Parkinsons Disease

Question 1

What is Parkinsons?

Answer 1

A progressive degenerative disease of the central nervous system – Symptoms manifest later in the disease

Question 2

Demographics:

Answer 2

Men and women affected equally,
Common in people over 50
More likely in white people

Question 3

Aetiology of PD:

Answer 3

Unknown

Question 4

4 Cardinal motor signs and symptoms:

Answer 4

1. Bradykinesia (slow movement) – slow walk, initiation of movement, speech – soft, write small
2. Tremor
3. Postural instability
4. Rigidity

Question 5

Other signs and symptoms of PD:

Answer 5

Cognitive – planning, abstract thinking, initiating/inhibition appropriate actions
Mood – depression, anxiety
Behaviour – binge eating, gambling
Thought – hallucinations, delusions
Others – sleeping, vision and GI disturbances

Question 6

Pathophysiology of PD:

Answer 6

Cell death in substantia nigra causes
reduced dopamine production therefore nigrostriatal pathway dysfunction.
This causes increased inhibitory output from globus pallidus acting on thalamocortical pathways (sensorimotor afferent pathway)

Question 7

Conventional therapies:

Answer 7

• Levodopa (converted to dopamine – causes dyskinesias)
• Dopamine agonists (also causes side effects)
• Deep brain stimulation

Question 8

What are some other symptoms?

Answer 8

Dizziness

Urinary dysfunction

Question 9

What scale is used to find out what stage of PD a person has?

Answer 9

Hoehn and Yahr Staging

Question 10

What are some common medications taken in PD?

Answer 10

Dopaminergics
Anticholinergics
MAO B -inhibitors
COMT inhibitors

Question 11

What are some side effects of the medications in PD?

Answer 11

Orthostatic hypotension 
Tachy/bradycardia
Arrhythmias
Blurred vision 
Ataxia
Heat stroke

Question 12

What are some goals in patients with PD?

Answer 12

trunk rotation

hand-eye co- ordination