Parkinsonism Flashcards
What are the signs and symptoms f parkinsonism?
Bradykinesia + rigidity= Parkinsonism
Tremor- at rest, starts unilaterally, pill rolling
Postural instability
What causes Parkinsonism?
Parkinson's Parkinson's plus syndromes Lewy body dementis Drugs Small vessel brain disease Toxins- rare
what are some Parkinson’s plus syndromes?
Progressive suprenuclear palsy
Multisystem atrophy
What drugs cause Parkinsonism?
Usually antipsychotics- chlorpromazine, haloperidol
What is Parkinson’s?
Clinical disease of idiopathic Parkinsonism
What causes Parkinson’s?
Cell death and dopamine loss in basal ganglia
What are the main presenting features of Parkinson’s?
Tremor- starts unilaterally
Bradykinesia
Rigidity
Postural instability
What are some less common features of Parkinson’s?
Mask like expression
Micrographia
Slurred, quiet, monotone voice
Executive dysfunction
What are some features of late Parkinson’s?
Dementia
Bilateral tremor
Progresses slowly
How is Parkinson’s diagnosed?
Diagnosis of exclusion
What is the 1st lie management of Parkinson’s?
Levodopa- dopamine precursor
What is the 2nd line management of Parkinson’s?
Dopamine agonists
MAO-B inhibitors
COMT inhibitors
What are some complications of Parkinson’s management?
Impulsivity- esp with dopamine agonists
Cannot be stopped suddenly
What is the non-charm management option for Parkinson’s?
Deep brain stimulation- only if dopamine responsive
What are the features of progressive supra nuclear palsy?
Parkinsonism Impairment of vertical gaze- supra nuclear opthalmoplegia Falls Slurring of speech Cognitive impairment
