Parkinsons -Cosgrove

Question 1

Who is more likely to get parkinson’s - males or female?

Answer 1

Males

Ratio Males : females
3:2

Question 2

Who is most likely to get parkinsons? Caucasians, Asians, Africans?

Answer 2

Caucasians are more likely to get parkinsons than asians or africans

Question 3

What is the relationship between smoking and parkinsons?

Answer 3

Parkinsons is rarely diagnosed in those who have smoked.

Question 4

What are the possible protective factors for parkinsons?

Answer 4

smoking and caffiene

Question 5

What is parkinsonism?

Answer 5

Parkinsonism is a clinical syndrome comprising Bradykinesia (slow movment) and one of:

• tremor
• rigidity
• postural instability

Question 6

Parkinson’s disease is the most common cause of parkinsonism. What happens to the brain in parkinsons disease?

Answer 6

Lewy bodies and neuronal degeneration of the substantia nigra. So less dopamine to basal ganglia. so cant initiate movement.

Question 7

What are the causes of parkinsonism?

Answer 7

1) neurodegenerative conditions:
- parkinsons disease
- Lewy body dementia
- Progressive supranuclear palsy
- Multiple system atrophy

2) Drug induced
3) Vascular

4) Metabolic
wilsons disease

Question 8

What metabolic disease can cause parkinsonism

Answer 8

Wilson’s disease

Question 9

What are the key features of parkinson disease gait?

Answer 9

• can’t start / stop
• shuffling
• stooped posture
• several steps to turn
• reduced arm swing

Question 10

What are the characteristics of a parkinsons tremor?

Answer 10

• pill rolling

- starts in one hand then becomes bilateral

Question 11

What is the difference in the DaTscan of the putamen in normal and PD brain?

Answer 11

DaTscan in normal brain shows “comma” shaped putamen.
In PD brain shows “full stop” putamen.
This indicated reduced putamen neurones.

Question 12

What are the types of drugs used to treat PD?

Answer 12

1) Dopamine agonists (aactivates dopamine receptors)
2) L-dopa (pecusor to dopamine)
3) MAO-inhibitor (inhibits MAO which breaks down dopamine)
4) COMT-inhibitor (inhibits COMT which breaks down dopamine.)

Question 13

What happens if there is too much dopaminergic stimulation in PD drug therapy?

Answer 13

• abnormal movements
• confusion
• hallucination
• impulse control disorders

Question 14

What are the advanced treatments of PD?

Answer 14

1) apomorphine
2) Duodopa
3) Deep Brain Stimulation