Parkinsons Disease Flashcards
definition of parkinsons
the progressive degeneration of the dopaminergic neurones in the substantia Niagara causing altered movement
SIGN/SYMTOMS TRAP
T- tremor (pill-rolling)
R- rigidity (cog work arms lead pipe legs)
A- Akinasea - inability to move/ Bradykinasea -struggle to move/get moving)
P- postural instability - hunched over
masked face?
expressionless face caused by Akinasea
epidemiology of parkinsons
Prevalence increases with age
Peak onset is 55-65
More common in males
Parkinson’s is thought to double in the next generation because:
People are getting older
The population is increasing
Note: although it is more prevalent in older people – it doesn’t mean there is nobody diagnosed in their 40s – it does happen!
causes of parkinsons
some genetic link
mostly idiopathic (unknown)
also could be caused by infections - encephalitis etc
toxin induced- carbon monoxide or drugs
can also have vascular Parkinsons (strokes causing damage)
what does substantia niagra produce
dopamine
pathophysiology
loss of dopamine secreting cells from pars compact in substantial nigra that project to the striatum = reduced dopamine low dopamine= inhibits the thalamus = decr in movement could be due to an abnormal accumulation of alpha-psynuden bound to ubiquitin form Lewy bodies which are clumps of protein
risk factors
family history
male
inc age
non-smoker- smoke reduces chance
differential diagnosis
tumour - very common hydrocephalus causing enlarged ventricles indicates hydrocephalus if they have: incontinence dementia tremor in action symmetry IN THE BEGINING
Investigations/ test
important to detect hydrocephalus
diagnosis usually made by symptoms/exams
daTSCAN:
image dopaminergic terminals of nigrastraiatal neurones
reduced dopamine to straitum can be made visible in alive patients
Head CT/MRI show nigra atrophy
microscopy - lewy bodies
management
not curable but can manage symptoms
L-DOPA with peripheral DOPA = CARBIDOPA
dopamine agonists = ROPINIROLE
MAO-B inhibs = SELEGILINE
