of movement
3. muscle rigidity
4. balance problems/postural instability

Question 3

Tremor

Answer 3

• RESTING TREMOR = 4-5 movemens per seconds
  
  • occuring while peron is not actively engaging in purposeful motor behavior
• PIT ROLLING= thumb rubs against index and middle fingers
• start in one limb, mainly hands/feet before knees/elbow
• primary onset

Question 4

Rigidity

Answer 4

• muscle stiffness
• lead pipe rigidity- can’t move a limb at all
• mask face- can no longer make facial expressions (later stages)

Question 5

Cogwheeling

Answer 5

• patient makes full circle with their arms
• rather than smooth it will look like a rachet

Question 6

Gait Instability

Answer 6

• shuffling walk
• forward flexed posture
• falls are common
• broken bones due to falls

Question 7

Why does Parkinson’s cause all these motor deficits?

Answer 7

• associated with degeneration of dopamine producting cells of the BASIL GANGLIA
• called…substania nigra
• part of brain responsible for motor coordination, planning, and intentional movements
• accumulation of protiend in basil ganglia
• same protiens as DLB..occur in different areas yet have similar motor symptoms

Question 8

Treatment

Answer 8

• L-dopa
• metabolic precursor to domapine
• cholinergics assist in rigidity
• Deept brain stimulation

Question 9

Deep brain stimulation

Answer 9

• a lead with electrodes is inserted in the brain and send currents into the brain that blocks the chemical that blocks dopamine.
• highly effective but eventually resistance is built up, just like with medication

Question 10

Differential Dx

Answer 10

• DLB/AD= do motor symptoms occurs at the same time as cognitive ones or does one occur before the other?
• DLB occurs w cog deficits at same time of motor