Parkinsons Flashcards
What are the three cardinal features of parkinsons disease
Tremor at Rest
Hypokinesia
Rigidity
A fourth cardinal feature of parkinsons is added later in the course of the disease. What is it
Postural instability
Substantia Nigra
Heterogenous portion of the midbrain and major element of the basal ganglia
What the hell is a lewy body
Eosinophillic inclusion found in the cell cytoplasm of a few specific locations- Substantia nigra, nucleus basalis of Meynert, Locus ceruleus, Dorsal raphe, dorsal motor nucleus of CN X
Lewy Bodies contain what three important substances
- Alpha Synuclein
- Neurofilament proteins
- Ubiquitin
What sense is almost universally lost in parkinsons
Smell
Most common pathologic feature in parkinsons
Loss of pigmentin the substantia nigra
Signs and symptoms that are atypical for parkinsons and suggest that something else is the issue
- Early onset or rapidly progressive dementia
- Rapidly progressive course
- Supranuclear Gaze palsy
- Upper Motor Neuron Signs
- Cerebellar signs- dysmetria, ataxia
- Urinary incontinence
- Early symptomatic postural hypotension
- Early Falls
Most common disease which mimics parkinsons
Multiple System Atrophy (MSA-P)- Resembles parkinsons disease except that tremor is less prominent andit tends to be very bilateral
MSA-C presents as a cerebellar syndrome
What is the difference in Lewy Body Dementia and Parkinsons
Lewy body dementia comes with cognitive disorder such as early onset dementia, delusions, hallucinations. Parkinsons usually does not include dementia
Parkinsons treatment
Levodopa or a dopamine agonist
Levodopa given with
Carbidopa
Dopamine agonists act directly as
D2 receptor activators
MAO-B inhibitors
Selegiline Rasagiline
Amantadine is primarily used for
Alleviating Levodopa induced dyskinesias
