Parkinsons

Question 1

What is Parkinson’s disease?

Answer 1

Disabling progressive disease where there is de-generation of nerve cells in the basal ganglia.
The basal ganglia is the centre of the brain that initiates motor control
Dopamine is produced in this area of the brain and is reduced when nerves in this area die.
Reason for degeneration is unknown.

Question 2

What are the 4 cardinal signs of the disease?

Answer 2

Bradykinesia - slow initiation of movement
Resting tremor
Postural instability - impairment of gait and increased falls
Rigidity - increased muscle tone

Question 3

What are the features noticed in a patient with parkinson’s disease?

Answer 3

Impaired dexterity
Abnormal posture and difficulty walking - impaired gait
Resting tremor
Slow speech and difficulty swallowing

Question 4

Dental relevance of Parkinson’s?

Answer 4

May have difficulty accepting treatment
- Bodily tremor at rest
- Do not be put off by mandibular tremor - tremor typically improves on intentional movement.

Dry mouth - dopamine agonists

Drug interactions

Question 5

What are the signs that a patient is in pain but cannot communicate it well?

Answer 5

General:
- Fidgeting
- Pallor
- Clenching onto chair

Facial signs
- Frowning
- Grimacing
- Clenching teeth
- Biting

Behavioural
- Aggressive behaviour
- Refusal to co-operate
- Withdrawl

Question 6

What is the difference between Parkinsons’ and how it differs from cerebral palsy?

Answer 6

Both are disease that affect mobility but cerebral palsy is caused by damage to the developing brain but Parkinson’s develops later into adulthood.

Parkinson’s typically present with resting tremors.