Parkinsons Disease Flashcards
What is Parkinson’s disease?
Parkinson’s disease is a chronic, progressive neurodegenerative disorder characterised by motor and non-motor symptoms due to the loss of dopamine-producing neurons in the substantia nigra.
What are the classic motor symptoms of Parkinson’s disease?
Tremor, bradykinesia, rigidity, and postural instability.
What is the typical resting tremor in Parkinson’s disease?
A “pill-rolling” tremor that occurs at rest and decreases with voluntary movement.
What is bradykinesia?
Slowness of movement, often with a reduction in amplitude and speed of repetitive actions.
What type of rigidity is seen in Parkinson’s disease?
“Cogwheel” rigidity, a jerky resistance to passive movement of the limbs.
What non-motor symptoms are common in Parkinson’s disease?
Depression, anxiety, cognitive impairment, autonomic dysfunction, sleep disturbances, and anosmia.
What is the aetiology of Parkinson’s disease?
The exact cause is unknown, but it involves a combination of genetic and environmental factors.
What is the pathophysiology of Parkinson’s disease?
Degeneration of dopamine-producing neurons in the substantia nigra leads to reduced dopamine in the basal ganglia, affecting motor control.
What is the role of Lewy bodies in Parkinson’s disease?
Lewy bodies, abnormal aggregates of alpha-synuclein protein, are found in the brains of Parkinson’s disease patients.
What are the risk factors for Parkinson’s disease?
Advancing age, family history, male gender, and exposure to environmental toxins.
What is the prevalence of Parkinson’s disease?
Parkinson’s disease affects approximately 1–2 per 1,000 people in the general population, increasing with age.
What is the typical clinical course of Parkinson’s disease?
It is a slowly progressive disorder with a gradual worsening of motor and non-motor symptoms.
What is the main differential diagnosis for Parkinson’s disease?
Parkinsonism, which includes conditions like drug-induced parkinsonism, multiple system atrophy, and progressive supranuclear palsy.
What medications can induce parkinsonism?
Antipsychotics, metoclopramide, and other dopamine-blocking drugs.
What is the first-line medical treatment for Parkinson’s disease?
Levodopa, often combined with a dopa-decarboxylase inhibitor such as carbidopa or benserazide.
What are dopamine agonists, and when are they used?
Dopamine agonists (e.g., pramipexole, ropinirole) stimulate dopamine receptors and are used as monotherapy in early disease or adjunctive therapy later.
What is the role of MAO-B inhibitors in Parkinson’s disease?
MAO-B inhibitors (e.g., selegiline, rasagiline) reduce the breakdown of dopamine and are used to manage motor symptoms.
What are common side effects of levodopa?
Nausea, vomiting, postural hypotension, dyskinesia, and motor fluctuations (e.g., “on-off” phenomena).
What surgical treatment options exist for Parkinson’s disease?
Deep brain stimulation (DBS) is used in selected patients with advanced Parkinson’s disease and motor fluctuations.
What supportive therapies are important in Parkinson’s disease management?
Physiotherapy, occupational therapy, speech therapy, and dietary advice.
What is the “on-off” phenomenon in Parkinson’s disease?
Sudden, unpredictable fluctuations between mobility (“on”) and immobility (“off”) due to variable responses to levodopa.
What autonomic dysfunctions are associated with Parkinson’s disease?
Orthostatic hypotension, constipation, urinary incontinence, and excessive salivation.
What is Parkinson’s disease dementia?
Cognitive impairment that occurs in the later stages of Parkinson’s disease, affecting memory, attention, and executive function.
What is the diagnostic criteria for Parkinson’s disease?
A clinical diagnosis based on the presence of bradykinesia and at least one of the following: tremor, rigidity, or postural instability.
What imaging techniques can support a Parkinson’s disease diagnosis?
DaTscan (dopamine transporter imaging) can help differentiate Parkinson’s disease from other forms of parkinsonism.
