Parkinsons Flashcards
Definition
Caused from problems occurring within the basal ganglia of the brain
Problems in the communication between the basal ganglia and the cortex in the initiation of voluntary movements
Cause
The lack of presence of dopamine within the basal ganglia
Inside the substantia nigra there is usually dopaminergic neurons, which release dopamine to bind to receptors of gabaergic neurons to create the function of the brain
However in people with parkinsons these dopaminergic neurons can die leading to an improper function
How can the dopaminergic neurons die
Protein misfolding
Apoptosis
Gliosis at SN
Demyleniation at SN
Neuronal loss at SN
Presence of lewy bodies
Epidemiology
Occurs in 1-2% of the population over the age of 65
Major age of incidence between the ages of 70-79
Men are more likely than women
– unknown why but oestrogen is thought to be argued as to of why
Clinical presentation
Resting tremor- usually the first symptom seen, usually most evident in one hand with the arm at rest. Usually asymettric
Bradykinesia:
– difficulty with daily activities like doing up buttons, shaving, writing, using a knife and fork, drinking out of a cup, using a television remote
Rigidity:
– hypertonia of the muscles, increasing the resistance in the flexors and extensors, particularly in the forearm and arm
Postural instability:
– due to loos of postural reflexes
Shuffling gait
Depression:
– occurs in 50% of cases, been argued that gambling is more likely in parkinsons patients than the general population
Cognitive impairment:
– slowness to do cognitive movements and execute motor tasks with increased difficulty as well
Concentration:
– impaired concentration in most cases, at least 1/3 becomes demented during the course of the disease
Craniofacial features:
– hypomimia (decrease in facial expression), dysphagia, hypophonia
Visual problems:
– blurred vision
– eyelid opening apraxia (slow opening of eyelids)
