Parkinsons Disease

Question 1

What is Parkinson’s disease?

Answer 1

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.

Question 2

What are the classic motor symptoms of Parkinson’s disease?

Answer 2

Tremor, bradykinesia, rigidity, and postural instability.

Question 3

What is the typical resting tremor in Parkinson’s disease?

Answer 3

A “pill-rolling” tremor that occurs at rest and decreases with voluntary movement.

Question 4

What is bradykinesia?

Answer 4

Slowness of movement, often with a reduction in amplitude and speed of repetitive actions.

Question 5

What type of rigidity is seen in Parkinson’s disease?

Answer 5

“Cogwheel” rigidity, a jerky resistance to passive movement of the limbs.

Question 6

What non-motor symptoms are common in Parkinson’s disease?

Answer 6

Depression, anxiety, cognitive impairment, autonomic dysfunction, sleep disturbances, and anosmia.

Question 7

What is the aetiology of Parkinson’s disease?

Answer 7

The exact cause is unknown, but it involves a combination of genetic and environmental factors.

Question 8

What is the pathophysiology of Parkinson’s disease?

Answer 8

Degeneration of dopamine-producing neurons in the substantia nigra leads to reduced dopamine in the basal ganglia, affecting motor control.

Question 9

What is the role of Lewy bodies in Parkinson’s disease?

Answer 9

Lewy bodies, abnormal aggregates of alpha-synuclein protein, are found in the brains of Parkinson’s disease patients.

Question 10

What are the risk factors for Parkinson’s disease?

Answer 10

Advancing age, family history, male gender, and exposure to environmental toxins.

Question 11

What is the prevalence of Parkinson’s disease?

Answer 11

Parkinson’s disease affects approximately 1–2 per 1,000 people in the general population, increasing with age.

Question 12

What is the typical clinical course of Parkinson’s disease?

Answer 12

It is a slowly progressive disorder with a gradual worsening of motor and non-motor symptoms.

Question 13

What is the main differential diagnosis for Parkinson’s disease?

Answer 13

Parkinsonism, which includes conditions like drug-induced parkinsonism, multiple system atrophy, and progressive supranuclear palsy.

Question 14

What medications can induce parkinsonism?

Answer 14

Antipsychotics, metoclopramide, and other dopamine-blocking drugs.

Question 15

What is the first-line medical treatment for Parkinson’s disease?

Answer 15

Levodopa, often combined with a dopa-decarboxylase inhibitor such as carbidopa or benserazide.

Question 16

What are dopamine agonists, and when are they used?

Answer 16

Dopamine agonists (e.g., pramipexole, ropinirole) stimulate dopamine receptors and are used as monotherapy in early disease or adjunctive therapy later.

Question 17

What is the role of MAO-B inhibitors in Parkinson’s disease?

Answer 17

MAO-B inhibitors (e.g., selegiline, rasagiline) reduce the breakdown of dopamine and are used to manage motor symptoms.

Question 18

What are common side effects of levodopa?

Answer 18

Nausea, vomiting, postural hypotension, dyskinesia, and motor fluctuations (e.g., “on-off” phenomena).

Question 19

What surgical treatment options exist for Parkinson’s disease?

Answer 19

Deep brain stimulation (DBS) is used in selected patients with advanced Parkinson’s disease and motor fluctuations.

Question 20

What supportive therapies are important in Parkinson’s disease management?

Answer 20

Physiotherapy, occupational therapy, speech therapy, and dietary advice.

Question 21

What is the “on-off” phenomenon in Parkinson’s disease?

Answer 21

Sudden, unpredictable fluctuations between mobility (“on”) and immobility (“off”) due to variable responses to levodopa.

Question 22

What autonomic dysfunctions are associated with Parkinson’s disease?

Answer 22

Orthostatic hypotension, constipation, urinary incontinence, and excessive salivation.

Question 23

What is Parkinson’s disease dementia?

Answer 23

Cognitive impairment that occurs in the later stages of Parkinson’s disease, affecting memory, attention, and executive function.

Question 24

What is the diagnostic criteria for Parkinson’s disease?

Answer 24

A clinical diagnosis based on the presence of bradykinesia and at least one of the following: tremor, rigidity, or postural instability.

Question 25

What imaging techniques can support a Parkinson’s disease diagnosis?

Answer 25

DaTscan (dopamine transporter imaging) can help differentiate Parkinson’s disease from other forms of parkinsonism.