Parkinsons Disease Flashcards
What is Parkinsons Disease?
Progressive neurological condition
What chemical is lacking in Parkinsons?
Dopamine - cells have died
What are the 3 main symptoms for Parkinsons?
Tremor
Rigidity
Bradykardia
What are other symptoms of Parkinsons?
Tired, pain, depression, constipation
How many people are affected by Parkinsons?
1/500 UK, mostly over 50 yrs
Is there a cure for Parkinsons?
No
What can treatments do for Parkinsons?
Restore level of dopamine in brain by mimicking actions
Brain stimulation
Physical therapy for speech and language
What motor symptoms are associated with Parkinsons?
TREMOR - rolling pill movements which spread, seen in resting state
BRADYKINESIS - slow movement or inability to make voluntary and involuntary movements
RIGIDITY - increased muscle tone
POSTURAL INSTABILITY - imbalance, stooped, shuffle
AKINESIA - lacking facial expression, blinking, swallowing
What non - motor symptoms are associated with Parkinsons?
AUTONOMIC DYSFUNCTION - Varied BP Cardiac disarrythmias Excessive sweating lack of sleep Dry mouth Constipation
BEHAVIORAL - Depression Dementia Psychosis Weight loss Lack of energy
How do we diagnose Parkinsons?
We cant be 100% sure until post mortem confirmation
What causes Parkinsons?
Damage/loss of 60% neurones that store and release dopamine in the substantia nigra
Less neurones means less dopamine in striatum of basal ganglia
What is dopamine needed for?
Smooth muscle and coordination of body movements
What causes the death of the dopamine releasing cells?
Genes
Trauma
What are Lewy bodies?
Surviving neurones which are believed to be involved in neuronal damage
They have factors responsible for the development of intraneuronal cytoplasmic fibrillar aggregates of protein alphs - synuclein
What reduces the occurance of Parkinsons?
Caffeine
Nicotine
NSAIDS
At what point are medications given to Parkinsons sufferer?
When symptoms interfere with level of functioning
What medications are given for Parkinsons?
LEVODOPA - crosses BBB and taken up by remaining neurones and is transformed into dopamine. Given alongside drugs that inhibit levodopa being converted to dopamine, leaving more levodopa available, long term not good.
DOPAMINE AGONISTS - bypass nigral neurones and stimulate dopamine receptors directly - Cabergoline but that can lead to IE.
ANTICHOLINERGICS - treat tremors but dont help rigidity
ECSTASY
SURGERY - electrodes to inhibit movement
What orofacial symptoms with Parkinsons patients have?
Reduced blink rate Upward gaze Lip tongue and eyelid tremors TMJ pain cracked teeth cant retain dentures reduced smell drooling chelitis Treat with botox to reduce saliva flow
How can we make appts better for Parkinsons?
Shorter appts
Morning appts
LA - only 3 cartridges
Chair not flat
