Parkinsons Flashcards
What is Parkinson’s?
Parkinsons is a neurodegenerative condition that forms from a progressive loss of dopaminergic neurons in the brain.
These are dopamine producing neurons in the brains substantial nigra, which regulates motor signalling.
What is Parkinson’s characterised by?
It is characterised by associated motor symptoms. These symptoms only tend to show when around 50% of neurons are lost. Symptoms will also evolve as the condition progresses.
Symptoms include:
- brady akinesia (slow movement)
- muscle stiffness
- hypomimia (no facial expressions)
- tremors
- gait disturbance (they may shuffle to run or be fall prone)
- autonomic disturbance (constipation) - cognitive impairment.
- involuntary shaking (tremors)
What causes Parkinson’s?
The cause is unclear, it may be genetics, exposure to industrial chemicals, infections, age (60) or gender as it is more common in men.
How is Parkinson’s treated?
There is no cure, so treatments reduce main symptoms and maintain quality of life.
Treatments include:
• levodopa
• carbidopa
• dopamine agonists
• supportive therapy’s
• diet deep brain stimulation
How does levodopa treat Parkinson’s?
This is a dopamine alternative to replace the dopamine that the individual is lacking.
Levodopa is absorbed by neurones in the brain and then converted into the chemical dopamine, which is then used to transmit messages between the parts of the brain and the nerves that control movement. Improving movement problems.
This can be taken as a tablet or a liquid.
At first it can cause a dramatic improvement in symptoms, but its effects can reduce over time as more neurones are lost in the brain, so there is fewer available to take up the medication.
Side effects include sickness, tiredness and dizziness. Long term use can also cause uncontrollable jerky movements.
How does carbidopa treat Parkinson’s?
This inhibits the destruction/breakdown of levodopa, increasing the amount in the brain. It also reduces the side effects of levodopa.
Over time this will have less of an affect and can cause involantary movements.
How does deep brain stimulation treat Parkinson’s?
If people no longer benefit from medication they may be given deep brain stimulation. Which can ease the symptoms for some patients.
The procedure involves inserting fine wires into the brain through holes drilled in the skull. This is done under local anaesthetic and helps to identify the exact location of the parts of the brain responsible for modification of movement. Once identified, a permanent electrode is inserted and then the electrode is attached to a pulse generator that is implanted under the skin on the chest walls.
High frequency electrical impulses are delivered, leading to an improvement in symptoms.
Risks include strokes.
What are supportive therapies?
These make living with Parkinson’s easier, examples include:
• physiotherapy
• occupational therapy
• speech and language therapy
How does physiotherapy treat Parkinson’s?
A physiotherapist can work with you to relieve muscle stiffness and joint pain through movement (manipulation) and exercise.
The physiotherapist aims to make moving easier and improve your walking and flexibility.
They also try to improve your fitness levels and ability to manage things for yourself.
How does occupational therapy help to manage Parkinson’s?
An occupational therapist can identify areas of difficulty in your everyday life, such as dressing yourself or getting to the local shops.
They can help you work out practical solutions and ensure your home is safe and properly set up for you. This will help you maintain your independence for as long as possible.
How does speech and language therapy help to manage Parkinson’s?
Many people with Parkinson’s disease have swallowing difficulties (dysphagia) and problems with their speech.
A speech and language therapist can often help you improve these problems by teaching speaking and swallowing exercises, or by providing assistive technology.
How can a change in diet help to improve Parkinson’s symptoms?
These changes can include:
- increasing the amount of fibre in your diet and making sure you’re drinking enough fluid to reduce constipation.
- increasing the amount of salt in your diet and eating small, frequent meals to avoid problems with low blood pressure, such as dizziness when you stand up quickly.
- making changes to your diet to avoid unintentional weight loss.
How do dopamine agonists treat Parkinson’s?
These also act as a substitute for dopamine in the brain and have a similar but milder effect than levodopa.
They’re often taken as a tablet but can also be given as a skin patch.
These are sometimes taken at the same time as levodopa, to allow a smaller dose of levodopa to be used.
Side effects include dizziness, tiredness, sickness and possible hallucinations.
At what age do parkinson’s symptoms start to develop?
After the age of 50, although some people develop symptoms under the age of 40.
What is dopamine involved in?
The regulation of movement in the body.
