Parkinsons Flashcards
Idiopathic PD
PD we know, due to a loss of dopamine producing neurons in pars compacts of substantial nigra
Parkinsonism
A state of mimicking or appear to look like idiopathic PD without actually having PD
Parkinson’s-plus syndrome
Neurdegenerative diseases that produce parkinsonism as well as other neurological signs
4 PD characteristized
Tremor at rest
Rigidity
Akinesia/ bradykinesia
Postural instability
(2 of these need to be present for diagnosis)
Tremor (details)
Involuntary at rest tremors
Pin rolling tremor of the hand
Rigidity
Increase resistance to passive mvmt (independent from speed or posture)
Cogwheel and leadpipe rigidity
As the disease progresses, rigidity increases
Akinesia / Bradykinesia
Problems with voluntary mvmts
Akinesia: absence of mvmts (freezing gait)
Bradykinesia: slowness in mvmt
Hypokinesia: decreased amplitude of mvmt
Postural Instability
Abnormalities in posture and balance
Abnormal coactivation patterns leading to rigidity
Motor planning problems
Start hesitation
Freezing episodes
Hypomimia (masked face)
Poverty of mvmt (decrease number and amplitude of mvmt
Micrographia
Gait complications
Festinating gait (shortened strides with progressively increasing speed)
Freezing gait
Shuffling steps
Deceased trunk rotation
Decreased arm swing
Difficulty with dual task demands
Difficulty with increased attentional demands
Early signs and symptoms
Loss of sense of smell (first one!)
Masked face
Dysphagia
Dysphonia
Micrographia
Festinting gait
Stooped posture
Later signs and symptoms
Difficulty arising from chair or turning in bed
Cognitive changes/ dementia
Drooling (sialorrhea)
GI dysfunction: constipations, decreased appetite
Foot dystonia- twisting and turning of the foot
Disease- specific measures
Unified Parkinson’s disease rating scale (UPDRS)
the Parkinson’s disease questionnaire (PDQ-39)
Interventions- Medical management
No cure
Slow disease process and for symptoms management wit drug therapy (levodopa and carbidopa)
Honeymoon period- levodopa causes drastic improvement in symptoms then becomes less effective at same dosage and increased dosage is required
Sudden discontinuation of drugs can be life threatening
Side efffects of Levodopa
Gastrointestinal- vomiting constipatino
Cognitive- confusion hallucination
Cardiovascular- arrhythmias, hypotension
Genitourinary- dysuria
Neuromuscular- dyskinesia, dystonia, motor fluctuations
Sleep disturbances
