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AY Neurology > Parkinson's disease & Parkinsonism > Flashcards

Parkinson's disease & Parkinsonism Flashcards

1
Q

What are the clinical features of parkinsonian syndrome/

A

Rigidity
Akinesia/bradykinesia
Resting tremor
Postural instability

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2
Q

What is chorea & ballismus?

A

Fragments of movements flow irregularly fromonebody segment to another causing a dance-like appearance (ballismus if amplitude of movements is large)

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3
Q

What are the clinical motor features of Parkinson’s disease?

A

Resting tremor (4-6 Hz)
Muscular rigidity
Akinesia
Gait & postural impairment

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4
Q

What is the course and prognosis of tremor dominant PD compared to Non-tremor dominant PD?

A

Tremor subtype = slower progression and less functional disability

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5
Q

What are the clinical non-motor features of Parkinson’s?

A 
Olfactory dysfunction 
Cognitive impairment 
Psychiatric symptoms
Sleep disorders
Autonomic dysfuncton
Pain
Dysphonia
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6
Q

What tends to present first in PD motor or non-motor symptoms?

A

Non-motor

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7
Q

What is REM sleep behaviour disorder?

A

Parasomnia characterised by abnormal disruptive behaviours which occur during REM sleep and are often related to dream enactment

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8
Q

What is the treatment for REM sleep behaviour disorder?

A

Clonazepam or melatonin at bedtime

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9
Q

If patients have PD & RBD what are they more predisposed to?

A

More severe

  • autonomic dysfunction
  • Gait impairment
  • Dementia
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10
Q

What are the pathological hallmarks of PD?

A 
Loss of dopaminergic neurons within the SNpc 
Lewy body (a-synuclein) pathology
Pigment loss in substantia nigra & locus coeruleus
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11
Q

Risk factors for PD

A

Male
Age
Genetics (early onset)
Pesticide

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12
Q

What drugs are used to treat symptoms of Parkinson’s?

A

Levodopa
Dopamine agonists
MAO B inhibitors
Amantadine

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13
Q

What medications can be effective at treating the tremor in PD?

A

Anticholnergic agents (trihexyphenidyl, clozapine)

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14
Q

What are the side effects of dopamine agonists & levodopa?

A

Nausea
Daytime sleepiness
Oedema (more so in DA)

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15
Q

Why should dopamine agonists not be prescribed in the elderly with cognitive impairment?

A

Associated with hallucinations

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16
Q

What is long term effects of levodopa use?

A

Motor complications (dyskinesia & motor fluctuations)

17
Q

What drugs can reduce visual hallucinations in PD patients with dementia

A

Cholinesterase inhibitors (Rivastigmine)

18
Q

How is psychosis managed in PD patients?

A

Clozapine

19
Q

What is the first line investigation for PD?

A

Trial of dopamineric agent

AY Neurology (12 decks)

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