Parkinsons Disease Flashcards
What is Parkinson’s disease
degeneration of neurons
What is the prevalence of Parkinson’s
18-418/ 100,000
Is it more common in men or women
Men
2x more common
What is bradykinesia
Slowness of movement
Difficulty initiating movement
Reduction of speed
Fine movements are lost first
Discuss tremors in Parkinson’s
Occurs in 75-100% of patients
Starts unilateral then develops to both sides
Discuss rigidity in Parkinson’s
All body parts
‘Lead pipe’ resistance - results in fatigue
‘Cogwheel’ resistance - jerky movements
Discuss posture in Parkinson’s
Forward leaning
Loss of arm swing
What occurs with speech and communication in Parkinson’s
Speech becomes monotonous Hypophonic Disordered rate Difficulty starting a sentence Communication- Difficulty turntaking Understanding topics Lack of non verbal cues
Discussing the staging of Parkinson’s
1- unilateral involvement 2- bilateral involvement 3- posture and balance difficulties 4- patient requires help 5- restricted to bed
What tests can they do
EMG- measure tremor frequency
MRI- excludes structural lesions
DAT scans - test regions
radioactive substance injected which binds to dopamine transporters if there is a weak signal it shows the neurons are dying
Pathophysiology behind Parkinson’s
Parkinson’s is the loss of dopaminergic neurons in the substantia nigra
Dopamine levels have to fall to 1/5 for Parkinson symptoms to occur
Protein aggregates form (lewy bodies)
What other disturbances are caused due to lack of dopamine
Mood disturbances
Cognitive disturbances
Sleep disturbances
Discuss drugs used in Parkinson’s
Drugs must be able to cross the blood brain barrier
Levodopa is used as pure dopamine cannot Cross
It is administered with L- amino acid decarboxylase
What can drugs do for a person with Parkinson’s
Delay dyskinesia
Reduce dopamine breakdown (MAO-B inhibitors)
Restore dopamine acetylcholine balance (anticholinergics)
What non drug options are there?
Deep brain stimulations
Ablative surgery
