Parkinson's Disease - types, risk factors, BG, and Pathogensis Flashcards
What are the two most common movement disorders?
Parkinsonism
Huntington‘s disease
What are movement disorders?
Neurological conditions that affect the speed, fluency, quality, and ease of movement.
What are some other examples of movement disorders?
Ataxia Dystonia Myoclonus Restless leg syndrome Tics Tourette's syndrome Tremor Wilson’s disease - (from copper in liver)
What are the 3 types of Parkinsonism disorders and what are they caused by
Refers to a group of disorders producing abnormalities in the Basal Ganglia:
1) Parkinson’s Disease (aka Idiopathic Parkinsonism) –unknown etiology
2) Secondary Parkinsonism – due to identifiable causes
3) Atypical Parkinsonism (aka Parkinson-Plus Syndromes) – due to neurodegenerative disorders
Possible causes of secondary Parkinsonism
Drug-induced Toxin-induced Metabolic Structural lesions (i.e. vascular Parkinsonism) Hydrocephalus Infections
Features of Atypical Parkinsonism
Abrupt onset, rapidly progressive course
Early onset of, or rapidly progressing, dementia
More symmetrical, axial (chest and not arms), & early gait/balance impairments
Upward/Downward gaze palsy
UMN signs & Cerebellar signs – dysmetria, ataxia
Urinary incontinence
Early symptomatic postural hypotension
Early postural instability
Unresponsive to L-Dopa - (that’s how you know)
3 types of atypical parkinsonism
Progressive Supranuclear Palsy (PSP)
Cortical Basal Ganglia Degeneration (CBGD)
Multiple System Atrophy (MSA) formerly Shy-Drager Syndrome
What is PSP
Progressive Supranuclear Palsy (PSP)
Supranuclear palsy – difficulty looking up/down
Upright posture, frequent falls
What is CBGD
Cortical Basal Ganglia Degeneration (CBGD)
Unilateral coarse tremor
Limb apraxia, dystonia
What is MSA
Multiple System Atrophy (MSA) formerly Shy-Drager Syndrome:
- Rigid muscles
- Difficulty bending your arms and legs
- Slow movement (bradykinesia)
- Tremors (rare in MSA compared with classic Parkinson’s disease)
- Problems with posture and balance
Why do people with PSP have frequent falls
They stand very upright like a tree trunk and when they bend they fall
(Progressive Supranuclear Palsy)
Incidence of PD
Increases to 2.6% by 85 yo
~10% of all cases develop symptoms before the age of 40 -> Young-Onset PD (often familial)
40% of cases may be undiagnosed at any given time
Risk factors for PD
Etiology remains unknown, risk factors include:
Environmental toxin exposure:
pesticides or herbicides
Genetic predisposition: The parkin gene -> early onset PD (begins ~ age 40)
Head Trauma – 3.8x higher risk for PD
Factors that reduce risk of PD
Cigarette smoking
Caffeine consumption
Most common cause of Idiopathic Parkinson’s Disease
Most common cause is idiopathic
+ family history is considered a risk factor
A study on a group of drug addicts in the 1980’s
A synthetic narcotic (MPTP) caused PD type symptoms in a group of younger individuals
Has allowed for closer study of the syndrome, as the disease can be produced in the laboratory
Made it possible to develop 1st animal model & attempt fetal brain tissue transplants to treat PD
