Parkinsonism Flashcards
What is vascular Parkinsonism?
Essentially cerebrovascular disease affecting the basal ganglia
Describe the onset and progression of vascular Parkinsonism?
Generally has an abrupt onset and stepwise progression
What are some signs that differentiate vascular Parkinsonism from PD?
Predominantly affects the lower limbs and resting tremor is uncommon
What will happen when someone with vascular Parkinsonism is given a Levodopa challenge?
Poor response
Drugs which do what are most likely to cause drug induced Parkinsonism?
Block the action of dopamine
What are some signs that differentiate drug induced Parkinsonism from PD?
Symptoms are typically symmetrical and the tremor is postural
When do symptoms of drug induced Parkinson’s occur? When do they resolve?
After a new drug exposure / within a few months of drug withdrawal
What are the most common medications to cause drug induced Parkinsonism? What is another that is widely used?
Anti-psychotics / metoclopramide
What are some features that are more suggestive of a Parkinson’s plus syndrome?
Symmetrical onset of motor symptoms, less prominent tremor and poor response to Levodopa
What are Parkinson’s plus syndromes?
A group of neurodegenerative disorders leading to Parkinsonism
Who do most Parkinson’s plus syndromes present in?
People in their 50s/60s
What are the core features of multiple systems atrophy?
Autonomic dysfunction, cerebellar features and Parkinsonism
What would an MRI of multiple systems atrophy show?
Pontocerebellar atrophy
What is the main differentiating feature of progressive supranuclear palsy?
Vertical gaze palsy (lack of upgaze_
How may patients with progressive supranuclear palsy look?
They have wide open eyes, often giving them a surprised look
