Parkinson's Disease and Parkinsonism Flashcards
What are the three hallmarks of the Parkinsonian syndrome?
- Rigidity
- Akinesia/Bradykinesia
- Resting tremor
What are the pathological changes which cause PD?
- Loss of the dark pigment in the substansia nigra of the brainstem and the locus coeruleus
- Lewy body deposits
What does the loss of pigment mean?
Loss of dopaminergic cell bodies
What name is given to progressively smaller handwriting seen in PD?
Micrographia
What is the most distinguishing resting tremor seen in PD?
‘Pill-rolling’ tremor (http://www.rightdiagnosis.com/sym/pill_rolling_hand_movements.htm)
What can be done to help observation of PD tremor in patients?
Get them to perform a mental task such as counting backwards from 100
What distinguishes the rigidity of PD compared to spasticity seen in UMN lesions?
Resistance is felt throughout full range of movement and there is no increase (or ‘catch’) when increasing velocity
What is rigidity and resting tremor occurring at the same time known as?
‘Cog wheel’ rigidity (especially felt at the wrist)
What are some early non-motor features of PD?
- Hyposmia
- Rapid eye movements
- Constipation
- Depression
What symptoms or signs distinguish Progressive Supranuclear Palsy from PD?
- Tremor rare
- Vertical gaze supranuclear palsy
- Continuous activity of frontalis muscle (staring, high eyebrows)
- NO response to levodopa
What are side effects of levodopa therapy in PD patients?
- Peak dose dyskinesias (impairment of voluntary movement)
- Wearing off quickly
