Parkinsons Disease Flashcards
What makes up Parkinsonism syndrome?
Rigidity
Bradykinesia/ akinesia
Resting tremor
Pathology of Parkinson’s disease?
Degeneration of dopaminergic neurones in substantia Nigra pars compacta associated with Lewy bodies
In Parkinson’s disease, what does a section through the brainstem look like?
Loss of dark black pigment in substantia Nigra and locus coeruleus - correlates with dopaminergic cell loss
When does Parkinson’s typically present?
60-65 years old
Is Parkinson’s more prominent so in males or females?
Males, 3:2
Clinical motor features of Parkinson’s?
Bradykinesia Tremor Muscular rigidity Gait and postural impairment Resting tremor
Clinical non motor features or Parkinson’s?
Olfactory dysfunction Cognitive impairment / depression Constipation Hallucinations Dribbling saliva Sleep disorders
What tends to present first, motor or non- motor features in Parkinson’s?
Non motor - can be present for up to 10years before motor although diagnosis is made with motor features
Diagnosis of rapid eye movement sleep behaviour disorder?
Overnight polysomnography
Treatment of rapid eye movement sleep behaviour disorder?
Clonazepam/ melatonin at bedtime
Potential genetic risk factors for Parkinson’s disease?
GBA
LRRK2 and Parkin
SNCA
What increases risk for Parkinson’s?
Pesticide exposure Agricultural occupation Rural living Head injury Beta blockers Well water drinking
What decreases risk of Parkinson’s?
Tobacco smoking Coffee drinking NSAID use CCB use Alcohol
Investigations for Parkinson’s?
Structural brain imaging Positive levodopa challenge Genetic testing is appropriate Dopamine functional imaging - PET with fluoro-dopa - dopamine transporter imaging with single photon emission CT
Treatment for tremor in Parkinson’s?
Anticholinergic agents
Clozapine
Trihexyphenidyl
